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【文摘发布】晚期肝门静脉硬化致肝衰及肝移植
Authorsabel Fiel M, Thung SN, Hytiroglou P, Emre S, Schiano TD.
Source:Am J Surg Pathol. 2007 Apr;31(4):607-14.
IF:4.337(2005)
Hepatoportal sclerosis (HPS) is one of the causes of noncirrhotic portal hypertension. In general, hepatic synthetic function is preserved and treatment is aimed at relief of the portal hypertension. In this study, we present the clinical and pathologic features of HPS cases who underwent liver transplantation (LT). LT cases with confirmed gross and microscopic diagnosis of HPS are included. Weight of the explanted liver, presence of thrombi in the main blood vessels, and gross and microscopic characteristics were assessed. Clinical information was gathered from chart review. From 1995 to 2004, 8 LT patients were diagnosed with HPS. Cirrhosis resulting from alcohol (2), autoimmune hepatitis (2), and hepatitis B (1), or cryptogenic cirrhosis (3) was the presumed diagnoses pre-LT. Seven patients presented with bleeding varices and 5 had concomitant ascites. At the time of LT, mean values were: prothrombin time of 15.2 seconds, serum albumin 3.2 g/dL, serum bilirubin 3.5 mg/dL, alkaline phosphatase 140 IU/L, aspartate aminotransferase 39.4 IU/L, and alanine aminotransferase 34.7 IU/L. Explanted livers were shrunken, with weights ranging from 715 to 1199 g (mean 934). Nonocclusive portal vein thrombosis was present in 2 patients. On histologic examination, there was dense portal fibrosis, marked phlebosclerosis, and presence of variable degrees of megasinusoid formation. Four livers also had features of incomplete septal cirrhosis. None showed histologic features of the presumed underlying liver disease. In conclusion, HPS can cause hepatic synthetic dysfunction that may necessitate LT. Small liver volume, significant portal fibrosis, and phlebosclerosis may contribute to hepatic parenchymal loss and subsequent synthetic compromise. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Title:Liver failure and need for liver transplantation in patients with advanced hepatoportal sclerosis
题目：晚期肝门静脉硬化致肝衰及肝移植治疗
Author：Fiel M, Thung SN, Hytiroglou P, Emre S, Schiano TD
作者：Fiel M, Thung SN, Hytiroglou P, Emre S, Schiano TD
Source:Am J Surg Pathol. 2007 Apr;31(4):607-14.
IF:4.337(2005)
来源：美国病理外科杂志.2007 Apr;31(4):607-14.
影响因子：4.337(2005)
Hepatoportal sclerosis (HPS) is one of the causes of noncirrhotic portal hypertension. In general, hepatic synthetic function is preserved and treatment is aimed at relief of the portal hypertension. In this study, we present the clinical and pathologic features of HPS cases who underwent liver transplantation (LT).
肝门静脉硬化(HPS)是引起非肝硬化性门脉高压的原因之一。一般情况下肝功正常，因此治疗主要针对缓解门静脉高压。本研究中，我们对实施过肝移植(LT)的HPS病例进行了临床和病理学特征的分析。
LT cases with confirmed gross and microscopic diagnosis of HPS are included. Weight of the explanted liver, presence of thrombi in the main blood vessels, and gross and microscopic characteristics were assessed. Clinical information was gathered from chart review. From 1995 to 2004, 8 LT patients were diagnosed with HPS.
病例为经大体及显微镜诊断为HPS，并且进行了LT的病人。我们对移出肝脏的重量、大血管是否存在血栓及其大体标本和显微镜下特征进行了测定。临床资料来源于病例回顾。从1995到2004年，有8名LT患者诊断为HPS.
Cirrhosis resulting from alcohol (2), autoimmune hepatitis (2), and hepatitis B (1), or cryptogenic cirrhosis (3) was the presumed diagnoses pre-LT. Seven patients presented with bleeding varices and 5 had concomitant ascites.
由酒精 (2)，自身免疫性肝炎 (2), 乙肝病毒 (1),或不明原因引起的肝硬化是移植前假定的诊断类型。7名患者伴有静脉曲张，5名伴有腹水。
At the time of LT, mean values were: prothrombin time of 15.2 seconds, serum albumin 3.2 g/dL, serum bilirubin 3.5 mg/dL, alkaline phosphatase 140 IU/L, aspartate aminotransferase 39.4 IU/L, and alanine aminotransferase 34.7 IU/L. Explanted livers were shrunken, with weights ranging from 715 to 1199 g (mean 934). Nonocclusive portal vein thrombosis was present in 2 patients.
LT时，各参考值平均为：凝血酶原时间15.2秒，血清白蛋白3.2g/dL，血清胆红素mg/dL，碱性磷酸酶140IU/L，谷草转氨酶39.4IU/L，谷丙转氨酶34.7IU/L。移出的肝脏出现皱缩，重量在715g到1199g(平均934g).2名患者出现非阻塞性门静脉血栓。
On histologic examination, there was dense portal fibrosis, marked phlebosclerosis, and presence of variable degrees of megasinusoid formation. Four livers also had features of incomplete septal cirrhosis. None showed histologic features of the presumed underlying liver disease.
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作者:admin@医学,生命科学 2010-09-22 05:11
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