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肝移植受者肝活检后发生脓毒症:病例报告及文献综述

Sepsis Following Liver Biopsy in a Liver Transplant Recipient: Case Report and Review of Literature.

作者信息

Agrawal Lokesh, Jain Sachin, Madhusudhan Kumble S, Das Prasenjit, Dash Nihar R, Sahni Peush, Pal Sujoy

机构信息

Department of Gastrointestinal Surgery and Liver Transplantation, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.

Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.

出版信息

J Clin Exp Hepatol. 2021 Mar-Apr;11(2):254-259. doi: 10.1016/j.jceh.2020.07.005. Epub 2020 Jul 19.

Abstract

Percutaneous liver biopsy is a relatively safe procedure with low complication rates. Infections following liver biopsy are uncommon and can lead to a poor outcome. There are limited data on liver biopsy-related infections among liver transplant (LT) recipients. Also, there is a paucity of data regarding the use of prophylactic antibiotics in LT patients undergoing percutaneous liver biopsy. We report a case of systemic sepsis following percutaneous liver biopsy in a LT recipient with choledochojejunal anastomosis. This was followed by severe rejection and deterioration of liver function and recurrence of primary sclerosing cholangitis (PSC) to the extent that he has been listed for retransplantation. This case report emphasizes the potential risk of sepsis in LT recipients with bilioenteric anastomosis undergoing percutaneous liver biopsy. This increased risk may warrant periprocedural broad spectrum antibiotic prophylaxis, in this subgroup of patients.

摘要

经皮肝活检是一种相对安全的操作,并发症发生率较低。肝活检后感染并不常见,但可能导致不良后果。关于肝移植(LT)受者中与肝活检相关感染的数据有限。此外,对于接受经皮肝活检的LT患者使用预防性抗生素的数据也很匮乏。我们报告一例LT受者在进行经皮肝活检后发生系统性败血症的病例,该患者存在胆总管空肠吻合术。随后出现严重排斥反应、肝功能恶化以及原发性硬化性胆管炎(PSC)复发,以至于他已被列入再次移植名单。本病例报告强调了接受经皮肝活检的具有胆肠吻合术的LT受者发生败血症的潜在风险。在这一亚组患者中,这种增加的风险可能需要围手术期使用广谱抗生素进行预防。

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