95例次肝移植臨床分析

Objective To reportthe experience oflivertransplantationin patients with terminalliver diseases and de velopment of the new surgicaltechnique in liver transplantation . Methods From October 1991 to April 1999 ,92 patients in Queen Mary Hospital underwent 95 orthotopic liver transplantations. The liver grafts were obtained from 58brain death donors and 37 living donors . Thirty - eight hepatitis Bpositive patients received liver transplantation . Thenew drug Lamivudine(100 mg/d) was given before and after the operation . Eightliver cancer patients with cirrhosis un derwentliver transplantation . Results The one - year survivalrate of the liver grafts was 86.3% (82/95) . The one -year survivalrate of patients was 87.0 % (80/92) . The recurrence - free survivalrate at 3 years was 100% . Twelve pa tients died within 1 year. Conclusion Liver transplantation is a feasible and viable treatment for patients with end -stageliver diseases and selective H C C. The innovation of technique breaks through the limitation ofliving related donorliver transplantation . To a certain degree ,living related donor liver transplantation can solve the problem of donor short age . The application of Lamivudine gives hope to hepatitis Bpositive patients 目的 探討肝臟移植治療各種終末期肝病的療效，探索肝臟移植手術的方法。方法 從１９９１ 年１０月至１９９９ 年４ 月，香港大學瑪麗醫院為９２ 例終末期肝病病人做了９５ 例次肝移植。尸肝移植５８ 例，活體肝移植３７ 例。３８ 例乙肝表面抗原陽性病人接受了肝移植，術前和術后口服抗乙肝新藥 Ｌａｍｉｖｕｄｉｎｅ（１００ ｍｇ／ｄ） 。８ 例肝癌病人接受了肝移植術。結果 肝移植后移植肝１ 年成活率為８６.３ ％ （８２／９５） 。肝移植病人１ 年生存率為８７.０ ％ （８０／９２） 。本組肝癌病人移植術后３ 年無復發生存率為１００ ％ 。１２ 例病人在肝移植后１ 年內死亡。結論 肝臟移植是唯一能挽救終末期肝病病人生命的方法。移植手術的創新突破了活體肝移植的種種限制，活體肝移植在一定程度上緩解供體短缺的矛盾。新藥的應用使得乙肝病人獲得肝移植機會。伴有嚴重肝硬化的較早期肝癌病人是肝移植的一個很好的適應證