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序贯肝-肾移植治疗常染色体显性遗传多囊肾病患者肝囊肿感染复发:病例报告。

Sequential Liver-Kidney Transplantation for Recurrent Liver Cysts Infection in a Patient With Autosomal Dominant Polycystic Kidney Disease: A Case Report.

机构信息

Department of Hepato-gastroenterology, Saint-Luc Hospital, Brussels, Belgium.

Department of Hepato-biliopancreatic Surgery, Saint-Luc Hospital, Brussels, Belgium.

出版信息

Transplant Proc. 2021 May;53(4):1322-1326. doi: 10.1016/j.transproceed.2021.02.018. Epub 2021 Apr 12.

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is the most prevalent hereditary kidney disorder. Liver cysts are the most common extrarenal manifestation of the disease and usually remain asymptomatic. Liver cyst infection is rare, and its treatment is challenging. Liver transplantation (LT) is the only curative therapeutic option in symptomatic polycystic liver disease associated with ADPKD. Only a few cases of LT for recurrent liver cyst infection have been published. To our knowledge, we report the first case of sequential liver-kidney transplantation for recurrent liver cysts infection in a patient with ADPKD. A 55-year-old woman with ADPKD who had a kidney transplantation (KT) presented with multiple liver cysts infection 9 months after her KT. These episodes started after biliary tract complications due to an ampullary adenoma necessitating multiple endoscopic interventions. Her general status gradually degraded because antibiotic treatment was not effective, and she underwent LT for recurrent liver cysts infection 1 year and 9 months after her KT. LT in this setting turned out to be challenging but was possible. We think that better biliary tract workup before KT may prompt better care in these patients.

摘要

常染色体显性遗传性多囊肾病(ADPKD)是最常见的遗传性肾脏疾病。肝脏囊肿是该疾病最常见的肾外表现,通常无症状。肝脏囊肿感染很少见,治疗具有挑战性。肝移植(LT)是与 ADPKD 相关的有症状多囊性肝病的唯一根治性治疗选择。仅有少数 LT 治疗复发性肝脏囊肿感染的病例被报道。据我们所知,我们报告了首例 ADPKD 患者因复发性肝脏囊肿感染行序贯肝肾移植的病例。一位 55 岁的女性 ADPKD 患者在肾移植(KT)后 9 个月出现多发性肝脏囊肿感染。这些感染发生在因壶腹腺瘤导致胆道并发症而需要多次内镜介入治疗后。由于抗生素治疗无效,她的一般状况逐渐恶化,并在 KT 后 1 年零 9 个月接受 LT 治疗复发性肝脏囊肿感染。在这种情况下进行 LT 具有挑战性,但却是可行的。我们认为,在 KT 前进行更好的胆道检查可能会促使这些患者得到更好的护理。

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