摘要
目的 探讨亲体部分肝移植（LRLT）术后肝动脉栓塞（HAT）的预防和治疗。方法 于2001年1月至6月成功的对6例肝豆状核变性患者进行了亲体部分肝移植。术中重视肝动脉吻合技术;根据红细胞压积（HCT）控制输血量;术后根据B超检查肝动脉血流及凝血相结果,选择不同的血浆输注,井采用低分子肝素、华法令和低分子右旋糖酐等联合抗凝治疗。结果6例肝移植后均健康存活,1例发生HAT,经急诊取栓并行肝动脉重建术后无效,再次肝移植后存活。结论 理想的肝动脉吻合、适当控制血制品和正确使用抗凝治疗,是预防LRLT后HAT的重要手段,一旦发生HAT,应急诊取栓,进行肝动脉重建术,甚至进行再次肝移植。
To investigate prevention and treatment of hepatic artery thrombosis (HAT) following living related liver transplantation (LRLT). Methods From Jan. to June 2001, 6 children with Wilson's disease were treated consecutively by LRLT. The donors were the patients' mothers. Special attention was paid to the following points: careful selection of maternal donors; exquisite technique in hepatic artery anastomosis; accurate controlling of blood transfusion volume according to the hematocrit. With the aid of ultra-sound evaluation of the hepatic artery flow and hemostatic status, various kinds of plasma products and anticoagulants such as low molecular weight heparin, dextran and warfarin were applied. Results Until now all 6 cases have survived and are in good condition. But one case developed HAT postoperatively. Since emergence thrombus removal with re-anastomosis of hepatic artery ended with failure, re-transplantation was required with a successful outcome. Conclusions Exquisite technique of hepatic artery anastomosis, adequate application of blood products and accurate anticoagulation are the key points in the prevention and treatment of postoperative HAT. In case of occurrence of this complication, emergence thrombus removal with reanastomosis of hepatic artery or even liver retransplantation have to be considered.
出处
《中华器官移植杂志》
CAS
CSCD
北大核心
2002年第4期216-217,共2页
Chinese Journal of Organ Transplantation
