摘要
目的总结分析再次肝移植患者的临床病理特征,提高再次肝移植的临床病理诊断水平。方法回顾性分析我院施行再次肝移植患者的临床病理资料,并进行随访。结果523例接受原位肝移植患者中,共有22例患者接受了23次（4．4％）再次肝移植,再次肝移植的原因主要为胆道并发症13例（59．1％）,肝动脉血栓形成3例（13．6％）,肝细胞性肝癌复发5例（22．7％）,移植肝原发无功能1例（4．5％）。结论肝移植术后的胆道并发症是再次肝移植的最主要原因,肝内广泛胆汁淤积、小胆管增生及以中性粒细胞为主的炎细胞浸润是其重要的病理特征;早期开展计划性肝穿刺,对各种并发症进行鉴别诊断并借助于影像学检查有利于指导临床合理治疗,避免对患者施行再次肝移植。
Objective To analyze the clinical and pathological features of patients with liver retransplantation. Methods The clinical and pathological data of 22 patients who had liver retransplantation at our center from October 2003 to June 2006 were retrospectively analyzed. Results Among the 523 patients who underwent liver transplantation, 22 （4.4%） had liver retransplantation. The causes of liver retransplantation were biliary tract complications （13/22）, hepatic artery thrombosis （3/22）, recurrence of hepatocellular carcinoma （5/22） and nonfunctional primary graft （1/22）. The pathological changes in the livers of patients with biliary complications were intrahepatic cholestasis, primary bile duct hyperplasia and neutrophil infiltrations. Conclusion Biliary tract complications are the main cause of liver retransplantation. Differential diagnosis of various complications through early liver puncture biopsy and imaging examination will contribute to guide clinical treatment and may help in avoiding liver retransplantation.
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2007年第5期370-373,共4页
Chinese Journal of Hepatology
基金
广东省科技计划项目（2006B36003012）
关键词
肝移植
再手术
临床病理特征
Liver transplantation
Reoperation
Clinicopathologic feature
