肝泡型包虫病肝移植术后复发的诊断和治疗

Diagnosis and treatment of hepatic alveolar echinoeoccosis after liver transplantation

肝移植作为晚期肝泡型包虫病的一种治疗手段，近年来开展逐渐增多。2012年11月解放军第四医院收治1例肝移植术后肝泡型包虫病复发的患者。该患者于2006年因肝泡型包虫病行肝移植术，2012年11月检查发现胰头、右肺泡型包虫病复发灶，肝功能不全。经行保肝治疗肝功能好转，现仍行包虫病药物治疗中。总结该例患者的治疗经验，对符合下列情况的晚期肝泡型泡虫病患者可行肝移植：（1）严重肝功能不全。（2）无法行根治性切除。（3）无肝外转移灶。同时在肝移植术后至少正规服用阿苯达唑2年，并持续行包虫抗体监测及影像学检查10年，做到复发后早期处理。

As a treatment method for advanced hepatic alveolar echinococcosis （AE）, liver transplantation has been gradually performed. One patient with hepatic AE recurrence after liver transplantation was admitted to the Fourth Hospital of PLA in November 2012. The patients received liver transplanta- tion in 2006 for the treatment of hepatic AE. Recurrent lesions were found in the head of the pancreas and the right lung. The patient was also associated with liver dysfunction. Liver function was improved obviously after liver-protective treatment, and continuous albendazole treatment was giving to the patient. Based on a full discussion of the patient, we thought that hepatic AE patients who met the following conditions could receive liver transplantation ： （ 1 ） Severe hepatic insufficiency. （2） Inability to receive radical liver resection. （3） Absence of extra-hepatic metastasis of AE. Albendazole should be administered for at least 2 years after liver transplantation, and the patient should be monitored for a minimum of 10 years for the prevention of possible recurrence of AE.