Liver Transplantation for Acute Liver Injury in Asians Is More Likely Due to Herbal and Dietary Supplements.
Liver Transplantation for Acute Liver Injury in Asians Is More Likely Due to Herbal and Dietary Supplements.
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DOI：
10.1002/lt.26260
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Odin JA
中科院分区：
文献类型：
--
作者：
Kesar V;Channen L;Masood U;Grewal P;Ahmad J;Roth NC;Odin JA
药物、草药和膳食补充剂(HDS)引起的药物性肝损伤(DILI)是导致肝移植(LT)后急性肝损伤的主要原因。这项研究使用器官共享联合网络的LT数据来分析美国严重的HDS所致的急性肝损伤。按照惯例，急性DILI患者被列为“急性肝坏死”(AHN)，列在“AHN：药物其他指定”的副标题下。从1994年到2020年，所有等待治疗的患者被分成3个亚组：HDS DILI组、非HDS DILI组和AHN：未知药物组。分析以确定HDS DILI患者和非HDS DILI患者之间的流行病学差异。对移植患者进行了子分析，包括纵向变化。在等待肝移植的1875名患者中，736名(39.2%)接受了肝移植。HDS DILI组的亚裔患者比例显著高于非HDS DILI组(17.4%vs3.8%，p<；0.001)。排除对乙酰氨基酚病例，HDS DILI与非HDS组中黑人患者的比例显著降低(8.7%vs25.3%，p<；0.001)。排队等候的HDS DILI患者明显年龄较大(HDS DILI患者的中位年龄为38岁，非HDS DILI患者的中位年龄为31岁，p=0.03)。最后，由于HDS DILI而需要接受肝移植的患者数量随着时间的推移显著增加，与前15年(1994年至2009年)相比，70%以上的病例发生在过去10年(2010年至2020年)(P趋势=0.001)。种族可能有助于确定严重急性DILI的原因，随着越来越多的患者试验HDS，这是一个日益严重的问题。
Drug induced liver injury (DILI) due to medications and herbal and dietary supplements (HDS) is a major cause of acute liver injury leading to liver transplantation (LT). This study used United Network for Organ Sharing LT data to analyze severe HDS induced acute liver injury in the United States. By convention, patients with acute DILI are listed as “Acute Hepatic Necrosis” (AHN) under the subheading “AHN: Drug Other Specify”. All patients waitlisted from 1994 to 2020 were divided into 3 subgroups: “HDS DILI”, “Non-HDS DILI”, and “AHN: unknown drug. Analyses were performed to identify epidemiologic differences between HDS DILI and Non-HDS DILI patients. Sub-analysis was performed for transplanted patients, including longitudinal changes. Of 1875 patients waitlisted for LT, 736 (39.2%) underwent LT. The proportion of Asian patients in the HDS DILI group was significantly higher compared to the non-HDS DILI group (17.4% v. 3.8%, p < 0.001). Excluding acetaminophen cases, the proportion of Black patients in the HDS DILI v. non-HDS group was significantly lower (8.7% v. 25.3%, p < 0.001). Waitlisted HDS DILI patients were significantly older (median age 38 y for HDS DILI vs 31 y for non-HDS DILI, p=0.03). Lastly, the number of patients requiring LT due to HDS DILI increased significantly over time with more than 70 % of cases occurring in the last 10 years (2010–2020) compared to the prior 15 years (1994–2009) (Ptrend =0.001). Ethnicity may help in identifying the cause of severe acute DILI, a growing problem as more patients experiment with HDS.
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DOI：
10.1002/hep.31538
发表时间：
2021-06
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Hoofnagle JH;Bonkovsky HL;Phillips EJ;Li YJ;Ahmad J;Barnhart H;Durazo F;Fontana RJ;Gu J;Khan I;Kleiner DE;Koh C;Rockey DC;Seeff LB;Serrano J;Stolz A;Tillmann HL;Vuppalanchi R;Navarro VJ;Drug-Induced Liver Injury Network
通讯作者：
Drug-Induced Liver Injury Network
影响因子：
12.6
作者：
Rossi, Simona;Navarro, Victor J.
通讯作者：
Navarro, Victor J.
影响因子：
4.6
作者：
Russo, MW;Galanko, JA;Watkins, P
通讯作者：
Watkins, P
影响因子：
158.5
作者：
EISENBERG, DM;KESSLER, RC;DELBANCO, TL
通讯作者：
DELBANCO, TL
影响因子：
29.4
作者：
Nicoletti P;Aithal GP;Bjornsson ES;Andrade RJ;Sawle A;Arrese M;Barnhart HX;Bondon-Guitton E;Hayashi PH;Bessone F;Carvajal A;Cascorbi I;Cirulli ET;Chalasani N;Conforti A;Coulthard SA;Daly MJ;Day CP;Dillon JF;Fontana RJ;Grove JI;Hallberg P;Hernández N;Ibáñez L;Kullak-Ublick GA;Laitinen T;Larrey D;Lucena MI;Maitland-van der Zee AH;Martin JH;Molokhia M;Pirmohamed M;Powell EE;Qin S;Serrano J;Stephens C;Stolz A;Wadelius M;Watkins PB;Floratos A;Shen Y;Nelson MR;Urban TJ;Daly AK;International Drug-Induced Liver Injury Consortium, Drug-Induced Liver Injury Network Investigators, and International Serious Adverse Events Consortium
通讯作者：
International Drug-Induced Liver Injury Consortium, Drug-Induced Liver Injury Network Investigators, and International Serious Adverse Events Consortium