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连续活体供肝移植中的简化肝静脉流出道重建术
Simplifying hepatic venous outflow reconstruction in sequential living donor liver transplantation
Chan, S.C., Lo, C.M., Ng, K.K., Chok, K.S., Fan, S.T.  2010/1/13 11:54:00 
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Liver Transplantation, 2009, Volume 15, Issue 11 
 

The native liver of a familial amyloidotic polyneuropathy recipient who undergoes living donor liver transplantation used as a graft for sequential liver transplantation does not include the inferior vena cava. Implantation of this whole liver graft to a second recipient could be simplified by borrowing the experience from right liver living donor liver transplantation. With careful release of the hepatic vein from its surrounding adventitia mainly by sharp dissections, adequate lengths of these veins could be attained without compromising the native inferior vena cava. Following venoplasty of the right and middle/left hepatic vein stumps, the single cuff of the hepatic veins is anastomosed to the inferior vena cava without interpositional venous graft or patch. Satisfactory venous outflow is reliably achieved because this is the most direct outflow tract. © 2009 AASLD.

Correspondence Address: Lo, C. M.; Department of Surgery, University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China; email:chungmlo@hkucc.hku.hk 
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曹晶珠  邹大进

 

解放军第二军医大学附属长海医院内分泌科

 

患者为中年女性,35岁,因多饮、多尿、全身乏力、闭经1年,体重增加、肝区不适半年20088月入院。患者2007年感冒后出现多饮、多尿,每日饮水约10,000 ml,未予重视及诊治。2007年出现闭经,在外院妇产科就诊,先后予2次黄体酮肌肉注射,仍未来月经。半年前体重增加25 kg,肝区不适,肝功能示转氨酶升高。患者无便秘腹胀、无皮肤感染、无双下肢水肿,活动后稍感胸闷、气喘,夜尿增多,平均每小时1次。最大体重88.7 kg。既往史无特殊。月经史:初潮14岁,4/283020086月。

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