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首页> 外文期刊>Arquivos de Gastroenterologia >Transplante hepático na hepatite delta: experiência da América do Sul
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Transplante hepático na hepatite delta: experiência da América do Sul

机译:肝炎三角洲的肝移植:南美的经验

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BACKGROUND: The Amazon region is one of the main endemic areas of hepatitis delta in the world and the only one related to the presence of genotype 3 of the delta virus. OBJECTIVE: To analyze the profile, mortality and survival of cirrhotic patients submitted to liver transplantation for chronic hepatitis delta virus and compare with those transplanted by hepatitis B virus monoinfection. METHODS: Retrospective, observational and descriptive study. From May 2002 to December 2011, 629 liver transplants were performed at the Walter Cantídio University Hospital, of which 29 patients were transplanted due to cirrhosis caused by chronic delta virus infection and 40 by hepatitis B chronic monoinfection. The variables analyzed were: age, sex, MELD score, Child-Pugh score, upper gastrointestinal bleeding and hepatocellular carcinoma occurrence before the transplantation, perioperative platelet count, mortality and survival. RESULTS: The Delta Group was younger and all came from the Brazilian Amazon Region. Group B presented a higher proportion of male patients (92.5%) compared to Group D (58.6%). The occurrence of upper gastrointestinal bleeding before transplantation, MELD score, and Child-Pugh score did not show statistical differences between groups. The occurrence of hepatocellular carcinoma and mortality were higher in the hepatitis B Group. The survival in 4 years was 95% in the Delta Group and 75% in the B Group, with a statistically significant difference ( P =0.034). Patients with hepatitis delta presented more evident thrombocytopenia in the pre-transplantation and in the immediate postoperative period. CONCLUSION: The hepatitis by delta virus patients who underwent liver transplantation were predominantly male, coming from the Brazilian Amazon region and with similar liver function to the hepatitis B virus patients. They had a lower incidence of hepatocellular carcinoma, more marked perioperative thrombocytopenia levels and frequent episodes of upper gastrointestinal bleeding. Patients with hepatitis by delta virus had lower mortality and higher survival than patients with hepatitis B virus.
机译:背景:亚马逊地区是世界上三角洲肝炎的主要流行地区之一,也是唯一与三角洲病毒基因型3有关的地区。目的:分析接受慢性肝炎三角洲病毒肝移植的肝硬化患者的概况,死亡率和生存率,并与经乙肝病毒单次感染的肝移植患者进行比较。方法:回顾性,观察性和描述性研究。从2002年5月到2011年12月,沃尔特·坎蒂迪奥大学医院进行了629例肝移植,其中29例因慢性三角洲病毒感染引起的肝硬化而被移植,40例因乙型肝炎慢性感染而被移植。分析的变量为:年龄,性别,MELD评分,Child-Pugh评分,上消化道出血和移植前肝细胞癌的发生,围手术期血小板计数,死亡率和存活率。结果:三角洲集团更年轻,全部来自巴西亚马逊地区。与D组(58.6%)相比,B组的男性患者比例更高(92.5%)。移植前上消化道出血的发生,MELD评分和Child-Pugh评分在两组之间无统计学差异。乙型肝炎组肝细胞癌的发生和死亡率较高。 Delta组的4年生存率为95%,B组的为75%,差异具有统计学意义(P = 0.034)。三角洲肝炎患者在移植前和术后即刻出现血小板减少症。结论:接受肝移植的δ病毒性肝炎患者主要是男性,来自巴西亚马逊地区,具有与乙肝病毒患者相似的肝功能。他们的肝细胞癌发病率较低,围手术期血小板减少症的水平更为明显,并且上消化道出血的频率较高。丙型肝炎病毒携带者比乙型肝炎病毒携带者死亡率更低,生存率更高。

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