Serin Ayfer, Sahin Tolga, Arikan Bahadir Turkmen, Emek Ertan, Bozkurt Birkan, Tokat Yaman
Sisli Florence Nightingale Hospital, Liver Transplantation Institute, Hospital of Istanbul Bilim University, Istanbul, Turkey.
Sisli Florence Nightingale Hospital, Liver Transplantation Institute, Hospital of Istanbul Bilim University, Istanbul, Turkey.
Transplant Proc. 2019 Sep;51(7):2416-2419. doi: 10.1016/j.transproceed.2019.01.190. Epub 2019 Aug 8.
Nonalcoholic steatohepatitis (NASH) is an increasing cause of liver transplantation (LT) worldwide, especially in Europe and North America. In this study, we aimed to investigate the changing pattern of etiologic causes of LT in our center for the past 15 years.
A cohort of 967 consecutive adult patients with history of LT between 2004 and 2018 in our center was reviewed regarding etiologies for LT. All patients who had a transplant during this time frame were divided into 3 time periods as follows: 2004 to 2009, 2010 to 2013, and 2014 to 2018. All explanted liver samples were sent to pathology for establishment of a definitive etiologic cause.
Chronic hepatitis B virus (HBV) infection was the leading cause of LT in the overall cohort (37%), followed by hepatitis C virus (HCV) infection (11%), and alcoholic liver disease (9.5%). NASH accounted for 7.5% of the cases. While HBV decreased from 44% in 2004 to 2009 to 36% in 2014 to 2018, NASH increased from 1.1% to 9.4% in overall transplants during the same period, accounting for one-third of the etiologies for LT following HBV and HCV.
There might be a global changing figure regarding etiology for LT in Turkey, especially NASH, which is the fastest growing cause of LT. However, this topic needs to be evaluated in large cohort series from collaborative multicenter studies from Turkey.
非酒精性脂肪性肝炎（NASH）是全球范围内肝移植（LT）日益增多的原因，尤其是在欧洲和北美。在本研究中，我们旨在调查过去15年中我们中心肝移植病因的变化模式。
回顾了2004年至2018年期间在我们中心连续967例有肝移植病史的成年患者的肝移植病因。在此时间段内进行移植的所有患者被分为3个时间段，如下：2004年至2009年、2010年至2013年和2014年至2018年。所有切除的肝脏样本均送病理科以确定明确的病因。
慢性乙型肝炎病毒（HBV）感染是整个队列中肝移植的主要原因（37%），其次是丙型肝炎病毒（HCV）感染（11%）和酒精性肝病（9.5%）。NASH占病例的7.5%。虽然HBV在2004年至2009年期间从44%降至2014年至2018年的36%，但同期NASH在总体移植中的比例从1.1%升至9.4%，占HBV和HCV之后肝移植病因的三分之一。
土耳其肝移植的病因可能存在全球变化趋势，尤其是NASH，它是肝移植增长最快的原因。然而，这个话题需要通过土耳其多中心合作研究的大型队列系列进行评估。
