肝移植术后早期高胆红素血症的原因与治疗

目的探讨肝移植术后早期发生高胆红素血症的原因和治疗。方法收集我院2001年2月至2005年2月共施行的63例肝移植手术的临床资料,分析其术前状况、供体质量、术后肝功能和辅助检查结果。结果63例肝移植患者共发生了64例次高胆红素血症,其中术前重型肝炎13例(20.6%),缺血再灌注损伤21例(33.3%),急性排斥反应15例(23.8%),胆道并发症9例(14.3%),FK506毒性反应5例(7.9%),乙型肝炎复发1例(1.6%)。结论高胆红素血症是肝移植术后常见的临床表现,其原因错综复杂,应首先明确其发生的原因,才能进行有效的治疗。

Causes and Treatment of Early Postoperative Hyperbilirubinemia after Liver Transplantation

Objective To investigate the causes and treatment of early postoperative hyperbilirubinemia after liver transplantation. Methods From February 2001 to February 2005, clinical data of 63 patients with liver transplantation were collected to analyze the condition before liver transplantation, the quality of donor, the hepatic function after liver transplantation and the results of auxiliary examinations. Results Sixty-three patients experienced 64 incidents of hyperbilirubinemia including 13 incidents of severer type hepatitis (20.6%), 21 incidents of ischemia reperfusion injury (33.3%), 15 incidents of acute rejection (23.8%), 9 incidents of biliary complications (14.3%), 5 incidents of FK506 toxicity (7.9%) and 1 incident of hepatitis B recurrence (1.6%). Conclusion Hyperbilirubinemia is a common clinical manifestation after liver transplantation with complicated causes. The key point for successful treatment is to identify the causes.