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2. Protocolo diagnóstico y terapéutico de la ascitis

Author

Sanz, M. de Benito, Martínez, E. Velasco, and Carrasco, N. Marcos

Abstract

La ascitis se define como la acumulación de líquido libre en la cavidad peritoneal. Las tres causas más frecuentes para el desarrollo de la ascitis son la descompensación hidrópica en el seno de la cirrosis hepática (85%), las neoplasias malignas (7%) y el fallo cardíaco. Aproximadamente el 5% de los pacientes presentan más de una causa. El tratamiento exitoso depende de un diagnóstico preciso de la causa de la ascitis; por ejemplo, la carcinomatosis peritoneal no responde al tratamiento con diuréticos.

Published
2024
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3. Indicaciones y valoración de la paracentesis diagnóstica

Author

Sanz, M. de Benito, Prada, S. Fernández, Rodríguez, J. Ruiz, and Pajares, F. García

Abstract

La paracentesis diagnóstica es un procedimiento que se realiza para obtener una pequeña muestra de líquido ascítico con fines diagnósticos; también puede emplearse la paracentesis de alto volumen con fines terapéuticos. El procedimiento consiste en insertar una aguja o catéter en la cavidad peritoneal a través de la piel, atravesando la pared abdominal, y extraer el líquido ascítico, el cual se analiza en el laboratorio para determinar la etiología de la ascitis y evaluar la presencia de infección.

Published
2024
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4. Recurrence of anastomotic biliary stricture in orthotopic liver transplantation (OLT) recipients after previous endoscopic treatment. Risk factors and endoscopic treatment options

Author

Fuentes-Valenzuela, E., additional, Sanz, M. De Benito, additional, Herrero, I. Peñas, additional, De La Serna-Higuera, C., additional, Sánchez-Ocaña, R., additional, Martin, C. Alonso, additional, ÁLvarez, C. Almohalla, additional, García-Pajares, F., additional, Antolín, G. Sánchez, additional, and Perez-Miranda, M., additional

Published
2023
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6. Interventional EUS (i-EUS) in the management of biliary complications of deceased-donor orthotopic liver transplantation (OLT) not amenable to ERCP

Author

Fuentes-Valenzuela, E., additional, Sanz, M. De Benito, additional, Herrero, I. Peñas, additional, Martin, C. Alonso, additional, ÁLvarez, C. Almohalla, additional, García-Pajares, F., additional, Sánchez-Ocaña, R., additional, Antolín, G. Sánchez, additional, De La Serna-Higuera, C., additional, and Perez-Miranda, M., additional

Published
2023
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7. Double-blind multicenter randomized clinical trial comparing the efficacy of glucagon vs placebo in the resolution of alimentary esophageal impaction

Author

Sanz, M. De Benito, additional, Tejedor, J., additional, Sánchez-Ocaña, R., additional, García-Alonso, F. J., additional, Diez Redondo, M. P., additional, Nuñez Rodriguez, M. H., additional, Fuentes-Valenzuela, E., additional, Higuera, C. De La Serna, additional, and Perez-Miranda, M., additional

Published
2023
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8. P386 Clinical presentation, management, and evolution of lymphomas in patients with Inflammatory Bowel Disease: an ENEIDA registry study

Author

I Guerra Marina, L Bujanda, M Mañosa, I Pérez-Martínez, M J Casanova, L de la Peña, M de Benito, M Rivero, P Varela, L Bernal, A C Franco, Y Ber, M Piqueras, C Tardillo, Á Ponferrada, S Olivares, A J Lucendo, P Gilabert, M Sierra Ausín, M Bellart, A Herrarte, M Calafat, R de Francisco, J P Gisbert, J Guardiola, E Domènech, and F Bermejo

Subjects
Gastroenterology, General Medicine
Abstract

Background An increased risk of lymphoma has been described in patients with Inflammatory Bowel Disease (IBD). The aims of our study were to determine the clinical presentation of lymphoma, previous exposure to immunosuppressive and biologic therapies, and the management and evolution of lymphomas in patients with IBD. Methods IBD patients with diagnosis of lymphoma from October 2006 to June 2021 were identified from the prospectively maintained ENEIDA registry of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU). Investigators at each participating centre provided additional information on lymphomas. Results We identified 52 patients with lymphoma in 18 centres following 21,740 patients with IBD (2.4 cases of lymphoma/1,000 patients with IBD; 95% CI 1.8-3.1). 35 were men (67%) and 27 (52%) had Ulcerative Colitis. Non-Hodgkin lymphoma was the most common lymphoma (65%). The median age at diagnosis of lymphoma was 59 years old (IQR 48-67). 31 patients (60%) received thiopurines, and 20 (38%) an anti-TNF drug (one of them had not received thiopurines) before lymphoma diagnosis. Age at diagnosis of lymphoma was lower in those patients treated with thiopurines (53 ± 17 years old) and anti-TNF drugs (47 ± 17 years old) than in those patients not treated with thiopurines nor anti-TNF drugs before the diagnosis of lymphoma (63 ± 12 years old; p Conclusion Most IBD patients with lymphoma had been treated with thiopurines and/or anti-TNF agents before lymphoma diagnosis, and these patients were younger at diagnosis of lymphoma than those not treated with these drugs. IBD treatment was usually changed after a diagnosis of lymphoma. Relapse and mortality of lymphoma were not related to the use and duration of thiopurines or biologic therapies.

Published
2023

17. Utility of Oral Anticoagulants as Prophylaxis of Recurrent Portal Thrombosis after Liver Transplantation

Author

C. Almohalla-Alvarez, F. Garcia-Pajares, Ramon Sanchez-Ocana, G. Sanchez-Antolin, A. Barrera-Rebollo, J. Tejedor-Tejada, M Cimavilla-Roman, E. Asensio-Diaz, M de Benito-Sanz, and B. Pérez-Saborido

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Liver transplantation, Recurrence, Prevalence, Humans, Medicine, Retrospective Studies, Venous Thrombosis, Transplantation, Portal Vein, business.industry, Warfarin, Anticoagulants, Retrospective cohort study, Heparin, Heparin, Low-Molecular-Weight, Middle Aged, medicine.disease, Thrombosis, Liver Transplantation, Portal vein thrombosis, Surgery, Portal thrombosis, Female, Transplant patient, business, medicine.drug
Abstract

Introduction Portal vein thrombosis (PVT) is a relatively common finding in patients undergoing liver transplantation. Although the recommendation to prevent its recurrence is anticoagulation for a duration of 3 to 6 months, this is controversial. Aim The aim of our study was to determine the efficacy of oral anticoagulants (OAC) as prophylaxis for recurrent PVT after liver transplantation. Materials and Methods Our study included 215 liver transplant patients who underwent surgery in our center from January 2012 to August 2017. We selected all patients diagnosed with PVT either pre-transplantation (using Doppler echography or Angio-CT) or during transplant surgery. All patients with PVT were initially anticoagulated with low-molecular-weight heparin in the postoperative period; at discharge they received OAC for a duration of six months. Control Doppler ultrasound was performed at 3, 6, and 12 months post-transplantation. Results PVT was identified in 37 out of 215 patients (17.2%). PVT was diagnosed with a pre-transplant vascular study in 17 out of 37 cases (45.9%). All patients were anticoagulated with OAC (warfarin) for at least 6 months. There were no cases of recurrent thrombosis and no complications associated with anticoagulant treatment throughout the follow-up period. Conclusions The prevalence of portal thrombosis in liver transplant patients in our study was fairly high, at 17.2%. PVT was identified in nearly 50% of patients using high-quality vascular studies prior to transplant surgery. Anticoagulation with OAC for 6 months was effective in preventing a recurrence of thrombosis and there were no associated complications.

Published
2019

18. Double Over-The-Scope Clip (OTSC) Closure Following Lumen-Apposing Metal Stent (LAMS) Dislodgement Allows Single-Session Eus-Directed Transgastric Ercp (EDGE)

Author

C De La Serna Higuera, M De Benito Sanz, M Pérez-Miranda, E Fuentes Valenzuela, C Chavarria Herbozo, and Ramon Sanchez-Ocana

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Closure (topology), Lumen (anatomy), Medicine, Stent, Over the scope clip, Edge (geometry), business, Single session, Surgery
Published
2021

19. Rendezvous Ercp Via EUS-Guided Gallbladder Drainage To Salvage Lumen-Apposing Metal Stent (LAMS) Dislodgement During EUS-Guided Choledochoduodenostomy

Author

R Najera Muñoz, Ramon Sanchez-Ocana, M De Benito Sanz, C Chavarria Herbozo, M Pérez-Miranda, and C De La Serna Higuera

Subjects
medicine.medical_specialty, medicine.anatomical_structure, business.industry, Gallbladder, medicine.medical_treatment, medicine, Rendezvous, Lumen (anatomy), Stent, Radiology, Drainage, business
Published
2021

20. VALIDATION OF AN ONLINE LEARNING TOOL FOR OPTICAL DIAGNOSIS OF DIMINUTIVE COLORECTAL POLYPS

Author

MB Balén, NF Fernández, L de Castro, B Romero, AR de Jesus, JD de Castro, JM Herrero, F Baiocchi, M Puga, L Rivas, B Peñas, ER de Santiago, M Aicart, C Senosiain, PD Redondo, H Nuñez, M de Benito, FJG Alonso, B Dobarro, DR Remedios, N Pin, S Vazquez, L Cid, YP Garcia, V Hernandez, P Estevez, A Martinez, S Lopez, M Sierra, S Parejo, A Sanahuja, MP Ballester, M Bañuls, P Vazquez, G Pacheco, G Cordon, S Bejar, MF de la Varga, and HADO Study Group

Subjects
Diminutive, medicine.medical_specialty, Computer science, Optical diagnosis, Online learning, medicine, Medical physics
Published
2020

22. EUS-GUIDED LEFT HEPATICO-DUODENOSTOMY (L-HDS): A NOVEL OPTION FOR EUS-GUIDED BILIARY DRAINAGE (EUS-BD) OF THE LEFT BILE-DUCT WHEN HEPATICOGASTROSTOMY (EUS-HGS) IS NOT FEASIBLE

Author

Ramon Sanchez-Ocana, M Pérez-Miranda, C De la Serna-Higuera, C Chavarria Herbozo, M de Benito, G Salazar, and I Fanjul Yanicelli

Subjects
Biliary drainage, Hepaticogastrostomy, medicine.medical_specialty, medicine.anatomical_structure, business.industry, Bile duct, Duodenostomy, Medicine, Radiology, business
Published
2020

24. ENDOSCOPIC ULTRASOUND-DIRECTED TRANSGASTRIC ERCP (EDGE) IN PATIENTS WITH ROUX-EN-Y GASTRIC BYPASS (RYGB): TECHNIQUE AND RESULTS IN A EUROPEAN CASES SERIES

Author

J García-Alonso, Javier Tejedor Tejada, M Pérez-Miranda, M De Benito Sanz, Beatriz Burgueño, Ayc Lóopez, C De La Serna Higuera, I Peñas Herrero, Rso Hernández, and Sbp de Rozas

Subjects
Endoscopic ultrasound, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Gastric bypass, medicine, In patient, business, Roux-en-Y anastomosis, Surgery
Published
2020

25. EUS-GUIDED HEPATICOGASTROSTOMY (HGS) AND ANTEGRADE TREATMENT WITH KAFFES ANASTOMOTIC STENT (KAS) OF BILIO-ENTERIC ANASTOMOTIC STRICTURES (BEAS) IN PATIENTS WITH SURGICALLY ALTERED ANATOMY (SAA)

Author

C Alonso-Martín, C De la Serna-Higuera, M Pérez-Miranda, Ramon Sanchez-Ocana, J García-Alonso, Carlos Chavarría, Javier Tejedor-Tejada, M de Benito-Sanz, and Ayc López

Subjects
Hepaticogastrostomy, medicine.medical_specialty, business.industry, medicine.medical_treatment, Medicine, Stent, In patient, Anastomosis, business, Surgery
Published
2020

27. OBLITERATION OF GASTRIC VARICES GUIDED BY ECO-ENDOSCOPY WITH COILS INSERTION COATED WITH EXPANDABLE HIDROGEL POLYMERS

Author

Ramon Sanchez-Ocana, Manuel Perez-Miranda, S Bazaga, Francisco Javier García-Alonso, C De La Serna, J Tejedor, Ana Yaiza Carbajo, and M de Benito

Subjects
Endoscopic ultrasound, medicine.medical_specialty, Polymers, Esophageal and Gastric Varices, law.invention, law, medicine, Humans, Thrombus, Contraindication, Retrospective Studies, Varix, medicine.diagnostic_test, business.industry, Gastroenterology, Endoscopy, Hydrogels, General Medicine, Gastric varices, medicine.disease, Treatment Outcome, Cyanoacrylate, Portal hypertension, Radiology, Gastrointestinal Hemorrhage, business
Abstract

Introduction: gastric varices hemorrhage is a severe complication of portal hypertension, with high mortality rates and few management alternatives, especially when there is a contraindication to transjugular intrahepatic portosystemic shunts (TIPS). The usual therapeutic options are the injection of cyanoacrylate, the insertion of coils or both. Hydrocoils are special coils coated with different types of expandable hydrogel polymers conventionally used in neurovascular interventionism. They allow rapid occlusion of vessel, forming a mesh that favors the local formation of thrombus and the development of a neointima on the gel cover. We consider the use of endoscopic ultrasound (EUS) guided hydrocoil insertion in gastric varices, without using cyanoacrylate. Objective: this study aimed to evaluate the safety and effectivity of the application of EUS-guided hydrocoils in patients with gastric varices hemorrhage with TIPS contraindication. Material and methods: this was a retrospective case series of four patients with TIPS contraindication after interventional radiologist evaluation. Linear echoendoscopes, fluoroscopy, 19G needles and hydrocoils (Azur®, Terumo) and Progreat® 3 Fr microcatheters were used. An interventional radiologist expert advised the procedures and endoscopic ultrasound confirmed the varix obliteration. Results: technical and clinical success occurred in all patients involved in this study. There were no adverse effects related to the procedure or endoscopic equipment damage. Conclusions: the application of EUS-guided hydrocoils can be a safe and effective method in the short term for gastric varices bleeding in patients who are not candidates for TIPS. Besides, a complete obliteration of the vascular lumen could occur and thus, dispense with the use of cyanoacrylate. Further studies are needed to corroborate these preliminary results.

Published
2020

28. Effects of a strength endurance training program on endurance levels

Author

G. Cuadrado, A. M. De Benito, S. Sedano, J. M. Izquierdo, J. C. Redondo, and J. C. Granado

Subjects
Sports, GV557-1198.995, Sports medicine, RC1200-1245
Abstract

The purpose of the current study was to determine whether a strength endurance training program of lower limbs isolate can increase endurance levels, both aerobic capacity and aerobic power, in order to adapt the strength training for endurance races. 20 phisically active men participated in the study. They were divided into two groups: control group (GC) (n=10) and experimental group (GE) (n=10). GE carried out a strength endurance training program for ten weeks. Results obtained showed that this type of training regime was useful to improve the performance in an aerobic endurance test. This could be due to an improvement in aerobic capacity, maximal dynamic strength, explosive strength and reactive strength. Moreover, there was a decrease in fat mass without increase in muscle mass. Key Words: Training, strength endurance, aerobic capacity, anthropometry.

Published
2010

33. HEMOSPRAY FOR GASTROINTESTINAL BLEEDING: EFFECTIVENESS, PREDICTORS OF FAILURE AND SURVIVAL IN A NATIONWIDE STUDY

Author

D Oyón Lara, A Guerrero García, A. Albillos, J Aranda Hernández, R Borobia Sánchez, C Carbonell Blanco, S Parejo Carbonell, D Coto Ugarte, Á Terán Lantarón, S Prados Leira, C. Froilán Torres, I Ortiz Polo, D Burgos Santamaría, E Vázquez Sequeiros, C Chavarria Herbozo, L Ciriano Hernández, E Martínez Bauer, Enric Brullet, A Ibañez Pinto, M Angel de Jorge Turrión, C. Ferre Aracil, Hmm Prieto, J García Lledó, C Santander Vaquero, A. López Serrano, M López Ibáñez, D Pérez Corte, N Volpato Machado, D. Juzgado Lucas, F Riu Pons, C Rodríguez Escaja, M De Benito Sanz, O Murcia Palomares, S Sevilla Ribota, Giulia Pagano, I Becerro González, FJ García Alonso, I Fernández-Urién Sainz, A Barturen Barroso, B Peñas García, O Nogales Rincón, M González-Haba Ruíz, E. Rodríguez de Santiago, E. Martínez Moneo, and L Pérez Carazo

Subjects
medicine.medical_specialty, Gastrointestinal bleeding, business.industry, Internal medicine, Medicine, business, medicine.disease
Published
2019

34. SINGLE-SCOPE MONO-RAIL EUS-GUIDED RENDEZVOUS TO SALVAGE FAILED DUODENAL INTUBATION AND FAILED BILIARY CANNULATION

Author

Francisco Javier García-Alonso, R Sánchez-Ocaña Hernández, M De Benito Sanz, M Pérez-Miranda Castillo, S Bazaga Pérez de Rozas, AY Carbajo López, C De la Serna-Higuera, and J Tejedor Tejada

Subjects
medicine.medical_specialty, Scope (project management), business.industry, medicine.medical_treatment, General surgery, medicine, Rendezvous, Intubation, business
Published
2019

35. TEMPORARY BILIARY METAL STENT PLACEMENT IN THE CYSTIC DUCT AS AN AID TO CHOLANGIOSCOPY-GUIDED LASER LITHOTRIPSY OF MIRIZZI SYNDROME (MS)

Author

Francisco Javier García-Alonso, J Tejedor, C De La Serna Higuera, A Yaiza Carbajo, S Bazaga, Ramon Sanchez-Ocana, Manuel Perez-Miranda, and M de Benito

Subjects
medicine.medical_specialty, Stent placement, medicine.anatomical_structure, business.industry, medicine.medical_treatment, Mirizzi Syndrome, medicine, Cystic duct, Radiology, business, Laser lithotripsy
Published
2019

36. COMBINED RETROGRADE/ANTEGRADE ENDOSCOPIC APPROACH TO DISCONNECTED BILE-DUCT (DBD) AS A RESULT OF SEVERE POSTOPERATIVE INJURY

Author

Gloria Sánchez-Antolín, Ramon Sanchez-Ocana, Manuel Perez-Miranda, M de Benito, Irene Penas-Herrero, S Bazaga, Félix García-Pajares, C De La Serna, Ana Yaiza Carbajo, C. Almohalla, J Tejedor-Tejeda, and Francisco Javier García-Alonso

Subjects
medicine.medical_specialty, medicine.anatomical_structure, business.industry, Bile duct, Medicine, business, Surgery
Published
2019

37. TEMPORARY EUS-GUIDED ANASTOMOSES (TEA) AS THERAPEUTIC ACCESS FISTULAS (TAF) IN BENIGN BILIARY OBSTRUCTION (BBO) NOT AMENABLE TO ERCP: EMERGING APPLICATION OF EUS-GUIDED BILIARY DRAINAGE (EUS-BD)

Author

M de Benito, Francisco Javier García-Alonso, Ramon Sanchez-Ocana, Manuel Perez-Miranda, Félix García-Pajares, A Yaiza Carbajo, Irene Penas-Herrero, C De La Serna Higuera, and S Bazaga

Subjects
medicine.medical_specialty, Biliary drainage, business.industry, medicine, Radiology, Anastomosis, business
Published
2019

38. SINGLE-SCOPE TRANSGASTRIC ANTEGRADE CHOLANGIOSCOPY (STAC) AND INTRADUCTAL POLYPECTOMY VIA EUS-GUIDED HEPATICOGASTROSTOMY (HGS) WITH A LUMEN-APPOSING-METAL STENT (LAMS)

Author

S Bazaga, Ramon Sanchez-Ocana, Manuel Perez-Miranda, M de Benito, C De La Serna, Ana Yaiza Carbajo, Francisco Javier García-Alonso, and J Tejedor

Subjects
Hepaticogastrostomy, medicine.medical_specialty, Scope (project management), business.industry, medicine.medical_treatment, Medicine, Stent, Lumen (anatomy), Radiology, business, Polypectomy
Published
2019

40. A HOME-MADE BILIARY SENGSTAKEN TUBE AS A TEMPORIZING STRATEGY FOR MASSIVE BLEEDING SECONDARY TO ARTERIO-BILIARY FISTULA (ABF)

Author

M Pérez-Miranda, Ramon Sanchez-Ocana, Sergio Sevilla-Ribota, Henar Nuñez-Rodriguez, Pilar Diez-Redondo, A Carbajo-Lopez, M de Benito-Sanz, C De la Serna-Higuera, M Cimavilla-Roman, and Raúl Torres-Yuste

Subjects
medicine.medical_specialty, business.industry, Massive bleeding, Biliary fistula, Medicine, Tube (fluid conveyance), business, medicine.disease, Surgery
Published
2018

41. PREDICTORS OF SUCCESS AND RESCUE OPTIONS OF EUS-GUIDED RENDEZVOUS (EUS-RV) FOR BILIARY ACCESS AFTER FAILED ERCP CANNULATION

Author

M de Benito, Ana Yaiza Carbajo, N Mora, Paula Gil-Simon, Robert M. Torres, Marta Cimavilla, Irene PeñAs, Manuel Perez-Miranda, J García-Alonso, C De La Serna, and S Sevilla

Subjects
03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, business.industry, 030220 oncology & carcinogenesis, General surgery, medicine, Rendezvous, 030211 gastroenterology & hepatology, business
Published
2018

42. NATURAL ORIFICE TRANSLUMINAL ENDOSCOPIC SURGERY (NOTES) SALVAGE OF PARTIAL MISPLACEMENT OF LUMEN-APPOSING METAL STENT (LAMS) DURING EUS-GUIDED GALLBLADDER DRAINAGE

Author

Ramon Sanchez-Ocana, Ryan Law, J García-Alonso, M Pérez-Miranda, Raúl Torres-Yuste, A Carbajo-Lopez, C De la Serna-Higuera, M Cimavilla-Roman, Sergio Sevilla-Ribota, and M de Benito-Sanz

Subjects
medicine.medical_specialty, medicine.anatomical_structure, business.industry, medicine.medical_treatment, Gallbladder, medicine, Stent, Lumen (anatomy), Natural orifice transluminal endoscopic surgery, Drainage, business, Surgery
Published
2018

43. HEPATICO-DUODENOSTOMY WITH A LUMEN-APPOSING METAL STENT (LAMS) TO ACHIEVE COMPLETE BILIARY DRAINAGE IN A METASTATIC BILATERAL HILAR STRICTURE

Author

Raúl Torres-Yuste, Ramon Sanchez-Ocana, M Cimavilla-Roman, J García-Alonso, M de Benito-Sanz, L Siu-Tong, Sergio Sevilla-Ribota, C De la Serna-Higuera, M Pérez-Miranda, and A Carbajo-Lopez

Subjects
Biliary drainage, medicine.medical_specialty, business.industry, Duodenostomy, medicine.medical_treatment, Medicine, Lumen (anatomy), Stent, business, Surgery
Published
2018

45. SINGLE-SESSION EUS-GUIDED GASTRO-JEJUNOSTOMY AND CHOLEDOCHO-DUODENOSTOMY TO TREAT DUAL STENT DYSFUNCTION IN CONCURRENT MALIGNANT GASTRIC OUTLET AND BILIARY OBSTRUCTION

Author

Ramon Sanchez-Ocana, M de Benito-Sanz, Sergio Sevilla-Ribota, C De la Serna-Higuera, A Carbajo-Lopez, M Cimavilla-Roman, Raúl Torres-Yuste, M Pérez-Miranda, and Irene Penas-Herrero

Subjects
medicine.medical_specialty, Gastro, business.industry, medicine.medical_treatment, Duodenostomy, Jejunostomy, medicine, Stent, business, Single session, Surgery
Published
2018

46. Efficacy of Direct-acting Antivirals to Improve Clinical Condition, Fibrosis, and Liver Function in Liver Transplant Recipients Infected by Hepatitis C

Author

Ramon Sanchez-Ocana, G. Sanchez-Antolin, Irene Penas-Herrero, M Cimavilla-Roman, C. Almohalla-Alvarez, M de Benito-Sanz, J. Tejedor-Tejada, F. Sánchez-Martín, Raúl Torres-Yuste, and F. Garcia-Pajares

Subjects
Ledipasvir, Adult, Liver Cirrhosis, Male, medicine.medical_specialty, Daclatasvir, Pyrrolidines, Sofosbuvir, Sustained Virologic Response, medicine.medical_treatment, Liver transplantation, Gastroenterology, Antiviral Agents, Liver disease, chemistry.chemical_compound, Liver Function Tests, Simeprevir, Internal medicine, medicine, Humans, Aged, Retrospective Studies, Transplantation, Fluorenes, business.industry, Imidazoles, Valine, Hepatitis C, Hepatitis C, Chronic, Middle Aged, medicine.disease, Liver Transplantation, chemistry, Paritaprevir, Surgery, Benzimidazoles, Female, Liver function, Carbamates, business, medicine.drug
Abstract

Direct-acting antivirals (DAAs) have revolutionized the treatment of hepatitis C, including transplant recipients with an advanced fibrosis stage. Our aim in this study was to assess the clinical and functional benefits and improvement in liver fibrosis after treatment with DAAs in liver transplant recipients with chronic hepatitis C virus who achieved sustained virologic response (SVR).We retrospectively analyzed 42 patients who underwent liver transplantation (LT) at our institution and were treated with DAAs from June 2014 to December 2015. Two patients died, so we ultimately included 40 transplant patients with chronic hepatitis C who received DAAs and achieved SVR. We assessed liver function, fibrosis stage, and clinical features at the start of the treatment, and then at 6 and 12 months after SVR. The indication for LT was hepatocellular carcinoma in 8 patients (20%) and Child-Pugh score B/C in 32 patients (80%).The DAAs regimens were sofosbuvir plus daclatasvir (45.0%), simeprevir plus sofosbuvir (42.5%), sofosbuvir plus ledipasvir (7.5%), and ombitasvir/paritaprevir/ritonavir (5%). The mean Modified End-stage Liver Disease (MELD) score pretreatment was 10.78, and was 8.46 at 1 year after treatment (P .05). In addition, fibrosis stage decreased significantly from 14.81 kPa to 9.07 kPa (FibroScan) at 12 months after SVR. Clinically, there was a significant improvement, including control of ascites and chronic hepatic encephalopathy.DAAs were used successfully in the treatment of hepatitis C after orthotopic liver transplantation and resulted in significant improvement in liver function as measured by MELD score, fibrosis level, and cirrhotic clinical condition, even in patients with very advanced disease.

Published
2018

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