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Selection of donors of living related liver transplantation for Wilson's disease
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF ORGAN TRANSPLANTATION
- Issue:
- 5
- DOI:
- 10.3760/cma.j.issn.0254-1785.2006.05.002
- Key Word:
- 肝移植;活体供者;肝豆状核变性
Abstract： 目的总结亲属活体供肝移植治疗肝豆状核变性时选择供者的经验.方法 29例肝豆状核变性患者接受亲属活体供肝移植,共有70名供者入选筛查,筛查内容包括肝功能、血清肝炎标记物、肝体积的估测及肝血管和胆管系统解剖结构的预测,以及年龄、体型、供受者配型、伦理学方面的评估等.结果 23名供者被排除,10名(43.5%)志愿者是因为受家庭、亲属和社会上的传统观念的影响而最终放弃捐肝意愿;6名(26.1%)因铜代谢指标异常,血清铜蓝蛋白＜200 mg/L,24 h尿铜＞100 μg;4名(17.4%)因为脂肪肝;3名(13%)因为乙型肝炎.10例为右叶供肝,19例为左叶供肝.供肝重量与受者体重之比为(1.38±0.44)%.所有供者术后恢复正常生活.3名供者术后发生外科相关并发症,其中2例为一过性胆漏,经穿刺引流后治愈,1例为肝断面渗血,经保守治疗痊愈.结论影响供肝选择的主要因素有传统观念、供者铜代谢指标的异常、乙型肝炎及脂肪肝;而术前对供者进行全面评估及供肝切取技术的改进,是保证供者安全和供肝质量的关键.
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