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肝胆相照论坛 论坛 肝癌,肝移植 评论文章:预防肝移植术后乙肝患者的乙肝移植感染:免疫 ...
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[肝移植] 评论文章:预防肝移植术后乙肝患者的乙肝移植感染:免疫 [复制链接]

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发表于 2020-8-4 21:19 |只看该作者 |倒序浏览 |打印
Review article: preventing hepatitis B graft infection in hepatitis B patients after liver transplantation: immunoglobulin vs anti-virals
James S Park  1   2 , Vijay Gayam  3 , Calvin Q Pan  1   4
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    PMID: 32743822 DOI: 10.1111/apt.15999

Abstract

Background: A critical aspect of liver transplantation in hepatitis B patients is to prevent graft reinfection with hepatitis B virus. The use of hepatitis B immune globulin after transplant was a significant milestone, which allowed prolonged graft and patient survival by controlling hepatitis B reinfection in liver grafts. The development of anti-viral treatments with oral nucleos(t)ide analogues, led to a further reduction in graft reinfection and improvement in patient survival. The combination of the aforementioned two therapies has been widely used in hepatitis B-associated liver transplants.

Aim: To address the post-transplant management of hepatitis B and provide updates on preventing graft reinfection.

Methods: We performed a literature search on Ovid and PubMed for RCTs or cohort studies in English, which investigated the effectiveness of hepatitis B immune globulin and anti-viral therapy on hepatitis B-associated transplants (1/2000-1/2020). Studies that met pre-established criteria were reviewed.

Results: Based on currently available evidence, an algorithm for post-transplant management with anti-viral therapy is proposed. Also, the management of recipients who received grafts from hepatitis B core antibody-positive donors is discussed.

Conclusions: The development of hepatitis B immune globulin and anti-viral treatments led to substantial improvement in graft and patient survival. The prevention of hepatitis B graft reinfection is complex and involves a broad interdisciplinary team.

© 2020 John Wiley & Sons Ltd.

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发表于 2020-8-4 21:19 |只看该作者
评论文章:预防肝移植术后乙肝患者的乙肝移植感染:免疫球蛋白与抗病毒药
詹姆斯·S·帕克1 2,维杰伊·盖亚姆3,卡尔文·潘1 4
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    PMID:32743822 DOI:10.1111 / apt.15999

抽象

背景:乙型肝炎患者肝移植的关键方面是防止乙型肝炎病毒移植物再感染。移植后使用乙型肝炎免疫球蛋白是一个重要的里程碑,通过控制肝脏移植物中的乙型肝炎再感染,可以延长移植物和患者的生存期。口服核苷酸(t)ide类似物的抗病毒治疗的发展,导致移植物再感染的进一步减少和患者生存率的提高。前述两种疗法的组合已被广泛用于乙型肝炎相关的肝移植。

目的:解决乙型肝炎的移植后管理问题,并提供预防移植物再感染的最新信息。

方法:我们在Ovid和PubMed上进行了英文文献检索,以进行RCT或英语队列研究,研究了乙型肝炎免疫球蛋白和抗病毒疗法对与乙型肝炎相关的移植的有效性(1 / 2000-1 / 2020)。审查符合既定标准的研究。

结果:基于目前可用的证据,提出了一种抗病毒治疗的移植后管理算法。此外,还讨论了从乙肝核心抗体阳性供体接受移植的接受者的管理。

结论:乙型肝炎免疫球蛋白和抗病毒治疗的发展导致移植物和患者生存率的显着提高。乙型肝炎移植物再感染的预防工作复杂,涉及广泛的跨学科团队。

分级为4 +©2020 John Wiley&Sons Ltd.

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发表于 2020-8-4 21:20 |只看该作者
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