活体肝移植术后移植肝段再生的多层螺旋CT研究

目的 探讨含肝中静脉(MHV)与不含MHV主支2种术式对移植肝Ⅴ、Ⅷ段再生的影响.方法 把25对进行了右半肝移植的供-受体按移植肝是否包含MHV分成2组,含MHV组(A组,14对)和不含MHV行Ⅴ、Ⅷ段MHV分支血管重建组(B组,11对),对供体术前、受体术后半月及3月时Ⅴ、Ⅷ段肝体积进行测量,记录2组供体术前、受体术后半月及3月时移植肝Ⅴ、Ⅶ段的体积数值,并计算再生率,然后对术后半月及3月时2组移植肝Ⅴ、Ⅷ段的肝再生率进行比较.结果 A组术后半月移植肝Ⅴ、Ⅷ段平均肝再生率分别是0.360±0.043、0.853±0.059,术后3月移植肝Ⅴ、Ⅷ段的平均肝再生率分别是0.253±0.043、0.708±0.059;B组术后半月移植肝Ⅴ、Ⅷ段平均肝再生率分别是0.306±0.049、0.815±0.066,术后3月移植肝Ⅴ、Ⅷ段平均肝再生率分别是0.161±0.049、0.627±0.066.术后半月和3月时,2组间移植肝Ⅴ、Ⅷ段平均肝再生率差异无统计学意义(P=0.685,P>0.05、P=0.738,P>0.05).结论 关于活体右半肝移植,不含MHV行MHV主要分支重建不影响移植肝Ⅴ、Ⅷ段肝再生.

Multi-slice Spiral CT Study of Liver Graft Regeneration after Living Donor Liver Transplantation

Objective To study the effect of liver transplantation using right liver lobe Ⅴ and Ⅷ segments with middle hepatic vein(MHV) and without main MHV on the regeneration of liver transplantation. Methods 25 pair of donors and receptors of liver transplantation were divided in to two groups:with M HV group (group A, n= 14) and without main MHV (group B, n=11). The volumes of Ⅴ and Ⅷ segments of liver were measured in donors presurgicaUy,half month and 3 month in receptors postsurgically, the rates of regeneration of the Ⅴ and Ⅷ segment were calculated half month and 3 months postsurgically and compared between two groups. Results In group A,the regenerate rates of the Ⅴ,Ⅷ segment were 0.360±0.043 and 0.853±0.059 half month after surgery,0.253±0.043 and 0.708±0.059 three months after surgery respectively. In group B, the regenerate rates of the Ⅴ,Ⅷ segment were 0.306±0.049 and 0.815±0.066, respectively half month after graft, 0.161±0.049 and 0.627±0.066, respectively three months after surgery. There were no statistically significant differences in regenerate rates of the Ⅴ, Ⅷ segment of graft be-tween the two groups (P= 0.685 ,P>0.05 and P= 0.738, P>0.05). Conclusion The right lobe living donor liver transplantation, maintaining the MHV or reconstruct MHV tributaries without MHV has similar effects on the regeneration of Ⅴ,Ⅷ segment of graft.