首页> 外文期刊>Liver transplantation: official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society >Impact of Immunosuppression Without Steroids on Rejection and Hepatitis C Virus Evolution After Liver Transplantation: Results of a Prospective Randomized Study
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Impact of Immunosuppression Without Steroids on Rejection and Hepatitis C Virus Evolution After Liver Transplantation: Results of a Prospective Randomized Study

机译:无类固醇的免疫抑制对肝移植后排斥反应和丙型肝炎病毒进化的影响:一项前瞻性随机研究的结果

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The purpose of this study was to evaluate the influence of a steroid-free immunosuppression on hepatitis C virus (HCV) recurrence. A total of 198 liver transplantation (LT) patients were randomized to receive immunosuppression with basiliximab and cyclosporine, either with prednisone (steroid [St] group) or without prednisone (no steroids [NoSt] group). The group of 89 HCV-infected patients was followed up with protocol biopsies for 2 years after LT. This group of HCV patients are the patients evaluated in the present study. The rejection rate was 19% (St: 21% versus NoSt: 17%; P = 0.67). Patients in the St group had a slightly higher rate of bacterial infections (59% versus 38%; P = 0.05). Almost all patients had histological HCV-recurrence (St: 39/40 (97%) versus NoSt: 40/41 (97%); P = 1). The percentage of accumulated biopsies with grade 4 portal inflammation at 6 months, 1 year, and 2 years were, 23%, 49%, and 49% in the NoSt group, compared to 33%, 55%, and 69% in the St group, respectively (P = 0.04 at 2 years). The percentage of accumulated biopsies with grade 3 or 4 fibrosis at 6 months, 1 year, and 2 years were 0%, 8%, and 22% in the NoSt group, compared to 8%, 19%, and 31% in the St group, respectively. Immunosuppression without steroids in HCV patients is safe, reduces bacterial infections and metabolic complications, and improves histological short-term evolution of HCV recurrence. Liver Transpl 14:1752-1760, 2008. (C) 2008 AASLD.
机译:这项研究的目的是评估无类固醇的免疫抑制对丙型肝炎病毒(HCV)复发的影响。总共198例肝移植(LT)患者被随机分配接受含巴立昔单抗和环孢霉素的免疫抑制治疗,联合泼尼松(类固醇[St]组)或不联合泼尼松(无类固醇[NoSt]组)。该组89例被HCV感染的患者在LT后进行了2年的方案活检。这组HCV患者是本研究中评估的患者。拒绝率为19%(St:21%vs NoSt:17%; P = 0.67)。 St组患者的细菌感染率略高(59%比38%; P = 0.05)。几乎所有患者均具有组织学HCV复发(St:39/40(97%)与NoSt:40/41(97%); P = 1)。 NoSt组在6个月,1年和2年时具有4级门静脉炎症的活检样本百分比分别为23%,49%和49%,而St组为33%,55%和69%组分别(2年时P = 0.04)。 NoSt组在6个月,1年和2年时发生3或4级纤维化的活检的百分比分别为0%,8%和22%,而St组分别为8%,19%和31%组。 HCV患者无类固醇的免疫抑制是安全的,可减少细菌感染和代谢并发症,并改善HCV复发的组织学短期演变。 Liver Transpl 14:1752-1760,2008。(C)2008 AASLD。

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