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Impact of utilization of hepatitis C positive organs in liver transplant:Analysis of united network for organ sharing database

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World Journal of Hepatology 2022年第5期14卷 984-991页

作者： Amaninder Dhaliwal Banreet Dhindsa Daryl Ramai Harlan Sayles Saurabh Chandan rajani rangray Department of Gastroenterology and Hepatology Moffitt Cancer CenterTampaFL 33612United States Department of Gastroenterology and Hepatology University of Nebraska Medical CenterOmahaNE 68198United States Department of Internal Medicine The Brooklyn Hospital CenterBrooklynNY 11201United States Department of Biostatistics University of Nebraska Medical CenterOmahaNE 68198United States Department of Gastroenterology and Hepatology Creighton University Medical CenterOmahaNE 68124United States

BACKGROUND The utility of hepatitis C virus(HCV)organs has increased after the Food and Drug Administration approval of direct acting anti-viral(DAA)medications for the HCV *** efficacy of DAA in treating HCV is nearly 100%.AIM To analyze the United Network for Organ Sharing(UNOS)database to compare the survival rates between the hepatitis C positive donors and negative recipients and hepatitis C negative donors and *** We analyzed the adult patients in UNOS database who underwent deceased donor liver transplant from January 2014 to December *** primary endpoint was to compare the survival rates among the four groups with different hepatitis C donor and recipient status:(Group 1)Both donor and recipient negative for HCV(Group 2)Negative donor and positive recipient for HCV(Group 3)Positive donor and negative recipient for HCV(Group 4)Both positive donor and recipient for *** 9.4 software was used for the data *** Meier log rank test was used to analyze the estimated survival rates among the four *** A total of 24512 patients were included:Group 1:16436,Group 2:6174,Group 3:253 and Group 4:*** 1-year(Group 1:91.8%,Group 2:92.12%,Group 3:87%,Group 4:92.8%),2-year(Group 1:88.4%,Group 2:88.1%,Group 3:84.3%,Group 4:87.5%),3-year(Group 1:84.9%,Group 2:84.3%,Group 3:75.9%,Group 4:83.2%)survival rates showed no statistical significance among the four *** Meier log rank test did not show any statistical significance difference in the estimated survival rates between Group 3 vs all the other *** The survival rates in hepatitis C positive donors and negative recipients are similar as compared to both hepatitis C negative donors and *** could be due to the use of DAA therapy with cure rates of nearly 100%.This study supports the use of hepatitis C positive organs in the selected group of recipients with and without HCV *** long-term studies are needed to further valid

关键词： Hepatitis C Liver transplant Survival United Network for Organ Sharing Direct acting antiviral

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Spontaneous bacterial empyema in cirrhosis:A systematic review and meta-analysis

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World Journal of Hepatology 2022年第6期14卷 1258-1268页

作者： William Reiche Smit Deliwala Saurabh Chandan Babu P Mohan Banreet Dhindsa Daryl Ramai Abhilash Perisetti rajani rangray Sandeep Mukherjee Department of Internal Medicine CHI Creighton University Medical CenterOmahaNE 68124United States Department of Internal Medicine Michigan State University at Hurley Medical CenterFlintMI 48503United States Division of Gastroenterology and Hepatology CHI Creighton University Medical CenterOmahaNE 68124United States Department of Gastroenterology University of UtahSalt Lake CityUT 84132United States Division of Gastroenterology and Hepatology University of Nebraska Medical CenterOmahaNE 68198United States Division of Gastroenterology Parkview HealthFort WayneIN 46845United States

BACKGROUND Spontaneous bacterial empyema(SBE)occurs when a hepatic hydrothorax becomes infected and runs a course similar to spontaneous bacterial peritonitis(SBP).It remains underdiagnosed as patients with cirrhosis do not routinely undergo diagnostic *** understanding is limited by small cohorts,while studies reporting its association with ascites/SBP are *** To explore the incidence of SBE,to determine its association with ascites,and to summarize what is known regarding treatment and outcomes for patients with *** Major databases were searched until June *** include the incidence of SBE in pleural effusions,SBP in peritoneal fluid,and SBE in patients without ascites within our cohort of patients with *** performed a meta-analysis using a randomeffects model with pooled proportions and 95%confidence intervals(CI).We assessed heterogeneity using I^(2)and classic fail-safe to determine *** Eight studies with 8899 cirrhosis patients were *** median age ranged between 41.2 to 69.7 *** majority of the patients were Child-Pugh B and *** MELD score was 18.6±8.09.A total of 1334 patients had pleural effusions and the pooled incidence of SBE was 15.6%(CI 12.6-19;I^(2)50).Amongst patients diagnosed with SBE,the most common locations included right(202),left(64),and bilateral(8).Amongst our cohort,a total of 2636 patients had ascites with a pooled incidence of SBP of 22.2%(CI 9.9-42.7;I^(2)97.8).The pooled incidence of SBE in patients with cirrhosis but without concomitant ascites was 9.5%(CI 3.6-22.8;I^(2)82.5).CONCLUSION SBE frequently occurs with concurrent ascites/SBP;our results suggest high incidence rates of SBE even in the absence of *** pleura can be an unrecognized nidus and our findings support the use of diagnostic thoracentesis in patients with decompensated cirrhosis after exclusion of other causes of pleural *** should be considered particularly in p

关键词： Spontaneous bacterial peritonitis Spontaneous bacterial peritonitis Postparacentesis circulatory dysfunction Refractory ascites Hepatic hydrothorax

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