不采用体外静脉-静脉转流技术的经典原位肝移植术

目的　评价在成人经典原位肝移植术中不采用体外静脉 静脉转流技术的结果和可行性。　方法　对 4 3例采用体外静脉转流技术的原位肝移植和 15例不采用体外静脉转流技术的经典原位肝移植进行了对比分析。　结果　在采用和不采用体外静脉转流技术的 2组患者中 ,术后 3d血肌酐值和肛门排气时间差异无显著性。不采用体外静脉转流技术的患者组 ,手术时间 (5 6± 1 4 )h ,术中出血量 (42 0 0± 85 0 )ml,术中输血量 (480 0± 92 0 )ml,ICU停留时间 6 3d ,均低于或短于采用体外静脉转流技术的患者组。　结论　原位肝移植术中不采用体外静脉 静脉转流技术在大多数成人肝移植中是安全而又可行的 ,并且可以缩短手术时间 ,减少术中出血量和输血量 ,缩短ICU停留时间

Orthotopic liver transplantation with no veno-venous bypass

OBJECTIVE: To assess the feasibility and outcome of orthotopic liver transplantation (OLT) with no veno-venous bypass (VVB) in adult patients. METHODS: Between 1999 and June 2001, 43 adult patients were subjected to orthotopic liver transplantations with veno-venous bypass (28), or no veno-venous bypass (15). RESULTS: There was no significant difference in mean serum creatinine on day 3 and gas discharge time in patients with veno-venous bypass or not. With no veno-venous bypass, the average operative time was 5.6 +/- 1.4 h, median amount of blood loss during operation was 4 200 +/- 850 ml, median amount of blood transfused intraoperatively was 4 800 +/- 920 ml, and median intensive care unit stay was 6.3 days. All these were lower or shorter than those of the patients with veno-venous bypass. CONCLUSIONS: Orthotopic liver transplantation with no veno-venous bypass is safe and can be performed in the majority of adult patients. Liver transplantation with no veno-venous bypass is associated with shorter total operating time, lower blood product usage, and shorter intensive care unit stay compared with standard technique of OLT with routine use of VVB.