Abnormal liver function after liver transplantation
10.3969/j.issn.2095-4344.2013.31.017
- VernacularTitle:肝移植后肝功能的异常★
- Author:
Jun LI
;
Hong CHEN
;
Tieyan FAN
;
Xu WANG
- Publication Type:Journal Article
- Keywords:
organ transplantation;
organ transplantation review;
liver transplantation;
liver function;
cause;
rejection;
autoimmune hepatitis;
transaminase;
total bilirubin;
direct bilirubin
- From:
Chinese Journal of Tissue Engineering Research
2013;(31):5686-5692
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:The causes for abnormal liver function after liver transplantation is complex, and it is important for the treatment to clarify the causes of abnormal liver function. OBJECTIVE:To analyze the cause of abnormal liver function after liver transplantation, and to use it in clinical diagnosis and treatment. METHODS:The CNKI database and FMJS database were retrieved by computer for articles published from January 1991 to July 2012. Articles were searched with the key words of“liver transplantation, abnormal liver function, transaminase abnormalities, bilirubin increased, causes”in Chinese and English. A total of 98 articles were retrieved. Thirty-five articles directly related to abnormal liver function after liver transplantation and those published in authoritative magazines were included to review.RESULTS AND CONCLUSION:Many reasons can lead to abnormal liver function after liver transplantation, with complex clinical manifestations. The most common causes were acute rejection, biliary complications and virus infection. When the abnormal liver function occurred in the early postoperative period, especial y in one month after liver transplantation, the smal size syndrome and primary graft non-function should be vigilant. The transaminase and bilirubin levels were different for different causes. Transaminase increased more significantly than bilirubin in acute rejection, autoimmune hepatitis, viral infection, ischemia-reperfusion injury, portal vein and hepatic vein stenosis. However, obstruction enzyme such as alkaline phosphatase, glutamyltransferase, total bilirubin and direct bilirubin was increased more significantly in chronic rejection, biliary complications, hepatic artery, primary biliary cirrhosis and primary sclerosing cholangitis;transaminase increasing mainly and bilirubin increasing mainly can both appear in the patients with tumor, and which one wil happen depending on the size and oppression of the tumor. In addition, col ecting the medical history careful y can help to diagnose early as each patient have his special medical history. In a word, It’s important to col ect medical history careful y in clinical work, and the common cause of abnormal liver function should be consider firstly according to the increasing of transaminase and bilirubin, and other relatively uncommon causes should be considered after remove the common causes through clinical proven. It can help to diagnose and treat as soon as possible to make ful use of examinations, such as laboratory tests, imaging studies and liver puncture biopsy.