The etiology and management of early postoperative hyperbilirubinemia after liver transplantation
- VernacularTitle:50例肝移植术后近期高胆红素血症的原因及处理
- Author:
Shichun LU
;
Lunan YAN
;
Bo LI
- Publication Type:Journal Article
- Keywords:
Liver transplantation;
Hyperbilirubinemia;
Graft rejection
- From:
Chinese Journal of Organ Transplantation
1996;0(02):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the etiology and management of early postoperative hyperbilirubinemia after liver transplantation. Methods The etiology and dynamic alteration of early postoperative hyperbilirubinemia in 50 liver transplants were retrospectively analyzed by a comparative trial of clinical manifestation with serial liver biopsy. Results The total serum bilirubin (TB) level profile presented like a invert "S" curve. At the first week, second week and 4th week after liver transplantation the serum TB levels were in average ( 127.19? 113.15)? ( 135.45? 124.6) and ( 73.1? 49.52)??mol/L respectively. Three months later, the serum TB level approximated to normal TB level ( 29.8? 37.56)??mol/L. The dynamic alternations of total serum bilirubin level were incorporated with the morphological improvement under microscopy of liver allograft following liver transplantation. The initial hyperbilirubinemia of reciepient before liver transplantation (10 cases, 20?%), preservation injury (containing 44 cases of ischemic reperfusion injury, 88?%), acute cellular rejection (13 cases, 26?%) and bile duct leakage (4 cases, 8?%) were 4 essential causes responsible for the early postoperative hyperbilirubinemia. The total serum bilirubin level profile was not characteristic of each catergory. Those 4 casuses mentioned above presented either independently or concomitantly in concrete case. No primary hepatic failure (PHF) occurred and curability of hyperbilirubinemia was about 100?% in our series. Furthermore, the perioperative survival rate of the recipients and liver allograft was 90.6?% and 1-year accumulative survival rate was about 80?%.Conclusions The hyperbilirubinemia is common clinical manifestion within 3 months after liver transplantation. Preservative injury, acute rejection, preoperative hyperbilirubinemina and bile duct leakage are four essential causes. The comprehensive management targeted to etiology can usually achieve a good outcome for the reciepients with hyperbilirubinemia.
