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中华移植杂志(电子版) ›› 2025, Vol. 19 ›› Issue (03) : 193 -196. doi: 10.3877/cma.j.issn.1674-3903.2025.03.015

病例报告

肝移植术后抗体介导排斥反应合并肺孢子菌肺炎一例
周家康, 刘忠忠, 张涛, 叶少军, 熊艳()   
  1. 430071 武汉,武汉大学中南医院 武汉大学肝胆疾病研究院
  • 收稿日期:2025-01-08 出版日期:2025-06-25
  • 通信作者: 熊艳
  • 基金资助:
    国家自然科学基金(82271810)

Antibody mediated rejection complicated by pneumocystis pneumonia after liver transplantation: a case report

Jiakang Zhou, Zhongzhong Liu, Tao Zhang, Shaojun Ye, Yan Xiong()   

  1. Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Wuhan 430071, China
  • Received:2025-01-08 Published:2025-06-25
  • Corresponding author: Yan Xiong
引用本文:

周家康, 刘忠忠, 张涛, 叶少军, 熊艳. 肝移植术后抗体介导排斥反应合并肺孢子菌肺炎一例[J/OL]. 中华移植杂志(电子版), 2025, 19(03): 193-196.

Jiakang Zhou, Zhongzhong Liu, Tao Zhang, Shaojun Ye, Yan Xiong. Antibody mediated rejection complicated by pneumocystis pneumonia after liver transplantation: a case report[J/OL]. Chinese Journal of Transplantation(Electronic Edition), 2025, 19(03): 193-196.

图1 肝移植术后抗体介导排斥反应合并肺孢子菌肺炎患者入院第13天肝穿刺活检病理学结果(HE)注:a.汇管区炎性细胞浸润明显(50%); b.箭头示明显静脉炎征象;c.箭头示肝细胞内胆汁淤积、胆色素聚集;d.箭头示胆管炎征象,以炎性细胞浸润和胆管上皮损伤为特征
图2 肝移植术后抗体介导排斥反应合并肺孢子菌肺炎患者入院第35天肝穿刺活检病理学结果(HE)注:a.汇管区炎性细胞浸润明显(20%); b.箭头示炎性细胞粘附于静脉壁,可见静脉炎征象;c.箭头示肝细胞内胆汁淤积、胆色素聚集;d.箭头示胆管内炎性细胞浸润
图3 肝移植术后抗体介导排斥反应合并肺孢子菌肺炎患者入院第40天肺部CT影像注:双肺见斑片状高密度影及磨玻璃影
图4 肝移植术后抗体介导排斥反应合并肺孢子菌肺炎患者入院第69天肝穿刺活检病理学结果(HE)注:a.汇管区炎性细胞浸润明显(10%); b.箭头示炎性细胞粘附于静脉壁,但未见静脉炎征象;c.箭头示肝细胞内胆汁淤积、胆色素聚集;d.箭头示胆管内炎性细胞浸润
图5 肝移植术后抗体介导排斥反应合并肺孢子菌肺炎患者住院期间肝功能指标变化情况注:a、b、c.第1~3次肝穿刺活检;TBil.总胆红素;GGT. γ-谷氨酰转移酶;ALP.碱性磷酸酶
图6 肝移植术后抗体介导排斥反应合并肺孢子菌肺炎患者住院期间他克莫司血药浓度变化情况注:a、b、c.第1~3次肝穿刺活检
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