肝移植术后移植物抗宿主病的诊治进展  

Progress of the giagnosis and treatment of postoperative liver transplant-associated graft versus host disease

作　　者：朱晓璐[1] 郑树森[2] Zhu Xiaolu;Zheng Shusen(Zhejiang University School of Medicine,Hangzhou 310058,China;Department of Hepatopancreatobiliary Surgery,the First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou 310003,China)

机构地区：[1]浙江大学医学院,杭州310058 [2]浙江大学医学院附属第一医院肝胆胰外科,杭州310003

出　　处：《中华移植杂志（电子版）》2019年第1期75-80,共6页Chinese Journal of Transplantation(Electronic Edition)

基　　金："十三五"国家科技重大专项(2017X10203201)

摘　　要：肝移植术后移植物抗宿主病(GVHD)发生率低,但病死率极高,典型症状包括不明原因发热、皮疹、腹泻和骨髓抑制。其发病机制目前尚未完全阐明,诊断缺乏统一标准,治疗缺乏特异性手段。近年来,针对GVHD免疫反应进程中的病理生理学研究,为开辟新的诊断方法和治疗手段提供可能。目前,大剂量糖皮质激素联合静脉注射免疫球蛋白冲击、免疫抑制剂减少或停用可能是较为有效的治疗方案。而对于糖皮质激素难治性GVHD,应用多种不同的分子靶向药物可能对改善受者预后起到积极作用。The incidence of graft versus host disease(GVHD) after liver transplantation is low, but the mortality rate is extremely high. The typical symptoms are: unidentified high fever, tetter, diarrhea and myelosuppression. The standardized treatment of GVHD after liver transplantation remains unclear. It is probably more effective to use high- dose of methylprednisolone combined with intravenous immunoglobulin, withdrawing or decline the dosage of immunosuppressant to treat GVHD after liver transplantation. For the hormone- refractory GVHD, the application of a variety of targeted drugs of cytokine or chemokine may play a positive role in improving the prognosis of patients.

关 键 词：肝移植 移植物抗宿主病 发病机制 药物治疗 

分 类 号：R657.3[医药卫生—外科学]