Baidu
map

J Hepatol:DAA治疗对肝移植的影响:对适应症和结果演变的影响

2018-09-23 MedSci MedSci原创

在欧洲,引入DAA治疗后,由HCV相关肝脏疾病(失代偿性肝硬化和HCC)而进行肝移植的比例较利巴韦林时代,显著下降;与此同时,进行肝移植的患者的3年生存率,得到了改善。

研究背景:DAA治疗显著改善了HCV感染患者的治疗效果,其中包括HCV失代偿性肝硬化患者。本研究分析了欧洲近10年来肝移植(LT)适应症和结果的改变;尤其关注DAA开始治疗HCV患者后,肝移植适应症和结果的改变。

研究方法:本研究一项基于欧洲肝脏移植登记处数据的队列研究。研究分析了2007年1月至2017年6月期间由HCV、HBV、酒精性脂肪肝和非酒精性脂肪肝等病因而进行肝移植的成人的相关数据。研究将时间分为几个不同的时间段:干扰素 (IFN/RBV; 2007-2010);酶抑制剂(PI; 2011-2013)和二代DAA(DAA; 2014-June 2017)。

研究结果:2007年1月至2017年6月期间,总共有60527例患者进了肝移植,其中有36,382 例患者是因HCV、HBV、酒精性肝炎和NASH而进行肝移植的。由HCV-相关肝脏疾病导致LTs的比例随时间变化显著(p<0.0001),从FN/RBV 时代的22.8%下降到DAA时代的17.4%;然而由NASH导致的肝移植的比例,显著增加(p<0.0001)。在DAA时代,由HCV导致的LTs比例显著下降(p<0.0001),从21.1%(2014年)降至10.6%(2017年)。相比由HCV导致的HCC癌患者,在HCV失代偿性肝硬化患者中,肝移植比例下降的更为明显(58.0% VS 41.2%)。相反,由HCV相关肝脏疾病而进行肝移植的患者的3年生存率从 IFN/RBV时代的65.1%上升到DAA时代的76.9%;现在此生存率可与乙肝病毒感染患者的存活率相媲美。

研究结论:在欧洲,引入DAA治疗后,由HCV相关肝脏疾病(失代偿性肝硬化和HCC)而进行肝移植的比例较利巴韦林时代,显著下降;与此同时,进行肝移植的患者的3年生存率,得到了改善。

原始出处


Belli LS, Perricone G, Adam R, et al. Impact of DAAs on liver transplantation: Major effects on the evolution of indications and results. An ELITA study based on the ELTR registry. J Hepatol, 2018, 69(4), 810-817.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1745855, encodeId=d23d1e45855c1, content=<a href='/topic/show?id=34a5666451b' target=_blank style='color:#2F92EE;'>#演变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66645, encryptionId=34a5666451b, topicName=演变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96a135615295, createdName=oliver181, createdTime=Tue Jun 04 15:51:00 CST 2019, time=2019-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1336766, encodeId=bf1f1336e6631, content=<a href='/topic/show?id=554d94e13ae' target=_blank style='color:#2F92EE;'>#适应症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94713, encryptionId=554d94e13ae, topicName=适应症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3dd32500118, createdName=644982816_68283321, createdTime=Tue Sep 25 08:51:00 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1361851, encodeId=a9ca136185137, content=<a href='/topic/show?id=a88b564ea6' target=_blank style='color:#2F92EE;'>#DAA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5647, encryptionId=a88b564ea6, topicName=DAA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Tue Sep 25 08:51:00 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1427241, encodeId=3568142e241b4, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Tue Sep 25 08:51:00 CST 2018, time=2018-09-25, status=1, ipAttribution=)]
    2019-06-04 oliver181
  2. [GetPortalCommentsPageByObjectIdResponse(id=1745855, encodeId=d23d1e45855c1, content=<a href='/topic/show?id=34a5666451b' target=_blank style='color:#2F92EE;'>#演变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66645, encryptionId=34a5666451b, topicName=演变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96a135615295, createdName=oliver181, createdTime=Tue Jun 04 15:51:00 CST 2019, time=2019-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1336766, encodeId=bf1f1336e6631, content=<a href='/topic/show?id=554d94e13ae' target=_blank style='color:#2F92EE;'>#适应症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94713, encryptionId=554d94e13ae, topicName=适应症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3dd32500118, createdName=644982816_68283321, createdTime=Tue Sep 25 08:51:00 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1361851, encodeId=a9ca136185137, content=<a href='/topic/show?id=a88b564ea6' target=_blank style='color:#2F92EE;'>#DAA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5647, encryptionId=a88b564ea6, topicName=DAA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Tue Sep 25 08:51:00 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1427241, encodeId=3568142e241b4, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Tue Sep 25 08:51:00 CST 2018, time=2018-09-25, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1745855, encodeId=d23d1e45855c1, content=<a href='/topic/show?id=34a5666451b' target=_blank style='color:#2F92EE;'>#演变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66645, encryptionId=34a5666451b, topicName=演变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96a135615295, createdName=oliver181, createdTime=Tue Jun 04 15:51:00 CST 2019, time=2019-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1336766, encodeId=bf1f1336e6631, content=<a href='/topic/show?id=554d94e13ae' target=_blank style='color:#2F92EE;'>#适应症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94713, encryptionId=554d94e13ae, topicName=适应症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3dd32500118, createdName=644982816_68283321, createdTime=Tue Sep 25 08:51:00 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1361851, encodeId=a9ca136185137, content=<a href='/topic/show?id=a88b564ea6' target=_blank style='color:#2F92EE;'>#DAA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5647, encryptionId=a88b564ea6, topicName=DAA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Tue Sep 25 08:51:00 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1427241, encodeId=3568142e241b4, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Tue Sep 25 08:51:00 CST 2018, time=2018-09-25, status=1, ipAttribution=)]
    2018-09-25 qingting
  4. [GetPortalCommentsPageByObjectIdResponse(id=1745855, encodeId=d23d1e45855c1, content=<a href='/topic/show?id=34a5666451b' target=_blank style='color:#2F92EE;'>#演变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66645, encryptionId=34a5666451b, topicName=演变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96a135615295, createdName=oliver181, createdTime=Tue Jun 04 15:51:00 CST 2019, time=2019-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1336766, encodeId=bf1f1336e6631, content=<a href='/topic/show?id=554d94e13ae' target=_blank style='color:#2F92EE;'>#适应症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94713, encryptionId=554d94e13ae, topicName=适应症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3dd32500118, createdName=644982816_68283321, createdTime=Tue Sep 25 08:51:00 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1361851, encodeId=a9ca136185137, content=<a href='/topic/show?id=a88b564ea6' target=_blank style='color:#2F92EE;'>#DAA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5647, encryptionId=a88b564ea6, topicName=DAA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Tue Sep 25 08:51:00 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1427241, encodeId=3568142e241b4, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Tue Sep 25 08:51:00 CST 2018, time=2018-09-25, status=1, ipAttribution=)]
    2018-09-25 gwc384
Baidu
map
Baidu
map
Baidu
map