| タイトル | ： canadaok-pharmacy.net reviews |
| 投稿日 | ： 2015/06/25(Thu) 04:40 |
| 投稿者 | ： Rob1Kl <robertdit@mail.ru> |
Wilsons disease should be considered in any individual with liver abnormalities or neurological movement disorders of uncertain cause. Age alone should not be the basis for eliminating a diagnosis of Wilsons diseaseIn approximately 10% of AIH patients liver transplantation remains the only life- saving option (Strassburg 2004). The indication for liver transplantation in AIH is similar to that in other chronic liver diseases and includes clinical deterioration, development of cirrhosis, bleeding esophageal varices and coagulation abnormalities despite adequate immunosuppressive therapy (Neuberger 1984, Sanchez-Urdazpal 1991, Ahmed 1997, Prados 1998, Tillmann 1999, Vogel 2004). There is no single indicator or predictor for the necessity of liver transplantation. Candidates for liver transplant are usually patients who do not reach remission within 4 years of continuous therapy. Indicators of a high mortality associated with liver failure are histological evidence of multilobular necrosis and progressive hyperbilirubinemia. In Europe, 4% of liver transplants are for AIH (Strassburg 2009). The long-term results of liver transplantation for AIH are excellent. The 5- year survival is up to 92% (Sanchez-Urdazpal 1991, Prados 1998, Ratziu 1999) and well within the range of other indications for liver transplantation. The European liver transplant database indicates 76% survival in 5 years and 66% survival after 10 years (1647 liver transplantations between 1988 and 2007). When these numbers are considered it is necessary to realize that patients undergoing liver transplantation usually fail standard therapy and may therefore have a reduced life expectancy after liver transplant compared to those who achieve stable complete remission on drug therapy.
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