NOVOSIBIRSK REGION PROGRAM OF THE LIVER TRANSPLANTATION IN CHILDREN

The aim of the study was to analyze the early and late outcomes of pediatric liver transplantation (LTx) program in the Novosibirsk region. Material and Methods. The retrospective study included 24 patients aged 72 ± 74.8 months (from 4 to 212 months, median – 20 months) with a body weight of 21.7 ± 18.1 kg (from 4.5 to 55 kg, median – 12.5 kg). Two (8.3 %) cadaveric whole liver grafts, 19 (79.2 %) living donor liver grafts, and 3 (12.5 %) cadaveric liver fragments (reduced-size or split-liver) were transplanted. Results. The features of vascular and biliary reconstruction in different types of LTx are discussed. The incidence of vascular and biliary complications was 8.3 and 20.8%, respectively. The patients stayed in the intensive care unit for 9 ± 5.1 days (from 4 to 22 days, median 8 days) and total length of hospital stay was for 40 ± 25.4 days (from 19 to 136 days, median 32 days). Two (8.3 %) recipients had early graft dysfunction. Perioperative mortality (up to 90 days) was absent. The overall 5-year patient and graft survival rates were 95 and 88 %, respectively. Conclusion. The Novosibirsk region has a pediatric LTx program with outcomes comparable to the data of the leading world and Russian centers

Эффективность и безопасность препарата нарлапревир при хроническом гепатите С в реальной клинической практике

Objective: to analyze the efficacy and safety of using direct antiviral action drug narlaprevir/ritonavir in combination with the prolonged alpha-interferon and ribavirin drugs in the conditions of day-time hospitals of St. Petersburg and. Novgorod.Materials and methods: The study included. 35 patients with CHC of the 1st genotype. For treating these patients, a three-component regimen was used, which included the use of narlaprevir/ritonavir in combination, with peg-interferon and ribavirin.Results: among all patients included, in the study, a sustained, virological response was noted, in 85,7%. Early virological response was observed, in 91,3% cases. The recurrence rate was observed, in 10% patients. In 3 patients, therapy was interrupted, for the following reasons: due to inefficiency, the development of serious adverse events, and on its own initiative.Conclusion: the data obtained, demonstrate high, virological and. clinical efficacy and. safety of narlaprevir in combination with peg-interferon and ribavirin, in the treatment of chronic viral hepatitis C.Цель: проанализировать эффективность и безопасность применения препарата прямого противовирусного действия нарлапревира в сочетании c ритонавиром и препаратами пролонгированного альфа-интерферона и рибавирина в условиях дневных стационаров Санкт-Петербурга и Великого Новгорода.Материалы, и методы: в исследование были включены. 35 пациентов с хроническим, гепатитом. С (ХГС) 1 генотипа. Для терапии данных больных применялась схема лечения, включавшая нарлапревир в сочетании с ритонавиром., пег-интерфероном и рибавирином.Результаты: устойчивый вирусологический ответ, через 24 недели после окончания терапии (УВО 24) был отмечен у 85,7% пациентов, при этом, вирусологический ответ, на момент окончания терапии составил 91,4%. У 3 пациентов терапия была прервана по следующим, причинам: в связи с неэффективностью, развитием, нежелательных явлений. У 2 пациентов развился рецидив.Заключение: полученные данные демонстрируют высокую эффективность и безопасность препарата нарлапревир при терапии ХГС в комбинации с ритонавиром, пегилированным интерфероном и рибавирином. в условиях рутинной клинической практики

Liver transplantation in the Novosibirsk Region: evolution of the program and its outcomes

Objective: To assess early and late outcomes of the orthotopic liver transplantation (LTx) program in the Novosibirsk Region from August 2010 to June 2018.Materials and methods: This retrospective study included 176 patients aged 41.5 ± 16.69 years (from 5 months to 69 years; median 44 years), who underwent 185 LTx procedures including nine retransplantations.Results: Some particulars of vascular and biliary reconstruction in various LTx types are discussed. The incidence of vascular and biliary complications was 1.6% and 10.3%, respectively. The duration of stay in the intensive care unit was 7 ± 7.1 days (from 0 to 69 days, median 5) and mean total duration of hospital stay was 33 ± 18.1 days (from 1 to 136 days, median 30). Early graft dysfunction was observed in 28 (15.9%) of the recipients. Perioperative (up to 90 days) mortality was 4.5% (8 recipients, including one intra-operative death). There was zero mortality in the liver fragment recipients. The overall 5-year patient and graft survival rates were 71% and 65%, respectively.Conclusion: The Novosibirsk Region has a well-established LTx program, with its outcomes being comparable to those of the leading Russian centers and large worldwide registries. In 2017, LTx prevalence was 12.9 per million of the population. Thus, the region has become one of the most provided with this type of medical care in the Russian Federation

Effectiveness and safety of narlaprevir in real clinical practice of chronic hepatitis C

Objective: to analyze the efficacy and safety of using direct antiviral action drug narlaprevir/ritonavir in combination with the prolonged alpha-interferon and ribavirin drugs in the conditions of day-time hospitals of St. Petersburg and. Novgorod.Materials and methods: The study included. 35 patients with CHC of the 1st genotype. For treating these patients, a three-component regimen was used, which included the use of narlaprevir/ritonavir in combination, with peg-interferon and ribavirin.Results: among all patients included, in the study, a sustained, virological response was noted, in 85,7%. Early virological response was observed, in 91,3% cases. The recurrence rate was observed, in 10% patients. In 3 patients, therapy was interrupted, for the following reasons: due to inefficiency, the development of serious adverse events, and on its own initiative.Conclusion: the data obtained, demonstrate high, virological and. clinical efficacy and. safety of narlaprevir in combination with peg-interferon and ribavirin, in the treatment of chronic viral hepatitis C