Chen Hong, Wang Xu, Fan Tieyan, Li Jun, Wang Letian, Shen Zhongyang
Institute of Organ Transplantation, The General Hospital of Chinese People's Armed Police Forces, Beijing 100039, P.R. China.
Exp Ther Med. 2014 Jan;7(1):141-144. doi: 10.3892/etm.2013.1401. Epub 2013 Nov 11.
The present case report describes the diagnosis and treatment of a patient with venoocclusive disease (VOD) following liver transplantation. Combining the clinical data and relevant literature, the study aimed to consider the causes of VOD following liver transplantation, and the pathogenesis, clinical diagnosis and auxiliary examination features of VOD. A 42-year-old man who had a long history of taking traditional Chinese medicine (essential components unknown) underwent an orthotropic liver transplantation on January 14, 2011, due to small venous occlusion disease of the liver. The patient was treated with tacrolimus as an antirejection therapy following the surgery, and gradually developed right upper quadrant pain and fatigue. The examination results were consistent with the diagnostic standards for VOD. Following treatment with methylprednisolone, the patient was treated with alprostadil and Danhong injections. Forty days later, the patient's total bilirubin (TBIL) level was observed to have decreased significantly, the liver function had returned to normal and the ascites had decreased, but had not completely disappeared. The patient then underwent a transjugular intrahepatic portosystemic shunt (TIPS) procedure, following which the ascites were shown to have completely disappeared.
本病例报告描述了1例肝移植术后发生肝静脉闭塞病（VOD）患者的诊断与治疗过程。结合临床资料及相关文献，该研究旨在探讨肝移植术后VOD的病因、发病机制、临床诊断及辅助检查特点。1例有长期服用中药史（具体成分不详）的42岁男性，因肝小静脉闭塞病于2011年1月14日接受原位肝移植。术后患者接受他克莫司抗排斥治疗，逐渐出现右上腹疼痛和乏力。检查结果符合VOD诊断标准。患者先接受甲泼尼龙治疗，之后使用前列地尔及丹红注射液治疗。40天后，患者总胆红素（TBIL）水平显著下降，肝功能恢复正常，腹水减少，但未完全消失。随后患者接受经颈静脉肝内门体分流术（TIPS），术后腹水完全消失。
