Transplantation for primary biliary cirrhosis.
Transplantation for primary biliary cirrhosis.
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原发性胆汁性肝硬化的移植。
DOI：
10.1016/0016-5085(88)90014-5
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发表时间：
1988
期刊：
影响因子：
29.4
通讯作者：
Tzakis,AG
中科院分区：
文献类型：
--
作者：
Esquivel,CO;VanThiel,DH;Demetris,AJ;Bernardos,A;Iwatsuki,S;Markus,B;Gordon,RD;Marsh,JW;Makowka,L;Tzakis,AG
原发性胆汁性肝硬化是肝移植的常见指征。本报告的目的是介绍我们在原发性胆汁性肝硬化肝移植方面的经验。应注意同种异体移植物中出现的肝功能障碍的原因。此外，我们还回顾了原发性胆汁性肝硬化移植患者术后遇到的问题以及最后一次随访时的生活质量。 1980年3月至1985年9月，匹兹堡大学共对76例晚期原发性胆汁性肝硬化患者进行了97例原位肝移植手术。移植手术相对容易进行。最常见的技术并发症是受者肝动脉断裂和壁内夹层，其中 20% 的病例需要进行动脉移植。大多数术后死亡率发生在移植后的前 6 个月内，从该时间点到预计 5 年生存率为 66%，精算寿命生存曲线基本平坦。常见的死亡原因包括排斥反应和原发性移植物无功能。 76 名患者中有 13 名在最后一次随访时出现一些肝功能障碍，但没有人出现黄疸。任何患者均未发现原发性胆汁性肝硬化复发。几乎所有术后研究的患者的血清中都检测到了抗线粒体抗体。最重要的是，几乎所有 52 名幸存患者都已得到社会和职业康复。
Primary biliary cirrhosis is a frequent indication for liver transplantation. The purpose of this report is to present our experience with liver transplantation for primary biliary cirrhosis. Attention is given to the causes of hepatic dysfunction seen in allografts. In addition, we review the postoperative problems encountered and the quality of life at time of last follow-up in patients with transplants for primary biliary cirrhosis. A total of 97 orthotopic liver transplant procedures were performed in 76 patients with advanced primary biliary cirrhosis at the University of Pittsburgh from March 1980 through September 1985. The transplant operation was relatively easy to perform. The most common technical complications experienced were fragmentation and intramural dissection of the recipient hepatic artery, which required an arterial graft in 20% of the cases. Most of the postoperative mortality occurred in the first 6 mo after transplantation, with an essentially flat actuarial life survival curve from that time point to a projected 5-yr survival of 66%. Common causes of death included rejection and primary graft nonfunction. Thirteen of the 76 patients had some hepatic dysfunction at the time of the last follow-up, although none were jaundiced. Recurrence of primary biliary cirrhosis could not be demonstrated in any of the patients. Antimitochondrial antibody was detected in the serum of almost all of the patients studied postoperatively for it. Most important, almost all of the 52 surviving patients have been rehabilitated socially and vocationally.