Ali Saad Emhmed, Benrajab Karim M, Cruz Anna Christina Dela
Division of Hospital Medicine, Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, KY 40536, United States.
Division of Digestive Diseases and Nutrition, Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, KY 40536, United States.
World J Hepatol. 2020 Nov 27;12(11):1067-1075. doi: 10.4254/wjh.v12.i11.1067.
Gastric antral vascular ectasia (GAVE) is a significant complication of cirrhosis. Numerous medical, surgical, and endoscopic treatment modalities have been proposed with varied satisfactory results. In a few small studies, GAVE and associated anemia have resolved after orthotopic liver transplantation (OLT).
To assess the impact of OLT on the resolution of GAVE and related anemia.
We retrospectively reviewed clinical records of adult patients with GAVE who underwent OLT between September 2012 and September 2019. Demographics and other relevant clinical findings were collected, including hemoglobin levels and upper endoscopy findings before and after OLT. The primary outcome was the resolution of GAVE and its related anemia after OLT.
Sixteen patients were identified. Mean pre-OLT Hgb was 7.7 g/dL and mean 12 mo post-OLT Hgb was 11.9 g/dL, ( = 0.001). Anemia improved (defined as Hgb increased by 2g) in 87.5% of patients within 6 to 12 mo after OLT and resolved completely in half of the patients. Post-OLT esophagogastroduodenoscopy was performed in 10 patients, and GAVE was found to have resolved entirely in 6 of those patients (60%).
Although GAVE and associated anemia completely resolved in the majority of our patients after OLT, GAVE persisted in a few patients after transplant. Further studies in a large group of patients are necessary to understand the causality of disease and to better understand the factors associated with the persistence of GAVE post-transplant.
胃窦血管扩张症（GAVE）是肝硬化的一种重要并发症。已经提出了许多药物、手术和内镜治疗方法，效果各异。在一些小型研究中，原位肝移植（OLT）后GAVE及相关贫血得到缓解。
评估OLT对GAVE及相关贫血缓解情况的影响。
我们回顾性分析了2012年9月至2019年9月期间接受OLT的成年GAVE患者的临床记录。收集了人口统计学和其他相关临床资料，包括OLT前后的血红蛋白水平和上消化道内镜检查结果。主要结局是OLT后GAVE及其相关贫血的缓解情况。
共纳入16例患者。OLT前平均血红蛋白水平为7.7g/dL，OLT后12个月平均血红蛋白水平为11.9g/dL（P = 0.001）。87.5%的患者在OLT后6至12个月内贫血得到改善（定义为血红蛋白增加2g），其中一半患者贫血完全缓解。10例患者接受了OLT后的食管胃十二指肠镜检查，其中6例（60%）患者的GAVE完全缓解。
尽管大多数患者在OLT后GAVE及相关贫血完全缓解，但仍有少数患者移植后GAVE持续存在。有必要对大量患者进行进一步研究，以了解疾病的因果关系，并更好地理解移植后GAVE持续存在的相关因素。
