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【文摘发布】成人间活体供肝移植中左叶移植物
Author: Konishi N, Ishizaki Y, Sugo H, Yoshimoto J, Miwa K, Kawasaki S.
Source : Am J Transplant. 2007 Nov 16 [Epub ahead of print]
Abstract:
In adult-to-adult living donor liver transplantation (LDLT), left-lobe grafts can sometimes be small-for-size. Although attempts have been made to prevent graft overperfusion through modulation of portal inflow, the optimal portal venous circulation for a liver graft is still unclear. Hepatic hemodynamics were analyzed with reference to graft function and outcome in 19 consecutive adult-to-adult LDLTs using left-lobe grafts without modulation of graft portal inflow. Overall mean graft volume (GV) was 398 g, which was equivalent to 37.8% of the recipient standard liver volume (SV). The GV/SV ratio was less than 40% in 13 of the 19 recipients. Overall mean recipient portal vein flow (PVF) was much higher than the left PVF in the donors. The mean portal contribution to the graft was markedly increased to 89%. Average daily volume of ascites revealed a significant correlation with portal vein pressure, and not with PVF. When PVP exceeds 25 mmHg after transplantation, modulation of portal inflow might be required in order to improve the early postoperative outcome. Although the study population was small and contained several patients suffering from tumors or metabolic disease, all 19 patients made good progress and the 1-year graft and patient survival rate were 100%. A GV/SV ratio of less than 40% or PVF of more than 260 mL/min/100 g graft weight does not contraindicate transplantation, nor is it necessarily associated with a poor outcome. Left-lobe graft LDLT is still an important treatment option for adult patients.
PMID: 18021282 [PubMed - as supplied by publisher]
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1600-6143.2007.02037.x Title: Impact of a Left-Lobe Graft Without Modulation of Portal Flow in Adult-to-Adult Living Donor Liver Transplantation.
题目:成人间活体供肝移植中左叶移植物不进行门脉血流调整的影响
Author: Konishi N, Ishizaki Y, Sugo H, Yoshimoto J, Miwa K, Kawasaki S.
作者:Konishi N, Ishizaki Y, Sugo H, Yoshimoto J, Miwa K, Kawasaki S.
Source : Am J Transplant. 2007 Nov 16 [Epub ahead of print]
出处:《美国移植杂志》2007年 11月16 日 [印刷前互联网发表]
Abstract:
摘要:
In adult-to-adult living donor liver transplantation (LDLT), left-lobe grafts can sometimes be small-for-size. Although attempts have been made to prevent graft overperfusion through modulation of portal inflow, the optimal portal venous circulation for a liver graft is still unclear.
在成人间活体供肝移植(LDLT)中，肝左叶移植往往在尺寸上会小。虽然通过调整门脉流入量，已经做了一些尝试用来预防移植肝的过度灌注，但(人们)对于移植肝最佳的门静脉循环尚未明确。
Hepatic hemodynamics were analyzed with reference to graft function and outcome in 19 consecutive adult-to-adult LDLTs using left-lobe grafts without modulation of graft portal inflow. Overall mean graft volume (GV) was 398 g, which was equivalent to 37.8% of the recipient standard liver volume (SV).
在连续19例未进行移植肝门脉流入量调整的，肝左叶移植的成人间活体供肝移植中，分析了肝脏血流动力学与移植肝功能和移植结局的关系。测得总体的平均移植肝脏体积(GV)是398克，这相当于受体标准肝脏体积(SV)的37.8%。
The GV/SV ratio was less than 40% in 13 of the 19 recipients. Overall mean recipient portal vein flow (PVF) was much higher than the left PVF in the donors. The mean portal contribution to the graft was markedly increased to 89%. Average daily volume of ascites revealed a significant correlation with portal vein pressure, and not with PVF.
在19名受体中，有13名受体的GV/SV的比值小于40%。 总体平均受体门静脉血流量较供体门脉左支血流量要高得多。门脉对移植肝的平均供血量显著地增加到89%。平均每天的腹水量显示其与门静脉压力显著相关，而与门静脉血流量无显著相关。
When PVP exceeds 25 mmHg after transplantation, modulation of portal inflow might be required in order to improve the early postoperative outcome. Although the study population was small and contained several patients suffering from tumors or metabolic disease, all 19 patients made good progress and the 1-year graft and patient survival rate were 100%.
当移植术后门静脉压力超过25mmHg的时候，为了改善早期手术后结果，可能需要对门脉流入量进行调整。虽然本研究人群的数量少，而且包含了几个患有肿瘤或代谢性疾病的患者，但全部19名患者的病情都获得了改善，1年移植肝和患者的存活率是100%。
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作者:admin@医学,生命科学 2011-08-12 17:22
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