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INCREASED NASH INDICATION FOR LIVER TRANSPLANTATION IN RECENT YEARS RETROSPECTIVE ANALYSIS FLORES-VILLALBA E,* RODRÍGUEZ-MONTALVO C,* TIJERINA-GÓMEZ L,1 BOSQUES-PADILLA F,* DEL REAL-ROMO Z,** CISNEROS-GARZA L,* LÓPEZ-GARNICA D*** *CENTRO DE ENFERMEDADES HEPÁTICAS, HOSPITAL SAN JOSÉ-TEC DE MONTERREY, NUEVO LEÓN. **PROGRAMA MULTICÉNTRICO RESIDENCIAS MÉDICAS CIRUGÍA GENERAL ITESM-SSNL. MÉXICO. ***ESCUELA DE MEDICINA Y CIENCIAS DE LA SALUD DEL TECNOLÓGICO DE MONTERREY, NUEVO LEÓN. MÉXICO. Introduction: Fatty liver disease affects 17-33% of the general population in Western countries, while non-alcoholic steatohepatitis (NASH) occurs in 6-17% and is directly related to obesity. In patients with NASH, the risk of developing cirrhosis is estimated to be up to 25%. Moreover, according to recent statistics, worldwide Mexico ranks second in adult obesity and first in childhood. Thus, an increase in candidates for liver transplantation owing to NASH is to be expected. Material and methods: We reviewed all transplants performed by our group from June 1999 to January 2013. The population was divided into two periods: 1999-2007 and 2008-2013. Indications for transplantation were compared using chi-squared. Kaplan Meyer curves were used for differences in survival according to the indication. Results: We analyzed 62 liver transplants in 61 patients. There were 39 (63%) transplants during the first period and 23 (37%) in the second. Globally, indications for liver transplant were as follows: HCV 19 (30.6%), OH 19 (30.6%), NASH 6 (9.7%), autoimmune hepatitis 6 (9.7%), others 12 (19.4%). When comparing the two study groups, the following differences were found: HCV 14 (36%) vs. 5 (22%), p = 0.271; OH 10 (25%) vs. 9 (39%), p = 0.393; NASH 1 (3%) vs. 5 (22%), p = 0.023; other 14 (36%) vs. 4 (17%), p = 0.154. Survival rates at 1 and 5 years were 84 and 70% respectively, with a mean follow up of 59 months. There was no significant difference in survival according to the indication for transplant (log-rank-test 0.919). Conclusions: Cirrhosis caused by NASH has increased in recent years as an indication for liver transplantation. No differences in survival of these patients were found when compared with other indications. The authors declare that there is no conflict of interest.

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2013-07-15   |   451 visitas   |   Evalua este artículo 0 valoraciones

Vol. 12 Núm.4. Julio-Agosto 2013 Pags. 655-702 Ann Hepatol 2013; 12(4)