摘要
目的总结接受心脏死亡器官捐献（DCD）供体肝脏移植的终末期肝病患者的治疗经验及效果。方法回顾性分析2008年3月至2012年12月本院行原位肝脏移植手术的终末期肝病患者22例，均接受DCD供体，供者年龄2～53岁，均为中国Ⅲ类可控性DCD，车祸致严重脑损伤导致脑死亡13例，脑部神经系统疾病导致脑死亡9例；热缺血时间13～28分钟，平均18分钟；冷缺血时间5～12小时，平均7.5小时。所有受者接受肝移植后早期均采用三联免疫抑制方案（他克莫司+吗替麦考酚酯+类固醇激素），程序化复查移植肝脏功能及血药浓度，记录移植肝功能的恢复、并发症发生及存活情况。结果22例患者均顺利接受DCD供肝移植，术后移植肝原发无功能1例；围手术期死亡2例，20例患者恢复顺利。随访2～40个月，1例患者于术后16个月因肿瘤复发而死亡，其他患者术后肝功能恢复顺利，预后良好，未出现手术相关并发症。结论 DCD供肝肝移植后肝功能多可顺利恢复，术后并发症发生率无明显增加。
Objective To summarize the experience of liver transplantation with donor after cardiac death free-donated liver. Methods There were 22 patients with end stage liver disease patients underwent orthotopic liver transplantation(OLT)with donor liver of after cardiac death patients from March 2008 to December 2012 at our institute. The age of donors was from 2 to 53 years old.The average of warm-ischemia time was 18 minutes,and the cold-ischemia time was 7.5 hours. All recipients received triple immunosuppression including tacrolimus(FK506), mycoplenolate mofetil and methyprednisolone post-transplantation. The liver function and FK506 blood level were detected routinely. Results All 22 patients were underwent liver transplantation successfully,one case of primary transplantation liver nonfunction post operation happened;2 died during peroperative period,and 20 cases recovered smoothly. Patients were followed from 2 months to 40 months,one patient died after 16 months for cancer recurrence, the liver function of other patients recover successfully,prognosis were well and none suffered surgical complications. Conclusion The results revealed that liver function recovers on time after transplantation using donor after cardiac death free-donated liver,while there is no obvious post operation complications happening.
出处
《实用器官移植电子杂志》
2013年第1期13-16,共4页
Practical Journal of Organ Transplantation(Electronic Version)
基金
卫生部公益性行业基金资助项目(20080200)
关键词
心脏死亡后捐献
肝移植
治疗
Donation after cardiac death
Liver transplantation
Treatment
