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目的 :探讨公民逝世后器官捐献(DCD)与年龄相关的边缘供肝临床肝移植应用经验。方法 :对南京医科大学第一附属医院2013年12月至2015年10月3例与年龄相关的边缘供肝应用于肝移植的临床情况进行回顾分析,包括供受者双方的临床资料及受者术后短期恢复情况。结果:3例供者其中2例实施中国Ⅲ类即脑-心双死亡(DBCD)器官捐献,另外1例实施中国Ⅱ类器官捐献。3例供者中1例为7岁儿童,另外2例分别为79岁老年男性和83岁老年女性。3例肝移植受者术后恢复顺利,肝功能恢复良好,其中儿童供肝肝移植患者术后1个月出现幻觉、幻听及被害妄想等神经精神症状,经治疗痊愈。结论:本研究在一定程度上说明儿童和老年边缘供肝只要科学评估和合理应用于合适的受体一样可以获得良好的效果,年龄不应该成为独立的肝移植禁忌证,在做好充分评估的基础上,与年龄相关的边缘供肝应用于肝移植具有较高的可行性。
OBJECTIVE: To explore the clinical experience of donor liver transplantation (DCD) with age-related peripheral liver transplantation after the death of a citizen. Methods: The clinical data of 3 age-related limbal liver transplantation patients who were admitted to the First Affiliated Hospital of Nanjing Medical University from December 2013 to October 2015 were retrospectively analyzed, including clinical data and recipients Postoperative short-term recovery. Results: Two of the three donors were donated in China with type Ⅲ organ-brain death (DBCD) and the other one with type Ⅱ organ donation in China. One of the three donors was a 7-year-old child and the other two were 79-year-old men and 83-year-old women, respectively. Three recipients of liver transplantation recovered smoothly and their liver function recovered well. Among them, neuropsychiatric symptoms such as hallucinations, hallucinations and delusions were found in children with liver transplantation one month after operation, and were cured after treatment. CONCLUSIONS: This study to some extent shows that children and elderly marginal donors receive good results as long as scientific assessment and rational use of appropriate receptors are appropriate, and age should not become a contraindication to an independent liver transplant. Based on the age-related marginal supply of liver transplantation for liver transplantation has a higher feasibility.