乙型肝炎后肝硬变终末期行肝移植术的可行性探讨

目的　对乙型肝炎后肝硬变终末期行肝移植术的可行性探讨。方法　报告 1例乙型肝炎后肝硬变终末期在肝移植术后接受 lamivudine(拉米沃丁 )系统治疗后 ,乙型表面活性物质及 PCR- HBV- DNA的变化过程 ,分析在肝移植术中为最大程度地去除 HBV寄宿器官所能采取的可行性措施 ,并观察围手术期应用lamivudine治疗后乙型表面活性物质及 PCR- HBV- DNA的变化状态。结果　该例患者术前 HBs Ag(+ )、Anti-HBe(+ )、Anti- HBc(+ )、PCR- HBV- DNA(+ ) ,术后第 7d始 ,HBs Ag转阴、PCR- HBV- DNA转阴 ,肝功能正常 ,术后 6 0 d保持上述病毒抑制状态。结论　必须重新认识乙型肝炎后肝硬变行肝移植的传统观念 ,对该例患者行肝移植手术是可行的。

Feasibility probe of orthotopic liver transplantation for termi nal posthepatitic cirrhosis

Objective To study the feasibility of orthotopic liver transplantation for the most end-stage cirrhosis behind hepatitis B.Methods One case of the most end-stage cirrhosis behind hepatitis B accepted lamivudine system curing after orthotopic liver transplantation.Change course of surface active substance and PCR-HBV-DNA of the hepatitis B has been observed.Several workable measures were taken in the operation to remove the HBV lodging organs to a maximum,and were analyzed.Results Virological screening showed that of the four positives (HBsAg,Anti-HBe,Anti-HBc,PCR-HBV-DNA),HBsAg,PCR-HBV-DNA turned negative on the 7 th day after operation,with a normal liver function;above-mentioned inhibitory state remained up to 60 days after operation.Conclusion The traditional concept that liver transplantation could not be carried out for the patient with liver cirrhosis behind hepatitis B must be reconsidered,our orthotopic liver transplantation has proved successful as an instance.