Diagnosis and treatment of chronic graft rejection in patients with liver transplantation / 中国普通外科杂志

ABSTRACT

Objective To explore the cause and treatment strategy of chronic graft rejection characteristic of jaundice in patients with liver transplantation. MethodsPrimary disease, immunosuppressive protocol were reviewed in nine cases surviving more than 1 year after liver transplantation. The pathology examination, choledochoscopy and ultrasound examination were performed. The dosage of immunosuppressive agent was adjusted. Four cases underwent operation. Results Chronic rejection was well controlled in 6 out of the 9 cases with total bilirubin level decreased from 200 ?mol/L to less than 100 ?mol/L. Bile flocculus and bile slush became less obvious or disappeared after flushing and dilataltion of the common bile duct. Three cases died in spite of aggressive therapy. ConclusionsInsufficient immunosuppressive strength is one of the most important causes for chronic rejection. Immunological injury results in hepatocellular damage, bile slush, inflamed thick bile duct.