Melum Espen, Schrumpf Erik, Bjøro Kristian
Section of Gastroenterology and Hepatology, Department of Medicine, Rikshospitalet, Oslo, Norway.
Scand J Gastroenterol. 2006 May;41(5):592-6. doi: 10.1080/00365520500347113.
Hepatitis C virus (HCV) cirrhosis is the most common indication for liver transplantation (LTX) world-wide. The prevalence of HCV infections is much lower in Norway than in most other countries from which data on HCV infection and liver transplantation have been published.
Patients with HCV infection referred for evaluation of a possible LTX between 1990 and 2005 were included in the study. Their clinical status, biochemical parameters and risk factors were recorded. All patients were followed until 1 January 2005 irrespective of transplantation status.
Fifty-one patients were included; 80% were males and 18% were non-Caucasians. Previous intravenous drug abuse (28%) and exposure to contaminated IgG products (15%) were the most common routes of infection. In 45/51 (88%) of the evaluated patients at least one risk factor for rapid progression of HCV disease was identified. Twenty-seven patients were accepted on the waiting list. The MELD (model for endstage liver disease) score for the accepted patients was significantly higher than that for the patients who were not listed because they were found to be too healthy (18.4 versus 12.1, p<0.01). Twenty-four patients (89% of those listed) received a liver allograft; their 1-, 3- and 5-year survival rates following LTX were 81%, 68% and 68%, respectively. Two patients needed a second transplantation.
A low number of HCV-infected patients have so far been evaluated for LTX in Norway. The present study demonstrates that almost all of the HCV patients progressing to cirrhosis and being evaluated for LTX in Norway have additional risk factors for development of cirrhosis.
丙型肝炎病毒（HCV）肝硬化是全球肝移植（LTX）最常见的适应证。挪威HCV感染的患病率远低于已发表HCV感染和肝移植数据的大多数其他国家。
本研究纳入了1990年至2005年间因可能进行肝移植而接受评估的HCV感染患者。记录他们的临床状况、生化参数和危险因素。所有患者均随访至2005年1月1日，无论其移植状态如何。
共纳入51例患者；80%为男性，18%为非白种人。既往静脉注射吸毒（28%）和接触受污染的免疫球蛋白产品（15%）是最常见的感染途径。在45/51（88%）例接受评估的患者中，至少发现了一项HCV疾病快速进展的危险因素。27例患者被列入等待名单。被列入等待名单的患者的终末期肝病模型（MELD）评分显著高于因健康状况良好而未被列入名单的患者（18.4对12.1，p<0.01）。24例患者（占列入名单患者的89%）接受了肝脏移植；肝移植后他们的1年、3年和5年生存率分别为81%、68%和68%。2例患者需要再次移植。
到目前为止，挪威接受肝移植评估的HCV感染患者数量较少。本研究表明，在挪威，几乎所有进展为肝硬化并接受肝移植评估的HCV患者都有发生肝硬化的其他危险因素。
