四例肝移植后急性移植物抗宿主病治疗失败的病例报告。
Unsuccessful treatment of four patients with acute graft-vs-host disease after liver transplantation.
机构信息
Department of Liver and Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
出版信息
World J Gastroenterol. 2012 Jan 7;18(1):84-9. doi: 10.3748/wjg.v18.i1.84.
Abstract
AIM
To investigate appropriate therapeutic strategies for graft-vs-host disease (GVHD) following liver transplantation.
METHODS
Four patients who developed GVHD after liver transplantation in West China Hospital were included in this study. Therapeutic strategies with augmentation or withdrawal of immunosuppressants combined with supportive therapy were investigated in these patients. In addition, a literature review of patients who developed GVHD after liver transplantation was performed.
RESULTS
Although a transient response to initial treatment was detected, all four patients died of complications from GVHD: one from sepsis with multiple organ failure, one from gastrointestinal bleeding, and the other two from sepsis with gastrointestinal bleeding. Few consensuses for the treatment of GVHD after liver transplantation have been reached.
CONCLUSION
New and effective treatments are required for GVHD after liver transplantation to improve the prognosis of patients with this diagnosis.
摘要
目的
探讨肝移植后移植物抗宿主病（GVHD）的适宜治疗策略。
方法
本研究纳入了华西医院 4 例肝移植后发生 GVHD 的患者。对这些患者采用了强化或停用免疫抑制剂联合支持治疗的治疗策略。此外，还对肝移植后发生 GVHD 的患者进行了文献复习。
结果
尽管初始治疗后有短暂的反应，但所有 4 例患者均因 GVHD 的并发症而死亡：1 例死于脓毒症伴多器官功能衰竭，1 例死于胃肠道出血，另外 2 例死于脓毒症伴胃肠道出血。对于肝移植后 GVHD 的治疗，尚未达成共识。
结论
需要新的有效的治疗方法来改善肝移植后 GVHD 患者的预后。
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