肝移植术后五年随访

Follow-up study of a liver transplantation patient for 5 years.

目的肝移植术后长期存活所面对的问题。我院移植外科于１９９４年完成一例肝移植手术，现已存活五年。方法追踪术后过程。患者术后近期即出现乙肝再感染现象，ＨＢｓＡｇ（＋）术后一年肝活检提示：移植肝呈慢活肝表现。术后三年患者无诱因出现食道静脉曲张出血。即行经内镜套扎术止血。结果近两年随访：食道静脉曲张消失，无再出血，生活质量未受影响。结论肝移植术后乙肝病毒再感染是影响患者愈后的重要因素之一，乙肝表面抗体（ＨＢｌｇ）及抗病毒药对预防乙肝再感染有一定疗效。

Objective To observe problems encountered in long--term survival after orthotopic liver trans-plantation in a patient with HBV-related cirrhsis at our institution in 1994, who has been living for five years up topresent. Method The postoperative course was followed up. Results HBV reinfection was demonstrated in thefirst year and bleeding from esophageal varices occurred in the third year after the operation. The latter wes treatedwith endoscopic ligation. In recent 2 years esophageal bleeding disappeared and the life quality of the patient wasnot affected. Conclusion Patients undergoing liver transplantation for hepatitis B-related liver disease are prone torecurrence, which is one of the important factors affecting prognosis. The combined antiviral therapy with HBIg andantiviral drugs is effective for prevention from and control of HBV reinfection.