Multi-disciplinary team of complex cholestatic liver injury after liver transplantation
10.3969/j.issn.1674-7445.2021.06.012
- VernacularTitle:肝移植术后复杂胆汁淤积型肝损伤的多学科综合诊疗
- Author:
Heyu HUANG
1
;
Xiaodong SUN
;
Yuguo CHEN
;
Xuxiang XIA
;
Guoyue LYU
Author Information
1. Liver Transplantation Center, the First Hospital of Jilin University, Changchun 130000, China
- Publication Type:Research Article
- Keywords:
Liver transplantation;
Cholestasis;
Liver injury;
Multi-disciplinary team;
Biliary stricture;
Rejection;
Biliary tract infection;
Drug-induced liver injury
- From:
Organ Transplantation
2021;12(6):720-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the role of multi-disciplinary team (MDT) in the treatment of complex cholestatic liver injury after liver transplantation. Methods MDT consultation was conducted to clarify the causes and therapeutic strategies for one case of complex cholestatic liver injury after liver transplantation admitted to Liver Transplantation Center of the First Hospital of Jilin University on June 23, 2020. And the role of MDT in the treatment of complex cholestatic liver injury after liver transplantation was summarized. Results The patient presented with abnormal liver function after liver transplantation. The diagnosis of biliary stricture, rejection and biliary tract infection was confirmed successively. Endoscopic retrograde cholangiopancreatography (ERCP) stent internal and external double drainage, glucocorticoid shock and anti-infection therapy yielded low clinical efficacy. After MDT consultation, complex cholestatic liver injury after liver transplantation was confirmed. It was suggested to optimize the immunosuppressive regimen based on the exclusion of rejections by pathological examination, deliver targeted anti-infection interventions and prevent the potential risk of concomitant drug-induced liver injury. The patient was discharged after proper recovery. Conclusions The causes of complex cholestatic liver injury after liver transplantation are diverse, and the condition changes dynamically. MDT consultation are performed to deepen the understanding of this disease, strengthen the classification of diagnosis and treatment ideas and enhance the precision and efficacy of corresponding treatment.