再次肝移植6例報道及文獻復習_《中國普外基礎與臨床雜志》

作者：

劉其雨 , 陳剛 , 溫小明 , 趙英鵬 , 朱新鋒 , 李曉延 , 李立

昆明市第一人民醫院肝膽外科暨云南省肝移植中心（昆明 650011）;

關鍵詞：

肝移植移植肝失功排斥反應并發癥再次肝移植

視頻：

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目的總結再次肝移植的臨床經驗。
方法對6例患者施行再次肝移植，再次肝移植的原因分別為原發性移植肝無功能（2例）、排斥反應（2例）、膽管吻合口狹窄（1例）以及原發性硬化性膽管炎（1例）。供肝植入采用背馱式及經典原位肝移植術；術后免疫抑制治療采用他克莫司（tacrolimus）、嗎替麥考酚酯（MMF）和激素三聯免疫抑制方案。
結果 5例治愈，已分別存活16個月、11個月、8個月、5個月及2個月，1例于術后第4 天死于多器官功能衰竭。術后并發癥有深部真菌感染及切口感染。
結論再次肝移植是移植肝功能衰竭的有效治療方法，適應證及手術時機的正確把握、圍手術期的嚴密監測和正確處理是提高再次肝移植患者存活率的關鍵。

引用本文： 劉其雨,陳剛,溫小明,趙英鵬,朱新鋒,李曉延,李立. 再次肝移植6例報道及文獻復習. 中國普外基礎與臨床雜志, 2009, 16(7): 540-544. doi: 復制

1.	嚴律南. 成人間活體肝移植的外科技術與創新 [Ｊ]. 中國普外基礎與臨床雜志， 2008； 15（3）： 151154.
2.	呂波，文天夫. 肝癌肝移植及肝癌肝切除術后復發特點的比較 [Ｊ]. 中國普外基礎與臨床雜志， 2008； 15（3）： 166170.
3.	Ghabril M, Dickson RC, Machicao VI, et al. Liver retransplantation of patients with hepatitis C infection is associated with acceptable patient and graft survival [Ｊ]. Liver Transpl, 2007； 13(12): 17171727.
4.	Ghabril M, Dickson R, Wiesner R. Improving outcomes of liver retransplantation: an analysis of trends and the impact of Hepatitis C infection [Ｊ]. Am J Transplant， 2008； 8(2): 404411.
5.	Ghobrial RM. Changing faces of liver retransplantation: it is all about selection [Ｊ]. Liver Transplantation, 2007； 13(2): 188189.
6.	Yamauchi Y, Wettergren A, Yamashita Y, et al. Retransplantation of the liver in adults: longterm outcome and prognostic modeling [Ｊ]. Hepatogastroenterology， 2007； 54(76): 11811186.
7.	Ng V, Anand R, Martz K, et al. Liver retransplantation in children: a SPLIT database analysis of outcome and predictive factors for survival [Ｊ]. Am J Transplant， 2008； 8(2): 386395.
8.	Martí J, Charco R, Ferrer J, et al. Optimization of liver grafts in liver retransplantation: a European singlecenter experience [Ｊ]. Surgery， 2008； 144(5): 762769.
9.	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.
10.	Reese PP, Yeh H, Thomasson AM, et al. Transplant center volume and outcomes after liver retransplantation [Ｊ]. Am J Transplant， 2009； 9(2): 309317.
11.	Davis A, Rosenthal P, Glidden D. Pediatric liver retransplantation: outcomes and a prognostic scoring tool [Ｊ]. Liver Transpl， 2009； 15(2): 199207.
12.	Magee JC, Barr ML, Basadonna GP, et al. Repeat organ transplantation in the United States, 19962005 [Ｊ]. Am J Transplant， 2007; 7(5 Pt 2): 14241433.
13.	Sun CK, Chen CL, Concejero AM, et al. Retransplantation for endstage liver disease: a singlecenter Asian experience [Ｊ]. Transplant Proc， 2008； 40(8): 25032506.
14.	Zhu ZJ, Rao W, Sun JS, et al. Liver retransplantation for ischemictype biliary lesions after orthotopic liver transplantation: a clinical report of 66 cases [Ｊ]. Hepatobiliary Pancreat Dis Int，2008； 7(5): 471475.
15.	Kwo PY, Saxena R, Cummings OW, et al. Intravenous interferon during the anhepatic phase of liver retransplantation and prevention of recurrence of cholestatic hepatitis C virus [Ｊ]. Liver Transpl， 2007； 13(12): 17101713.
16.	Rosen HR. Liver retransplantation for hepatitis C: seeing is believing [Ｊ]. Liver Transpl, 2007； 13(9): 12171218.
17.	Uemura T, Randall HB, Sanchez EQ, et al. Liver retransplantation for primary nonfunction: analysis of a 20year singlecenter experience [Ｊ]. Liver Transpl， 2007；13(2): 227233.
18.	Bonatti H, Goegele H, Tabarelli D, et al. Pseudallescheria boydii infection after liver retransplantation [Ｊ]. Liver Transpl， 2007； 13(7): 10681069.
19.	DobleckiLewis S, Palaios E, Bejarano PA, et al. Hepatic gas gangrene following orthotopic liver transplantation: three cases treated with retransplantation and a review of the literature [Ｊ]. Transpl Infect Dis， 2008； 10(4): 280285.
20.	Garcia JH, Vasconcelos JB, Gonalves BP, et al. A new biliodigestive anastomosis technique after hepatic artery thrombosis as bridge to liver retransplantation: a case presentation [Ｊ]. Transplant Proc， 2007； 39(10): 35233526.
21.	冉江華，張升寧，李鑄，等 . 肝動脈腹主動脈搭橋在原位肝移植術中的應用 [Ｊ]. 中國普外基礎與臨床雜志， 2008； 15（2）： 102105.
22.	Maggi U, Consonni D, Bertoli P, et al. A risk score and a flowchart for liver retransplantation [Ｊ]. Transplant Proc， 2008； 40(6): 19561960.
23.	Lang H, Sotiropoulos GC, Beckebaum S, et al. Incidence of liver retransplantation and its effect on patient survival [Ｊ]. Transplant Proc， 2008； 40(9): 32013203.
24.	Yan JQ, Peng CH, Li HW, et al. Preliminary clinical experience in liver retransplantation [Ｊ]. Hepatobiliary Pancreat Dis Int， 2007； 6(2): 152156.
25.	Uribe M, Buckel E, Ferrario M, et al. Pediatric liver retransplantation: indications and outcome [Ｊ]. Transplant Proc， 2007； 39(3): 609611.
26.	Qasim A, Zaman BM, Geoghegan J, et al. Significant influence of the primary liver disease on the outcomes of hepatic retransplantation [Ｊ]. Ir J Med Sci， 2009； 178(1): 4751.

1. 嚴律南. 成人間活體肝移植的外科技術與創新 [Ｊ]. 中國普外基礎與臨床雜志， 2008； 15（3）： 151154.
2. 呂波，文天夫. 肝癌肝移植及肝癌肝切除術后復發特點的比較 [Ｊ]. 中國普外基礎與臨床雜志， 2008； 15（3）： 166170.
3. Ghabril M, Dickson RC, Machicao VI, et al. Liver retransplantation of patients with hepatitis C infection is associated with acceptable patient and graft survival [Ｊ]. Liver Transpl, 2007； 13(12): 17171727.
4. Ghabril M, Dickson R, Wiesner R. Improving outcomes of liver retransplantation: an analysis of trends and the impact of Hepatitis C infection [Ｊ]. Am J Transplant， 2008； 8(2): 404411.
5. Ghobrial RM. Changing faces of liver retransplantation: it is all about selection [Ｊ]. Liver Transplantation, 2007； 13(2): 188189.
6. Yamauchi Y, Wettergren A, Yamashita Y, et al. Retransplantation of the liver in adults: longterm outcome and prognostic modeling [Ｊ]. Hepatogastroenterology， 2007； 54(76): 11811186.
7. Ng V, Anand R, Martz K, et al. Liver retransplantation in children: a SPLIT database analysis of outcome and predictive factors for survival [Ｊ]. Am J Transplant， 2008； 8(2): 386395.
8. Martí J, Charco R, Ferrer J, et al. Optimization of liver grafts in liver retransplantation: a European singlecenter experience [Ｊ]. Surgery， 2008； 144(5): 762769.
9. 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.
10. Reese PP, Yeh H, Thomasson AM, et al. Transplant center volume and outcomes after liver retransplantation [Ｊ]. Am J Transplant， 2009； 9(2): 309317.
11. Davis A, Rosenthal P, Glidden D. Pediatric liver retransplantation: outcomes and a prognostic scoring tool [Ｊ]. Liver Transpl， 2009； 15(2): 199207.
12. Magee JC, Barr ML, Basadonna GP, et al. Repeat organ transplantation in the United States, 19962005 [Ｊ]. Am J Transplant， 2007; 7(5 Pt 2): 14241433.
13. Sun CK, Chen CL, Concejero AM, et al. Retransplantation for endstage liver disease: a singlecenter Asian experience [Ｊ]. Transplant Proc， 2008； 40(8): 25032506.
14. Zhu ZJ, Rao W, Sun JS, et al. Liver retransplantation for ischemictype biliary lesions after orthotopic liver transplantation: a clinical report of 66 cases [Ｊ]. Hepatobiliary Pancreat Dis Int，2008； 7(5): 471475.
15. Kwo PY, Saxena R, Cummings OW, et al. Intravenous interferon during the anhepatic phase of liver retransplantation and prevention of recurrence of cholestatic hepatitis C virus [Ｊ]. Liver Transpl， 2007； 13(12): 17101713.
16. Rosen HR. Liver retransplantation for hepatitis C: seeing is believing [Ｊ]. Liver Transpl, 2007； 13(9): 12171218.
17. Uemura T, Randall HB, Sanchez EQ, et al. Liver retransplantation for primary nonfunction: analysis of a 20year singlecenter experience [Ｊ]. Liver Transpl， 2007；13(2): 227233.
18. Bonatti H, Goegele H, Tabarelli D, et al. Pseudallescheria boydii infection after liver retransplantation [Ｊ]. Liver Transpl， 2007； 13(7): 10681069.
19. DobleckiLewis S, Palaios E, Bejarano PA, et al. Hepatic gas gangrene following orthotopic liver transplantation: three cases treated with retransplantation and a review of the literature [Ｊ]. Transpl Infect Dis， 2008； 10(4): 280285.
20. Garcia JH, Vasconcelos JB, Gonalves BP, et al. A new biliodigestive anastomosis technique after hepatic artery thrombosis as bridge to liver retransplantation: a case presentation [Ｊ]. Transplant Proc， 2007； 39(10): 35233526.
21. 冉江華，張升寧，李鑄，等 . 肝動脈腹主動脈搭橋在原位肝移植術中的應用 [Ｊ]. 中國普外基礎與臨床雜志， 2008； 15（2）： 102105.
22. Maggi U, Consonni D, Bertoli P, et al. A risk score and a flowchart for liver retransplantation [Ｊ]. Transplant Proc， 2008； 40(6): 19561960.
23. Lang H, Sotiropoulos GC, Beckebaum S, et al. Incidence of liver retransplantation and its effect on patient survival [Ｊ]. Transplant Proc， 2008； 40(9): 32013203.
24. Yan JQ, Peng CH, Li HW, et al. Preliminary clinical experience in liver retransplantation [Ｊ]. Hepatobiliary Pancreat Dis Int， 2007； 6(2): 152156.
25. Uribe M, Buckel E, Ferrario M, et al. Pediatric liver retransplantation: indications and outcome [Ｊ]. Transplant Proc， 2007； 39(3): 609611.
26. Qasim A, Zaman BM, Geoghegan J, et al. Significant influence of the primary liver disease on the outcomes of hepatic retransplantation [Ｊ]. Ir J Med Sci， 2009； 178(1): 4751.

《中國普外基礎與臨床雜志》

再次肝移植6例報道及文獻復習

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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《中國普外基礎與臨床雜志》

再次肝移植6例報道及文獻復習

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