原位肝移植肝动脉重建及其并发症防治

目的分析总结原位肝移植肝动脉重建及其并发症的处理经验。方法总结72例原位肝移植的临床资料，分析影响肝动脉重建的因素和处理技巧。结果72例原位肝移植患者术后仅有1例(1.4％)于肝动脉吻合口旁发生假性动脉瘤，经介入栓塞治疗成功，并保留了移植肝的动脉血液供应；全部病例随访3～43个月，住院期间死亡6例，随访期内死亡6例，总的1、3年累积存活率均为83.3％，没有病例死于肝动脉并发症。结论供、受者的血管变异情况和质量以及肝动脉重建技术，是影响肝动脉重建的关键因素。

Hepatic artery reconstructions and complications after orthotopic liver transplantation in 72 cases

Objective To investigate the preventions and managements of hepatic artery reconstructions and its complications. Method Seventy-two patients who underwent the reconstruction of hepatic artery in orthotopic liver transplantation (OLT) and were followed up during recent 3 years after OLT were collected and analyzed retrospectively. Results The overall hepatic artery complications rate was 1.4 % (1/72). A pseudoaneurysm at the side of hepatic artery anastomosis was found by angiography and embolized successfully. The patency of hepatic artery toward donor liver was remained. Postoperative Doppler ultrasonography monitoring showed that no hepatic arterial thrombosis and stenosis occurred during 43 months of follow-up after OLT. Six patients died in the hospital after OLT and 6 patients died during the follow-up period. The overall cumulative 1-, 3-year survival rate was 83.3 % and 83.3 % respectively. No death associated with hepatic artery complications occurred. Conclusion Complete evaluation and prompt management perioperatively of hepatic artery reconstruction and its complications may improve the long-term survival of the recipients and grafts after OLT.