Перспективы лечения пациентов с хроническими вирусными гепатитами в цирротической стадии

Эдуард Васильевич Волков; Ольга Игоревна Соколова; Александра Яновна Комарова; Александра Александровна Караваева; Алексей Авенирович Яковлев

doi:10.21638/11701/spbu11.2018.102

Authors

Эдуард Васильевич Волков St. Petersburg State University, 7–9, Universitetskaya nab., St. Petersburg, 199034, Russian Federation
Ольга Игоревна Соколова St. Petersburg State University, 7–9, Universitetskaya nab., St. Petersburg, 199034, Russian Federation; S. P. Botkin Clinical Infectious Diseases Hospital, 3, Mirgorodskya ul., St. Petersburg, 191167, Russian Federation
Александра Яновна Комарова St. Petersburg State University, 7–9, Universitetskaya nab., St. Petersburg, 199034, Russian Federation; S. P. Botkin Clinical Infectious Diseases Hospital, 3, Mirgorodskya ul., St. Petersburg, 191167, Russian Federation
Александра Александровна Караваева St. Petersburg State University, 7–9, Universitetskaya nab., St. Petersburg, 199034, Russian Federation
Алексей Авенирович Яковлев St. Petersburg State University, 7–9, Universitetskaya nab., St. Petersburg, 199034, Russian Federation; S. P. Botkin Clinical Infectious Diseases Hospital, 3, Mirgorodskya ul., St. Petersburg, 191167, Russian Federation

DOI:

https://doi.org/10.21638/11701/spbu11.2018.102

Abstract

We performed a retrospective cohort study at S. P. Botkin Clinical Infectious Diseases Hospital, St. Petersburg, Russia from January to December 2014. The purpose of this study was to evaluate indications and contraindications for liver transplant in cirrhotic patients with chronic hepatitis. We analyzed 310 medical record of patients with established diagnosis “Chronic viral hepatitis, cirrhosis”. According to the EASL 2015, 59.4 % (184) of patients with liver cirrhosis had one or multiple indications for liver transplantation. 64.1 % (118) patients were of working age. Chronic hepatitis C virus infection was detected in 56.3 % (71). The most significant contraindication was active alcohol or drug addiction: 76 % (44). Extrahepatic malignant neoplasms detected in 19 % (11) and active extrahepatic infection in 5 % (3). Risk factors of mortality during the current hospitalization were significantly associated with the MELD score, the presence of hepatocellular carcinoma, active alcoholism, active extrahepatic infection and extrahepatic malignant neoplasms. Among patients hospitalized with the diagnosis “Chronic viral hepatitis, cirrhosis”, 40 % (126) had indications and had no contraindications for liver transplantation. Under the conditions of an insufficient number of liver transplantations, high mortality, especially in working-age patients with no contraindications for this operation, it is necessary to find early treatment with effective influence on the pathological mechanisms to prevent the need for liver transplantation.

Keywords:

liver cirrhosis, decompensated cirrhosis, liver transplantation, chronic hepatitis C virus infection, MELD score

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References

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