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儿童心脏死亡捐肝移植治疗儿童肝糖原累积症
Liver Transplantation in Treatment of Children with Glycogen Storage Disease by Using Liver Graft from Pediatric Cardiac Death

DOI: 10.12677/ACRP.2014.22004, PP. 13-19

Keywords: 肝移植,糖原累积症,心脏死亡,器官捐赠
Liver Transplantation
, Glycogen Storage Disease, Cardiac Death, Organ Donation

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Abstract:

目的:总结儿童心脏死亡捐肝治疗儿童肝糖原累积症的体会。方法:供者为男孩,38个月,因严重病毒性脑炎致脑死亡继发心脏死亡行器官捐献;受者为男孩,42个月,体重15 kg,生长发育迟缓,因肝糖原累积症继发肝功能不全、严重低血糖。手术采用经典原位肝移植术式,供肝热缺血时间6 min,冷缺血时间约180 min,术中留置T管和经胃空肠造瘘管。术后密切监测生命体征和移植肝功能,同时给予抗感染、改善微循环及营养支持等处理,采用他克莫司 + 甲泼尼龙片二联免疫抑制方案。结果:受者手术时间约420 min,其中无肝期约55 min,术中出血量400 ml。患儿术后2 h血糖恢复正常,6 h醒并拔除气管插管,24 h后开始经胃空肠造瘘管进行肠内营养,术后7天下床,移植肝功能恢复正常,术后18天痊愈出院。术后

References

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[2]  Ausems, M.G., Verbiest, J., Hermans, M.P., et al. (1999) Frequency of glycogen storage disease type II in the Nether- lands: Implications for diagnosis and genetic counselling. European Journal of Human Genetics, 7, 713-716.
[3]  Thomas, E.S., Anthony, J.D., Massimo, T., et al. (1993) Chimerism after liver transplantation for type IV glycogen storage disease and type I gaucher’s disease. The New England Journal of Medicine, 328, 745-749.
[4]  Bartlett, A., Vara, R., Muiesan, P., Mariott, P., et al. (2010) A single center experience of donation after cardiac death liver transplantation in pediatric recipients. Pediatric Transplantation, 14, 388-392.
[5]  Bellingham, J.M., Santhanakrishnan, C., Neidlinger, N., et al. (2011) Donation after cardiac death: A 29-year expe- rience. Surgery, 150, 692-702.

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