Evolution of indications and results of liver transplantation in Europe. A report from the European Liver Transplant Registry (ELTR)

Ötvenéves a magyar szervtranszplantáció, és ezzel egyidejűleg ötven évvel ezelőtt történt az első sikeres májátülte-tés az Egyesült Államokban, amelyet Thomas Starzl végzett. A világon évente több százezer, Magyarországon több mint 7000 ember hal meg májbetegségben. Az esetek nagy részében krónikus elégtelenségről van szó, de 10-15%-ban akut májelégtelenségről beszélhetünk, amelynek mortalitása műtét nélkül 80% feletti. A végstádiumú és akut májbetegek esetében a különféle konzervatív kezelési módszerek csak átmeneti megoldást jelentenek. Az egyetlen, hosszú távú túlélést jelentő gyógymód a transzplantáció. Napjainkban a májátültetést követő átlagos öt-éves, úgynevezett kumulatív túlélés 80% feletti. Az indikációs terület egyre szélesebb, leggyakoribb a vírus és alkohol okozta cirrhosis és a cholestaticus májbetegségek miatt végzett májátültetés. Gyermekeknél főként fejlődési rendellenességek, congenitalis betegségek és metabolikus májbetegségek akut manifesztációi emelendők ki az indikációs körből. A májtranszplantációs túlélési eredményeink a jó nemzetközi statisztikáknak megfelelőek, de a graft-és betegtúlélés további javításában a testre szabott immunszuppressziós kezelés bevezetésének nagy jelentősége lehet. Orv. Hetil., 2013, 154, 858-862. Kulcsszavak: szervtranszplantáció, májátültetés, grafttúlélés, testre szabott gyógyszeres kezelés Progress of the liver transplantation programme in HungaryThe history of organ transplantation in Hungary dates back to 50 years, and the fi rst succesful liver transplantation was performed in the United States in that time as well. The number of patients with end stage liver disease increased worldwide, and over 7000 patients die in each year due to liver disease in Hungary. The most effective treatment of end-stage liver disease is liver transplantation. The indications of liver transplantation represent a wide spectrum including viral, alcoholic or other parenchymal liver cirrhosis, but cholestatic liver disease and acute fulminant cases are also present in the daily routine. In pediatric patients biliary atresia and different forms of metabolic liver disorders represent the main indication for liver transplantation. The results of liver transplantation in Hungary are optimal with over 80% long-term survival. For better survival individual drug therapy and monitoring are introduced in liver transplant candidates. Orv. Hetil., 2013, 154, 858-862. A májátültetés történeteAz első sikeres májátültetés Thomas Starzl nevéhez fű-ződik (Denver, 1963). Az 1970-es évek elején már Európában is elindultak az első sikerekkel járó próbál-kozások. Magyarországon az első sikeres májátültetést

show abstract

“…Relatív kontraindikáció a portathrombosis, a többször operált has és a humán immundefi cientia-vírus-(HIV-) fertőzés [11].…”

Section: Indikáció éS Ellenjavallatunclassified

Progress of the liver transplantation programme in Hungary

et al. 2013

View full text Add to dashboard Cite

show abstract

“…In liver transplant recipients, the allograft is less susceptible to immunological injuries, so the clinical significance of chronic rejection, also termed vanishing bile duct syndrome (VBDS), appears to be less important than in the other organ transplants. In the European Liver Transplant Registry, chronic rejection was the cause of death in only 3% of patients and the indication for retransplantation in 14% of patients (15).…”

Section: Introductionmentioning

confidence: 99%

The Impact of Infection on Chronic Allograft Dysfunction and Allograft Survival After Solid Organ Transplantation

Martín-Gandul

Mueller

Pascual

et al. 2015

American Journal of Transplantation

133

103

View full text Add to dashboard Cite

Infectious diseases after solid organ transplantation (SOT) are a significant cause of morbidity and reduced allograft and patient survival; however, the influence of infection on the development of chronic allograft dysfunction has not been completely delineated. Some viral infections appear to affect allograft function by both inducing direct tissue damage and immunologically related injury, including acute rejection. In particular, this has been observed for cytomegalovirus (CMV) infection in all SOT recipients and for BK virus infection in kidney transplant recipients, for community-acquired respiratory viruses in lung transplant recipients, and for hepatitis C virus in liver transplant recipients. The impact of bacterial and fungal infections is less clear, but bacterial urinary tract infections and respiratory tract colonization by Pseudomonas aeruginosa and Aspergillus spp appear to be correlated with higher rates of chronic allograft dysfunction in kidney and lung transplant recipients, respectively. Evidence supports the beneficial effects of the use of antiviral prophylaxis for CMV in improving allograft function and survival in SOT recipients. Nevertheless, there is still a need for prospective interventional trials assessing the potential effects of preventive and therapeutic strategies against bacterial and fungal infection for reducing or delaying the development of chronic allograft dysfunction.

show abstract

“…Chronic hepatitis C is a leading cause of end-stage liver disease in North America and Europe (1,2). In Sweden, as in most industrialized countries, injection drug use is the predominant route of infection.…”

Section: Introductionmentioning

confidence: 99%

Chronic hepatitis C in Swedish subjects receiving opiate substitution therapy—Factors associated with advanced fibrosis

Jerkeman

Westin

Lagging

et al. 2014

Scandinavian Journal of Infectious Diseases

View full text Add to dashboard Cite

Chronic hepatitis C in Swedish subjects receiving opiate substitution therapy-Factors associated with advanced fibrosis.OGIONWO JERKEMAN, ANNA; Westin, Johan; Lagging, Martin; Norkrans, Gunnar; Lidman, Christer; Frimand, Jan; Simonsberg, Christian; Kakko, Johan; Widell, Anders; Björkman, Per Link to publication Citation for published version (APA): Jerkeman, A., Westin, J., Lagging, M., Norkrans, G., Lidman, C., Frimand, J., ... Björkman, P. (2014). Chronic hepatitis C in Swedish subjects receiving opiate substitution therapy-Factors associated with advanced fibrosis. Scandinavian Journal of Infectious Diseases, 46(5), 340-347. DOI: 10.3109/00365548.2013.879994 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal

show abstract

Evolution of indications and results of liver transplantation in Europe. A report from the European Liver Transplant Registry (ELTR)

Cited by 773 publications

References 22 publications

Progress of the liver transplantation programme in Hungary

Progress of the liver transplantation programme in Hungary

The Impact of Infection on Chronic Allograft Dysfunction and Allograft Survival After Solid Organ Transplantation

Chronic hepatitis C in Swedish subjects receiving opiate substitution therapy—Factors associated with advanced fibrosis

Contact Info

Product

Resources

About