Persistent hyperbilirubinemia in follow-up patients after liver transplantation
10.3760/cma.j.issn.1007-631X.2012.02.016
- VernacularTitle:肝移植术后持续高胆红素血症的诊治
- Author:
Lei HUANG
;
Guangming LI
;
Jiye ZHU
;
Tao LI
;
Xinyu LI
;
Xisheng ENG
- Publication Type:Journal Article
- Keywords:
Liver transplantation;
Hyperbilirubinemia;
Follow-up studies
- From:
Chinese Journal of General Surgery
2012;27(2):141-144
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the etiologies of persistent hyperbilirubinemia in follow-up patients after liver transplantation. Methods The clinical data of 527 follow-up patients after liver transplantation at the department of hepatobiliary surgery in Peking University People's Hospital between May 2000 and Dec 2009 were analyzed retrospectively. Results Sixty-five patients experienced persistent hyperbilirubinemia,there were 34 cases of biliary complications (52.3％ ),14 cases with drug-induced liver injury(21.5％ ),6 cases with hepatitis B or C recurrence(9.2％ ),4 cases with acute rejection (6.2％ ) 3 cases with inflammatory stenosis of the duodenal papilla ( 4.6％ ),2 cases with hepatic carcinoma recurrence(3.1％ ),1 case with neomalignancy and 1 case with unknown reason.Treatment included use of liver protectant and choleretics,the adjustment and replacement of anti-rejection drugs,cholelithotomy by choledochoscope,PTCD,placement of biliary stent and re-operation.Of all the 65 cases 50 patients were cured or in stable condition,15 patients died. Conclusions Jaundice is a common clinical manifestation after liver transplantation with multiple and complicated causes.Diffuse stricture of intrahepatic biliary tract predicts poor prognosis,drug-related liver injury was less common cause of hyperbilirubinemia and often misdiagnosed.
