König V, Bauditz J, Lobeck H, Lüsebrink R, Neuhaus P, Blumhardt G, Bechstein W O, Neuhaus R, Steffen R, Hopf U
Department of Internal Medicine, Universitätsklinikum Rudolf Virchow-Charlottenburg, Freie Universität Berlin, Germany.
Hepatology. 1992 Nov;16(5):1137-43. doi: 10.1002/hep.1840160506.
From September 1988 to May 1991, 160 orthotopic liver transplantations were performed in our hospital. Twenty-four patients had end-stage cirrhosis caused by chronic non-A, non-B hepatitis. Antibodies against hepatitis C virus were documented before and after orthotopic liver transplantation in 13 patients. Studies using the polymerase chain reaction demonstrated hepatitis C virus RNA in the serum and liver tissue of 17 patients (10 of whom tested positive for hepatitis C virus antibodies) before orthotopic liver transplantation. Tissue samples taken from liver grafts during the operation were hepatitis C virus RNA negative in every case. Ten of these 17 patients had positive hepatitis C virus RNA findings in serum and liver biopsy specimens within the first month after surgery. One patient died of Mucor sepsis 2 mo after orthotopic liver transplantation. Another patient died of multi-organ failure 3 mo after a retransplantation. Two patients underwent retransplantation for graft rejection at 2 and 3 mo, respectively. One year after orthotopic liver transplantation, hepatitis C virus RNA was demonstrated in allograft biopsy specimens in 13 of 15 patients. Two patients remained hepatitis C virus RNA negative in repeated biopsies up to 12 mo. Mild portal and lobular hepatitis developed within 6 months of orthotopic liver transplantation in four patients and within 1 yr in five additional patients. The data suggest that persistent hepatitis C virus reinfects the allograft in most cases, but the risk of acute organ damage caused by hepatitis C virus reinfection is low.
1988年9月至1991年5月，我院共进行了160例原位肝移植手术。24例患者患有慢性非甲非乙型肝炎所致的终末期肝硬化。13例患者在原位肝移植前后均检测到抗丙型肝炎病毒抗体。聚合酶链反应研究显示，17例患者（其中10例丙型肝炎病毒抗体检测呈阳性）在原位肝移植前血清和肝组织中存在丙型肝炎病毒RNA。手术中取自肝移植物的组织样本在每例中丙型肝炎病毒RNA均为阴性。这17例患者中有10例在术后第一个月内血清和肝活检标本中丙型肝炎病毒RNA检测结果呈阳性。1例患者在原位肝移植后2个月死于毛霉菌败血症。另1例患者在再次移植后3个月死于多器官功能衰竭。2例患者分别在术后2个月和3个月因移植物排斥反应接受了再次移植。原位肝移植1年后，15例患者中有13例的同种异体肝活检标本中检测到丙型肝炎病毒RNA。2例患者在长达12个月的重复活检中丙型肝炎病毒RNA仍为阴性。4例患者在原位肝移植后6个月内、另外5例患者在1年内出现了轻度门静脉和小叶性肝炎。数据表明，在大多数情况下，丙型肝炎病毒持续感染同种异体肝，但丙型肝炎病毒再次感染导致急性器官损伤的风险较低。
