同种异体原位肝移植一例报告

为一肝脏巨大平滑肌肉瘤患者进行原位肝移植术。供者为一２５岁的男性脑死亡者。供肝用４℃ＵＷ液自腹主动脉灌注，快速切取肝脏，热缺血时间为８分钟。受者用＂Ｙ＂形管建立左侧股静脉、门静脉和左侧腋静脉的体外循环后切除病肝，供肝的肝上下腔静脉、肝下下腔静脉和门静脉与受者的相应血管行端端吻合。术后并发腹腔内出血、急性肾功能衰竭、肺部感染和黄疸等，于术后４７天死于脑溢血。该例移植肝功能良好，未出现排斥反应。应用ＵＷ液灌洗和保存肝脏，快速切取肝脏，能提高供肝质量。术后早期应测定血中环孢素Ａ的浓度，慎用广谱抗生素。

Orthotopic liver allotransplantation (one case report)

the orthotopic liver transplantation for massive hepatic Leiomyosarcoma was performed in our hospital on APril 13, 1993. The donor was a 25 years old male with brain death. The distal aorta was used as the access for perfusion with UW solution. The liver was harvested rapidly, and the warm ischemia time was eight minutes.After a Pump-drived Veno-Venous bypass was built from the portal vein and the left femoral vein to the left axillary vein. the native live was resected. The suprohepatic and infrahepatic vena cava and the portal vein of the graft were anastomosed end-to-end to the corresponding native veins. The posttransplant complications were blee ding in the abdominal cavity, acute nenal failure, lung infection and obstructive jaundice. The patient died of cerebral hemorrhage at the 47th potoperative day. The function of the graft was normal without rejection. The results showed that the good viability of the liver could be achieved by flushing and Preserving of the liver with UW soluting and by the technique of rapid harvesting. Cyclosporine concentration should be detected in the early postoperative. The Wide spectrum antibiotics ought to be used cautiously.