Orthotopic liver transplantation for biliary atresia
Orthotopic liver transplantation for biliary atresia
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DOI：
10.1016/j.transproceed.2004.11.031
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发表时间：
2005-03-01
影响因子：
0.9
通讯作者：
Torre, G
中科院分区：
文献类型：
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作者：
Colledan, M;Torri, E;Torre, G
胆道闭锁（BA）是儿科人群中最常见的肝移植（OLTX）适应症。本文的目的是提出一个系列收集在过去的7年，从1997年10月至2004年7月，包括260名儿童OLTX在231例。BA是137例患者的适应症。有69名男孩和68名女孩，平均体重10.68 kg，中位年龄0.9岁。作为初次移植，99例患者接受了LLS移植; 27例接受了整个移植; 4例接受了I+ IV-VIII节段移植，2例接受了I-IV节段移植。平均随访1047天（范围：1-2496天）。感染45例，血管并发症27例。25例患者发生了需要再次干预的手术并发症。41例发生胆道并发症，11例需要再次介入。16例再次移植。在2例病例中，进行了另一次重新OLTx。目前126例患者存活，1年生存率为92%，5年生存率为91%，1年移植物生存率为85%，3年和5年移植物生存率为82%。我们的研究结果证实了OLTx治疗BA和加塞手术失败的儿童的有效性。劈离式肝移植为这些患者提供了极好的器官供应，实现了最佳结果，等待名单上没有死亡。
Biliary atresia (BA) represents the most frequent indication for liver transplantation (OLTX) in the pediatric population. The aim of this paper was to present a series collected over the last 7 years from October 1997 through July 2004, including 260 pediatric OLTX in 231 patients. BA was the indication in 137 patients. There were 69 boys and 68 girls of mean weight 10.68 kg and median age 0.9 years. As a primary transplant, 99 patients received a LLS graft; 27 a whole graft; four a I+ IV-VIII segment, and two a I-IV segment. Mean follow up was 1047 days (range, 1-2496 day). Infections were diagnosed in 45 patients, vascular complications in 27 patients. Surgical complications that required reintervention occurred in 25 patients. In 41 cases biliary complications occurred, 11 requiring reintervention. 16 patients were retransplanted. In two cases another re-OLTx was performed. Currently 126 patients are alive, showing an actuarial 1 year survival of 92% and 5 year 91%, with actuarial graft survivals of 85% at 1 year and 82% at 3 and 5 years. Our results confirm the effectiveness of OLTx for the treatment of children with BA and a failed Kasai procedure. Split liver grafts represent an excellent organ supply for these patients, achieving optimal results with no mortality on the waiting list.