Xu Yan-Tian, Liu De-Jie, Meng Fan-Ying, Li Guang-Bing, Liu Jun
Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China.
Hepatobiliary Pancreat Dis Int. 2014 Jun;13(3):328-31. doi: 10.1016/s1499-3872(14)60256-3.
Liver transplantation for autoimmune hepatitis (AIH) is usually successful with excellent long-term outcomes, but primary disease may recur. The recurrence of AIH is a significant cause of graft loss. This study was to analyze the effect of splenectomy in preventing AIH relapse. The clinical courses of 12 patients who had transplantation for AIH were analyzed retrospectively. All patients were subjected to transplantation for end-stage liver disease caused by chronic AIH. Based on the duration of immunosuppressive treatment before liver transplantation, simultaneous splenectomy was performed in ten patients. Two patients underwent liver transplantation without splenectomy, one of them developed recurrent AIH and died from graft failure caused by AIH relapse. However, no episode of AIH recurrence was observed in patients who had undergone simultaneous splenectomy. Splenectomy might be an option to prevent AIH relapse in some patients with high risk factors.
自身免疫性肝炎（AIH）肝移植通常很成功，长期疗效良好，但原发性疾病可能复发。AIH复发是移植物丢失的重要原因。本研究旨在分析脾切除术在预防AIH复发中的作用。回顾性分析了12例因AIH接受移植患者的临床病程。所有患者均因慢性AIH导致的终末期肝病接受移植。根据肝移植前免疫抑制治疗的持续时间，10例患者同时行脾切除术。2例患者未行脾切除术接受肝移植，其中1例发生AIH复发，死于AIH复发导致的移植物衰竭。然而，同时行脾切除术的患者未观察到AIH复发事件。对于一些具有高风险因素的患者，脾切除术可能是预防AIH复发的一种选择。
