25例原位肝移植的临床总结

目的：总结肝脏移植治疗不同终末期肝病的经验。方法：对23例原位肝移植与2例肝、肾联合移植的临床资料进行回顾性分析。手术方式均采用同种异体原位肝移植，包括经典原位，经典背驮及改良背驮式。结果：全组死亡7例，存活18例。术后发生排斥反应、感染及脑血管意外等并发症。术后服用拉米呋啶的20例乙型肝炎患者3例复发。结论：开展肝移植的初期应严格掌握适应证，选择条件较好的受者；术式的改进及围手术期的严密监测与正确处理、并发症的防治是肝移植成功的重要条件。

Orthotopic liver transplantation:a report of 25 successfully performed consecutive cases

Objective:To sum up the clinical experience of liver transplantation for various liver diseases at end stage.Methods:The clinical data of 23 cases of liver transplantation and 2 cases of combined liver kidney transplantation were analyzed retrospectively from 2001 to 2004. Surgical procedures all adopted homoplastic orthetopic liver transplantation in 25 cases, including 15 with standard orthotopic liver transplantation (SOLT), 4 standard piggyback liver transplantation (SPBLT) and 11 ameliorated piggyback liver transplantation (APBLT).Results:The recovery of liver graft function was good after the operation in 25 patients. Seven cases died, the remaining 18 cases recovered well. Complication included acute rejection, infection and cerebral hemorrhage. Three of 20 patients treated with lamivudine recurred with hepatitis B.Conclusion:It is necessary to abide by the indications of liver transplantation to select good condition recipients in primary stage of performing liver transplant. Perfect surgical technique, comprehensive monitoring, correct management and prevention of complication are major successful factors.