由于肝移植后急性排斥导致的严重移植功能障碍的成功恢复:一个案例报告
Marina Isokawa1, Ryoichi Goto1, Takuji Ota1
1Gastroenterological Surgery, Hokkaido University Graduate School of Medicine, Sapporo, JPN.
Cureus
|January 6, 2026
概括
移植后严重的急性肝移植排斥可以通过保守的治疗成功治疗,避免重新移植. 这一案例突出了肝移植恢复的潜力,即使在严重的功能障碍中,也为面临供体短缺的患者提供了希望.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植免疫学 移植免疫学
- 胃肠病学 胃肠病学
背景情况:
- 移植失败是肝移植 (LT) 后的一个严重并发症.
- 急性排斥是肝移植衰竭的主要原因.
- 肝细胞癌 (HCC) 和酒精性肝硬化是LT的常见症状.
研究的目的:
- 报告一种罕见的严重急性肝移植排斥病例,在没有再移植的情况下成功康复.
- 突出严重的移植功能障碍中保守管理的潜力.
- 强调需要识别移植恢复的预测因素.
主要方法:
- 一名58岁的HCC男性患者接受了已故供体LT.
- 手术后发生严重急性排斥,导致严重的肝细胞破坏和功能衰竭.
- 保守的医疗管理被管理了四个月.
主要成果:
- 患者在术后23天经历了严重的急性排斥, ~90%的肝细胞被破坏.
- 总 bilirubin 的峰值达到 29.6 mg/dL,表明了严重的移植功能障碍.
- 肝移植最终通过保守治疗恢复了功能,避免了重新移植.
结论:
- 严重的急性肝移植排斥可以通过全面的保守治疗成功管理.
- 即使在严重功能障碍的情况下,移植的恢复也是可能的,这挑战了立即重新移植的必要性.
- 对预测移植恢复的临床参数进行进一步的研究是有必要的,以优化治疗策略.
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