兒童心臟死亡器官捐獻供肝在成人受者肝移植中的應用（附1例報道）_《中國普外基礎與臨床雜志》

作者：

魏林 , 朱志軍 , 董沖 , 高偉 , 楊濤 , 孫麗瑩 , 曲偉 , 饒偉 , 孫曉葉 , 沈中陽

天津市第一中心醫院移植外科（天津 300192）;

關鍵詞：

肝移植心臟死亡器官捐獻兒童供肝術后并發癥

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目的　探討成人受者接受兒童心臟死亡器官捐獻（DCD）供肝的受者選擇標準、手術方式、常見并發癥及處理方法。
方法　回顧性分析2011年我院完成的1例成人受者接受兒童DCD供肝移植病例的臨床資料并進行文獻復習。
結果　供者為6歲女性溺水兒童，心臟死亡后捐獻肝臟，供肝重量598g，熱缺血時間10min。受者體重55kg，移植物受者體重比為1.09%，移植物體積/受者估計標準肝體積為61.8%。手術采用經典非轉流術式，術后患者肝功能恢復順利，術后第14天CT顯示移植肝動、靜脈未見異常，移植肝體積增至1 003cm3，于術后45d出院。術后3個月隨訪患者肝功能正常。
結論　兒童DCD供肝可以成功地應用于成人受者，但需要根據供肝情況選擇合適的受者及手術方式。

引用本文： 魏林,朱志軍,董沖,高偉,楊濤,孫麗瑩,曲偉,饒偉,孫曉葉,沈中陽. 兒童心臟死亡器官捐獻供肝在成人受者肝移植中的應用（附1例報道）. 中國普外基礎與臨床雜志, 2012, 19(5): 490-492. doi: 復制

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8.	Chan EY, Olson LC, Kisthard JA, et al．Ischemic cholangiopathy following liver transplantation from donation after cardiac death donors [J]. Liver Transpl, 2008, 14(5)：604-610．.
9.	Fujita S, Mizuno S, Fujikawa T, et al．Liver transplantation from donation after cardiac death：a single center experience [J].Transplantation, 2007, 84(1)：46-49．.
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11.	中華人民共和國衛生部醫療服務監管司. 衛生部辦公廳關于啟動心臟死亡捐獻器官移植試點工作的通知( 附件1 －中國心臟死亡器官捐獻分類標準.doc) [EB/OL]. http://www. moh.gov. cn/publicfiles/business/htmlfiles/zwgkzt/s9968/201104/51516.htm.
12.	Kolovos NS, Webster P, Bratton SL．Donation after cardiac death in pediatric critical care [J]. Pediatr Crit Care Med, 2007, 8(1)：47-49．.
13.	Emre S, Soejima Y, Altaca G, et al．Safety and risk of using pediatric donor livers in adult liver transplantation [J]. Liver Transpl,2001, 7(1)：41-47．.
14.	Adam R, Castaing D, Bismuth H．Transplantation of small donor livers in adult recipients [J]. Transplant Proc, 1993, 25(1 Pt 2)：1105-1106．.
15.	Yasutomi M, Harmsmen S, Innocenti F, et al．Outcome of the use of pediatric donor livers in adult recipients [J]. Liver Transpl,2001, 7(1)：38-40．.
16.	Ghabril M, Dickson RC, Krishna M, et al．Liver transplantation using young pediatric donor grafts in adults with hepatitis C infection [J]. Transplantation, 2009, 87(8)：1174-1179．.

1. Shore PM, Huang R, Roy L, et al．Potential for liver and kidney donation after circulatory death in infants and children [J]. Pediatrics,2011, 128(3)： e631-e638．.
2. Grewal HP, Willingham DL, Nguyen J, et al．Liver transplantation using controlled donation after cardiac death donors：an analysis of a large single-center experience [J]. Liver Transpl,2009, 15(9)：1028-1035．.
3. Chaib E, Massad E．The potential impact of using donations after cardiac death on the liver transplantation program and waiting list in the state of Sao Paulo, Brazil [J]. Liver Transpl, 2008, 14(12)：1732-1736．.
4. Klein AS, Messersmith EE, Ratner LE, et al．Organ donation and utilization in the United States, 1999-2008 [J]. Am J Transplant,2010, 10(4 Pt 2)：973-986．.
5. Mateo R, Cho Y, Singh G, et al．Risk factors for graft survival after liver transplantation from donation after cardiac death donors：an analysis of OPTN/UNOS data [J]. Am J Transplant,2006, 6(4)：791-796．.
6. Merion RM, Pelletier SJ, Goodrich N, et al．Donation after cardiac death as a strategy to increase deceased donor liver availability [J]. Ann Surg, 2006, 244(4)：555-562．.
7. Selck FW, Grossman EB, Ratner LE, et al．Utilization, outcomes,and retransplantation of liver allografts from donation after cardiac death：implications for further expansion of the deceased-donor pool [J]. Ann Surg, 2008, 248(4)：599-607．.
8. Chan EY, Olson LC, Kisthard JA, et al．Ischemic cholangiopathy following liver transplantation from donation after cardiac death donors [J]. Liver Transpl, 2008, 14(5)：604-610．.
9. Fujita S, Mizuno S, Fujikawa T, et al．Liver transplantation from donation after cardiac death：a single center experience [J].Transplantation, 2007, 84(1)：46-49．.
10. de Vera ME, Lopez-Solis R, Dvorchik I, et al．Liver transplantation using donation after cardiac death donors：long-term followup from a single center [J]. Am J Transplant, 2009, 9(4)：773-781．.
11. 中華人民共和國衛生部醫療服務監管司. 衛生部辦公廳關于啟動心臟死亡捐獻器官移植試點工作的通知( 附件1 －中國心臟死亡器官捐獻分類標準.doc) [EB/OL]. http://www. moh.gov. cn/publicfiles/business/htmlfiles/zwgkzt/s9968/201104/51516.htm.
12. Kolovos NS, Webster P, Bratton SL．Donation after cardiac death in pediatric critical care [J]. Pediatr Crit Care Med, 2007, 8(1)：47-49．.
13. Emre S, Soejima Y, Altaca G, et al．Safety and risk of using pediatric donor livers in adult liver transplantation [J]. Liver Transpl,2001, 7(1)：41-47．.
14. Adam R, Castaing D, Bismuth H．Transplantation of small donor livers in adult recipients [J]. Transplant Proc, 1993, 25(1 Pt 2)：1105-1106．.
15. Yasutomi M, Harmsmen S, Innocenti F, et al．Outcome of the use of pediatric donor livers in adult recipients [J]. Liver Transpl,2001, 7(1)：38-40．.
16. Ghabril M, Dickson RC, Krishna M, et al．Liver transplantation using young pediatric donor grafts in adults with hepatitis C infection [J]. Transplantation, 2009, 87(8)：1174-1179．.

《中國普外基礎與臨床雜志》

兒童心臟死亡器官捐獻供肝在成人受者肝移植中的應用（附1例報道）

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《中國普外基礎與臨床雜志》

兒童心臟死亡器官捐獻供肝在成人受者肝移植中的應用（附1例報道）

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料