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目的:研究辅助式肝移植行功能性分流治疗门静脉高压症肝脏血流动力学的变化规律及病理生理学机制。方法:回顾性分析2014年7月至2018年12月在首都医科大学附属北京友谊医院以活体供肝方式的小体积移植物行功能性分流治疗门静脉高压症患者临床资料，共纳入6例患者为研究对象，其中4例男性，2例女性，中位年龄35.5(29.0～52.0)岁。采集患者术中及术后血流监测数据，分析肝脏血流动力学变化特征。结果:移植术后自体残肝门静脉血流量逐渐减少至无血流灌注，同时伴随肝动脉血流速度明显升高。移植肝门静脉血流量在术后早期逐渐增加；后由于移植肝门静脉灌注阻力增加导致门静脉血流量呈下降趋势；至术后第10天，移植肝门静脉血流量再次逐渐增加，并在术后第30天移植肝门静脉流量达峰值并开始下降至稳态。腹腔引流量在术后第5～10天达到峰值后呈缓慢下降趋势，在术后第30天腹腔引流液消失。结论:利用辅助式肝移植行功能性分流治疗门静脉高压症时，自体残肝能够作为移植肝门静脉高灌注的压力梯度引导性缓冲，并在术后1月左右达到血流分布稳态，同时依赖自体残肝肝动脉缓冲反应预防小肝综合征的发生。“,”Objective:To study the hepatic hemodynamics changes and pathophysiological mechanisms of the use of a functional shunt after auxillary liver transplantation to treat portal hypertension associated with a small-for-size graft.Methods:A retrospective analysis of the clinical data of patients with portal hypertension treated with functional shunting of small-volume grafts from a living donor liver at the Beijing Friendship Hospital, Capital Medical University from July 2014 to December 2018, and a total of 6 patients were included as the research objects, including 4 males and 2 females, with a median age of 35.5 (29.0-52.0) years old. Blood flow monitoring data were collected during and after operation, and the characteristics of liver hemodynamics were analyzed.Results:The portal venous blood flow of the remnant native liver gradually decreased to no flow. As a buffer response, the flow velocity of hepatic artery increased. The portal venous blood flow of the graft gradually increased in the early postoperative period and then gradually decreased from post-operation Day 5 to 10 due to gradual increase in portal venous resistance. However, the portal venous perfusion gradually increased from Day 10 after the operation, reached to a level and declined to a stable level about 1 month after the operation. The volume of abdominal drainage slowly decreased after the peak level at Day 5-10 after the operation, and disappeared completely at Day 30 after operation.Conclusions:When using auxiliary liver transplantation for functional shunting to treat portal hypertension, autologous residual liver can act as a guide buffer for the pressure gradient of portal vein hyperperfusion in liver transplantation, and reach a steady state of blood flow distribution about 1 month after surgery, while relying on autologous remnant liver hepatic artery buffer response prevents small liver syndrome.