Management of liver transplant recipients with recurrent hepatitis C.

作者: Timothy M McCashland

DOI: 10.1097/MOT.0B013E32832ADE76

关键词: GastroenterologyHepatitis CInternal medicineCouncilman bodyDiabetes mellitusHepatitis C virusLiver transplantationTransplantationCalcineurinImmunosuppressionMedicine

摘要: Purpose of review Hepatitis C virus infection is the leading indication for liver transplantation, with recurrent hepatitis almost universal. Although posttransplant treatment remains suboptimal, active investigation continues to inform patient selection and risk–benefit analysis. Recent findings Several key studies have identified components in immunological response that are associated necroinflammatory fibrotic response. a higher rate diabetes mellitus after transplant. Patients metabolic syndrome poorer outcomes, aggressive management necessary. Differentiation acute rejection from difficult; however, use RNA tissue levels, immunohistochemistry Councilman body/portal tract ratio may help this diagnostic dilemma. The specific calcineurin inhibitor appears not influence C, but rapid steroid taper detrimental and, if steroids used, long slow should be used. Use early virological responses very helpful transplantation. In patients sustained response, histological survival benefits noted. Summary present highlights advances our understanding pathophysiology transplantation last few years.

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