Liebau P, Kuse E, Winkler M, Schlitt H J, Oldhafer K, Verhagen W, Flik J, Pichlmayr R
Abt. Anästhesiologie IV, Medizinische Hochschule Hannover, Germany.
Infection. 1996 Mar-Apr;24(2):130-5. doi: 10.1007/BF01713317.
Interstitial pneumonia caused by Herpes simplex virus type 1 (HSV-1) is a severe complication of orthotopic liver transplantation (LTX). The records of patients were reviewed who had an LTX at the age of 16 years or older between 1991 and 1994 with a mean follow-up of 21 months (range, 10 to 44 months). Six patients were included who had fever of > 38 degrees C, deterioration of arterial blood gases, radiological evidence of interstitial pneumonia and proof of HSV-1 in bronchoalveolar lavage fluid. All patients were anti-HSV-IgG positive before LTX. All patients were successfully treated with intravenous acyclovir, mechanical ventilation and reduced immunosuppression. Three patients who received cyclosporin A had a rejection which was successfully treated by switching to FK 506. Four patients were discharged in good health. One patient died 36 months after LTX of an unrelated cause. One patient died of urosepsis on postoperative day 139. Acyclovir together with mechanical ventilation and reduced immunosuppression proved to be an effective treatment for HSV-1 pneumonia following LTX.
1型单纯疱疹病毒（HSV-1）引起的间质性肺炎是原位肝移植（LTX）的一种严重并发症。回顾了1991年至1994年间16岁及以上接受LTX患者的记录，平均随访21个月（范围10至44个月）。纳入了6例患者，这些患者体温高于38摄氏度、动脉血气恶化、有间质性肺炎的影像学证据且支气管肺泡灌洗 fluid中证实有HSV-1。所有患者在LTX前抗HSV-IgG均为阳性。所有患者均接受静脉阿昔洛韦、机械通气和免疫抑制减量治疗，治疗成功。3例接受环孢素A治疗的患者发生排斥反应，通过换用FK 506成功治疗。4例患者健康出院。1例患者在LTX后36个月因无关原因死亡。1例患者在术后第139天死于泌尿道感染。阿昔洛韦联合机械通气和免疫抑制减量被证明是LTX后HSV-1肺炎的有效治疗方法。 （注：原文中“bronchoalveolar lavage fluid”表述有误，应该是“bronchoalveolar lavage fluid”，意为支气管肺泡灌洗 液）
