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新冠病毒感染后胆管病——肝移植的新适应证:病例报告。

Post-Covid-19 Cholangiopathy-A New Indication for Liver Transplantation: A Case Report.

机构信息

Division of Transplant Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin; Transplant Center, Froedtert & the Medical College of Wisconsin and Children's Wisconsin, Milwaukee, Wisconsin; Division of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.

Division of Transplant Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin; Transplant Center, Froedtert & the Medical College of Wisconsin and Children's Wisconsin, Milwaukee, Wisconsin.

出版信息

Transplant Proc. 2021 May;53(4):1132-1137. doi: 10.1016/j.transproceed.2021.03.007. Epub 2021 Mar 12.

DOI:10.1016/j.transproceed.2021.03.007
PMID:33846012
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7953456/
Abstract

Liver injury is one of the nonpulmonary manifestations described in coronavirus disease 2019 (COVID-19). Post-COVID-19 cholangiopathy is a special entity of liver injury that has been suggested as a variant of secondary sclerosing cholangitis in critically ill patients (SSC-CIP). In the general population, the outcome of SSC-CIP has been reported to be poor without orthotopic liver transplantation (OLT). However, the role of OLT for post-COVID-19 cholangiopathy is unknown. We present a case report of a 47-year-old man who recovered from acute respiratory distress syndrome from COVID-19 and subsequently developed end-stage liver disease from post-COVID-19 cholangiopathy. The patient underwent OLT and is doing well with normal liver tests for 7 months. To our knowledge, this is the first case report of a patient who underwent successful liver transplantation for post-COVID-19 cholangiopathy.

摘要

肝损伤是 2019 冠状病毒病(COVID-19)描述的非肺部表现之一。COVID-19 后胆管病是肝损伤的一种特殊类型,被认为是危重症患者继发性硬化性胆管炎(SSC-CIP)的一种变异。在普通人群中,据报道,SSC-CIP 患者如果不进行肝移植(OLT),其预后很差。然而,COVID-19 后胆管病患者是否需要进行 OLT 尚不清楚。我们报告了一例 47 岁男性的病例,该患者从 COVID-19 导致的急性呼吸窘迫综合征中康复,随后因 COVID-19 后胆管病发展为终末期肝病。该患者接受了 OLT,并且在 7 个月时肝脏检查正常,恢复良好。据我们所知,这是首例 COVID-19 后胆管病患者成功接受肝移植的病例报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e86e/7953456/8c6269cbdbe4/gr6_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e86e/7953456/3e50e3b08a87/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e86e/7953456/d31db7aad219/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e86e/7953456/f6aa68ff2de7/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e86e/7953456/107b0ebbf4e3/gr4_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e86e/7953456/abe04e8d0290/gr5_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e86e/7953456/8c6269cbdbe4/gr6_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e86e/7953456/3e50e3b08a87/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e86e/7953456/d31db7aad219/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e86e/7953456/f6aa68ff2de7/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e86e/7953456/107b0ebbf4e3/gr4_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e86e/7953456/abe04e8d0290/gr5_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e86e/7953456/8c6269cbdbe4/gr6_lrg.jpg

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BMJ Case Rep. 2020 Nov 9;13(11):e237984. doi: 10.1136/bcr-2020-237984.
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Hepatic pathology in patients dying of COVID-19: a series of 40 cases including clinical, histologic, and virologic data.
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