乙型肝炎表面抗原阳性供肝肝移植的临床疗效分析

刘荣强; 张英才; 姚嘉; 邓宜南; 朱曙光; 杨卿; 唐晖; 汪国营; 杨扬; 陈规划

doi:10.3969/j.issn.1674-7445.2017.06.008

乙型肝炎表面抗原阳性供肝肝移植的临床疗效分析

doi: 10.3969/j.issn.1674-7445.2017.06.008

510630 广州，中山大学附属第三医院肝脏外科暨肝移植中心

基金项目:

广东省自然科学基金 2015A030312013

广东省自然科学基金 2015A030313038

广州市科技计划项目 201400000001-3

广州市科技计划项目 201508020262

广州市科技计划项目 2014Y2-00200

详细信息

通讯作者:
汪国营, Email: wanggy3@126.com

中图分类号: R617, R512.6+2
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- 被引次数: 0
出版历程
- 收稿日期: 2017-09-10
- 网络出版日期: 2021-01-19
- 刊出日期: 2017-11-15

Clinical efficacy of application of hepatitis B surface antigen-positive donor liver in liver transplantation

Department of Hepatic Surgery and Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China

More Information

Corresponding author: Wang Guoying, Email: wanggy3@126.com

摘要

摘要: 目的探讨乙型肝炎表面抗原（HBsAg）阳性供肝在成人肝移植应用的临床疗效。方法回顾性分析2012年7月至2015年10月28例接受HBsAg阳性供肝肝移植的乙型病毒性肝炎（乙肝）相关性肝病受者的临床疗效，总结受者预后、并发症发生情况，了解血清HBsAg及乙型肝炎病毒（HBV）DNA变化特点。结果 28例受者术后单药口服恩替卡韦预防乙肝复发。围手术期死亡2例，分别死于脓毒症和急性心力衰竭，2例随访期内因肝细胞癌（肝癌）复发死亡。另24例受者随访12~26个月，随访期间血清HBsAg持续阳性，经治疗HBV DNA滴度逐月下降，至术后12个月受者HBV DNA＜1×10² copies/mL。24例存活受者均未发生因乙肝复发导致的移植物失功。结论作为边缘供肝，HBsAg阳性供肝可安全用于乙肝相关性肝病的肝移植受者，术后需加强抗HBV治疗并密切随访。
- 肝移植 /
- 乙型肝炎表面抗原，阳性 /
- 边缘供肝 /
- 终末期肝病 /
- 乙型肝炎核心抗体 /
- 乙型肝炎病毒 /
- 核苷类似物 /
- 乙型肝炎人免疫球蛋白
Abstract: Objective To evaluate the clinical efficacy of application of hepatitis B surface antigen (HBsAg)-positive donor liver in adult liver transplantation. Methods Clinical efficacy of 28 recipients with liver diseases induced by virus B hepatitis (hepatitis B) undergoing liver transplantation using HBsAg-positive donor liver from July 2012 to October 2015 was retrospectively analyzed. Clinical prognosis and postoperative complications of the recipients were summarized. The changing features of serum levels of HBsAg and hepatitis B virus (HBV) DNA was investigated. Results After liver transplantation, 28 recipients were orally administered with entecavir to prevent the recurrence of hepatitis B. During perioperative period, 2 recipients died from sepsis and acute heart failure. During postoperative follow-up, 2 cases died from the recurrence of hepatocellular carcinoma (liver cancer). The remaining 24 patients were followed up for 12-26 months. Throughout the follow-up, 24 recipients were positive for serum HBsAg. After treatment, the titre of HBV DNA was significantly declined to < 1×10² copies/mL at postoperative 12 months. No graft dysfunction induced by hepatitis B recurrence occurred in 24 recipients alive. Conclusions As a marginal donor liver, HBsAg-positive liver graft is safe for liver transplantation in the recipients with hepatitis B-related liver diseases. Postoperatively, anti-HBV treatment should be strengthened and intimate follow-up should be delivered.
- Liver transplantation /
- Hepatitis B surface antigen, positive /
- Marginal donor liver /
- End-stage liver disease /
- Hepatitis B core antibody /
- Hepatitis B virus /
- Nucleoside analogue /
- Hepatitis B immune globulin

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参考文献(33)

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