HBV携带者供体肾移植术后并发原发性肝癌一例及文献复习  

A case of primary liver cancer after donor kidney transplantation from an HBV-carrying donor and literature review

作　　者：林怡如 刘林林[1] 丁国锋[1] LIN Yiru;LIU Linlin;DING Guofeng(Department of Infectious Diseases,Binzhou Medical University Hospital,Shandong Province,Binzhou256600,China)

机构地区：[1]滨州医学院附属医院感染性疾病科,山东滨州256600

出　　处：《中国当代医药》2022年第13期161-163,168,共4页China Modern Medicine

摘　　要：本文回顾性分析1例接受乙肝病毒携带供体肾脏器官移植术后10年并发肝癌并肝内多发转移患者的诊治情况。该患者于2010年因“肾功能衰竭”接受乙型肝炎患者供体肾脏,手术过程顺利,术中输血情况不详,恢复尚可。患者移植术后规律服用抗排异药物,但并未规律进行抗病毒等相关治疗,也未定期随访甲胎蛋白(AFP)、乙型肝炎病毒脱氧核糖核酸(HBV-DNA)定量以及肝脏影像学等相关检查,于2019年10月确诊肝癌并肝内多发转移,后于2020年3月死亡。本文旨在探讨接受乙肝病毒感染供体器官移植后,进行规律抗病毒治疗以及肝脏相关功能定期随访的必要性,对于有条件的患者,应在移植术前进行抗病毒治疗,从而减少乙肝病毒相关器官移植术后恶性肿瘤的发生,进而提高供体器官的使用有效率,减少死亡率。This article retrospectively analyzes the diagnosis and treatment of a patient who received a hepatitis B virus-bearing donor kidney organ transplant 10 years after concomitant hepatocellular carcinoma with multiple intrahepatic metastases.This patient received a donor kidney from a patient with hepatitis B in 2010 due to"renal failure".The procedure went well,intraoperative blood transfusion is unknown,and recovery was fair.The patient took anti-rejection drugs regularly after transplantation,but did not take antiviral treatment regularly,nor did he have regular follow-ups for alpha fetal protein(AFP),hepatitis B virus DNA(HBV-DNA)quantification,and liver imaging,etc.He was diagnosed with hepatocellular carcinoma and multiple metastases in the liver in October 2019 and died in March 2020.The purpose of this study was to investigate the necessity of regular antiviral therapy and regular follow-up of liver-related functions after receiving hepatitis B virus-infected donor organ transplantation,and for patients who are eligible,antiviral therapy should be administered before transplantation,thus reducing the occurrence of malignant tumors after hepatitis B virus-related organ transplantation,and thus improving the efficiency of donor organ use and reducing mortality.

关 键 词：肾移植 原发性肝癌 乙肝病毒 器官移植 肾功能衰竭 

分 类 号：R617[医药卫生—外科学]