procedures of Operation

1.   To select access route and location .

2. 　 ☆ To separate the blood vessel which will be
used to anastomose.
　 ☆ To remove the diseased organ if orthotopic
transplantation will be performed.
3. To transplant graft to proper location.
4. To anastomose the blood vessels of graft and
recipient.
5. To anastomose other ducts such as common
bile duct and ureter and so on.
 Postoperation management

1.   The general observation and nursing of

　 postoperation
2.    To observe the function of graft
3.    Supporting treatment
4.    To prevent infection
5. Immunosuppression treatment
 Rejection
★ 1. hyperacute rejection
★ 2. accelerated acute
rejection
★ 3.  acute rejection
★ 4.  chronic rejection
 Liver transplantation

Indication of liver transplantation

1.  Hepatic parenchymal diseases
Post hepatitis cirrhosis
Alcoholic cirrhosis
Fulminant liver failure
Multiple cysts of liver
2. Congentital metabolic diseases (inborn error
of metabolism)
Tyrosinemia （酪氨酸血症）
Liver transplantation

Indication of liver transplantation

Faimilial non-hemolytic jaundice ( 家族性非溶血性黄
疸)
Ghycogenosis ( 糖累积综合征 )
Hepatolenticullar degeneration (wilson’s disease) （肝豆状
核变性）
3  Cholestatic diseases
Congentitial atresia of biliary trait （先天性胆 道闭锁）
Primary biliary cirrhosis 原发性胆汁性肝硬化
Sclerosing cholengitis
Liver transplantation
Indication of liver transplantation
4. Liver Tumor
Benign multiple liver adenomatosis 多
发性肝囊腺瘤
Giant hepatic hemangioma 巨大肝血管
瘤
Cholengicarcinoma of liver 肝管细胞癌
Liver transplantation

Harvest of liver graft

   Resection and harvest of liver

★ From Brain-death donor
★ From nonheart-beating donor
★ From living-related donor: right
lobe,left lobe and left lateral lobe of liver
 
liver transplantation

 Classification of liver transplantation

1 Othotopic liver transplantation
★ Classical or traditional liver transplantation
★ New methods of orthotopic transplantation
　⑴ Reduced-size liver transplantation
　　⑵ living related liver transplantation
　　⑶ Splitting liver transplantation
　　④ Pippy back liver transplantation
2.Heterotopic liver transplantation
 Indication of renal transplantation
Irreversible renal function failure caused by renal
diseases
1. Glomerulonephritis( 肾小球肾炎 )
2. Chronic pyelonephritis （慢性肾盂肾炎）
3. Genetic diseases such as congentital polycystic
kidney （先天性多囊肾）
4. Diabetic nephropathy （糖尿病肾病）
5. Toxicosic diseases such as heavy-metal toxicosis （重
金属中毒）
6. Acute progressive irreversible renal function failure
acute tubular necrosis (ATN)
7. Other renal disease:
renal trauma and renal tumor
Kidney transplantation

Harvest of donor kidney

From living-related donor.
From brain-death donor .
From nonheart-beating donor .
Procedures of renal transplantation
Orthotopic renal transplantation : in
renal fossa
Heterotopic renal transplantation : in
iliac fossa
 Indication of pancreas and
pancreas-kidney transplantations
 1. pancreas transplantation
Insulin-dependent diabetes(type I ) to has
complication or to be appearing
complication
 2.  pancreas-kidney transplantation
 Type I diabetes with renal failure
 Type II diabetes with renal failure
needing insulin treatment
 Procedures of pancreas and
pancreas-kidney transplantation
1. Site of transplant
★ to put pancreas in right iliac fossa
　　　 ★ to put kidney in left iliac fossa
2.   Reconstruction of blood vessels
3.   Management of donor pancreatic excorine secretions
★ pancreatic duct obstruction
★bladder drainge
★ jejunum drainge
4. Management of ureter
★anastomosis of donor’s ureter and recipient’s
bladder
 Heart transplantation
 Indication
 Irreversible end stage cardiac dieases.
Operation
 Orthotopic heart transplantation
 Heterotopic heart. transplantation
Indication and operation of
lung-transplantation
Indication
1.   End-stage pulmonary fibrosis
2.  Idiopathic pulmonary fibrosis( 原发性肺纤维
化)
3 ． Chronic obstructive non-infective pulmonary
diseases. Paeumonectasis( 肺气肿 )
4 ． Pulmonary hypertension
5. Chronic and infective pulmonary diseases:
bronchiectasis( 支扩 )
Operation of the lung transplantation

1. operation of unilateral lung

transplantation
2. operation of bilateral lung
transplantation.
3. lung-heart transplantation
 Other organs and cells
transplantation
 1. intestine transplantation
 2. spleen transplantation.
    3.  parathyroid transplantation
 4.  adrenal gland transplantation
        5. testis transplantation
6. ovary transplantation
        7. pancreatic islet transplantation
 8. bone marrow transplantation
The end