摘要
目的探讨死亡后器官捐献供者合并腹腔内广泛夹层动脉瘤,其供肝临床使用的可行性及效果。方法回顾性分析首都医科大学附属北京友谊医院在临床工作中,经中国人体器官分配与共享计算机系统分配来的1例供肝,术中发现腹腔内血管广泛的夹层动脉瘤,累及腹腔干至肝动脉左右分叉以上,肝动脉重建极其困难,最后采用供者近脾门处脾动脉作为间置血管搭桥,重建成功。结果术后早期监测肝脏血流均满意,无外科并发症,顺利出院。随访至目前,术后13月余,血流满意。结论结合文献复习,有腹腔内夹层动脉瘤使用成功的案例,其夹层未累及远端肝固有动脉,重建难度不大,但面对夹层动脉瘤累及范围较广泛的情况时,应慎重使用。
Objective To explore the clinical feasibility and efficacy of using donated liver procured from donors complicated with intra-peritoneal widespread dissecting aneurysm.Methods One case of liver donation was assigned to our center from COTRS.Intra-peritoneal widespread dissecting aneurysm was detected intraoperatively with an involvement of coeliac trunk until artery superior to bifercation of HA(hepatic artery).HA reconstruction was extremely challenging.With the final attempt of using donors artery next to hilus lienis as a bridge vessel,success of reconstruction was achieved.Results During an early postoperative period,satisfactory graft blood flow was established without surgical complications,the patient was discharged smoothly.At Month 13,blood flow of graft remained decent.Conclusions Through a review of the relevant articles,a few cases have been successful using of donated liver from donors with intra-peritoneal dissecting aneurysm as long as proper hepatic artery is not involved and the difficulty of HA reconstruction remains relatively low.As for widespread intra-peritoneal dissecting aneurysm,donor liver should be employed cautiously.
作者
曾志贵
魏林
朱志军
孙丽莹
曲伟
刘颖
王君
檀玉乐
周柳新
Zeng Zhigui;Wei Lin;Zhu Zhijun;Sun Liying;Qu Wei;Liu Ying;Wang Jun;Tan Yule;Zhou Liuxin(Liver Transplantation Center,National Clinical Research Center for Digestive Diseases,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《中华器官移植杂志》
CAS
北大核心
2020年第5期294-296,共3页
Chinese Journal of Organ Transplantation
基金
北京市医院管理局"登峰"人才培养计划(DFL20150101)。
关键词
肝移植
供者
夹层动脉瘤
并发症
Liver transplantation
Donor
Dissecting aneurysm
Complication
作者简介
通信作者:朱志军,Email:zhu-zhijun@outlook.com。
