Gender Differences in Patient Receiving Liver Transplantation for Viral Hepatitis

Zusammenfassung

Einleitung: Der Verlauf viraler Hepatitiden ist interindividuell sehr unterschiedlich und reicht von asymptomatischen Erkrankungen bis hin zum Leberversagen. Nur wenige Daten liegen bislang über Geschlechtsunterschiede bei Patienten mit Lebertransplantation (OLT) vor. Wir haben die Geschlechtsverteilung bei Patienten untersucht, die aufgrund einer Virushepatitis lebertransplantiert wurden. Methoden: Eine retrospektive Analyse wurde bei einer Kohorte von 368 Patienten durchgeführt, die bei Virushepatitis und akutem oder chronischem Leberversagen lebertransplantiert wurden. In 96 von ihnen lag zum Zeitpunkt der OLT noch ein hepatozelluläres Karzinom (HCC) vor. Die Geschlechtsverhältnisse der verschiedenen Hepatitis-Virusinfektionen sowie in Bezug zum HCC wurden analysiert. Ergebnisse: Signifikant mehr Männer als Frauen wurden für eine chronische Hepatitis B lebertransplantiert. Im Gegensatz dazu waren Patienten nach OLT bei einer fulminanten Hepatitis B häufiger weiblichen Geschlechts. Bei Patienten, die für eine chronische HCV- or HDV-Infektion transplantiert wurden, zeigten sich keine signifikanten Geschlechtsunterschiede. Allerdings fand sich bei Männern in diesen beiden Gruppen chronischer Lebererkrankungen häufiger ein HCC. Schlussfolgerung: Bei lebertransplantierten Patienten mit Hepatitis-B-Infektion zeigten sich deutliche Geschlechtsunterschiede, da mehr Frauen an fulminantem Verlauf der akuten HBV transplantiert wurden, während mehr Männer bei chronischer HBV im Endstadium transplantiert wurden. Die Rolle des Geschlechts bei chronischer HCV- und HDV-Infektion war weniger deutlich außer einem männlichen Übergewicht bei Patienten mit HCC.

Abstract

Introduction: The course of viral hepatitis shows wide interindividual differences, ranging from asymptomatic disease to liver failure. Only limited data on gender differences in patients undergoing liver transplantation (OLT) exist. We studied the gender distribution in patients who underwent liver transplantation for viral hepatitis. Methods: A retrospective analysis was performed on a cohort of 368 patients who underwent OLT for viral hepatitis-associated acute or chronic liver failure. In 96 of them, additional hepatocellular carcinoma (HCC) was present at transplantation. Gender ratios of the different hepatitis virus infections and in relation to HCC were evaluated. Results: Significantly more males than females underwent OLT for chronic HBV. In contrast, patients after OLT for fulminant HBV were more frequently females. In patients transplanted for chronic HCV or HDV, no significant gender differences were found. However, men presented more frequently with HCC in both groups of chronic liver disease. Conclusions: There was a gender difference in HBV infection with more women developing fulminant hepatic failure in acute HBV while more men progressed to end-stage liver disease in chronic HBV. The role of gender in chronic HCV and HDV infection was less pronounced, except for a male predominance among patients with HCC.

Schlüsselwörter

Leber - Hepatitis B - Hepatitis C - Hepatitis D - Virushepatitis

Key words

liver - hepatitis B - hepatitis C - hepatitis D - viral hepatitis

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