摘要
目的探讨预防成人间活体肝移植术后小肝综合征(SFSS)的方法。方法回顾性分析6例成人间活体肝移植(LDLT)的临床资料,包括受体术前血细胞计数、脾脏厚度、门静脉直径、移植物重量与受体体重比(GRWR)、移植物体积与受体标准肝体积比(GV/SLV)及肝静脉重建等,探讨合适体积移植物、良好肝静脉回流、及正常门静脉灌注对SFSS的预防作用。结果受体术前均无严重门静脉高压,均没有采用降门静脉压力与血流的措施,6例肝移植物GV/SLV均大于40%,除1例GRWR为0.74%外,余均大于0.8%。6例受体肝静脉重建均良好,重建后肝脏无淤血改变。术后无SFSS发生。结论LDLT通过选择合适体积移植物,重建良好的肝静脉回流,控制门静脉压力,防止门静脉过度灌注等有助于预防SFSS的发生。
Objective To explore the methods to prevent small-for-size syndrome（SFSS） in adult-to-adult living-related liver transplantation （ A-A LDLT ）. Methods The clinical data of 6 eases of A-A LDLT performed in our hospital between February 2007 to October 2008 were retrospectively analyzed, including blood cell count, spleen thickness, diameter of portal vein in recipients before operation, graft recipient body weight ratio （GRWR） , graft volume and standard liver volume ratio of receptor（ GV/SLV ） , and hepatic vein reconstruction. Results Of the six grafts, the GV/SLV was more than 40% , the GRWR was always above 0.8% except one case was 0.74%. All the recipient grafts had good hepatic vein reconstruction, with no congestion in the grafts;of the six recipients no severe portal hypertension was observed, and no SFSS occurred in the six cases. Conclusions The occurrence of SFSS can be prevented by selecting the appropriate graft size, adequate venous blood drainage through hepatic veins, and control of the portal pressure.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2009年第5期487-491,共5页
China Journal of General Surgery
关键词
肝移植
成人间
活体供者
小肝综合征/预防与控制
Liver Transplantation, Adult to Adult
Living Donor
Small-for-size Syndrome/prev
