原位肝移植治疗急性重型乙型肝炎

目的 探讨原位肝移植治疗急性重型乙型肝炎的效果。方法 在体外静脉转流下对７例急性重型乙型肝炎患者行原位肝移植，５例患者伴有不同程度的肝性脑病，１例合并急性肾功能衰竭，１例合并上消化道大出血。术后存活者均服用拉咪呋啶预防乙型肝炎的复发。结果术后５例存活，２例死亡。术胶伴有肾功能衰竭的１例，术后３ｄ死于多器官功能衰竭；另１例术后４４ｄ死于重型肝炎（复发）。５例存活者观察期内（２～６个月）未见乙型肝炎

Orthotopic liver transplantation to treat patients with fulminant Hepatitis-B

Objectives To investigate the therapeutic effects of orthotopic liver transplantation in the treatment of fulminant hepatitis B and the efficiency of lamivudine on recurrence of hepatitis B. Methods Seven patients with fulminant hepatitis B received orthotopic liver transplantation under veno venous bypass. All patients had serious jaundice, ascites and hemorrhagic tendency, and of whom 5 were associated with encephalopathy, 1 with acute renal failure, and 1 with gastrohemorrhage. Results Five patients survived for 2 to 6 months after transplantation, 2 died of multi organ failure or recurrence of fulminant hepatitis B . No recurrence of hepatitis B was found in the 5 survival patients taking lamivudine. Conclusions Orthotopic liver transplantation is an effective therapy for fulminant hepatitis B, and lamivudine may prevent recurrence of hepatitis B after transplantation.