新型冠状病毒肺炎相关肝炎并发近期活体肝移植
COVID-19 Associated Hepatitis Complicating Recent Living Donor Liver Transplantation.
作者信息
Lagana Stephen M, De Michele Simona, Lee Michael J, Emond Jean C, Griesemer Adam D, Tulin-Silver Sheryl A, Verna Elizabeth C, Martinez Mercedes, Lefkowitch Jay H
机构信息
Department of Pathology and Cell Biology (Dr. Lagana, Dr. De Michele, Dr. Lee, Dr. Lefkowitch); Department of Surgery (Dr. Emond, Dr. Griesemer); Department of Radiology (Dr Tulin-Silver); Department of Medicine Digestive and Liver Disease (Dr. Verna); Department of Pediatrics (Dr. Martinez), at the Columbia University Medical Center.
出版信息
Arch Pathol Lab Med. 2020 Apr 17. doi: 10.5858/arpa.2020-0186-SA.
We present a case of COVID-19 hepatitis in a living donor liver allograft recipient whose donor subsequently tested positive for COVID-19. The patient is a female infant with biliary atresia (failed Kasai procedure). She recovered well, with improving liver function tests for 4 days. On post-operative day (POD) 4 the patient developed respiratory distress and fever. COVID-19 testing (polymerase chain reaction) was positive. Liver function tests increased approximately 5-fold. Liver biopsy showed moderate acute hepatitis with prominent clusters of apoptotic hepatocytes and associated cellular debris. Lobular lymphohistiocytic inflammation was noted. Typical portal features of mild to moderate acute cellular rejection were also noted.
我们报告了一例活体肝移植受者发生新型冠状病毒肺炎（COVID-19）相关性肝炎的病例，其供体随后新型冠状病毒检测呈阳性。该患者为一名患有胆道闭锁（葛西手术失败）的女婴。她恢复良好，肝功能检查结果在4天内有所改善。术后第4天（POD 4），患者出现呼吸窘迫和发热。新型冠状病毒检测（聚合酶链反应）呈阳性。肝功能检查结果增加了约5倍。肝活检显示为中度急性肝炎，有明显的凋亡肝细胞簇及相关细胞碎片。可见小叶淋巴细胞-组织细胞性炎症。还注意到轻度至中度急性细胞排斥反应的典型门静脉特征。
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