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中华移植杂志(电子版) ›› 2019, Vol. 13 ›› Issue (01) : 75 -80. doi: 10.3877/cma.j.issn.1674-3903.2019.01.018

所属专题: 文献

综述

肝移植术后移植物抗宿主病的诊治进展
朱晓璐1, 郑树森2,()   
  1. 1. 310058 杭州,浙江大学医学院
    2. 310003 杭州,浙江大学医学院附属第一医院肝胆胰外科
  • 收稿日期:2018-12-30 出版日期:2019-02-25
  • 通信作者: 郑树森
  • 基金资助:
    "十三五"国家科技重大专项(2017X10203201)

Progress of the giagnosis and treatment of postoperative liver transplant-associated graft versus host disease

Xiaolu Zhu1, Shusen Zheng2,()   

  1. 1. Zhejiang University School of Medicine, Hangzhou 310058, China
    2. Department of Hepatopancreatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
  • Received:2018-12-30 Published:2019-02-25
  • Corresponding author: Shusen Zheng
  • About author:
    Corresponding author: Zheng Shusen, Email:
引用本文:

朱晓璐, 郑树森. 肝移植术后移植物抗宿主病的诊治进展[J]. 中华移植杂志(电子版), 2019, 13(01): 75-80.

Xiaolu Zhu, Shusen Zheng. Progress of the giagnosis and treatment of postoperative liver transplant-associated graft versus host disease[J]. Chinese Journal of Transplantation(Electronic Edition), 2019, 13(01): 75-80.

肝移植术后移植物抗宿主病(GVHD)发生率低,但病死率极高,典型症状包括不明原因发热、皮疹、腹泻和骨髓抑制。其发病机制目前尚未完全阐明,诊断缺乏统一标准,治疗缺乏特异性手段。近年来,针对GVHD免疫反应进程中的病理生理学研究,为开辟新的诊断方法和治疗手段提供可能。目前,大剂量糖皮质激素联合静脉注射免疫球蛋白冲击、免疫抑制剂减少或停用可能是较为有效的治疗方案。而对于糖皮质激素难治性GVHD,应用多种不同的分子靶向药物可能对改善受者预后起到积极作用。

The incidence of graft versus host disease(GVHD) after liver transplantation is low, but the mortality rate is extremely high. The typical symptoms are: unidentified high fever, tetter, diarrhea and myelosuppression. The standardized treatment of GVHD after liver transplantation remains unclear. It is probably more effective to use high-dose of methylprednisolone combined with intravenous immunoglobulin, withdrawing or decline the dosage of immunosuppressant to treat GVHD after liver transplantation. For the hormone-refractory GVHD, the application of a variety of targeted drugs of cytokine or chemokine may play a positive role in improving the prognosis of patients.

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