LIVING RELATED LIVER-TRANSPLANTATION

被引:48
作者
MAKUUCHI, M
KAWARAZAKI, H
IWANAKA, T
KAMADA, N
TAKAYAMA, T
KUMON, M
机构
[1] First Department of Surgery, Shinshu University, School of Medicine, Matsumoto, 390
[2] Department of Pediatric Surgery, University of Tokyo, Faculty of Medicine, Tokyo
[3] Department of Experimental Surgery, National Children's Medical Research Center, Tokyo
[4] Department of Surgery, National Cancer Center Hospital, Tokyo
[5] Noshi Central Hospital, Kohchi
来源
SURGERY TODAY-THE JAPANESE JOURNAL OF SURGERY | 1992年 / 22卷 / 04期
关键词
LIVER TRANSPLANTATION; LIVING DONOR; WARM ISCHEMIA; REDUCED SIZE GRAFT;
D O I
10.1007/BF00308735
中图分类号
R61 [外科手术学];
学科分类号
摘要
Liver transplantation from a brain death donor has not yet been accepted in Japan. The only alternative method at present is transplantation from a living donor. After the first successful living related liver transplantation was performed by Strong in Brisbane, Australia, Japanese hepatic and transplant surgeons also began to perform such operations. As of February 1991, 16 living related liver transplantations had already been performed in Japan, mainly for children with biliary atresia. Five of these patients subsequently died, however, our patient has survived more than 1 year, and she is presently leading a normal school life. The most important issue regarding living related liver transplantation is to ensure the donor's safety. For this purpose, we conducted a preoperative banking of the donor's own blood and plasma. In addition, a selective vascular occlusion was carried out to reduce blood loss during the resection of the liver. Intraoperative color Doppler ultrasonography was introduced for evaluating the circulation of the graft. By using this modality, the following three points were able to be accurately estimated in order to obtain optimal graft perfusion: 1) The most suitable position for the graft to be fixed to the abdominal wall, 2) whether or not the abdominal wall could be closed and 3) the indication for a ligation of the collateral veins to form a porto-systemic shunt. Thanks to these procedures, living related liver transplantations have now become an acceptable transplant method, however, a transplantation from a cadaver that is brain dead but still has a beating heart is still absolutely necessary for adult recipients. Therefore, in the future, both methods should be performed.
引用
收藏
页码:297 / 300
页数:4
相关论文
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