Differentiation Between Transient Intrahepatic Cholestasis and Acute Rejection after Liver Transplantation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHAO Xin , CHEN Dazhi , WU Tianming , JIN Zhongkui , HAN Dongdong , KOU Jiantao , LI Lixin , LANG Ren , HE Qiang

Department of Hepatobiliary Surgery， Beijing Chaoyang Hospital， Capital University of Medical Science， Beijing 100020， China;

Corresponding author：

Keywords：

Intrahepatic cholestasis; Acute rejection; Liver transplantation

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Objective To discuss the differentiation between transient intrahepatic cholestasis (TIHC) and acute rejection (AR) after liver transplantation． Methods Characteristics and the changes (before and within 21 d after transplantation) of alanine aminotransferase (ALT) and direct bilirubin (DBIL) in 30 patients undergone liver transplantation were observed. These patients were divided into TIHC group and AR group following the diagnosis criteria, and the serum levels of ALT and DBIL were compared respectively on day 1 before liver transplantation, day 3, 7 and 21 after liver transplantation． Results Compared with day 3 after transplantation in the TIHC group， DBIL significantly ascended while ALT was changeless on day 7 after transplantation. But in the AR group， DBIL ascended significantly and ALT showed an increasing tendency on day 7 after transplantation． After appropriate therapy, DBIL and ALT of two groups both descended significantly on day 21 after transplantation． Conclusion The changes of DBIL and ALT are available for the differentiation between TIHC and AR after transplantation.

Citation： ZHAO Xin,CHEN Dazhi,WU Tianming,JIN Zhongkui,HAN Dongdong,KOU Jiantao,LI Lixin,LANG Ren,HE Qiang. Differentiation Between Transient Intrahepatic Cholestasis and Acute Rejection after Liver Transplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(11): 817-819. doi: Copy

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4.	王燕庆，夏强，张建军，等．肝脏穿刺活检在诊断移植肝病理改变中的价值 [Ｊ]. 中华普通外科杂志， 2005； 20(11)∶693.
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14.	王政禄，张淑英，朱丛中，等． 906例次移植肝穿刺活检病理分析 [Ｊ]. 中华器官移植杂志， 2006； 27(1)∶18.
15.	李军，窦科峰，朱靓，等．人肝移植术后移植肝脏热休克蛋白70的表达及意义 [Ｊ]. 中国普外基础与临床杂志， 2008； 15(6)∶426.
16.	卢实春，严律南，李波，等． 50例肝移植术后近期高胆红素血症的原因及处理 [Ｊ]. 中华器官移植杂志， 2003； 24(2)∶73.
17.	王宇, 周杰, 蒋晓青．丹参对大鼠移植肝脏再灌注损伤的防护及肝细胞凋亡的影响 [Ｊ]. 南方医科大学学报， 2008； 28(5)∶870.
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1. 陈大志，郎韧，李宁，等．肝移植术后早期高胆红素血症分型及临床意义 [Ｊ]. 中华肝胆外科杂志， 2003； 9(12)∶729.
2. 郎韧，陈大志，贺强，等．肝移植术后一过性肝内胆汁淤积症的临床特征和诊治体会 [Ｊ]. 中华普通外科杂志， 2006； 21(11)∶785.
3. 曹晓伟，唱浩，王正昕，等．肝移植后急性排斥反应的诊断和防治 [Ｊ]. 第二军医大学学报， 2004； 25(8)∶916.
4. 王燕庆，夏强，张建军，等．肝脏穿刺活检在诊断移植肝病理改变中的价值 [Ｊ]. 中华普通外科杂志， 2005； 20(11)∶693.
5. 朱继业, 王东．肝移植术后急性排斥反应 [Ｊ]. 中华肝脏病杂志， 2005； 13(3)∶223.
6. González-Pinto IM, Rimola A, Margarit C, et al． Five-year follow-up of a trial comparing Tacrolimus and cyclosporine microemulsion in liver transplantation [Ｊ]. Transplant Proc, 2005; 37(4)∶1713.
7. Ziolkowski J, Paczek L, Niewczas M, et al． Effect of immunosuppressive regimen on acute rejection and liver graft function [Ｊ]. Transplant Proc, 2003; 35(6)∶2281.
8. Cutrin JC, Cantino D, Biasi F， et al． Reperfusion damage to the bile canaliculi in transplanted human liver [Ｊ]. Hepatology, 1996; 24(5)∶1053.
9. Doctor RB, Fouassier L. Emerging roles of the actin cytoskeleton in cholangiocyte function and disease [Ｊ]. Semin Liver Dis, 2002; 22(3)∶263.
10. Carrasco L, Sanchez-Bueno F, Sola J， et al． Effects of cold ischemia time on the graft after orthotopic liver transplantation. A bile cytological study [Ｊ]. Transplantation, 1996; 61(3)∶39311.
11. Koeppel TA, Trauner M, Mennone A， et al． Role of glutathione in hepatic bile formation during reperfusion after cold ischemia of the rat liver [Ｊ]. J Hepatol, 1998; 28(5)∶812.
12. Doctor RB, Dahl RH, Salter KD， et al． ATP depletion in rat cholangiocytes leads to marked internalization of membrane proteins [Ｊ]. Hepatology, 2000; 31(5)∶1045.
13. Kukan M, Haddad PS. Role of hepatocytes and bile duct cells in preservation-reperfusion injury of liver grafts [Ｊ]. Liver Transpl, 2001; 7(5)∶381.
14. 王政禄，张淑英，朱丛中，等． 906例次移植肝穿刺活检病理分析 [Ｊ]. 中华器官移植杂志， 2006； 27(1)∶18.
15. 李军，窦科峰，朱靓，等．人肝移植术后移植肝脏热休克蛋白70的表达及意义 [Ｊ]. 中国普外基础与临床杂志， 2008； 15(6)∶426.
16. 卢实春，严律南，李波，等． 50例肝移植术后近期高胆红素血症的原因及处理 [Ｊ]. 中华器官移植杂志， 2003； 24(2)∶73.
17. 王宇, 周杰, 蒋晓青．丹参对大鼠移植肝脏再灌注损伤的防护及肝细胞凋亡的影响 [Ｊ]. 南方医科大学学报， 2008； 28(5)∶870.
18. 崔巍，熊奇如．预防肝脏缺血再灌注损伤的研究现状 [Ｊ]. 中国实用外科杂志， 2005； 25(10)∶638.
19. 王琳，赵青川，陶开山，等．肝移植106例术后急性排斥反应的诊断和治疗 [Ｊ]. 第四军医大学学报， 2006； 27 (21)∶1990　.
20. 倪之嘉，丁国善，于勇，等．巴利昔单抗在预防肝移植术后排斥反应中的应用 [Ｊ]. 第二军医大学学报， 2007； 28（6）∶678.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Differentiation Between Transient Intrahepatic Cholestasis and Acute Rejection after Liver Transplantation

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