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超声造影早期检出联合间充质干细胞治疗改善肝移植术后胆道缺血预后的初步探讨

林跃君 郑博文 吴涛 周慧超 廖梅 吕艳 何玉婷 任杰

林跃君, 郑博文, 吴涛, 等. 超声造影早期检出联合间充质干细胞治疗改善肝移植术后胆道缺血预后的初步探讨[J]. 器官移植, 2021, 12(3): 324-328. doi: 10.3969/j.issn.1674-7445.2021.03.011
引用本文: 林跃君, 郑博文, 吴涛, 等. 超声造影早期检出联合间充质干细胞治疗改善肝移植术后胆道缺血预后的初步探讨[J]. 器官移植, 2021, 12(3): 324-328. doi: 10.3969/j.issn.1674-7445.2021.03.011
Lin Yuejun, Zheng Bowen, Wu Tao, et al. Preliminary study of early diagnosis by contrast-enhanced ultrasound combined with mesenchymal stem cell therapy in improving prognosis of biliary ischemia after liver transplantation[J]. ORGAN TRANSPLANTATION, 2021, 12(3): 324-328. doi: 10.3969/j.issn.1674-7445.2021.03.011
Citation: Lin Yuejun, Zheng Bowen, Wu Tao, et al. Preliminary study of early diagnosis by contrast-enhanced ultrasound combined with mesenchymal stem cell therapy in improving prognosis of biliary ischemia after liver transplantation[J]. ORGAN TRANSPLANTATION, 2021, 12(3): 324-328. doi: 10.3969/j.issn.1674-7445.2021.03.011

超声造影早期检出联合间充质干细胞治疗改善肝移植术后胆道缺血预后的初步探讨

doi: 10.3969/j.issn.1674-7445.2021.03.011
基金项目: 

国家自然科学基金面上项目 81971632

广东省自然科学基金面上项目 2020A1515010425

广东省重点领域研发计划项目 2019B020235002

详细信息
    通讯作者:

    任杰,Email: renj@mail.sysu.edu.cn

  • 中图分类号: R617, R445, R329.2

Preliminary study of early diagnosis by contrast-enhanced ultrasound combined with mesenchymal stem cell therapy in improving prognosis of biliary ischemia after liver transplantation

More Information
  • 摘要:   目的  探讨超声造影(CEUS)早期检出联合间充质干细胞(MSC)治疗肝移植术后胆道缺血的疗效。  方法  回顾性分析9例肝移植术后4周内CEUS提示胆道缺血且术后1年内确诊为非吻合口胆管狭窄(NAS)受者的临床资料。常规治疗组4例,行常规治疗,治疗方式包括护肝、利胆、介入治疗等; MSC治疗组5例,在常规治疗的基础上,分别于CEUS提示胆道缺血后1、2、4、8、12和16周接受MSC静脉输注。分析两组受者肝移植术后1年内介入治疗情况和预后。  结果  MSC治疗组2例受者需接受介入治疗,首次治疗时间为肝移植术后7~9个月,治疗次数1~2次; 常规治疗组所有受者均需接受介入治疗,首次治疗时间早于MSC治疗组,为术后1~3个月,治疗次数2~6次。肝移植术后1年内,MSC治疗组2例受者发生弥漫性胆管损伤,未发生移植物失功; 常规治疗组所有受者均发生弥漫性胆管损伤,2例受者发生移植物失功。  结论  应用CEUS早期检出肝移植术后胆道缺血并进行MSC治疗可延缓并减少NAS介入治疗需求,改善受者预后。

     

  • 图  1  1例肝移植术后CEUS提示胆道缺血接受常规治疗受者的超声表现

    注:A图示肝移植术后4周复查,彩色多普勒超声见肝动脉形态正常; B图示肝移植术后4周CEUS见胆管壁动脉期无增强,提示胆道缺血(箭头处为胆管壁,*为肝实质); C、D图示肝移植术后2个月,二维超声见肝动脉形态正常,肝门区积液(红色箭头),介入治疗中确诊积液为胆漏; E图示肝移植术后11个月,PTCD见以稀疏胆管树及多发肝内胆管狭窄为特点的弥漫性严重胆管损伤(红色箭头处为中心胆管狭窄)。

    Figure  1.  Ultrasonic findings of 1 recipient received conventional treatment with biliary ischemia determined by CEUS after liver transplantation

    图  2  1例肝移植术后CEUS提示胆道缺血且接受MSC治疗受者的超声表现

    注:A图示肝移植术后4周复查,彩色多普勒超声见肝动脉形态正常; B图示肝移植术后4周CEUS见胆管壁动脉期无增强,提示胆道缺血(箭头处为胆管壁,*为肝实质),此时开始MSC治疗; C图示肝移植术后5个月,受者出现轻中度肝功能异常,行MRCP确诊NAS,此时肝动脉形态正常; D图示肝移植术后1年,MRCP未见肝内胆管(白色箭头)及中心胆管(红色箭头)狭窄。

    Figure  2.  Ultrasonic findings of 1 recipient received MSC treatment with biliary ischemia determined by CEUS after liver transplantation

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出版历程
  • 收稿日期:  2021-01-11
  • 网络出版日期:  2021-05-19
  • 刊出日期:  2021-05-15

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