CAJ | 학술논문

目的总结活体肝肾联合移植1例的体会.方法 2007年9月对1例乙型肝炎后肝硬化(失代偿期)合并慢性肾功能衰竭(尿毒症期)的患者施行了成人间亲属活体肝肾联合移植.切取供者带肝中静脉的右半肝和右侧肾脏,受者手术采用背驮式肝移植及异位肾移植.受者给予巴利昔单抗联合他克莫司+吗替麦考酚酯+甲泼尼龙的方案抗排斥反应,供、受者术后加强护肝治疗、抗感染治疗和营养支持治疗.结果供、受者均顺利渡过围手术期,术后肝、肾功能均恢复良好.随访5年余,供者肝、肾功能正常,对生活质量无明显影响；受者移植肝、肾功能良好,未发生明显并发症.结论活体肝肾联合移植是治疗肝、肾功能衰竭的有效手段,供者同时捐赠部分肝脏和一个肾脏是安全可行的.
목적 총결활체간신연합이식1례적체회.방법 2007년9월대1례을형간염후간경화(실대상기)합병만성신공능쇠갈(뇨독증기)적환자시행료성인간친속활체간신연합이식.절취공자대간중정맥적우반간화우측신장,수자수술채용배타식간이식급이위신이식.수자급여파리석단항연합타극막사+마체맥고분지+갑발니룡적방안항배척반응,공、수자술후가강호간치료、항감염치료화영양지지치료.결과 공、수자균순리도과위수술기,술후간、신공능균회복량호.수방5년여,공자간、신공능정상,대생활질량무명현영향；수자이식간、신공능량호,미발생명현병발증.결론 활체간신연합이식시치료간、신공능쇠갈적유효수단,공자동시연증부분간장화일개신장시안전가행적.
Objective To summarize the experience in one case of adult-to-adult combined liver-kidney transplantation.Method In Sep.2007,one case of adult-to-adult liver-kidney transplantation from the same living donor was performed on a patient with liver cirrhosis (liver failure decompensation) and chronic renal failure (uremia).There was a donation of the right liver with the middle hepatic vein and right kidney in the same time from the living donor.The piggyback liver transplantation and ectopic kidney transplantation were performed for the recipient.Basiliximab and methylprednisolone were given for immune induction therapy in operation.Tacrolimus,MMF and prednisone were given for anti-rejection.There were hepatoprotective treatment,anti-infection treatment and nutritional support for the donor and recipient after operation.The follow-up period has now been more than five years.Result The donor and the patient were smooth in the perioperative period.The liver and kidney function of the donor is well so far.There was no significant influence on quality of life of the donor.The transplanted liver and kidney function of the recipient is well so far.There were no significant complications for the recipient.Conclusion The living liver-kidney transplantation is an effective means for the treatment of liver and kidney failure.The safety can be ensured for the donors that donate the right liver and one kidney simultaneously.