Primer sklerozan kolanjit nedeniyle karaciğer nakli yapılan hastalarda nakil sonrasındaki uzun dönem sonuçların retrospektif araştırılması
Küçük Resim Yok
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Karaciğer transplantasyonu, primer sklerozan kolanjit (PSK)'e bağlı ilerlemiş karaciğer hastalığı olan hastalar için tercih edilen tedavi yöntemidir. Çalışmamızın amacı, PSK nedeniyle karaciğer nakli yapılan hastalarda nakil sonrasındaki uzun dönem sonuçların retrospektif araştırılmasıdır. Gereç ve Yöntem: İnönü Üniversitesi Tıp Fakültesi Gastroenteroloji Bilim Dalında Şubat 2008 ile Ekim 2020 arasında Primer Sklerozan Kolanjit nedeniyle karaciğer nakli yapılan hastalar çalışmaya dahil edildi. Hastaların yaş, cinsiyet, nakil tipleri, yaşam süreleri, nakil sonrası biliyer komplikasyon, rejeksiyon ve nüks sıklıkları araştırıldı. Bulgular: PSK nedeniyle karaciğer nakli yapılan 18 erkek, 12 kadın toplam 30 hasta mevcuttu. Hastaların 27'sine canlı nakil (%90); 3'üne kadaverik nakil uygulandı (%10). PSK nedeniyle nakil yapılan hastalarda 1, 3, ve 5 yıllık sağkalım oranlarını sırasıyla; %75.9, %74.9 ve %74.9 olarak bulduk. Hastaların %50'sinde biliyer komplikasyon, %13.3'ünde ise PSK nüksü ve %10'unda kronik rejeksiyon geliştiği belirlendi. Hastaların hiçbirisine biliyer komplikasyon nedeniyle cerrahi tedavi uygulanmadı. Biliyer komplikasyonlu tüm hastalar endoskopik ve perkütan tedavi yöntemleri ile başarıyla tedavi edildi. Sonuçlar: Nakil sonrası yüksek sağkalım oranlarıyla karaciğer nakli, PSK hastalarında tek küratif tedavi seçeneği olmaya devam etmektedir. Nakil sonrası hastalar özellikle biliyer komplikasyon açısından yakın takip edilmelidir. Anahtar Kelimeler: Primer sklerozan kolanjit, karaciğer transplantasyonu, biliyer komplikasyon
Introduction: Liver transplantation is the treatment of choice for patients with advanced liver disease due to primary sclerosing cholangitis (PSC). The aim of our study is to retrospectively investigate the long-term results after transplantation in patients who underwent liver transplantation due to PSC. Material and Methods: Patients who underwent liver transplantation due to Primary Sclerosing Cholangitis between February 2008 and October 2020 in the Department of Gastroenterology of İnönü University Faculty of Medicine were included in the study. The patients' age, gender, transplant types, life expectancy, post-transplantation biliary complications, rejection and recurrence rates were investigated. Results: There were 30 patients, 18 male and 12 female, who underwent liver transplantation due to PSC. Live transplant in 27 of the patients (90%); Cadaveric transplantation was performed in 3 (10%). The 1, 3, and 5-year survival rates in patients transplanted due to PSC, respectively; We found 75.9%, 74.9% and 74.9%. Biliary complications were detected in 50% of the patients, PSC recurrence in 13.3%, and chronic rejection in 10%. Surgical treatment was not applied to any of the patients due to biliary complications. All patients with biliary complications were successfully treated with endoscopic and percutaneous treatment methods. Conclusion: Liver transplantation remains the only curative treatment option in PSC patients, with high post-transplant survival rates. Post-transplant patients should be followed closely, especially in terms of biliary complications. Keywords: Primary sclerosing cholangitis, liver transplantation, biliary complication
Introduction: Liver transplantation is the treatment of choice for patients with advanced liver disease due to primary sclerosing cholangitis (PSC). The aim of our study is to retrospectively investigate the long-term results after transplantation in patients who underwent liver transplantation due to PSC. Material and Methods: Patients who underwent liver transplantation due to Primary Sclerosing Cholangitis between February 2008 and October 2020 in the Department of Gastroenterology of İnönü University Faculty of Medicine were included in the study. The patients' age, gender, transplant types, life expectancy, post-transplantation biliary complications, rejection and recurrence rates were investigated. Results: There were 30 patients, 18 male and 12 female, who underwent liver transplantation due to PSC. Live transplant in 27 of the patients (90%); Cadaveric transplantation was performed in 3 (10%). The 1, 3, and 5-year survival rates in patients transplanted due to PSC, respectively; We found 75.9%, 74.9% and 74.9%. Biliary complications were detected in 50% of the patients, PSC recurrence in 13.3%, and chronic rejection in 10%. Surgical treatment was not applied to any of the patients due to biliary complications. All patients with biliary complications were successfully treated with endoscopic and percutaneous treatment methods. Conclusion: Liver transplantation remains the only curative treatment option in PSC patients, with high post-transplant survival rates. Post-transplant patients should be followed closely, especially in terms of biliary complications. Keywords: Primary sclerosing cholangitis, liver transplantation, biliary complication
Açıklama
Anahtar Kelimeler
Gastroenteroloji, Gastroenterology
