Experience of clinical treatment on patients on cirrhosis or liver cancer complicated with psoriasis after liver transplantation
10.3969/j.issn.1674-7445.2016.06.005
- VernacularTitle:肝硬化或肝癌伴银屑病患者肝移植术后治疗经验
- Author:
Guosheng DU
1
;
Lin ZHOU
;
Yonggen ZHENG
;
Lichao PAN
;
Haida SHI
;
Zhidong ZHU
;
Jiyong SONG
;
Likui FENG
Author Information
1. 解放军第309医院全军器官移植研究所肝胆外科
- Keywords:
Liver transplantation;
Psoriasis;
Sirolimus;
Tacrolimus;
Immunosuppressive agent;
Severity index
- From:
Organ Transplantation
2016;7(6):438-443
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical experience of immunosuppressive therapy for recipients suffering from psoriasis after liver transplantation. Methods Five patients diagnosed with cirrhosis or hepatocellular carcinoma (HCC)complicated with psoriasis after liver transplantation were recruited in this clinical trial. All participants were positive for serum biomarkers of hepatitis B virus (HBV). Induction therapy was adopted before surgery. Immunosuppressive regime of tacrolimus (FK506),mycophenolate mofetil (MMF)and adrenal cortical hormone (hormone) was implemented early after surgery. The hormone use was terminated within 1 week. Three cases of cirrhosis complicated with HCC due to chronic HBV infection were gradually switched to sirolimus substitution treatment within 1 month after liver transplantation. Two patients with cirrhosis were administered with FK506 with or without MMF following liver transplantation. All patients received anti-HBV therapy. Baseline data,changes in psoriasis area and severity index (PASI)score and adjustment of postoperative immunosuppressive agents were analyzed. Results Five patients undergoing transplantation were followed up until the submission date with a mean duration of (8. 3 ±1 . 5 )years and survived. Compared with preoperative values,PASI score was significantly reduced at postoperative 6 months (P<0. 05 ). Two patients with cirrhosis had recurrent psoriasis at 2 years after liver transplantation. PASI score was significantly increased and steadily declined after sirolimus substitution therapy. These patients remained physically stable and did not progress at postoperative 3 years. Three patients suffering from cirrhosis complicated with HCC presented with no recurrence of psoriasis postoperatively. Conclusions Sirolimus-based immunosuppressive therapy can effectively control the progression of psoriasis in liver transplantation recipients. Anti-HBV treatment should be simultaneously implemented for HBV positive patients.
