摘要
目的总结再次肝移植的临床经验。方法对6例患者施行再次肝移植,再次肝移植的原因分别为原发性移植肝无功能(2例)、排斥反应(2例)、胆管吻合口狭窄(1例)以及原发性硬化性胆管炎(1例)。供肝植入采用背驮式及经典原位肝移植术;术后免疫抑制治疗采用他克莫司(tacrolimus)、吗替麦考酚酯(MMF)和激素三联免疫抑制方案。结果5例治愈,已分别存活16个月、11个月、8个月、5个月及2个月,1例于术后第4天死于多器官功能衰竭。术后并发症有深部真菌感染及切口感染。结论再次肝移植是移植肝功能衰竭的有效治疗方法,适应证及手术时机的正确把握、围手术期的严密监测和正确处理是提高再次肝移植患者存活率的关键。
Objective To summarize the clinical experience of liver retransplantation. Methods Six liver retransplantations were performed. The indications consisted of primary non-function （PNF, 2 cases）, acute or chronic rejection （2 cases）, stomas stenosis of biliary tract （1 case） and primary sclerosing cholangitis （1 case）. The immunosuppressive protocols included tacrolimus, methylprednisolone （MP） and mycophenolate mofetil （MMF）. Results Five patients were cured. One patient died on day 4 after liver retransplantation because of multiple organ failure. Postoperative complications included deep fungal infection and wound infection. Conclusions Liver retransplantation is an effective method for graft failure after liver transplantation. Proper indication and optimum operative time, intensive perioperative supervision and proper treatment are very important to improv effect of liver retransplantation.
出处
《中国普外基础与临床杂志》
CAS
2009年第7期540-544,共5页
Chinese Journal of Bases and Clinics In General Surgery
关键词
肝移植
移植肝失功
排斥反应
并发症
再次肝移植
Liver transplantation
Poor graft function
Rejection
Complication
Liver retransplantation
