摘要
目的: 供体切取技术是器官移植的重要步骤，拟在实践中总结出一套较为合理的供体切取及修整方法，以供参考。
方法：①实验对象：2000-01/2006-12解放军总医院第二附属医院器官移植中心共完成无心跳肝肾供体切取100例，手术过程符合医学伦理学要求。采用原位肝肾分开切取24例，原位腹主动脉、门静脉双路灌注肝肾联合快速切取法切取供肝肾76例。②实验方法：对门静脉插管灌注方式进行改进，采用盆腔内引流，供肝修整顺序为下腔静脉、门静脉、肝动脉、胆道；供肾修整顺序为输尿管、肾动脉、肾静脉。③实验评估：术中观察器官色泽、张力及完整度，并记录手术操作时间。
结果：①全组供体平均热缺血时间为5 min；切取时间：肝肾分取平均为肝12 min、肾5 min，联合切取平均为15 min；保存时间平均为8 h。②全组供体均成功移植。
结论：本组开展的肝肾切取与修整技术经过长期大量的实践，逐步改进，形成了在插管、引流、手术、灌注、修整等多方面具有特点的一套方法，其最大特点是快速、实用，在临床实际应用中取得了较为满意的效果。
关键词：肝移植；肾移植；肝切除术；肾切除术；组织供者

戴新，石炳毅，金海龙.肝肾器官移植供体切取及修整实践[J].中国组织工程研究与临床康复，2008，12(5):875-877
[www.zglckf.com/zglckf/ejournal/upfiles/08-5/5k-875(ps).pdf]

Procurement and trimming of donor liver and kidney for organ transplantation

Abstract

AIM：Donor procurement technique is a major procedure in organ transplantation. We summarized a more reasonable technique on incising and chipping donor in clinic.
METHODS: ①100 cases of no heartbeat liver kidney donor were selected at Center for Organ Transplantation of Second Affiliated Hospital of General Hospital of Chinese PLA from January 2000 to December 2006. Experimental procedures were accorded with Medical Ethical Standards. Twenty-four cases were performed with orthotopic procurement individually, and seventy-six cases were performed with the technique of double orthotopic perfusions of abdominal artery and portal vein. ②Portal vein cannula perfusion was improved. Pelvic cavity drainage was performed. Donor liver was trimmed according to following orders, inferior caval vein, portal vein, hepatic artery and biliary tract. Donor kidney was trimmed according to following orders, renal duct, renal artery and renal vein. ③The color, tension, integrity of the organ and operated time are detected.
RESULTS: ①The average heat ischemia time of all the donor was 5 minutes. The operating time of liver and kidney was 12 minutes and 5 minutes individually. The average operating time of procurement liver and kidney as a union was 15 minutes. The average cold ischemia time of the donor was 8 hours. ②All the donor organs were successfully transplanted.
CONCLUSION: Technology on procurement and trimming donor organs has been improved. A group of methods have formed on intubation, drainage, surgery, perfusion and trimming. It is practical and effective, and has gained satisfactory results in clinic.

Dai X, Shi BY, Jin HL.Procurement and trimming of donor liver and kidney for organ transplantation.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2008;12(5):875-877(China)
[www.zglckf.com/zglckf/ejournal/upfiles/08-5/5k-875(ps).pdf]