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肝移植后病毒性肝炎再发是肝移植专家们最为关心的问题。应用拉米夫定和乙型肝炎免疫球蛋白疗法预防乙型肝炎病毒(HBV)再发以及应用干扰素(IFN)和利巴韦林联合预防丙型肝炎病毒(HCV)再发,其效果令人满意,但高昂的治疗费用却让患者对之望而却步。 作者报告2例患不能切除性肝细胞癌肝移植术后无HBV和HCV再发的患者,术前连续应用5-氟尿嘧啶(5-FU,750～1000mg)及IFN-β(600 MU)治疗共9次,术后门脉内给予5-FU(150～250mg,每天3次)共4次。其中1例丙型肝炎患者肝移植后两年未用任何治疗,未见有HCV再发。另1例乙型肝炎患者在肝移植后6个月仅用拉米夫定治疗,也未见有HBV再发。患者血清HBV DNA阴性,抗-HBs效价维持超过200U/mL。移植后1个月内迅速撤除
The recurrence of viral hepatitis after liver transplantation is a liver transplant expert most concerned about. Use of Lamivudine and Hepatitis B Immunoglobulin Therapy to Prevent Recurrent Hepatitis B Virus (HBV) and Interferon (IFN) and Ribavirin to Prevent Hepatitis C Virus (HCV) Relapse People are satisfied, but the high cost of treatment allows patients to prohibitive. The authors report 2 consecutive patients with unresectable hepatocellular carcinoma (HCC) after liver transplantation who had no HBV and HCV recurrence. The authors used 5-Fluorouracil (750-1000 mg) and IFN-β (600 MU) 9 times, 5-FU (150 ~ 250mg, 3 times a day) were given to the portal vein 4 times after the operation. One case of hepatitis C patients two years after liver transplantation without any treatment, no recurrence of HCV. Another case of hepatitis B patients treated with lamivudine only 6 months after liver transplantation, and no recurrence of HBV. Patients with negative serum HBV DNA, anti-HBs titer maintained over 200U / mL. Rapid withdrawal within 1 month after transplantation