实用肝脏病杂志 ›› 2023, Vol. 26 ›› Issue (6): 797-800.doi: 10.3969/j.issn.1672-5069.2023.06.008

• 病毒性肝炎 • 上一篇    下一篇

血清HBsAg阳性者接受肾移植术120周预后随访报告*

张玥, 宁玲, 李文渊, 郑晓玮, 刘洪涛, 张振华, 李磊   

  1. 233030 安徽省蚌埠市 蚌埠医学院研究生院(张玥,李磊);中国科学技术大学附属第一医院(安徽省立医院)感染病科(张玥,李磊,宁玲,李文渊,郑晓玮);肾移植科(刘洪涛);安徽医科大学第二附属医院感染病科(张振华)
  • 收稿日期:2022-12-10 出版日期:2023-11-10 发布日期:2023-11-20
  • 通讯作者: 李磊,E-mail:lilei0403@163.com
  • 作者简介:张玥,女,25岁,硕士研究生。E-mail:zhangyue977372@163.com
  • 基金资助:
    * 北京肝胆相照公益基金会人工肝专项基金资助项目(编号:RGGJJ-2021-002);安徽省自然科学基金资助项目(编号:1208085QH147)

120-week prognosis of serum HBsAg positive patients with chronic renal failure after renal transplantation

Zhang Yue, Ning Ling, Li Wenyuan, et al   

  1. Graduate School, Bengbu Medical College, Bengbu 233030, Anhui Province, China
  • Received:2022-12-10 Online:2023-11-10 Published:2023-11-20

摘要: 目的 分析血清HBsAg阳性患者在接受抗HBV治疗情况下肾移植术后长期生存情况。方法 2018年1月~2021年9月我院诊治的血清HBsAg阳性的慢性肾功能衰竭患者69例,均接受肾移植术治疗,其中26例接受血清HBsAg阳性供体肝脏。术后均接受恩替卡韦抗病毒和标准的抗免疫排斥反应治疗。随访196周(中位随访时间为120周)。结果 本组发生肾移植后移植物功能延迟恢复(DGF)3例(4.4%),到随访结束,生存67例(97.1%);在随访24 w、48 w、96 w和168 w,26例供体为血清HBsAg阳性与43例供体为血清HBsAg阴性或17例血清HBV DNA阳性与52例血清HBV DNA阴性受者血清ALT、AST和肌酐(sCr)水平均无显著性差异(P>0.05)。结论 血清HBsAg阳性肾移植受者在正规的抗病毒治疗情况下可以维持肝肾功能正常,受体基线血清HBV DNA载量、供体血清HBsAg状态和移植后使用免疫抑制剂均未见影响预后。

关键词: 乙型肝炎病毒表面抗原, 肾移植, HBsAg阳性供体, 恩替卡韦, 预后

Abstract: Objective This study was conducted to report the 120-week prognosis of serum HBsAg positive patients with chronic renal failure (CRF) after renal transplantation (RT). Methods The clinical data of 69 patients with serum HBsAg positive and CRF were retrieved. The patients were encountered in our hospital between January 2018 and September 2021, and all underwent RT, 26 of whom receiving liver from serum HBsAg positive donors, and followed-up for 196 weeks (with mean of 120 weeks). After RT, all patients took entecavir for antiviral treatment and standardized immunosuppression therapy. Results The incidence of delayed graft function recovery (DGF) occurred in 3 cases(4.4%) after RT in our series, and at the end of follow-up, 67 patients (97.1%) survived; at follow-up 24 week, 48 week, 96 week and 168 week, there were no significant differences as respect to serum ALT, AST and creatinine levels between 26 patients receiving livers from serum HBsAg positive and 43 patients receiving liver from serum HBsAg negative donors, or between 17 recipients with baseline serum HBV DNA positive and 52 recipients with HBV DNA negative (P>0.05). Conclusion Under the protection of regular antiviral therapy, the recipients with serum HBsAg-positive might survive long-termly with relatively normal liver and renal function tests, even with livers from serum HBsAg-positive donors. The baseline serum HBV DNA loads of the recipients, the donor's serum HBsAg status, and the immunosuppressants administered after RT might not impact the outcomes of recipients in this setting.

Key words: Hepatitis B surface antigen, Renal transplantation, HBsAg positive donors, Entecavir, Prognosis