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Di Benedetto F, De Ruvo N, Berretta M, Masetti M, Montalti R, Di Sandro S, Ballarin R, Codeluppi M, Guaraldi G, Gerunda GE.
肝脏及多器官移植中心，摩德纳大学，Policlinico di Modena，摩德纳，意大利。
简介：一些报告报道了肝脏移植（LT）对患有终末期肝病的艾滋病患者的治疗功效。肝硬化性肝癌是肝脏移植的另一个重要指征。但据我们所知，对于有肝癌的艾滋病患者，目前还没有任何关于肝移植的指征和功效等重要问题的报道，主要是因为人们更加关注患肝癌的HIV阴性患者。
方法：本报告的目的是将一组患者的肝移植指征、初步结果和并发症等信息集中考虑，研究对象为在我中心肝硬化性肝癌部门进行肝脏移植的7名艾滋病患者。
结果：采用国际通用的米兰标准来确定符合要求的艾滋病患者。所有患者都感染了HBV（乙型肝炎病毒)和/或HCV(丙型肝炎病毒)。平均CD4+细胞总数为249（范围为144-353），HIV-RNA量仅在一个案例中被察觉。在２３２天的平均随访期内（范围为３３－７７４天），无肝癌复发案例；其中一名患者死亡。
结论：报告中描述了研究方案的特征、患者、病毒学和免疫学特性、肿瘤分期和移植前疗法、并发症和生存期等，试图为患肝癌的艾滋病患者提供一个新的管理方法，并可能增加其治愈的机会。
PMID: 17590564 [PubMed - as supplied by publisher]
Hepatocellular carcinoma in HIV patients treated by liver transplantation.
Di Benedetto F, De Ruvo N, Berretta M, Masetti M, Montalti R, Di Sandro S, Ballarin R, Codeluppi M, Guaraldi G, Gerunda GE.
Liver and Multivisceral Transplant Centre, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.
INTRODUCTION: Several reports have shown the effectiveness of liver transplantation (LT) as a therapeutic option in HIV-patients affected by end-stage liver disease. HCC on cirrhosis is another major indication for LT. However, no reports, to our knowledge, have been published as yet addressing the important questions of indications and outcome of LT in HIV-patients with HCC, mainly because of concerns regarding a more aggressive course of HCC with respect to HCC seen in HIV-negative individuals.
METHODS: The aim of this report is to focus on indications, preliminary results and complications of LT in a group of 7 HIV-patients who underwent LT at our department for HCC on cirrhosis.
RESULTS: Indications to listing HIV-patients were HCC using the internationally accepted Milan criteria. All patients were HBV-and/or HCV-infected. The mean CD4+ cell-count was 249 (range 144-353), and the HIV-RNA load was undetectable in all but one case. After a mean follow-up period of 232days (range 33-774), no recurrence of HCC was seen; one patient died.
CONCLUSION: Characteristics of the study protocol, the patients, virological and immunological features, tumor stage and pre-transplantation treatment, complications and survival are herein described in an effort to provide new insights into methodology for an aggressive management of HCC in HIV patients, and possibly give a greater chance of cure.
PMID: 17590564 [PubMed - as supplied by publisher]
[责任编辑:刘 聪]
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