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多囊肾病的肝肾移植

Liver and kidney transplantation for polycystic disease.

作者信息

Jeyarajah D R, Gonwa T A, Testa G, Abbasoglu O, Goldstein R, Husberg B S, Levy M F, Klintmalm G B

机构信息

Baylor Institute of Transplant Sciences, Baylor University Medical Center, Dallas, Texas 75246, USA.

出版信息

Transplantation. 1998 Aug 27;66(4):529-32. doi: 10.1097/00007890-199808270-00019.

Abstract

BACKGROUND

With the poor results of resective and fenestration procedures for polycystic liver disease (PCLD), we present the first series of patients receiving orthotopic liver transplantation for this condition.

METHODS

Five of our six patients with PCLD had polycystic kidney disease also. Three of these five received combined organ transplants, while the other two required subsequent kidney transplants.

RESULTS

Forty-eight and 52 months after orthotopic liver transplantation, all surviving patients had relief of their pain, distention, and anorexia. Two patients had succumbed to infectious complications and died at 15 and 24 months after transplant.

CONCLUSIONS

We conclude that patients with PCLD can be transplanted safely for the relief of their distention and anorexia, with good results. Those patients with both PCLD and polycystic kidney disease who are not dialysis dependent can be managed for several years with isolated liver transplantation and then receive kidney transplantation if needed. Those who are dialysis dependent should receive combined liver-kidney transplantation. Unfortunately, patients with polycystic disease seem to be very susceptible to infectious complications after organ transplantation.

摘要

背景

鉴于多囊肝病(PCLD)的切除和开窗手术效果不佳,我们报告了首批接受原位肝移植治疗该病的患者系列。

方法

我们的6例PCLD患者中有5例也患有多囊肾病。这5例中的3例接受了联合器官移植,另外2例随后需要进行肾移植。

结果

原位肝移植后48个月和52个月时,所有存活患者的疼痛、腹胀和厌食症状均得到缓解。2例患者因感染性并发症于移植后15个月和24个月死亡。

结论

我们得出结论,PCLD患者可以安全地接受移植以缓解腹胀和厌食症状,效果良好。那些患有PCLD和多囊肾病且不依赖透析的患者可以通过单纯肝移植治疗数年,如有需要再接受肾移植。那些依赖透析的患者应接受肝肾联合移植。不幸的是,多囊病患者在器官移植后似乎极易发生感染性并发症。

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