摘要
通过对两例成功的背驮式原位肝移植术后早期环孢素的应用观察，我们发现：（１）术后早期移植肝对环孢素的耐受能力较差，环孢素引起移植肝中毒主要表现在以直接胆红素升高为主的阻塞性黄疸，而对丙氨酸转氨酶（ＡＬＴ）恢复无明显影响。（２）与肾移植不同，移植肝往往在早期排斥和中毒并存。术后１周左右容易发生急性排斥，术后２～３周后可能会出现一定程度的免疫耐受。（３）术后口服环孢素最好用环孢素微乳剂（Ｎｅｏｒａｌ），浓度适宜控制在３００～５００ｎｇｍｌ－１（多抗法），术后近期有必要加用抗淋巴细胞球蛋白（ＡＬＧ）１０～１５天。
Two cases of piggyback liver transplantation was given cyclosporine A (CsA) in the early stage after operation. It was found that: (1) The tolerance of the transplanted liver in the early stage to CsA was poor. The hepatotoxicity induced by CsA mainly revealed the increase of direct bilirubin (DBIL) without obvious influence on the ALT; (2) The rejection reaction and hepatotoxicity coexisted in the early stage of liver transplantation, which was different from that of kidney transplantation. Acute rejection reaction easily occurred about one week after operation and some degree of immunotolerance emerged at 2nd or 3rd week after operation; (3) When CsA given orally after operation, it is better to use Neaoral with the range of concentration of CsA between 300 to 500 ng\5ml-1. Additionally, it is necessary to use antilymphocyte globulin for 1015 days to make the transplanted liver smoothly recover without rejection and hepatoxicity.
出处
《中华器官移植杂志》
CAS
CSCD
1998年第2期74-75,共2页
Chinese Journal of Organ Transplantation
关键词
背驮式
肝移植
环孢素
微乳剂
Piggyback\ \ Liver transplantation\ \ Cyclosporine A
