肾移植术后的肝功能异常

为探讨肝功能异常对肾移植患者存活的影响，对４８例肾移植前后发生肝功能异常的病例资料进行分析。术前乙型肝炎病毒表面抗原（ＨＢｓＡｇ）阳性，伴或不伴丙氨酸转氨酶（ＡＬＴ）升高者３２例，术后肝功能正常者１８例，肝功能异常但经治疗预后好者６例，预后差者８例；术前仅ＡＬＴ升高者９例，术后肝功能正常者３例，肝功能异常但经治疗预后好者５例，预后差者１例；术前肝功能正常，术后发生肝功能异常者２８例，大部分系药物的肝毒性所致，经治疗预后好者１４例，预后差者１４例。认为ＨＢｓＡｇ阳性和ＡＬＴ异常并非肾移植术的禁忌证；对药物的肝毒性应引起足够的重视。

The abnormality of liver function following renal transplantation

In order to investigate the effects of the abnormality of liver function on the survival of the patients undergoing renal transplantation,the data of 48 patients having liver function abnormality pre-and post-transplantation of kidney were analyzed. After operation, 32 cases showed positive hepatitis B surface antigen(HBsAg)with or without an increase of ALT.After operation,liver function was normal in 18 cases.6 cases revealed abnormal liver function with fawmrable prognosis following treatment,while other 8 cases with unfavourable prognosis.Nine cases only showed an increase of ALT before operation.After operation,liver function was normal in 3 cases;liver function was abnormal with good prognosis in 5,bad prognosis in one.28 cases of preoperative normal liver function showed postoperative liver function abnormality mostly induced by the hepatoxication of the drugs.Of them,14 cases obtained good prognosis and 14 bad prognosis after the treatment.It was suggested that positive HBsAg and ALT abnormality was not the controindications for renal transplantation and full attention should pay to the drug's hepatoxication.