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Transdiaphragnatic exposure for direct atrioatrial anastomosis in liver transplantation

Chinese Medical Journal 2010年第24期123卷 3515-3518页

作者： XU Ming-qing CHEN Zhe-yu YAN Lü-nan ZENG Yong WEN Tian-fu LI Bo ZHAO Ji-chun WANG Wen-tao YANG Jia-yin Division of Liver Transplantation West China Hospital West China Medical School of Sichuan University Chengdu Sichuan 610041 China

Background Liver transplantation in Budd-Chiari syndrome remains controversial; however, some improved techniques lead to better results. We report medium-term follow-up results of liver transplantation with atrioatrial anastomosis for Budd-Chiari syndrome and explore the indications of liver transplantation with atrioatrial anastomosis for patients with end stage liver *** Nine patients （six Budd-Chiari syndromes, one end stage hepatolithiasis, one hepatocellular carcinoma and one incurable alveolar echinococcosis） underwent liver transplantation with atrioatrial anastomosis in West China Hospital of Sichuan University from 1999 to 2006. Eight liver transplants used cadaveric orthotopic livers and one a living donor liver. The operative technique was transdiaphragmatic exposure for direct atrioatrial anastomosis and replacement of inferior vena cava by cryopreserved vena cava graft with the help of venovenous *** All liver transplantations were successful. Two patients contracted pulmonary infection and acute rejection took place in another case. With proper treatment, all patients recovered well and had good quality of life. To date, they have been followed up for more than 24 months. The only death followed recurrence of hepatic carcinoma three years after liver *** Transdiaphragmatic exposure for direct atrioatrial anastomosis and the cryopreserved vena cava graftreplacement of inferior vena cava are possible for patients with end stage liver disease thus extending the indications of liver transplantation.

关键词： liver transplantation atrioatrial anastomosis Budd-Chiari syndrome venovenous bypass

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