尸体供者小肠肝和肾脏器联合切取及保存技术.doc

尸体供者小肠、肝和肾脏器联合切取及保存技术 李元新　李幼生　李民 【摘要】　目的　建立尸体供者全腹腔脏器切取和保存技术，同时为不同的小肠移植、肝移植和肾移植受者提供供器官。方法　共进行8 次同一尸体供者的全腹腔脏器切取手术。供体切取经腹主动脉与肠系膜下静脉插管，高渗枸橼酸－腺苷肾保存液及 University of Wisconsin 液原位灌注，肝、小肠、胰腺、脾、肾整块切取。供器官经后台修整后，分别成为肝、小肠和肾移植物进行相应的受者移植手术。结果 8 次供者腹腔脏器切取和后台修整手术共获取 8 具小肠移植物、8 具肝移植物和 16 具肾移植物。利用所修整出的供器官成功地完成 5 次单独小肠移植、8 次肝移植和 16 次肾移植，术后移植物功能良好。结论　所建立的尸体供者全腹腔脏器切取和保存技术，可同时为不同的小肠移植、肝移植和肾移植受者提供供器官；借鉴美国匹兹堡大学的供者器官后台分离技术，还可同时为胰腺移植受者提供供器官。【关键词】　器官切取；器官保存；小肠移植；肝移植；肾移植；胰腺移植Techniques for procurement and preservation of intestine，liver and kidneys grafts from the samecadaveric donor LI Yuan-xin，LI You-sheng，LI Min． Research Institute of General Surgery，NanjingGeneral Hospital of Nanjing Military Command，Peoples Liberation Army，Nanjing 210002，ChinaCorresponding author： LI Yuan-xin，Email： liyuanxin1966@ yahoo． com． cn【Abstract】 ObjectiveTo establish the techniques for procurement and preservation of fullabdominal grafts from the same non-heart-beating donor，and to transplant the intestine，liver and kidneyallografts retrieved from the same donor to different recipients． MethodsEight procurements of fullabdominal grafts from the same non-heart beating donor were performed． The donor organs were harvestedin situ by infusion with hypertonic citrate-adenine solution and University of Wisconsin solution and thegrafts including the intestine，liver，pancreas，and kidneys were harvested en bloc． On the back table，the intestine，liver and 2 kidney grafts were separated from the organ cluster，and then were simultane-ously transplanted to different recipients． Results Eight procurements of the donor grafts including theback-table procedures were accomplished and all allografts were intact． Five isolated small intestine，8liver，and 16 kidney transplants were performed with these grafts． None of these allografts sustained seri-ous ischemic injury． Conclusions Our refined technique for procurement and preservation of full abdomi-nal grafts from the same cadaveric donor can harvest intestinal，liver，and kidney allo