原位肝移植治疗肝门部胆管癌二例报告

目的 探讨肝门部胆管癌是否为肝移植的适应证。方法 为２例让部胆管癌的患者施行了同种原位肝移植术。供肝切取采用腹腔器官联合快速切取法，灌洗液及保存液为ＵＷ液。无肝期采用Ｂｉｏ－Ｍｅｄｉｕｃｕｓ转流泵行体外静脉转流。术后免疫抑制治疗，例１采用环孢素Ａ、泼尼松和硫唑嘌呤三联用药，例２采用霉酚酸酯代替硫唑嘌呤。结果 移植后肝功能恢复正常，黄疸减退、但例１术后４天因血液浓缩而出现脑栓塞，肺内感染，术后１２天

Orthotopic liver transplantation for the treatment of klatskin tumor

Objective To investigate whether or not that klatskin tumor is adapt to liver transplantation. Methods In April 1995 and Nov. 1997, orthotopic liver transplantation was successfully performed on 2 cases of klatskin tumor. The liver graft was harvested by combined rapid multiple organ harvesting technique, flushed and preserved with UW solution. Venovenous bypass was processed with BioMedicus pump in anhepatic phase. Immunosuppressive protocol was cyclosporin A, prednisone and azathioprine, while azathioprine was replaced by cellcept in case 2. Results Liver function recovered rapidly with an obvious regression of jaundice. Hemoconcentration occurred in case one on the 4th postoperative day, followed by cerebral thrombosis and lung infection, and died of multiple system organ failure on the 12th postoperative day. Another one was discharged 4 weeks postoperation, but died of tumor recurrence after 5 months. Conclusion The Bismuth hilar bile duct cancer is adapt to liver transplantation. But how to assess whether or not there are micrometastases before operation and effectively control tumor recurrence postoperation are important projections needed to resolve.