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Clinical experience of liver retransplantation in 14 patients
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF ORGAN TRANSPLANTATION
- Issue:
- 5
- DOI:
- 10.3760/cma.j.issn.0254-1785.2007.05.005
- Key Word:
- 肝移植;再手术
Abstract： 目的 总结再次肝移植的临床经验,提高再次肝移植患者的存活率. 方法 14例再次肝移植患者,其再次肝移植的原因分别为缺血性胆道并发症(9例)、急性肝动脉血栓形成(2例)、慢性排斥反应(2例)及重度药物性肝损害(1例).再次肝移植均采用改良背驮式,供、受者的门静脉均采用端端吻合;8例供、受者的肝动脉仍行端端吻合,6例供肝动脉经搭桥与受者的腹主动脉吻合;2例的供肝胆管与受者的空肠行Roux-en-Y吻合,12例的胆管行端端吻合. 结果 14例患者首次和再次肝移植术前终末期肝病模型评分分别为16.4±7.2和22.5±7.9(P＜0.05),手术耗时分别为(553.3±85.4)min和(796.4±125.2)min(P＜0.05),无肝期时间分别为(63.4±29.6)min和(102±32.8)min(P＜0.05),术中出血量分别为(1537.3±348.3)ml和(2589.3±429.7)ml(P＜0.05).14例中,死亡4例,均为MELD评分≥25分者. 结论 术前科学评估患者的病情、把握手术时机、提高手术技巧及防治术后感染是提高再次肝移植成功率的关键.
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