山东医药Issue(15)：11-13,3.DOI:10.3969/j.issn.1002-266X.2015.015.004
术后少见并发症致远期再次肝移植的手术指征、技巧及免疫抑制方案（附5例分析）
Indications, skills and immunosuppression of late liver re-transplantation caused by rare postoperative complication:report of 5 cases
摘要
Abstract
Objective To analyze the patients'clinical data of re-operation of liver re-transplantation caused by rare etiology and to discuss the choice of the indications, skills and immunosuppression of late liver transplantation. Methods Five cases of patients after liver transplantation for the first time receiving liver re-transplantation were se-lected.The indications consisted of chronic rejection (4 cases) and idiopathic portal hypertension (1 case).Five pa-tients after liver transplantation for the first time received liver re-transplantation in 6-14 months, and all cases adopt the classic orthotopic liver transplantation ( OLT) .The postoperative immunosuppression schemes of 4 cases were the triple immunosuppressive therapy of tacrolimus (FK506), mycophenolate mofetil (MMF) and hormone; and 1 case applied cyclosporin combined with hormone.Results After one-year follow-up, four patients were cured, and one patient died on week after liver re-transplantation because of poor graft function and respiratory failure.One case had biliary stenosis and then was improved by interventional radiology treatment.no complications and all in good condi-tion.No acute rejection and related complications were found in the postoperative immunosuppression.Conclusions As for patients who received liver transplantation for the first time having chronic rejection and idiopathic portal hyper-tension, late liver re-transplantation should be considered.Controlling the intraoperative bleeding and being familiar with vascular and bile duct reconstruction technique may improve the successful rate of surgery.For patients who re-ceived re-operation of liver re-transplantation, doctors should choose appropriate immunosuppressive scheme, which will help to improve the survival rate of patients.关键词
肝移植/再次肝移植/肝移植并发症/免疫抑制/特发性门静脉高压/移植物抗宿主反应Key words
liver transplantation/liver re-transplantation/complications of liver transplantation/immunosuppression/idiopathic portal hypertension/graft versus host reaction分类
医药卫生引用本文复制引用
张少辉,臧运金,范宁,路宾..术后少见并发症致远期再次肝移植的手术指征、技巧及免疫抑制方案（附5例分析）[J].山东医药,2015,(15):11-13,3.基金项目
国家高新技术研究发展计划项目（2012AA021006）。 （）
