摘要
乙肝终末期肝病患者肝脏移植术后乙肝复发是影响患者长期存活的重要因素。本文重点介绍肝脏移植术后乙肝复发的机制及影响因素;提出肝脏移植术后乙型肝炎病毒再感染及乙肝复发的诊断标准;探讨预防乙肝复发的各种方案的优劣,指出拉米夫定联合小剂量乙肝免疫球蛋白联合用药方案是目前报道的最为有效的预防方案。笔者认为,肝脏移植术后乙肝复发需进行综合防治,治疗从移植前开始进行,贯穿术中,术后进行长期乃至终生防治。
The outcome of liver transplantation for end-stage liver disease secondary to hepatitis B is remarkably impacted by recurrent infection and subsequent allograft failure. Pre-operational viral replication, immunosuppression degree, and disease types play an important role in hepatitis B recurrence. This article summarizes the mechanisms, the influencing factors, and clinical diagnosis for recurrence of hepatitis B following liver transplantation, and discusses multiple strategies to prevent hepatitis B recurrence. Lamivudine in combination with low-dose hepatitis B immuno-globulin currently is the most effective therapy to prevent recurrent hepatitis B virus allograft infection. It is emphasized that effective prophylaxis approaches against hepatitis B virus recurrence should be adopted before, during, and after operation. Long-term and even life-long antiviral therapy is important for a better outcome.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2005年第4期431-434,共4页
Acta Academiae Medicinae Sinicae
关键词
乙肝终末期肝病
肝脏移植
乙肝复发
end-stage liver disease secondary to hepatitis B
liver transplantation
hepatitis B recurrence
