Study for establishment of living - related licer transplantation.

为了建立活体相关肝移植(LRLT)，我们进行了23例LRLT，其中包括4例成人LRLT。为保证供体的安全，术前应进行肝功能检查、US、MRI、血管造影和ERP等检查，术中采用选择性血管阻断技术，最大限度地减少出血，保护移植物存活。捐献者在手术中和术后仅使用自体输血。术后并发症：应激性溃疡3例，药物性肝炎1例，均经治疗，供体目前均完全健康，为保证受者安全，术后应用彩色多普勒超声对血管吻合情况进行评估。术前血浆置换有助于维持患者的良好状态。作为一种免疫抑制治疗，选择CyA和FK506是很重要的。术后应用低分子肝素、前列腺素E_1、蛋白水解酶抑制剂、抗凝血酶、肌肉冷冻血浆等抗凝治疗，使Ht保持在较低水平是重要的。

To establish the living related liver transplantation (LRLT), we performed 23 LRLT, including 4 adult cases.For the donor safety, it is important to perform pre-operarive test as live function test, US, MRI, angiography and ERCP.Selective vascular occlusion technique was used during liver resection to minimize blood loss and preserve graft viability. Only autotransfusion was used during and post operatively for donors. As post operative minor complication, 3 cases had stress ulcer, 1 case had drug induced hepatitis, but all cases were treated and currently all donor are completely healthy.For the recipient safety, post-operative vascular anastomosis assessment using collar doppler US was useful. And pre operative plasma exchange was useful to keep patient in good condition. As a immunosuppressive therapy, it is important to select CyA and FK506. Post-operative anti coagulant therapy using low molecular heparin, prostaglandin E1, protease inhibitor, antithrombin, and flesh frozen plasma and keeping Ht in lower value was important.