Pol S, Debure A, Degott C, Carnot F, Legendre C, Brechot C, Kreis H
Départment de Néphrologie Adulte, Hôpital Necker, Paris.
Lancet. 1990 Apr 14;335(8694):878-80. doi: 10.1016/0140-6736(90)90477-m.
98 HBsAg-positive and 31 HBsAg-negative kidney recipients were compared to assess the effect of renal transplantation on chronic liver disease and vice versa. Diagnosis was based on analysis of liver biopsy specimens including semiquantitative evaluation of histological features of chronic hepatitis. Serial specimens were examined: chronic liver disease occurred in 88% of HBsAg-positive patients and 4% of HBsAg-negative patients with normal liver at the time of transplantation. Liver abnormalities in the former were chronic persistent hepatitis (32%), chronic active hepatitis (51%), and cirrhosis (17%). Actuarial patient survival was similar in HBsAg-positive (78%) and HBsAg-negative (87%) patients, as was allograft survival (64% and 71%, respectively). In both HBsAg-positive and HBsAg-negative patients chronic alcohol consumption was more frequent in those with chronic liver disease than those without. These data suggest that renal transplantation may be appropriate for haemodialysis patients with chronic hepatitis whatever their HBV status.
对98例乙肝表面抗原(HBsAg)阳性和31例HBsAg阴性的肾移植受者进行比较,以评估肾移植对慢性肝病的影响,反之亦然。诊断基于肝活检标本分析,包括对慢性肝炎组织学特征的半定量评估。对系列标本进行了检查:88%的HBsAg阳性患者和4%移植时肝脏正常的HBsAg阴性患者发生了慢性肝病。前者的肝脏异常为慢性持续性肝炎(32%)、慢性活动性肝炎(51%)和肝硬化(17%)。HBsAg阳性患者(78%)和HBsAg阴性患者(87%)的精算患者生存率相似,同种异体移植物生存率也相似(分别为64%和71%)。在HBsAg阳性和HBsAg阴性患者中,慢性肝病患者的慢性酒精消耗量均高于无慢性肝病患者。这些数据表明,无论乙肝病毒(HBV)状态如何,肾移植可能适用于慢性肝炎的血液透析患者。