肝移植106例术后急性排斥反应的诊断和治疗

目的:总结肝移植急性排斥反应的新表现及诊治经验. 方法:回顾我中心106例肝移植资料,对其中发生急性排斥反应病例的临床表现、病理组织学改变、诊治方案加以分析. 结果:106例肝移植中,术后发生急性排斥反应17例(16.0%);其中临界型1例,轻度6例,中度7例,重度3例. 这些病例在具备病理组织学改变的同时缺乏典型的临床特征和肝功能生化指标的改变. 结论:由于强效免疫抑制剂的应用,肝移植术后急性排斥反应发生的临床症状和体征不典型,我们应该重视急性排斥反应的诊断并积极治疗.

Diagnosis and treatment of acute rejection following liver transplantation: 106 cases report

AIM: To summarize the new clinical manifestations of acute rejection (AR) following liver transplantation and discuss the diagnosis and treatment of AR. METHODS: A total of 106 cases with liver transplantation in our center were retrospectively analyzed, with regard to the pathologic changes and clinical manifestations of AR, and the diagnosis and treatment of it. RESULTS: Among the 106 cases, 17 (16.0%) suffered with AR after liver transplantation, consisting of 1 critical AR, 6 mild AR, 7 moderate AR and 3 severe AR. However, all 17 cases which had pathologic changes were lack of typical clinical manifestations and biochemical changes. CONCLUSION: With the use of superactive immunosuppressive drugs, AR following liver transplantation is lack of typical clinical manifestations, therefore we should pay attention to the importance of the diagnosis and treatment of AR.