Abstract:

Objective To investigate the clinical efficacy of liver transplantation in the treatment of patientswith acute-on-chronic liver failure induced by discontinuation of nucleoside analogues（NAs）. Methods The preoperative and postoperative clinical data of 17 patients with acute-on-chronic liver failure induced by discontinuation of NAs in Tianjin First Central Hospital from September 2017 to December 2019 were retrospectively analyzed and summarized. Results All the 17 patients were operated successfully，with a 28-day survival rate of100%，a 3-month survival rate of 94.12%，and a 1-year survival rate of 94.12%. Conclusion Blind withdrawal of NAs in patients with chronic hepatitis B may lead to liver failure. Liver transplantation is an effective treatment forpatients with acute-on-chronic liver failure induced by discontinuation of NAs. Continuous antiviral therapy afteroperation is very important.

Key words: Liver transplantation , Acute-on-chronic liver failure , Discontinuation of nucleoside analogues, Prognosis

摘要：

目的 探讨肝移植治疗因停用核苷类似物（nucleoside analogues，NAs）导致慢加急性肝衰竭患者的临床疗效。方法 回顾性分析并总结 2017 年 9 月— 2019 年 12 月间天津市第一中心医院接受肝移植治疗的 17 例因停用 NAs 导致慢加急性肝衰竭患者的术前、术后临床资料。结果 17 例患者手术均获成功，术后 28 d 生存率 100%，术后 3 个月生存率 94.12%，术后 1 年生存率为 94.12%。结论 慢性乙肝患者盲目停用核苷类似物，可能会导致肝功能衰竭的发生，对于停用 NAs 导致慢加急性肝衰竭的患者，肝移植是一种有效的治疗手段，术后持续抗病毒治疗至关重要。

关键词: 肝移植 , 慢加急性肝衰竭 , 停用核苷类似物 , 预后