肝移植术后尿检异常，肾功能不全

Chronic kidney disease in post liver transplantation patient

48岁男性,乙型病毒性肝炎肝硬化12年。亲体肝移植术后3年,术后采用他克莫司+霉酚酸酯+泼尼松抗排斥治疗。近1年患者出现尿检异常伴血清肌酐升高。肾活检示75%的肾小球废弃,肾小管间质弥漫纤维化,肾间质血管病变重,免疫荧光检查证实IgA与C3弥漫分布于肾小球系膜区。诊断考虑肝移植后慢性肾脏病变。

A 48-year-old man, who had treated with tacrolimus for three years post orthotopic liver transplant, presented with renal dysfunction and abnormal urinanalysis. Renal biopsy showed 75% of glomerulosclerosis, diffuse interstitial fibrosis with tubular atrophy, and arteriolar hyalinosis. Immunofluerescence showed IgA and C3 deposited in mesangial areas. The final diagnosis of post liver transplantation chronic renal damage was made.