肝移植治疗终末期自身免疫性肝病7例的经验分析

Orthotopic Liver Transplantation for Treating End-stage Autoimmune Liver Disease:Experiences of 7 Cases

目的总结肝移植治疗终末期自身免疫性肝病(ESALD)的临床经验.方法7例接受肝移植ESALD患者,1例为原发性硬化性胆管炎,1例为自身免疫性肝炎,5例为原发性胆汁性肝硬化;供肝植入均采用改良背驮式肝移植术;术后免疫抑制治疗采用他克莫司(tacrolimus)、骁悉(MMF)和激素三联免疫抑制方案.结果7例患者随访至今仍健在,肝功能良好,最长存活2年;但具有一定的并发症.结论肝移植是治疗终末期自身免疫性肝病的唯一有效手段,手术时机的正确把握和有效的围手术期治疗是减少肝移植术后并发症的关键.

Objectives To summarize the experiences of orthotopic liver transplantation （OLT） for treating end-stage autoimmune liver disease. Methods Seven patients were performed reforming piggyback liver transplantation. The clinical data to therapy of one case of PSC, one case of AIH and five cases of PBC were investigated retrospectively. The immunosuppressive protocols included tacrolimus, methylprednisolone （MP） and Mycophenolate Mofetil （MMF）. Results Seven patients survied and had good liver function under follow-up. The most length was two years, however, some of them had several complications. Conclusions Orthotopic liver transplantation is an exclusive treatment for end-stage autoimmune liver disease. Proper indication and proper perioperative treatment are very important for decreasing occurrence of complication.