Carcinoma hepatocelular na cirrose criptogênica: experiência de um centro

  • Marcya Moanna Gonçalves Cruz Macedo Hospital Universitário Walter Cantídio (HUWC)
  • Paulo Everton Garcia Costa Hospital Universitário Walter Cantídio (HUWC)
  • Bartolomeu Feitosa Neto Hospital Universitário Walter Cantídio (HUWC)
  • Antônio Brazil Viana Junior Hospital Universitário Walter Cantídio (HUWC)
  • Tacilla Hanny de Souza Andrade Universidade Estadual do Ceará (UECE)
  • Maurício Yukio Ogawa Universidade Federal do Ceará (UFC)
  • José Huygens Parente Garcia Hospital Universitário Walter Cantídio (HUWC)
Palavras-chave: Cirrose hepatica, Transplante de Fígado, Hepatopatia gordurosa não alcoólica

Resumo

Objetivos: Avaliar as características clínicas de pacientes transplantados por carcinoma Hepatocelular (CHC) por cirrose Criptogênica e Vírus da Hepatite C. Métodos: Foram analisados, retrospectivamente, 45 pacientes entre 2003 a 2015. Dentre eles, 19 correspondiam a pacientes que transplantaram por etiologia indefinida da cirrose e CHC e 26 com infecção do vírus da Hepatite C (VHC) + CHC. Foram excluídos 4 pacientes, pois descobriu-se outra etiologia para a cirrose após histopatológico do explante, sendo utilizado teste qui-quadrado para análise. Resultados: 10 variáveis foram analisadas entre os grupos, evidenciando que a Bilirrubina (p<0,035), albumina (P<0,03), número de nódulos (P<0,026), CHILD (p<0,003) e INR (p<0,035) tiveram diferença significativa entre os dois grupos, sendo mais anormal naqueles com cirrose criptogênica. Aproximadamente 21% dos pacientes com cirrose criptogênica apresentam evidência para outras patologias. Conclusão: Muito esteato hepatites não alcoólicas e doença gordurosa não alcoólica do fígado são consideradas criptogênicas, sendo o tempo de permanência na fila maior que os pacientes com VHC; Transplantes por CHC por cirrose criptogênica são acompanhados por piores resultados laboratoriais e maior número de nódulos acometidos quando comparados com aqueles por VHC.

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Publicado
2019-11-27
Seção
ARTIGOS ORIGINAIS