Laparoscopic living donor hepatectomy for liver transplantation in children
Laparoscopic living donor hepatectomy for liver transplantation in children
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DOI：
10.1016/s0140-6736(02)07598-0
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发表时间：
2002-02-02
期刊：
影响因子：
168.9
通讯作者：
Houssin, D
中科院分区：
文献类型：
--
作者：
Cherqui, D;Soubrane, O;Houssin, D
由于尸体器官供体短缺，活体供体越来越多地用于移植。我们已经开发出一种安全，可重复的方法腹腔镜肝切除术。方法在腹腔镜下完成左肝叶切除术（切除第2和第3段），1名女性27岁，1名男性31岁。在腹腔镜下制备移植物，不进行任何血管夹闭，并通过耻骨上Pfannenstiel切口取出。两种移植物移植到患者各自的儿子，谁都是1岁，有胆道闭锁。结果供体手术持续7小时的女人和6小时的男人，和热缺血时间分别为4和10分钟。失血量分别为150和450 mL，无需输血。两名患者在含糖期间或之后均未发生并发症;住院时间分别为7天和5天。两个受者均存活，移植物功能良好。我们已经证明了从父母到孩子的腹腔镜活体肝切除术的可行性。如果该手术的安全性和可行性能够在更大的系列研究中得到证实，腹腔镜供肝左叶切除术可能成为小儿活体肝移植的一种新选择。
Background Because cadaveric organ donors are in short supply, living donors are increasingly being used in transplantations. We have developed a safe and reproducible method for laparoscopic liver resection.Methods Left hepatic lobectomy (resection of segments 2 and 3) was done by laparoscopy in one woman aged 27 years and one man aged 31 years. The grafts were prepared under laparoscopy, without any vascular clamping, and were externalised through a suprapubic Pfannenstiel incision. Both grafts were transplanted conventionally to the patients' respective sons, who were both aged 1 year and had biliary atresia.Findings Donor operations lasted 7 h for the woman and 6 h for the man, and warm ischaemia times were 4 and 10 min, respectively. Blood loss was 150 and 450 mL, respectively, and no transfusions were required. Neither patient had complications during or after sugary; and hospital stay was 7 and 5 days, respectively. Both recipients are alive and have excellent graft function.Interpretation We have shown the feasibility of laparoscopic living donor hepatectomy from parent to child. If the safety and feasbility of this procedure can be shown in larger series, laparoscopic donor left lobectomy could become a new option for paediatric living donor liver transplantation.