Lai M K, Huang C C, Chu S H, Chuang C K, Fong M T
Department of Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan.
Clin Transpl. 1989:281-6.
Among 137 renal transplant recipients, 53 were treated with an AZA-prednisolone regimen and 84 with a CsA-prednisolone regimen. Carriers of HBV had an increased risk of hepatic dysfunction. Forty-two recipients were HBsAg positive. HBsAg-positive status indicated 60% chronic hepatic dysfunction over 3.58 +/- 1.28 years of follow-up in CsA-treated patients and 64.7% over 6.31 +/- 0.99 years in AZA-treated patients. The presence of HBV markers did not seem to affect the patient and graft survival rates in both the CsA- and AZA-treated patients. However, anti-HBs positive patients had poorer graft survival in AZA-treated cadaveric transplants. Episodes of chronic hepatic dysfunction lead to marked reduction of CsA maintenance dosages. We concluded that it was logical to include HBV carriers in our kidney transplantation program. However, they should be followed closely for the possibility of hepatic dysfunction, liver cirrhosis, and hepatoma.
在137例肾移植受者中，53例接受硫唑嘌呤 - 泼尼松治疗方案，84例接受环孢素 - 泼尼松治疗方案。乙肝病毒携带者肝功能异常的风险增加。42例受者乙肝表面抗原呈阳性。在接受环孢素治疗的患者中，乙肝表面抗原阳性状态表明在3.58±1.28年的随访期间有60%出现慢性肝功能异常，而在接受硫唑嘌呤治疗的患者中，在6.31±0.99年的随访期间有64.7%出现慢性肝功能异常。乙肝病毒标志物的存在似乎不影响环孢素和硫唑嘌呤治疗患者的患者及移植物存活率。然而，在接受硫唑嘌呤治疗的尸体肾移植中，抗乙肝表面抗体阳性的患者移植物存活率较低。慢性肝功能异常发作导致环孢素维持剂量显著减少。我们得出结论，将乙肝病毒携带者纳入我们的肾移植项目是合理的。然而，应密切关注他们是否有可能出现肝功能异常、肝硬化和肝癌。
