肾移植术后早期环孢菌素A引起的肝损害

目的探讨肾移植术后3个月CsA免疫抑制剂的肝损害治疗措施.方法对19例出现肝功能异常的病例进行分析,测定肝功能异常时CsA的谷值浓度.及时调节免疫抑制剂用量,配合保肝利胆治疗.结果17例于2～4周肝功能恢复正常.2例无效,将CsA改为FK506后1个月后,肝功能指标逐渐恢复正常.结论低剂量CsA、MMF、pred三联是目前理想的免疫抑制治疗方案,结合保肝治疗,对减少术后早期CsA肝毒性的发生有一定疗效.

Cyclosporine induced liver damage in early stage after kidney transplantation

Objective: To investigate the liver damage in early postoperative period and the measures for prevention and treatment. Methods:19 patients having abnormal liver function after kidney transplantation were analyzed. ALT or/and BIL were increased in all the patients. The triple-combined immunosuppression was adjusted. Active therapy was co-administered to decrease liver injury and protect liver function as well.Results: Liver function of 17 cases recovered. In the 2 cases with administering of Fk506 when CsA was stopped, ALT and BIL recovered after treatment for 1 month. Conclusions: With active therapy to decrease liver injury and protect liver function, the triple-combined immunosuppressive protocol(low dosage of CsA ?MMF and pred) is an ideal regimen of immunosuppressive therapy.