Hepatitis: Núñez-Martínez O

Saiz de la Hoya-Zamácola P, Marco-Mouriño A, Clemente-Ricote G, Portilla-Sogorb J, Boix-Martínez V, Núñez-Martínez O, Reus-Bañuls S, Teixidó i Pérez N, Anonymous00274. · Servicios Médicos. Centro Penitenciario Alicante I. España. · Gastroenterol Hepatol. · Pubmed #17129550 No free full text.

Abstract: The prevalence of HCV infection in Spanish prisons is very high (38.5%). The characteristics of the infected patients, particularly the high rate of HIV coinfection, makes it very likely that the morbidity and mortality produced by serious liver disease secondary to this infection will increase considerably in the coming years. A group of Spanish experts with experience in patients who are inmates has been invited to establish a series of recommendations for the diagnosis and treatment of chronic hepatitis C infection in Spanish prisons.

Saiz de la Hoya-Zamácola P, Marco-Mouriño A, Clemente-Ricote G, Portilla-Sogorb J, Boix-Martínez V, Núñez-Martínez O, Reus-Bañuls S, Teixidó i Pérez N. · Servicios Médicos, Centro Penitenciario Alicante I, Alicante, España. · Enferm Infecc Microbiol Clin. · Pubmed #17125677 links to  free full text

Abstract: The prevalence of HCV infection in Spanish prisons is very high (38.5%). The characteristics of the infected patients, particularly the high rate of HIV coinfection, makes it very likely that the morbidity and mortality produced by serious liver disease secondary to this infection will increase considerably in the coming years. A group of Spanish experts with experience in patients who are inmates has been invited to establish a series of recommendations for the diagnosis and treatment of chronic hepatitis C infection in Spanish prisons.

Núñez-Martínez O, De la Cruz G, Salcedo M, Molina J, De Diego A, Ripoll C, Calleja J, Alvarez E, Clemente G. · Liver Transplantation Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain. · Transplant Proc. · Pubmed #12962824 No free full text.

Abstract: AIMS: The aim of this study was to analyse long-term outcomes of patients with liver transplantation for autoimmune hepatitis and to determine if fulminant/subfulminant hepatic failure (FSHF) at presentation was a predictor of outcome after ortothopic liver transplantation. PATIENTS AND METHODS: Between April 1990 and October 2002, 18 patients with autoimmune hepatitis underwent 21 liver transplants. Three patients were excluded because of coexisting causes of hepatitis. Seven patients had FSHF and eight patients had chronic disease. The initial immunosuppressive regimen was cyclosporine based in 80%, and all but one patient received steroids or azathioprine. RESULTS: Mean age at time of transplant was 44.2+/-15.5 years. Patients were followed for 38.9+/-29.6 months. Five patients (33.3%) had seven episodes of acute rejection (two steroid-resistant). Three patients developed chronic rejection. One patient displayed histologically proven recurrent autoimmune hepatitis. Actuarial patient and graft survival rates at 1 and 5 years were 80% and 56% and 78.6% and 51%, respectively. No differences in the clinical characteristics of the patients, rates of acute or chronic rejection episodes, end biliary or arterial complications were observed between FSHF and chronic autoimmune hepatitis. The study suggests a better survival for autoimmune FSHF (P=.003). CONCLUSIONS: Liver transplant is indicated for patients displaying autoimmune chronic liver disease and FSHF with similar clinical courses at however, patients with FSHF at presentation had better survivals.

Núñez-Martínez O, De la Cruz G, De Diego A, Molina J, Rincón D, Santos L, Matilla A, Bañares R, Salcedo M, Calleja J, Clemente G. · Liver Transplantation Unit, Hospital Gregorio Marañón, Madrid, Spain. · Transplant Proc. · Pubmed #12962823 No free full text.

Abstract: AIMS: The aim of this study was to assess the long-term course and outcome after liver transplantation (LTX) for fulminant/subfulminant hepatic failure (FSHF) to determine which factors relate to outcome. PATIENTS AND METHODS: Between April 1990 and October 2002, 30 adult patients with FSHF underwent LTX. King's College criteria were used to decide which patients needed LTX. Pretransplantation parameters (age, sex, degree of hepatic encephalopathy, etiology, and time between onset of symptoms and LTX) were examined as risk factors for LTX outcome. RESULTS: Mean age at LTX was 40.4+/-13.9 years and 46.7% were men. The most frequent causes of FSHF were virus B in 23.3%, autoimmune hepatitis in 23.3%, and cryptogenic in 20%. Fifty percent of the patients with a survival longer than 15 days suffered episodes of acute rejection; chronic rejection occurred in 25%. One- and five-year patient and allograft survival rates for FSHF were 56.3% and 54.7%, respectively. Autoimmune hepatitis was the only factor associated with better posttransplantation outcome, although there were no differences in posttransplant course. Patient survival rates increased during the study period. During the first 5 years (1990-1995) the survival rates were 53.3% (1-year and 5-year), whereas they were 60% at 1 and 5 years in the second interval (1996-2002). CONCLUSIONS: The mortality rate of FSHF is high during the first year post-LTX. LTX for FSHF of autoimmune etiology showed better outcomes with increasing patient survival rates during the study period.