造血干细胞移植 40 年来的肝胆并发症。
Hepatobiliary complications of hematopoietic cell transplantation, 40 years on.
机构信息
Gastroenterology/Hepatology Section, Fred Hutchinson Cancer Research Center and the Department of Medicine, University of Washington School of Medicine, Seattle, WA 98109-1024, USA.
出版信息
Hepatology. 2010 Apr;51(4):1450-60. doi: 10.1002/hep.23533.
Abstract
Liver problems caused by infection, cholestasis and sinusoidal liver injury in the months following HCT have become less frequent because of preventive and pre-emptive strategies. When patients develop jaundice after transplant, the time to search for treatable causes is early in the course of jaundice, as the risk of mortality rises steeply with small increments of serum bilirubin above normal. Chronic hepatitis C, persistent GVHD, cirrhosis and hepatocellular carcinoma are significant liver problems in the longest-lived survivors of HCT.
摘要
由于预防和先发策略，造血干细胞移植后数月内由感染、胆汁淤积和窦状肝损伤引起的肝脏问题已变得不那么常见。当患者在移植后出现黄疸时，寻找可治疗原因的时间是在黄疸过程的早期，因为血清胆红素略高于正常水平会使死亡率急剧上升。慢性丙型肝炎、持续性移植物抗宿主病、肝硬化和肝细胞癌是造血干细胞移植后存活时间最长的患者的重大肝脏问题。
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