Cirrhosis as a consequence of graft-versus-host disease.
Cirrhosis as a consequence of graft-versus-host disease.
复制标题
肝硬化是移植物抗宿主病的结果。
DOI：
10.1016/0016-5085(87)90150-8
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发表时间：
1987
期刊：
影响因子：
29.4
通讯作者：
Gollan,JL
中科院分区：
文献类型：
--
作者：
Knapp,AB;Crawford,JM;Rappeport,JM;Gollan,JL
一名患有严重特发性再生障碍性贫血的28岁女性接受了她哥哥的无反应性骨髓移植。在成功植入后的几个月里，她出现了皮肤和肝脏移植物抗宿主病，并伴有明显的胆汁淤积性黄疸。尽管进行了一系列治疗操作，胆汁淤积仍持续存在，但在接下来的10年中保持相对稳定。然而，连续的肝脏活组织检查显示进行性胆汁型纤维化最终发展为肝硬变。随后，她的临床病程恶化，出现肝功能衰竭的迹象，最终在骨髓移植后10.5年死亡。慢性移植物抗宿主病向肝硬变的演变可能是这组骨髓移植受者长期存活的限制因素。稳定的临床或生化指标与进展性肝病之间缺乏相关性，这表明骨髓移植后持续肝功能异常的患者需要进行连续的肝脏活检。
A 28-yr-old woman with severe idiopathic aplastic anemia received an HLA-identical mixed lymphocyte culture nonreactive bone marrow transplant from her brother. In the months after successful engraftment, she developed cutaneous and hepatic graft-versus-host disease, associated with marked cholestatic jaundice. Despite a series of therapeutic maneuvers, cholestasis persisted but remained relatively stable over the ensuing 10 yr. However, serial liver biopsies revealed progressive biliary-type fibrosis culminating in cirrhosis. Subsequently, her clinical course deteriorated and she developed signs of hepatic failure, and ultimately died 10.5 yr after bone marrow transplantation. The evolution of chronic graft-versus-host disease to cirrhosis may be a limiting factor in the long-term survival of this group of bone marrow transplant recipients. The lack of correlation between the stable clinical or biochemical indices and the progressive hepatic disease underscores the need for sequential liver biopsies in patients with sustained liver function abnormalities after bone marrow transplantation.