检索历史 清除

摘要Since the first liver transplantation in the world, liver transplantation has become the most effective means to treat all kinds of liver disease and hundreds of thousands of patients with end-stage liver disease around the world. The source of donor liver has always been a very big problem, so expanding the source of donor liver has always been a problem. After the first successful reduction of liver transplantation, one liver can be transplanted into two recipients, thus expanding the source of liver donors. Statistics show that SLT surgery can improve donor availability by 20%, which solves the problem of donor availability for experts in this field.<br>　　The ideal splitting donor is obviously young people, has non liver disease history and normal liver enzymes, stable hemodynamic and hospital stay was short in other words age, ABO compatibility, size matching, liver function, vasopressor demand, lack / insufficiency of arrest time, shortened donor hospital stay and serum sodium concentration have been used in various studies to narrow the scope of donor selection and achieve the best prospect. In recent years, some people have proposed different criteria for donor segmentation, and the standards of countries and transplant institutions are different. NITp established a specific multicenter SLT program in 1997. In a recently released report, the following donor eligibility criteria for segmentation surgery are listed: age less than 60 years, length of stay in intensive care unit less than 5 days, low muscle strength support (dopamine 5 g / kg / min, dobutamine 10 g / kg / min, no adrenaline or noradrenaline), The liver function test was close to normal.<br>　　UNOS method, MELD scoring model and waiting list criteria are adopted by the transplantation community almost all over the world because it can provide a better matching ratio between donors and recipients. The size matching of graft to receptor weight ratio (grwr) is very important; Although a grwr of 0.6% for LDLT may be acceptable, a grwr of at least 0.8% is recommended for deceased donor isolated liver transplantation in adult recipients.<br>　　Statistics of patients receiving split liver transplantation was analyzed in the Department of liver transplantation of the Affiliated Hospital of Qingdao University from January 2015 to January 2022. Firstly, the general clinical data of split liver transplantation in our center and the recovery of transplanted liver function after follow-up were statistically analyzed (divided into more than 3 years, 1 ~ 3 years and 1 year).<br>　　From January 2015 to January 2022, a total of 62 patients received split liver transplantation in the liver transplantation Department of the Affiliated Hospital of Qingdao University, including 27 males and 35 females; 43 adults and 19 children; 8 cases were transplanted in vivo (including 4 cases of left lateral lobe, 3 cases of left half liver and 1 case of right half liver), and 54 cases of DBD division in vivo; The donors were left lateral lobe in 12 cases, left half liver in 12 cases, right half liver in 14 cases and right third lobe in 24 cases; The causes of adult include 14 cases of liver malignant tumors, 13 cases of decompensated cirrhosis after hepatitis B, 4 cases of cirrhosis after autoimmune hepatitis, 3 cases of drug-induced liver damage and 9 cases of liver failure from other causes. There were 7 cases of biliary atresia, 8 cases of congenital metabolic diseases (including 2 cases of hepatolenticular degeneration) and 4 cases of liver failure due to other causes.<br>　　Results: After running the T-test in stata for data comparing of ALT, AST, ALB, Cr, TB, ALP, GGT and Lac. The comparison levels showed that there was significant difference in levels of ALT on 2nd, 4th, 5th, 6th and 7th and Lac at 1st day after operation between control and re-construction group. There was no significant difference in levels of AST, ALB, Cr, TB, ALP and GGT in any of data we collected (P ＜ 0.05).