肾移植患者环孢素A肝毒性作用的回顾性研究

目的：了解环孢素Ａ在肾移植患者肝功能受损中的作用和长期服用对患者的影响。方法：回顾性分析了３组资料：（１）１９７８年７月至１９８４年应用二联免疫抑制治疗（硫唑嘌呤＋泼尼松）的肾移植患者８３例，１９８５～１９９１年应用三联免疫抑制治疗（环孢素Ａ＋硫唑嘌呤＋泼尼松）的肾移植患者５８０例；（２）１９９４年１月至１９９７年８月进行的肾移植患者５１９例；（３）随访服用环孢素Ａ免疫抑制治疗８年以上患者６８例，

Retrospective analysis of the hepatotoxicity effect of Cyclosporine A in renal transplant patients

Objective:To study the effect of hepatotoxicity of cyclosporine A and its influence on renal transplant patientsduring long term medication.Methods:(1) From August 1978 to February 1991, 663 cases of renal transplantation were done in our hospital. One hundred and sixty two cases developed liver damage (12 cases in 83 cases received bigeminy immunosuppress therapy,150 in 580 received triad immunosuppress therapy).(2) From 1994 to 1997, five hundred and nineteen cases of renal transplantation were done in our hospital. Thirty cases developed severe liver dysfunction (5.8%,30/519). (3) One hundred cases who take cyclosporine A 8 years longer were attended.Results:(1) The incidence rate of liver damage in patients received bigeminy immunosuppress therapy was lower than in triad immunosuppress therapy. (2) HCV RNA was positive in 40% and HBsAg was detected in 36.6%, both were detected positive in 93.3% of the 30 patients with severe liver dysfunction.(3) One case developed cirrhosis in 100 attending patients who take cyclosporine A 8 years longer.Conclusion: The hepatotoxicity of Cyclosporine A and hepatitis virus infections are the main causes of liver damages in renal recipients. The hepatotoxicity of cyclosporine A are partially reversible after a proper treatment. Severe liver dysfunction directly affects the outcome of renal transplant recipients.HBV and HCV infection are the major causes of liver dysfunction in the recipients. It is safe to take cyclosporine A long term by renal transplant patients.