PBLT AND THE CONCERNED PROBLEMS (WITH A REPORT OF 48 CASES)

摘要：Objective:To study the new surgical technique by piggyback of liver transplantation(PBLT) used to treat end-stage liver disease.Methods:Forty-eight cases of PBLT have been performed by author in 45 patients from September, 1995 to December,2000. The piggyback procedure was used in all cases, which included 4 retransplantation and 3 combined kidney-liver transplantation(CKLT), 3 Orthotopic inferior vena cava(IVC)-bridge-atrium LT and 1 paraorthotopic IVC-bridge to atrium LT, 1 auxiliary combined hepatovenal transplantation(ACHRT), and 1 auxiliary combined hepatointestinal transplantation (ACHIT).Result:All performances were successful and no technique-related complications occurred. The longest survival of liver malignancy that had PBLT was 1 year and 4 months, and the other 2 patients of benign end-stage liver disease who had PBLT have survived 4 years and 10 months and 5 years and 6 months respectively with a life of good quality. The survival rate of the benign end-stage liver disease that had PBLT since the end of 1998 is 67%. The 2 cases who had CKLT and 1 case ACHRT had been living more than 1 year and 2 year six months.Conclusion:As the new technique being used since the end of 1980s, the PBLT procedure is better than the classical one because no veno-venous bypass is needed and the hemodynamics are stable. The difficulty with the procedure is the removal of the patient's liver, a series of ameliorations have been done, which include auxiliary LT technique and second PBLT technique.