肝移植前后慢性乙型肝炎的管理
Management of chronic hepatitis B before and after liver transplantation.
作者信息
Wang B, Agarwal K, Joshi D
机构信息
Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK.
出版信息
Frontline Gastroenterol. 2018 Jan;9(1):79-84. doi: 10.1136/flgastro-2016-100768. Epub 2017 Feb 14.
Abstract
Chronic hepatitis B infection is a global public health problem associated with significant morbidity and mortality. Persistent infection may evolve to liver cirrhosis and hepatocellular carcinoma, and hepatitis B-related liver disease is a common indication for liver transplantation. Patients with advanced liver disease should be treated with antiviral therapy which may result in clinical improvement. The management of patients after liver transplant then focuses on preventing hepatitis B recurrence in the graft. With the introduction of prophylactic treatment, patient and graft survival has improved significantly. In this review, we will discuss the management of patients with hepatitis B-related cirrhosis, both compensated and decompensated. We also review the management of hepatitis B after liver transplantation.
摘要
慢性乙型肝炎感染是一个全球性的公共卫生问题，与严重的发病率和死亡率相关。持续感染可能会发展为肝硬化和肝细胞癌，乙型肝炎相关肝病是肝移植的常见适应症。晚期肝病患者应接受抗病毒治疗，这可能会带来临床改善。肝移植后患者的管理重点在于预防移植肝中乙型肝炎复发。随着预防性治疗的引入，患者和移植肝的存活率有了显著提高。在本综述中，我们将讨论代偿期和失代偿期乙型肝炎相关肝硬化患者的管理。我们还将回顾肝移植后乙型肝炎的管理。
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