Testino Gianni
UOSD Epato-Gastroenterologia, Dipartimento Trapianti di Organo, Azienda Ospedaliera Universitaria Ospedale San Martino, Genova.
Recenti Prog Med. 2007 Apr;98(4):252-8.
HCV correlated chronic hepatophaty represents one of the main causes of cirrhosis and, therefore, of orthotopic liver transplantation (OLT). Furthermore, it is known how the post-OLT recurrent chronic hepatitis C represents a main cause for the re-transplantation. Aim of the present review is the analysis of the natural history of HCV cirrhosis and the evaluation of the introduction form in waiting list. It has been examined the management of the main complications due to portal hypertension in patients awaiting OLT with particular reference to the use of TIPS (transjugular intrahepatic porto-systemic stent shunt) and possible antiviral treatment to obtain post-OLT HCV negativization. Finally, the problem of chemoprevention of hepatocellular carcinoma (HCC) has been considered. As a matter of fact, the treatment with Interferon (IFN) has led to undeniable benefits. Nevertheless, its use has not lowered the incidence of HCC. Probably, such an effect will be reached by means of a maintenance treatment with a small weekly dose of Pegylated IFN independently from virological response.
丙型肝炎病毒（HCV）相关的慢性肝病是肝硬化的主要病因之一，因此也是原位肝移植（OLT）的主要病因之一。此外，已知OLT后复发性慢性丙型肝炎是再次移植的主要原因。本综述的目的是分析HCV肝硬化的自然史，并评估等待名单上的入选形式。研究了等待OLT的患者因门静脉高压引起的主要并发症的管理，特别提及经颈静脉肝内门体分流术（TIPS）的使用以及为实现OLT后HCV转阴而进行的可能的抗病毒治疗。最后，考虑了肝细胞癌（HCC）的化学预防问题。事实上，干扰素（IFN）治疗已带来了不可否认的益处。然而，其使用并未降低HCC的发病率。或许，通过每周小剂量聚乙二醇化干扰素维持治疗，无论病毒学反应如何，都能达到这一效果。
