心脏死亡器官捐献原位肝移植的初步经验:附单中心4例报告

目的:小结近期开展的心脏死亡器官捐献(DCD)肝移植的临床经验。方法:回顾性分析2011年9月—2012年2月4例接受DCD原位肝移植术的终末期肝病患者的临床资料。结果:全组肝移植病例均获成功,无肝功能延迟恢复;无胆漏、急性排斥反应、应激性溃疡出血、肾功能损害、爆发性肝炎等并发症。1例患者术后伤口感染及肝脏VII,VIII段部分坏死、右膈下积血,经加强抗感染、换药及穿刺引流后治愈。结论:DCD供肝原位肝移植效果良好,是解决我国肝移植面临的肝源短缺的一个极有潜力的办法,DCD肝移植的顺利开展尚有待广泛宣传及多部门、多学科通力合作。

Orthotropic liver transplantation using liver donated after cardiac death: a single-center report of 4 cases

Objective: To summarize the recent clinical experience of liver transplantation using liver donated after cardiac death(DCD). Methods: The clinical data of 4 patients with end-stage liver disease undergoing DCD liver transplantation from September 2011 to February 2012 were retrospectively analyzed. Results: All 4 patients underwent successful liver transplantation without delayed liver function recovery.There were no complications such as bile leakage,acute rejection,stress ulcer bleeding,renal function damage or fulminant hepatitis.Only one patient developed wound infection,partial necrosis of segment VII and VIII,and right subdiaphragmatic haematocele,which were cured through the enhanced anti-infection treatment,frequent dressing changes and percutaneous drainage. Conclusion: DCD orthotropic liver transplantation has proven effectiveness,and offers a potential solution to the donor shortage in China.The effective implementation of DCD liver transplantation still needs vigorous promotion,as well as multi-sectoral and multidisciplinary cooperation.