Clinical outcome of HCV-related graft cirrhosis and prognostic value of hepatic venous pressure gradient
Φόρτωση...
Ημερομηνία
Συγγραφείς
Kalambokis, G.
Manousou, P.
Samonakis, D.
Grillo, F.
Dhillon, A. P.
Patch, D.
O'Beirne, J.
Rolles, K.
Burroughs, A. K.
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer-reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
Transpl Int
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
Hepatitis C virus (HCV) allograft cirrhosis may progress rapidly requiring re-transplantation but its course is little studied. We evaluated serially biopsied patients who developed HCV-related allograft cirrhosis. We assessed outcome of graft cirrhosis in 55 out of 234 consecutive patients and predictors of decompensation and mortality, including hepatic venous pressure gradient (HVPG) in 38. Allograft cirrhosis (Ishak stage 6, 60%; stage 5, 40%) was diagnosed between 12 and 172 months (median, 52) from transplantation; subsequent follow up was 22 (1-78) months. Faster development (<or=48 months) was associated with tacrolimus and nonuse of azathioprine and prednisolone. Decompensation occurred in 22% with a probability of not developing decompensation reaching 60% at 5 years. Survival among compensated patients was 77% at 5 years, but fell rapidly after decompensation (12% at 1 year). Decompensation and mortality were independently associated with HVPG >or= 10 mmHg, Child-Pugh score >or= 7, and albumin levels <or= 32 g/dl but not with fibrosis stage 5 or 6, HCV genotype (1b, 34%) or immunosuppression used after diagnosis of cirrhosis. In conclusion, Ishak stage 5 and 6 HCV-related cirrhosis have similar prognosis after liver transplantation. An HVPG >or= 10 mmHg, in addition to liver dysfunction, gives independent prognostic information prior to decompensation, allowing early relisting before prognosis becomes extremely poor.
Περιγραφή
Λέξεις-κλειδιά
Adult, Aged, Female, Graft Survival, Hepatic Veins/physiopathology, Hepatitis C/*complications, Humans, Liver Cirrhosis/physiopathology/surgery/*virology, Male, Middle Aged, Prognosis, Recurrence, Treatment Outcome, Venous Pressure/physiology
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/18786149
http://onlinelibrary.wiley.com/store/10.1111/j.1432-2277.2008.00744.x/asset/j.1432-2277.2008.00744.x.pdf?v=1&t=h0ulsj3u&s=ab688bbeb5f30fd6182b33e2b2c5c06f4f472903
http://onlinelibrary.wiley.com/store/10.1111/j.1432-2277.2008.00744.x/asset/j.1432-2277.2008.00744.x.pdf?v=1&t=h0ulsj3u&s=ab688bbeb5f30fd6182b33e2b2c5c06f4f472903
Γλώσσα
en
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής