丁型肝炎病毒病中的肝移植

Liver transplantation in hepatitis delta virus disease.

作者信息

Rizzetto M, Macagno S, Chiaberge E, Verme G, Negro F, Marinucci G, di Giacomo C, Alfani D, Cortesini R, Milazzo F

出版信息

Lancet. 1987 Aug 29;2(8557):469-71. doi: 10.1016/s0140-6736(87)91789-2.

Abstract

Seven patients with hepatitis delta virus (HDV) cirrhosis underwent liver transplantation. In every case the HDV infection was florid but accompanied by an inactive hepatitis B virus (HBV) infection. The patients were given anti-HB surface antigen (HBsAg) serum globulins and HBV vaccine. Two patients cleared the HBsAg and the HDV, and are alive and well 14 and 15 months, respectively, after transplantation. HDV infection recurred in the other five patients: hepatitis developed in three, another died, and the fifth was re-transplanted for causes unrelated to viral hepatitis (reinfection was shown by the presence of HD antigen in the graft). Liver transplantation is feasible in patients with HDV disease but involves a high risk of HDV reinfection that cannot be predicted by the virological pattern of the native HBV infection or prevented by conventional HBV prophylaxis.

摘要

7例丁型肝炎病毒（HDV）肝硬化患者接受了肝移植。每例患者的HDV感染均较为活跃，但同时伴有不活跃的乙型肝炎病毒（HBV）感染。这些患者接受了抗乙型肝炎表面抗原（HBsAg）血清球蛋白和HBV疫苗治疗。2例患者清除了HBsAg和HDV，分别在移植后14个月和15个月时存活且状况良好。其他5例患者HDV感染复发：3例发生肝炎，另1例死亡，第5例因与病毒性肝炎无关的原因接受了再次移植（移植物中存在HD抗原表明发生了再感染）。HDV疾病患者进行肝移植是可行的，但HDV再感染风险很高，无法通过原HBV感染的病毒学模式预测，也不能通过常规HBV预防措施预防。