单中心肝移植治疗多囊肝病的疗效分析

目的 探讨肝移植治疗多囊肝病的疗效.方法 回顾性分析2003年9月至2009年7月中山大学附属第三医院收治的8例接受肝移植术的多囊肝病患者的临床资料.手术方式均采用附加腔静脉整形的改良背驮式肝移植术,其中1例同时行肝肾联合移植.术后对急性排斥反应、并发症、移植物功能、患者生存时间等进行随访.结果 全组患者手术均获得成功.平均手术时间为(7.5±2.8)h(4～11 h);平均无肝期时间为(42±14)min(25～70 min);术中平均出血量为(2250±1850)ml(2000～6500ml).围手术期患者死亡2例,其中1例于肝移植术后第39天死于肺部感染和MODS,另1例于肝肾联合移植术后第59天死于MODS.1例患者于肝移植术后第45天因肝动脉狭窄行再次肝移植术.6例患者中位随访时间为60个月(37 ～93个月),生存3年以上6例、5年以上4例、7年以上2例.截至随访终点,未发现移植物急性排斥反应.结论 肝移植是治疗多囊肝病患者安全、有效的方法.

Efficacy of liver transplantation for the treatment of polycystic liver disease: a single center analysis

Objective To investigate the efficacy of liver transplantation for the treatment of polycystic liver disease.Methods The clinical data of 8 patients with polycystic liver disease who received liver transplantation at the Third Affiliated Hospital from September 2003 to July 2009 were retrospectively analyzed.All patients underwent modified piggyback liver transplantation with vena cava plasty,and 1 of the patients received simultaneons liver-kidney transplantation.Data including acute rejections,complications,graft functions and survival time of patients were recorded.Results Operation was successfully performed on all patients.The mean operation time,anhepatic phase and operative blood loss were (7.5 +2.8)hours (range,4-11 hours),(42 + 14)minutes (range,25-70 minutes) and (2250 ± 1850)ml (range,2000-6500 ml),respectively.One patient received liver retransplantation at 45 days after primary liver transplantation because of hepatic artery stenosis.Two patients died during perioperative period.One patient died of pulmonary infection and multiple organ disfunction syndrome (MODS) at 39 days after operation,and the other one died of MODS at 59 days after operation.The median follow-up time was 60 months (range,37-93 months).Six patients survived for more than 3 years,4 patients survived for more than 5 years and 2 patients survived for more than 7 years.No acute rejection of gratis was observed at the end of the follow up.Conclusion Liver transplantation is safe and effective for the treatment of polycystic liver disease.