临床小儿外科杂志2023，Vol.22Issue(12)：1124-1129,6.DOI:10.3760/cma.j.cn101785-202306008-006
儿童亲体肝移植11例回顾性分析
Experiences of pro-liver transplantation in children:a report of 11 cases
摘要
Abstract
Objective To summarize the clinical efficacies and outcomes of pediatric living donor liver transplantation(LDLT).Methods From September 2021 to February 2023,retrospective analysis was per-formed for the relevant clinical data of 11 children undergoing LDLT at First Affiliated Hospital of Xinjiang Medical University.Primary diseases included biliary atresia(n=2),portal vein cavernous degeneration(n=2),hepatolenticular degeneration(n=3),tyrosinemia type Ⅰ(n=1),congenital liver fibrosis(n=2)and Budd-Chiari syndrome(n=1).Postoperative interventions included anti-infection,liver protection,bile promo-tion,anticoagulation and immunosuppression.The immunosuppressive protocols were a triple regimen of tacroli-mus,mycophenolate mofetil and methylprednisolone(n=8)and a dual regimen of tacrolimus and methylpred-nisolone(n=3).Results Mean operative duration was(11.85±1.85)h,mean graft-to-recipient weight ra-tio(GRWR)(2.20±2.03)％,mean cold ischemic time(75.91±20.87)min,mean warm ischemic time(2.63±2.30)min,mean anhepatic period(60.55±18.86)min and mean intraoperative volume of hemor-rhagic loss(770.91±541.12)mL.End-to-end biliary anastomosis(n=4)and bile-intestinal anastomosis(n=7)were performed.There were no vascular or biliary postoperative complications.However,there were thrombocytopenia(n=1),lung infection(n=1),lymphatic leakage(n=2),seizure(n=1)and hyperten-sion with irritability(n=1).All of them were cured and discharged after symptomatic measures.No postopera-tive complications occurred in donors.Conclusions LDLT is an effective treatment for end-stage liver disease and some genetically metabolic liver diseases in children.Indications for LDLT should be strictly tailored for dif-ferent primary diseases.And perioperative managements are individualized for optimizing long-term survivals and quality-of-life.关键词
肝移植/方法/活体供者/分类/活体肝移植/免疫抑制法/治疗结果/儿童Key words
Liver Transplantation/MT/Living Donors/CL/Living Donor Liver Transplantation/Im-munosuppression/Treatment Outcome/Child引用本文复制引用
刘辉,古力米热木·买买提江,李万富,沈中阳,高伟,董冲,孙超,阿尔新·哈布丁,樊珈榕..儿童亲体肝移植11例回顾性分析[J].临床小儿外科杂志,2023,22(12):1124-1129,6.基金项目
国家自然科学基金面上项目(82170672)National Natural Science Foundation of China(82170672) （82170672）
