Topical testosterone treatment for chronic allograft failure in liver transplant recipients with recurrent hepatitis C virus

被引:9
作者
Neff, GW
O'Brien, CB
Shire, NJ
DeManno, A
Kahn, S
Rideman, E
Safdar, K
Madariaga, J
Rudich, SR
机构
[1] Univ Cincinnati, Dept Med, Sch Med, Cincinnati, OH 45267 USA
[2] Ctr Liver Dis, Dept Med, Miami, FL USA
[3] Ctr Liver Dis, Dept Surg, Div Transplantat, Miami, FL USA
关键词
D O I
10.1016/j.transproceed.2004.11.004
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Introduction. Liver transplant recipients with allograft failure due to recurrent hepatits C virus (HCV) infection often develop marked muscle wasting and ascites prior to death and are denied repeat liver transplantation. We sought to determine whether topical testosterone therapy is associated with improved muscle mass and survival in patients with chronic allograft failure post-liver transplant. Methods. We performed a retrospective review of liver transplant recipients with chronic allograft failure. Group 1 patients were treated for >6 months with testosterone gel 1%; group 2 patients were untreated. Results. Fourteen patients were identified with stage 3 or 4 fibrosis, muscle wasting, and allograft failure due to recurrent HCV. Group 1 (n = 9) patients had statistically significant improvement in albumin, testosterone, muscle strength, well-being, and MELD/ CTP scores, while there was no improvement seen for any of these parameters in group 2 (n = 5). There were no deaths in group 1, while four of five patients in group 2 died on average 84 days posttransplant. Adverse effects of testosterone treatment included lower extremity edema (which resolved upon dose adjustment), hypertension, and pruritus. Conclusions. Topical testosterone gel appears to increase muscle strength, stimulate albumin synthesis, and improve survival in patients with allograft failure post-liver transplant.
引用
收藏
页码:3071 / 3074
页数:4
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