肾移植术后肝功能异常的临床分析

目的总结肾移植术后肝功能异常的病因及其预防。方法回顾性分析肾移植后发生肝损伤者的临床资料。结果68例患者出现肝损伤，其中21例发展至肝功能衰竭，肝损伤的原因主要有肝炎病毒(乙型肝炎病毒、丙型肝炎病毒)感染、免疫抑制剂肝毒性等。多数患者术后1年内出现肝功能异常临床表现，主要有丙氨酸转氨酶升高、乏力、纳差、黄疸、腹胀、肝性脑病、出血等。结论术前应对肾移植受者的肝脏情况进行严格的综合评估，术后定期进行相关检查，尤其是术前检查有阳性发现者。

Clinical analysis of liver dysfunction after renal transplantation

Objective To summary the pathogenic causes and therapeutic methods of liver dysfunction after renal transplantation.Methods Sixty-eight cases of kidney transplantation were analyzed retrospectively. Results Forty-seven patients had liver function injury with the incidence of 4.21 %. Twenty-one cases suffered from liver failure with the incidence of 1.88 %. The major pathogenic causes included the history of chronic hepatitis and cirrhosis, active status of hepatitis, superinfection of hepatitis and the administration of immunosuppressive agents. The liver injury and liver failure occurred in one year after kidney transplantation in most patients. The major clinical manifestations included the elevation of ALT, severe fatigue and poor appetite, higher jaundice, abdominal distention, liver coma, bleeding and hepatic-renal syndrome and so on.Conclusion Liver injury and liver failure were commonly occurred in patients with hepatitis after kidney transplantation. The history of hepatic diseases, active status of hepatitis and immunosuppressive agents are major inducements. It was suggested that preventive and treating measures should be constituted by both physicians and surgeons. Liver transplantation should be performed at suitable chance.