RESUMEN
Hepatitis B (HBV) is a public health problem worldwide; one-third of the population has already been in contact with HBV, and 350 million people are chronic carriers of virus. The appearance of hyperimmune gamma globulin and antiviral drugs has allowed that group to undergone hepatic transplantation, achieving satisfactory results to prevent a relapse. But the use of hyperimmune gamma globulin has an extremely high cost, and combined therapies with new antiviral drugs seem to be a therapeutic alternative. We analyzed 21 patients with hepatitis B associated or not with Delta hepatitis over a mean follow-up period of 19.5 months, concluding that use of only nucleotide analogues has sufficient to achieve satisfactory results.
Asunto(s)
Antivirales/uso terapéutico , Hepatitis B/cirugía , Hepatitis D/cirugía , Trasplante de Hígado/inmunología , Adenina/análogos & derivados , Adenina/uso terapéutico , Adulto , Anciano , Aspartato Aminotransferasas/sangre , Femenino , Guanina/análogos & derivados , Guanina/uso terapéutico , Hepatitis B/complicaciones , Hepatitis B/tratamiento farmacológico , Hepatitis B/prevención & control , Virus de la Hepatitis B/efectos de los fármacos , Virus de la Hepatitis B/genética , Hepatitis D/complicaciones , Hepatitis D/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Organofosfonatos/uso terapéutico , Reacción en Cadena de la Polimerasa , Recurrencia , Estudios Retrospectivos , Adulto JovenRESUMEN
BACKGROUND: Many factors, including the advances in surgical techniques and immunosuppression, have been brought significant improvement to graft and patient survivals of patients undergoing pancreatic transplantations. However, one third of these patients require reoperations (ReOps). PURPOSE: We sought to evaluate the distribution of ReOps in the early or late postoperative period and analyze their impact on patient and graft survivals. PATIENTS AND METHODS: This unicenter, retrospective study was performed using data from 182 patient charts after pancreas transplantation from January 2000 through December 2007. RESULTS: We performed 88 ReOps on 73 patients; 43 early and 41 late operations. The simultaneous pancreas-kidney transplantation group showed a greater incidence of premature ReOps. The group undergoing early ReOp showed a lower survival rate (87.2%) compared with the nonoperated group, but a similar survival rate (97.5%) to the late ReOp group. In relation to the survival of pancreatic grafts after 1 year, the early ReOp group showed inferior survival to the late ReOp group, both of which were significantly worse results then those of the group without ReOp. CONCLUSION: ReOps were related to the success of the procedure. When they were performed in the first 3 months they had a negative impact on patient and graft survival.