CAJ | 학술논문

目的观察肝移植治疗自身免疫性肝炎(AIH)的预后及复发情况. 方法回顾性分析因AIH行肝移植术16例患者的临床资料.分析患者术后累计生存率、AIH复发及并发症等情况.累计生存率分析采用Kaplan-Meier方法. 结果 16例患者均为女性,平均年龄52.6岁(41 ～ 66岁),平均终末期肝病模型(MELD)评分21.4;血清学分析提示1型AIH 15例,2型AIH 1例;3例患者死亡,其中2例死亡原因为肺部感染,1例为移植物失功能;患者1年、2年、5年累计生存率分别为93.8％、87.1％、79.1％;5例出现AIH复发,复发率31.3％.6例(37.5％)术后出现急性排斥反应,1例(6.3％)出现新发乙型肝炎病毒感染,经治疗后均有效控制.结论肝移植是终末期AIH的有效治疗方法,肝移植术后面临原发病复发及排斥反应等问题,但对患者生存无明显消极影响.
목적 관찰간이식치료자신면역성간염(AIH)적예후급복발정황. 방법 회고성분석인AIH행간이식술16례환자적림상자료.분석환자술후루계생존솔、AIH복발급병발증등정황.루계생존솔분석채용Kaplan-Meier방법. 결과 16례환자균위녀성,평균년령52.6세(41 ～ 66세),평균종말기간병모형(MELD)평분21.4;혈청학분석제시1형AIH 15례,2형AIH 1례;3례환자사망,기중2례사망원인위폐부감염,1례위이식물실공능;환자1년、2년、5년루계생존솔분별위93.8％、87.1％、79.1％;5례출현AIH복발,복발솔31.3％.6례(37.5％)술후출현급성배척반응,1례(6.3％)출현신발을형간염병독감염,경치료후균유효공제.결론 간이식시종말기AIH적유효치료방법,간이식술후면림원발병복발급배척반응등문제,단대환자생존무명현소겁영향.
Objective To describe the outcomes and recurrence of autoimmune hepatitis (AIH) after liver transplantation.Methods Clinical data of 16 patients with AIH who underwent liver transplantation were analyzed retrospectively.The postoperative cumulative survival rate of the patients was calculated.The postoperative rejections and AIH recurrence were analyzed.The Kaplan-Meier method was used for statistical analysis of survival.Results All patients were female, with an average age of 52.6 years (range: 41-66 years), and an average MELD score of 21.4.According serological analysis, 15 patients were AIH type 1 and 1 patient was AIH type 2.Three patients died, including 2 of pulmonary infection and 1 of graft dysfunction.The 1-, 2-and 5-year cumulative survival rates were 93.8％, 87.1％ and 79.1％, respectively.Five cases (31.3％) of recurrent AIH were diagnosed based on histological evidence.Acute rejection occurred in 6 (37.5％) patients, and de novo HBV infection occurred in 1 (6.3％) patient.Conclusion Liver transplantation is an effective treatment for end-stage AIH.Recurrence and rejection were commonly associated with AIH, but did not negatively impact patient survival.