伊朗丙型肝炎患者肝移植的临床过程和结果

IF 0.3 4区医学 Q4 GASTROENTEROLOGY & HEPATOLOGY

Hepatitis Monthly Pub Date : 2021-05-18 DOI:10.5812/HEPATMON.108405

F. Ejtehadi, Paymun Farahvashi, A. Shamsaeefar, R. Niknam, G. Sivandzadeh, L. Aminlari, N. Motazedian, K. Kazemi, H. Nikoupour, S. Nikeghbalian, H. Eghlimi, A. Taghavi, M. Fattahi, K. Bagheri Lankarani, S. Malek-Hosseini

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引用次数: 0

摘要

背景：丙型肝炎是世界范围内导致终末期肝病和肝移植的最常见原因之一。近年来，随着直接作用抗病毒药物（DAAs）治疗丙型肝炎的快速进展，该疾病的临床病程以及肝移植都有了显著改善。此外，DAA在治疗和预防肝移植后丙型肝炎复发方面已经完全取代了基于干扰素的方案。目的：这是第一项旨在调查伊朗丙型肝炎患者肝移植临床过程的研究。方法：本回顾性研究在设拉子器官移植中心对5年内（2012-2017年）18至65岁的丙型肝炎肝移植患者进行。记录所有人口统计学和临床数据。移植前病毒载量、疾病复发、移植物排斥反应和死亡率是本研究中最重要的指标。结果：在55名肝移植患者中，49%的患者在肝移植前接受过丙型肝炎治疗，以干扰素为基础的治疗方案更为普遍。此外，HCV基因型3是最常见的，其次是基因型1。对肝酶水平升高的患者进行了肝活检。间隔2个月、6个月、12个月和24个月的HCV复发患者数分别为3例、2例、0例和2例。在这些时间间隔内，分别发现8例、8例、1例和3例急性移植物排斥反应。8名患者死亡，一年生存率为85%。败血症和感染性并发症是最主要的死亡原因。结论：本研究是伊朗首次对丙型肝炎肝移植患者进行研究。在五年的研究期间，丙型肝炎患者的治疗取得了快速发展。它导致了DAAs的引入，取代了基于干扰素的治疗。这项研究的结果表明，伊朗丙型肝炎患者的肝移植成功率很高。本研究的结果可用于在未来的研究中比较DAAs的疗效。

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Clinical Course and Outcome of Liver Transplantation in Patients with Hepatitis C in Iran

Background: Hepatitis C is one of the most common causes of end-stage liver disease and liver transplant worldwide. In recent years, with the rapid advances in the treatment of hepatitis C by direct-acting antiviral drugs (DAAs), the clinical course of the disease as well as liver transplantation have had significant improvement. Also, DAAs have completely replaced interferon-based regimens in the treatment and prevention of HCV recurrence after liver transplant. Objectives: This is the first study that aimed to investigate the clinical course of liver transplantation in patients with hepatitis C in Iran. Methods: This retrospective study was conducted on patients with HCV liver transplantation within five years (2012 - 2017) with the age range of 18 to 65 years at Shiraz Organ Transplant Center. All demographic and clinical data were recorded. Pre-transplant viral load, disease recurrence, graft rejection, and mortality rate were the most important indices in this study. Results: Among 55 transplant patients, 49% had received hepatitis C treatment before liver transplantation and interferon-based regimens were more prevalent. Besides, HCV genotype 3, followed by genotype 1, was the most prevalent one. A liver biopsy was performed in patients with elevated liver enzyme levels. The numbers of patients with HCV recurrence at 2, 6, 12, and 24-month intervals were three, two, zero, and two patients, respectively. At these time intervals, eight, eight, one, and three cases of acute graft rejection were found, respectively. Eight patients died with a one-year survival rate of 85%. Sepsis and infectious complications were the most leading causes of death. Conclusions: This study is the first study of liver transplant patients with hepatitis C in Iran. In the five-year study period, rapid development was made in the treatment of HCV patients. It led to the introduction of DAAs, which replaced interferon-based therapies. The results of this study indicated the high success rate of liver transplantation in patients with hepatitis C in Iran. The results of this study could be used to compare the efficacy of DAAs in future research.

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来源期刊

Hepatitis Monthly 医学-胃肠肝病学

CiteScore

1.50

自引率

0.00%

发文量

审稿时长

3 months

期刊介绍： Hepatitis Monthly is a clinical journal which is informative to all practitioners like gastroenterologists, hepatologists and infectious disease specialists and internists. This authoritative clinical journal was founded by Professor Seyed-Moayed Alavian in 2002. The Journal context is devoted to the particular compilation of the latest worldwide and interdisciplinary approach and findings including original manuscripts, meta-analyses and reviews, health economic papers, debates and consensus statements of the clinical relevance of hepatological field especially liver diseases. In addition, consensus evidential reports not only highlight the new observations, original research, and results accompanied by innovative treatments and all the other relevant topics but also include highlighting disease mechanisms or important clinical observations and letters on articles published in the journal.