同种异体原位肝移植10例

目的总结我院自2003-09以来,开展的10例同种异体原位肝移植术的手术过程及经验体会。方法本组9例患者接受背驮式原位肝移植手术,1例接受经典非转流式原位肝移植手术。3例术后应用环孢霉素A+霉酚酸酯+甲基泼尼松龙三联预防排斥反应,7例应用普乐可复、霉酚酸酯、甲基泼尼松龙预防排斥反应。应用抗生素、抗真菌、抗病毒药物预防感染,口服拉米夫定、静脉滴注乙肝免疫球蛋白预防乙肝复发。结果10例手术全部成功,无严重并发症发生,患者生存至今,生活质量良好。多普勒超声扫描提示肝动脉血流正常,1个月后肝功能检查基本正常。结论原位肝移植术是治疗终末期肝病的唯一有效的手段,围手术期的正确处理和并发症的有效预防是手术成功的关键。

Report on 10 cases of homologous orthotopic liver transplantation

Objective To summarize the experience of homologous orthotopic liver transplantation (OLT) in 10 patients with advanced liver diseases since September,2003 in our hospital. Methods Nine patients received improved pigg-back OLT operations and one patient received standard OLT without venovenous bypass.Three cases received triple immunosuppressive therapy with CsA MMF steroid and seven received therapy with FK506 MMF steroid. Results Every operation was successful,no severy complication was found;all patients still survive and have satisfactory life-quality. Conclusion Liver transplantation is a feasible and viable treatment for patients with end-stage liver diseases.The key factors to successful liver transplantation are the good perioperative handles and the prevention of complications.