The 82-year-old Li Bo has suffered from polycystic liver and polycystic kidney for more than 20 years, and the 9-month-old baby Xiaohong has been congenital biliary atresia and has severe cirrhosis and liver failure, and both of them have entered the countdown......
Fortunately, thanks to the mature split-out liver transplantation technology of the Third Affiliated Hospital of Sun Yat-sen University (hereinafter referred to as the Third Affiliated Hospital of Sun Yat-sen University), one donor liver was split into two and placed into the abdominal cavity of two people, and Li Bo and Xiaohong were given a new life.
The surgery was carried out in 2021. Among the split liver transplantation operations reported internationally at that time, Li Bo was the oldest recipient, and the two were also the couple with the largest age difference.
Similar miracles of life have happened here many times. Now, the key points of technology that can bring hope to more lives will reach the desks of more doctors.
Recently, the first monograph in the field of split liver transplantation in China - "split liver transplantation" was released in Guangzhou, which is based on the development of split liver transplantation technology at home and abroad, systematically summarizes the clinical practice of the liver transplantation center of the Third Hospital of Zhongshan in recent years, and expounds the whole process of split liver transplantation.
劈离式liver transplant
The same efficacy as whole liver transplantation has been achieved
Liver transplantation has been widely accepted as the only effective treatment for end-stage liver disease, but the shortage of donors has always been a worldwide problem affecting its in-depth development. In this context, split liver transplantation technology has emerged, which expands the source of organ supply through surgical techniques, so that more patients can shorten the waiting time or obtain transplant opportunities.
However, this also means more sophisticated technical requirements. At present, among the nearly 200 units with liver transplantation qualifications in China, no more than 10 can carry out split liver transplantation on a large scale.
"One liver and two recipients are more complex than whole liver transplantation, and donor evaluation, donor liver splitting, surgical skills, and perioperative management need to be strictly controlled. Yang Yang, vice president of the Third Hospital of Sun Yat-sen and leader of liver surgery, pointed out.
Yi Shuhong, director of the organ transplantation department of the hospital, said that split liver transplantation is growing rapidly, with the overall proportion increasing from 1.25% in 2016 to 8.6% in 2021, and the number of child recipients increasing from 8% in 2017 to 18.8% in 2021. The surgical technology and efficacy have gradually improved, and the gap with mature transplant centers in Europe and the United States has been narrowing.
At the same time, the Third Hospital of Zhongshan has also built an exchange platform to promote the popularization of technology and solve difficult problems. In October 2020, he took the lead in cooperating with 25 liver transplantation centers in South China to establish the South China Split Liver Transplantation Alliance in China, held the alliance's academic forums for three consecutive years, and released the first expert consensus on split liver transplantation in China, the expert consensus on the evaluation of split liver transplantation donors and donors, and the Chinese expert consensus on vascular segmentation and reconstruction of split liver transplantation.
On the basis of the accumulation of previous experience, the liver transplantation team of the Sun Yat-sen Group of Hospitals compiled the book "Split Liver Transplantation", which shared the experience and wisdom of many years in combination with clinical practice. The book consists of 17 chapters, including the selection, evaluation and matching of donors and recipients, the methods and surgical techniques of donor liver splitting, the operation of recipients, anesthesia management, postoperative complication management, follow-up management and other core contents.
"At present, more than 200 cases of split liver transplantation have been carried out in the Third Hospital of Sun Yat-sen, and the follow-up results show that the technology has reached a mature level and achieved the same efficacy as whole liver transplantation. Yang Yang said that this book strives to give practical, comprehensive and effective guidance, hoping to let more liver transplantation centers across the country master and apply split liver transplantation technology, and work together to develop the technology to a higher level and benefit more patients.
Reporter | Yue Chaoqun
编辑 | 尹蓁 责编 | 张秀丽
通讯员 | 周晋安 甄晓洲
Produced by the Guangdong Health Online all-media team