22例肝脏再次移植的临床病理分析
[A clinicopathological analysis of liver retransplantation in 22 cases].
作者信息
Shao Chun-kui, Zhou Jing, Feng Zhi-ying, Chen Gui-hua
机构信息
Department of Pathology, Organ Transplantation Center, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China.
出版信息
Zhonghua Gan Zang Bing Za Zhi. 2007 May;15(5):370-3.
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.
目的
分析肝再次移植患者的临床及病理特征。
方法
回顾性分析2003年10月至2006年6月在本中心接受肝再次移植的22例患者的临床及病理资料。
结果
在523例行肝移植的患者中，22例（4.4%）接受了肝再次移植。肝再次移植的原因包括胆道并发症（13/22）、肝动脉血栓形成（3/22）、肝细胞癌复发（5/22）和原发性移植物无功能（1/22）。胆道并发症患者肝脏的病理变化为肝内胆汁淤积、原发性胆管增生和中性粒细胞浸润。
结论
胆道并发症是肝再次移植的主要原因。通过早期肝穿刺活检和影像学检查对各种并发症进行鉴别诊断，将有助于指导临床治疗，并可能有助于避免肝再次移植。
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