摘要
目的总结多囊肾合并多囊肝受者肾移植术后肝内囊肿反复感染接受肝移植的诊治经验。方法回顾性分析首都医科大学附属北京朝阳医院收治的1例多囊肾合并多囊肝患者肾移植术后肝内囊肿反复感染行肝移植的临床资料,并进行文献复习。结果受者为男性,60岁,31年前发现多囊肾合并多囊肝,2年前因肾功能衰竭(血肌酐700μmol/L)开始规律接受血液透析,15个月前(2018年3月20日)接受右肾切除术,并于9个月前接受肾移植。受者应用巴利息单抗行免疫诱导,免疫维持采用他克莫司+麦考酚钠+醋酸泼尼松。术后移植肾功能稳定(血肌酐在120~150μmol/L),术后2周顺利出院。6个月前,受者反复因高热伴左侧腰痛等症状入院,经与感染科、肝胆外科、呼吸科等相关科室会诊,考虑肝囊肿反复感染,决定行肝移植。肝移植术中病肝内可见多发囊肿,囊腔内大量脓性粘稠物质。术后感染得到迅速控制,移植肝功能良好,移植肾功能稳定,未发生严重并发症。截至末次随访,移植肾和移植肝功能均正常。结论肾移植术后对于多囊肝囊肿感染的处理,抗生素联合适当外科干预是必不可少的;对于反复感染,严重影响生存质量的受者,应考虑行肝移植术。
Objective To summarize the experiences of diagnosing and treating recurrent intrahepatic cyst infection in patients with autosomal dominant polycystic kidney disease(ADPKD)and polycystic liver after renal transplantation.Methods Clinical data were analyzed retrospectively for a patient with polycystic kidney complicated with polycystic liver after renal transplantation.Results At our center,a patient with recurrent infection of polycystic liver cyst after allogeneic kidney transplantation was treated.After a failure of regular antibiotic treatment,the patient underwent allogeneic liver transplantation.Infection was controlled and recovered well.Currently regular follow-ups were conducted.Conclusions For polycystic liver cyst infection,antibiotics plus appropriate surgical intervention are essential.For refractory infections seriously affecting quality-of-life,allogeneic liver transplantation should be considered.
作者
郑翔
谷丽
郎韧
孙兵
李绪言
王玮
Zheng Xiang;Gu Li;Lang Ren;Sun Bing;Li Xuyan;Wang Wei(Department of Urology,Affiliated Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)
出处
《中华器官移植杂志》
CAS
北大核心
2020年第8期470-473,共4页
Chinese Journal of Organ Transplantation
关键词
多囊肾
多囊肝
肾移植
囊内感染
肝移植
Polycystic kidney
Polycystic liver
Kidney transplantation
Intracapsular infection
Liver transplantation
