ACUTE LIVER ALLOGRAFT-REJECTION - IS TREATMENT ALWAYS NECESSARY

被引:79
作者
DOUSSET, B
HUBSCHER, SG
PADBURY, RTA
GUNSON, BK
BUCKELS, JAC
MAYER, AD
ELIAS, E
MCMASTER, P
NEUBERGER, JM
机构
[1] QUEEN ELIZABETH HOSP,LIVER UNIT,BIRMINGHAM B15 2TH,W MIDLANDS,ENGLAND
[2] UNIV BIRMINGHAM,DEPT PATHOL,BIRMINGHAM B15 2TT,W MIDLANDS,ENGLAND
关键词
D O I
10.1097/00007890-199303000-00014
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
A group of 195 consecutive adult patients who received a primary orthotopic liver allograft were reviewed retrospectively to analyze the incidence of rejection, the response to antirejection therapy, and the impact of acute rejection on the development of ductopenic rejection. The diagnosis of acute rejection (AR) was based on a combination of clinical and histological criteria, and 69.7% of the patients had at least one episode of acute rejection. Only 6.7% of the patients failed to respond to steroids and were treated with OKT3. Four (2.3%) patients developed acute vanishing bile duct syndrome (within 60 days) and 6 (3.5%) patients developed chronic rejection. Eight patients who spontaneously recovered from AR without additional immunosuppression are described in detail. In addition to histological damage, all developed significant hepatic dysfunction. Except for one patient who died from disseminated fungal infection, the 7 remaining patients are alive with excellent graft function 7 to 21 months posttransplant. While severe AR and recurrent AR should be treated without delay, some patients with mild-to-moderate rejection and hepatic dysfunction may resolve without additional immunosuppression.
引用
收藏
页码:529 / 534
页数:6
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