Dai Jun, Lu Shi-chun, Yan Lv-nan, Li Bo, Lai Wen, Liu Jun, Zhao Ji, Wen Tian-fu, Gui Mei, Lin Qi-yuan, Wang Wen-ya, Zhang Xiu-hui
West China Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, China.
Zhonghua Gan Zang Bing Za Zhi. 2004 Jun;12(6):331-3.
To investigate the alteration of HBV markers in liver allograft of HBV related recipients pre and post liver transplantation under Lamivudine or combination of Lamivudine with HBIG prophylaxis and explore the mechanism of HBV de nova infection in liver allograft after orthotopic liver transplantation, as well as seek to establish a optimal prophylactic protocol.
The serial liver biopsy specimens of 90 liver allograft and sera of 78 liver transplant recipients during operation and after 1 week, 1 month, 3 months, 6 months, 12 months, 24 months post transplantation have been collected and detected for HBV markers with enzyme-linked radioimmunoassay, fluorescent quantitative assay for HBV-DNA in serology and with immunohistochemistry stain, HBV-DNA in situ hybridization in histology for detection of HBV markers in liver allograft samples.
Whether recipients with active replicative or inactive replicative HBV preoperatively, none of positive HBV-DNA, HBsAg and HBcAg in 100% liver biopsy specimens with HBV-DNA hybridization in situ and immunohistochemistry stains in histology within 2 hours after reperfusion.
Whatever HBV replicative status the recipients have before surgery, no evidence of HBV particles direct invasion to the liver allograft from HBV related cirrhotics during operation under current prophylactic measures. However, the further supposed mechanism and its significance in HBV de nova infection of liver allograft remained to be disclosed further.
探讨拉米夫定或拉米夫定联合乙肝免疫球蛋白预防的情况下，乙肝相关受体肝移植受者肝移植前后肝移植肝内乙肝标志物的变化，探讨原位肝移植后肝移植肝内乙肝病毒（HBV）新发感染的机制，并寻求建立最佳预防方案。
收集90例肝移植肝的系列活检标本以及78例肝移植受者在手术期间及移植后1周、1个月、3个月、6个月、12个月、24个月的血清，采用酶联免疫吸附测定法检测乙肝标志物，血清学采用荧光定量法检测HBV-DNA，组织学采用免疫组织化学染色及原位杂交法检测肝移植标本中的HBV-DNA，以检测肝移植标本中的乙肝标志物。
无论术前乙肝病毒处于活跃复制还是非活跃复制状态，再灌注后2小时内，100%肝活检标本经原位HBV-DNA杂交及组织学免疫组织化学染色检测，均未发现HBV-DNA、HBsAg及HBcAg阳性。
无论受者术前乙肝病毒复制状态如何，在当前预防措施下，手术过程中均无证据表明乙肝相关肝硬化患者的乙肝病毒颗粒直接侵入肝移植肝。然而，肝移植肝内乙肝病毒新发感染的进一步推测机制及其意义仍有待进一步揭示。
