肝移植后乙型肝炎的复发和防治

目的 探讨乙型肝炎所致肝硬变患者施行原位肝移植后乙型肝炎复发的影响因素、临床诊断和治疗方案。方法 ２例乙型肝炎后肝硬变晚期患者在原位肝移植前后接受了基本相同的抗乙型肝炎病毒（ＨＢＶ）治疗。结果 １例术前乙型肝炎病毒表面抗原（ＨＢｓＡｇ）、ｅ抗原（ＨＢｅＡｇ）和ＨＢＶ ＤＮＡ均阳性的患者，术后２个月时乙型肝炎复发，死于乙型肝炎复发所致的肝、肾功能衰竭；另１例仅ＨＢｓＡｇ和ＨＢｅＡｇ阳性的患者术后已存

The prevention and treatment for recurrence of hepatitis B following liver transplantation

Objectives To study the influencing factors, clinical diagnosis and therapy for recurrence of hepatitis B following liver transplantation. Methods Two liver cirrhosis patients with positive HBsAg received liver transplantation. Similar anti-HBV treatments were given to both patients before and after the liver transplantation. Results Two months after liver transplantation, hepatitis B recurred in one of the patients with positive HBsAg, HBeAg and HBV-DNA and the patient died from liver and kidney failures caused by the recurred hepatitis. Another patient only positive for HBsAg and HBeAg had no signs of hepatitis B recurrence 26 months after liver transplantation. Conclusions To select the recipients with negative HBV-DNA, or convert their HBV status from replicating to non-or low replication states before operation , combine anti-HBV treatments, blood transfusion during and after operation and immunohistochemistry biopsy of liver samples might play important roles in the prevention of hepatitis B recurrence.