肝移植术后早期环孢素微乳剂的应用体会

通过对两例成功的背驮式的位肝移植术后早期环孢素的应用观察，我们发现：（１）术后早期移植对环孢素的耐受能力较差，环孢素引起移植肝中毒表现在以直接胆红素升高为主的阻塞性黄疸，而对丙氨酸酶ＡＬＴ恢复无明显影响。（２）与肾移植不同，移植肝往往在早期排斥和中毒并存。术后１周左右容易发生急性排斥，术后２－３周后可能会出现一定程度的免疫耐受。（３）术后口服环孢纱最后用环孢素微乳剂，浓度适宜控制在３００－５００ｎ

The application of Neaoral in the early stage of liver transplantation

Two cases of piggy-back liver transplantation was given cyclosporine A(CsA)inthe early stage after operation.It was found that:(1)The tolerance of the transplanted liver inthe early stage to CsA was poor.The hepatotoxicity induced by CsA mainly revealed the increaseof direct bilirubin(D-BIL)without obvious influenee on the ALT;(2)The rejection reaction andhepatotoxicity coexisted in the early stage of liver transplantation,which was different from thatof kidney transplantation.Acute rejection reaction easily occurred about one week after operationand some degree of immunotolerance emerged at 2nd or 3rd week after operation;(3)When CsAgiven orally after operation,it is better to use Neaoral with the range of concentration of CsA be-days to make the transplanted liver smoothly recover without rejection and hepatoxicity.