临床活体肝部分移植受体的免疫抑制治疗

Immunosuppressive treatment on recipient of living related liver transplantation

目的报道1例临床活体肝部分移植受体的免疫抑制治疗情况。方法1997年6月30日 ,我科成功地施行了1例活体肝部分移植术 ,术后采用皮质激素、硫唑嘌呤、环孢素A三联免疫抑制治疗 ,并监测环孢素A的血药浓度。术后第10天 ,发生急性移植排斥反应 ,经皮质激素冲击治疗及增加环孢素A的用量后 ,排斥反应被逆转。在恢复期 ,采用小剂量的环孢素A和骁悉维持治疗。结果目前患者一般情况良好 ,已健康生存2年9个月。结论活体肝部分移植术 ,对于终末期肝病患者是一种较好的治疗手段 ,采用三联免疫抑制治疗可预防和逆转排斥反应。而且 ,与尸肝移植相比较 ,免疫抑制剂用量较小、疗程短、副作用少 ,患者恢复较为顺利。

Ain To report a case of immunosuppressive treatment on recipient of living related liver transplantation. Method An operation on case of living related liver transplantation(LRLT) was performed successfully in our department on June 30,1997. After the operation, immunosuppressive agents such as steroid, azathioprine and cyclosporine A were used to prevent rejection, and the blood concentration of cyclosporine A was tested in the mean time. An acute rejection happened ten days after the operation, and the patient was cured with large dose of steroid and cyclosporine A. The patient was treated with cyclosporine A and cellcept with low dose in the recovery stage.Results The patient has survived for 2 years and 9 months until now. Conclusion It has demonstrated that LRLT is a feasible operation for the patient with terminal liver disease. Combined treatment of immunosuppressive agents will prevent and cure the rejection. It has also shwn that LRLT is better than cadaveric liver transplantation, with lower dose of immunosuppressive agent, shorter treatment course and less side effect. Furthermore, the patient's recovery is more satisfactorily.