肝移植术后早期肝功能异常受者22例的临床分析  

Clinical analysis of 22 cases of early liver dysfunction after liver transplantation

作　　者：张晓飞[1] 李瑞东[1] 杨鑫[1] 张全保[1] 陆吉麟[1] 金嫣婷 钦伦秀[1] 陶一峰[1] 王正昕[1] 

机构地区：[1]复旦大学附属华山医院普外科,上海200040

出　　处：《中华器官移植杂志》2015年第10期590-595,共6页Chinese Journal of Organ Transplantation

基　　金：国家自然科学基金（81270551）

摘　　要：目的探讨肝移植术后近期肝功能异常的病因及处理措施，并探讨巴利昔单抗的应用对术后发生排斥反应的影响。方法对复旦大学附属华山医院106例肝移植中22例术后1个月内发生肝功能异常的病例进行统计分析，统计22例的临床数据，分析近期肝功能异常的类型，与排斥反应及排斥反应严重程度的相关性，以及巴利昔单抗对排斥反应的影响。结果15例发生急性排斥反应（15／22，68．2％）。肝功能异常类型与是否发生排斥反应及排斥反应的严重程度有一定相关性；应用巴利昔单抗患者急性排斥反应的发生率为（8．8％），低于无诱导方案者的16．7％。结论在术后早期肝功能异常的情况下，应首先考虑急性排斥反应。巴利昔单抗诱导可能对降低肝移植术后早期急性排斥反应的发生率有一定作用。Objective To investigate the etiology and treatment measures of short-term liver dysfunction in the postoperative liver transplantation cases and explore the effect of application of Basiliximab on postoperative rejection. Method Among 106 cases of liver transplantation in Huashan Hospital of Fudan University, 22 cases of liver dysfunction within 1 month after operation were statistically analyzed. The type of liver dysfunction, its correlation with rejection and the severity of rejection, and the effect of Basiliximab on rejection were statistically analyzed. Result Acute rejection occurred in 15 cases （15/22, 68. 2%）. There was an association between the type of liver dysfunction and the severity of rejection. The acute rejection incidence （8.8 % ） in patients given Basiliximab was lower than that in the non-induction group （16. 7%）. Conclusion In the cases of early postoperative liver dysfunction, the acute rejection can be the first consideration. There are positive effects of Basiliximab induction on reduction of the early acute rejection after liver transplantation.

关 键 词：肝移植 移植物排斥 

分 类 号：R657.3[医药卫生—外科学]