Zhu X, Lu M, Wang G, Cai C, Yang Y, He X, Chen G, Huang J
Transplantation Center, First Affiliated Hospital, Sun Yat-sen University of Medical Sciences, Guangzhou 510080, China.
Chin Med J (Engl). 2001 Jan;114(1):73-5.
To investigate the effect of orthotopic liver transplantation (OLT) on hepatitis B(HB)-related diseases and the efficiency of prevention and treatment with lamivudine on recurrence of hepatitis B posttransplant in China.
Orthotopic liver transplantation (OLT) under veno-venous bypass was performed in 10, of whom 9 males had hepatitis B and 1 female had hepatocellular cancer (HCC) without HB pretransplant. Eight of the 9 males had fulminant hepatitis B (FHB) and they all had preoperative serious jaundice, ascites and coagulopathy. Six had encephalopathy; 1 was associated with acute renal failure, and 1 with gastrointestinal hemorrhage. Seven of the 10 patients had lamivudine to prevent reinfection with hepatitis B.
Of the 8 patients who have survived for 2-12 months, 7 have survived for 6-12 months. Two died, one of recurrent FHB and the other from multi-organ failure (MOF). Seven preoprative HB patients of the 8 survivors have excellent liver function through 1 has positive HBsAg 6 months after OLT. One of the 8 survivors, the female with HCC pretransplant, suffered hepatitis B 6 months after OLT and her hepatic function has been gradually improving with lamivudine therapy.
OLT is an effective therapy for certain cases of FHB and HCC and lamivudine may prevent recurrence of hepatitis B after OLT.
探讨原位肝移植（OLT）治疗乙型肝炎（HB）相关疾病的效果以及在中国使用拉米夫定预防和治疗OLT术后乙型肝炎复发的疗效。
对10例患者实施了静脉转流下行原位肝移植手术，其中9例男性患者患有乙型肝炎，1例女性患者术前无HB感染，患有肝细胞癌（HCC）。9例男性患者中有8例为暴发性乙型肝炎（FHB），他们术前均有严重黄疸、腹水及凝血功能障碍。6例有肝性脑病；1例合并急性肾衰竭，1例合并消化道出血。10例患者中有7例使用拉米夫定预防乙型肝炎再感染。
8例存活2至12个月的患者中，7例存活6至12个月。2例死亡，1例死于复发性FHB，另1例死于多器官功能衰竭（MOF）。8例存活者中7例术前HB患者肝功能良好，1例OLT术后6个月HBsAg呈阳性。8例存活者中的1例，即术前患有HCC的女性患者，OLT术后6个月发生乙型肝炎，经拉米夫定治疗后肝功能逐渐改善。
OLT是某些FHB和HCC病例的有效治疗方法，拉米夫定可预防OLT术后乙型肝炎复发。
