尸体供者小肠肝和肾脏器联合切取及保存技术.doc

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1、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UniversityofWisconsin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

2、。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Techniquesforprocurementandpreservationofintestine，liverandkidneysgraftsfromthesamecadavericd

3、onorLIYuan-xin，LIYou-sheng，LIMin．ResearchInstituteofGeneralSurgery，NanjingGeneralHospitalofNanjingMilitaryCommand，People'sLiberationArmy，Nanjing，ChinaCorrespondingauthor：LIYuan-xin，Email：liyuanxin1966@yahoo．com．cn【Abstract】ObjectiveToestablishthetechniquesforproc

4、urementandpreservationoffullabdominalgraftsfromthesamenon-heart-beatingdonor，andtotransplanttheintestine，liverandkidneyallograftsretrievedfromthesamedonortodifferentrecipients．MethodsEightprocurementsoffullabdominalgraftsfromthesamenon-heartbeatingdonorwereperfor

5、med．Thedonororganswereharvestedinsitubyinfusionwithhypertoniccitrate-adeninesolutionandUniversityofWisconsinsolutionandthegraftsincludingtheintestine，liver，pancreas，andkidneyswereharvestedenbloc．Onthebacktable，theintestine，liverand2kidneygraftswereseparatedfromth

6、eorgancluster，andthenweresimultane-ouslytransplantedtodifferentrecipients．ResultsEightprocurementsofthedonorgraftsincludingtheback-tableprocedureswereaccomplishedandallallograftswereintact．Fiveisolatedsmallintestine，8liver，and16kidneytransplantswereperformedwitht

7、hesegrafts．Noneoftheseallograftssustainedseri-ousischemicinjury．ConclusionsOurrefinedtechniqueforprocurementandpreservationoffullabdomi-nalgraftsfromthesamecadavericdonorcanharvestintestinal，liver，andkidneyallograftsandsimultane-ouslytransplanttodifferentrecipien

8、ts．Furthermore，withtheexvivoseparatingtechniqueofallograftsonbacktableoftheUniversityofPittsburgh，pancreaticgraftmayalsobesimultaneouslyharvested．【Keywords】Don