CAJ | 학술논문

目的探讨活体肝移植(1iving donor liver transplantation,LDLT)供、受者术前评估和手术方式的选择.方法回顾性分析1995年1月至2007年10月我中心95例LDLT患者的临床资料.良性终末期肝病92例,其中Wilson病45例;肝脏恶性肿瘤3例.结果供肝切取不带肝中静脉右半肝31例,带肝中静脉右半肝3例,带肝中静脉左半肝51例,不带肝中静脉左半肝或左外叶10例.所有供者术后顺利恢复,均未出现严重并发症.受者随访1～86个月,良性终末期肝病受者1、3、5年累积生存率分别为89%(82例)、78%(71例)和73%(67例),其中Wilson病受者1、3、5年累积生存率分别为92%(42例)、89%(40例)和76%(34例).3例肝脏恶性肿瘤患者死亡2例,1例长期生存.供、受者铜代谢均恢复正常.结论建立供者安全保障体系是LDLT开展的先决条件,选择合理的手术方式是提高受者生存率的关键.亲体肝移植是治疗Wilson病的有效手段.
목적 탐토활체간이식(1iving donor liver transplantation,LDLT)공、수자술전평고화수술방식적선택.방법 회고성분석1995년1월지2007년10월아중심95례LDLT환자적림상자료.량성종말기간병92례,기중Wilson병45례;간장악성종류3례.결과 공간절취불대간중정맥우반간31례,대간중정맥우반간3례,대간중정맥좌반간51례,불대간중정맥좌반간혹좌외협10례.소유공자술후순리회복,균미출현엄중병발증.수자수방1～86개월,량성종말기간병수자1、3、5년루적생존솔분별위89%(82례)、78%(71례)화73%(67례),기중Wilson병수자1、3、5년루적생존솔분별위92%(42례)、89%(40례)화76%(34례).3례간장악성종류환자사망2례,1례장기생존.공、수자동대사균회복정상.결론 건립공자안전보장체계시LDLT개전적선결조건,선택합리적수술방식시제고수자생존솔적관건.친체간이식시치료Wilson병적유효수단.
objective To investigate preoperative donor and recipient assessment,choice of surgical options in living donor liver transplantation(LDLT).Methods The clinical data of 95 patients who underwent LDLT from January 1995 to October 2007 in our center were retrospectively analyzed.Of all,92 recipients were benign end-stage liver disease patients (including 45 patients with Wilson disease),and 3 were malignant hepatic carcinbma patients.Results Thirty-one fight lobes without middle hepatic vein(MHV),3 right lobes with MHV,51 left lobes with MHV.and 10 left lobes or left lateral lobes without MHV were obtained.All the donors recovered after operation. Recipients with benign end-stage liver disease were followed up for 1 to 86 months,and the 1-,3-,5-year accumulative survival rates were 89%(82 cases),78%(71 cases)and 73%(67 cases),respectively. The 1-,3-,5-year survival rates of patients with Wilson disease were 92%(42 cases),89%(40 cases)and 76%(34 cases),respectively. For the 3 patients with malignant hepatic carcinoma,2 died and 1 was alive and well. The copper metabolism was back to normal in both donors and recipients. Conclusions Establishment of a system for the safety of donors is basic for LDLT. The key to raise the recipients' survival rates is to choose the optimal surgical approach. LDLT is effective in treating Wilson disease.