PDF(Pubmed)
Abstract：
We report on two cases of orthotopic liver transplantation (OLTX) due to SARS-Cov2-associated secondary sclerosing cholangitis (SSC) following long-term artificial respiration and extra-corporal membrane oxygenation in intensive care. Under these conditions, SSC is a rapidly progredient biliary disease featuring degenerative cholangiopathy, loss of bile ducts, ductular and parenchymal cholestasis, biliary fibrosis, and finally cirrhosis. Reduced perfusion and oxygenation of the peribiliary plexus, severe concurrent infections, and secondary medico-toxic effects appear to play a crucial role in the pathogenesis of the disease. A direct cytopathic effect of SARS-Cov2 on endothelial cells followed by thrombosis and fibrosing obliteration in all parts of the vascular bed of the liver may enhance the virus-associated liver disease and particularly SSC.
摘要：
我们报告了2例由于SARS-Cov2相关的继发性硬化性胆管炎（SSC）引起的原位肝移植（OLTX），这是长期人工呼吸和重症监护中的体膜氧合。在这些条件下,SSC是一种以退行性胆管疾病为特征的迅速进展的胆道疾病，胆管丢失,导管和实质胆汁淤积，胆道纤维化,最后是肝硬化.胆管周围丛的灌注和氧合减少，严重并发感染，和继发性药物毒性作用似乎在该疾病的发病机理中起着至关重要的作用。SARS-Cov2对内皮细胞的直接细胞病变作用，随后在肝脏血管床的所有部分中发生血栓形成和纤维化闭塞，可能会增强病毒相关的肝病，尤其是SSC。
