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Year 2017 Vol. 25 No 4
GENERAL & SPECIAL SURGERY
A.F. CHERNOUSOV, T.V. KHOROBRYKH, R.V. KARPOVA, K.I. ZENKOVA
EFFECT OF CRYOPRECIPITATE ON LIVER REGENERATION IN PATIENTS WITH CIRRHOSIS
FSBEE HE “I. M. Sechenov First Moscow State Medical University”, Moscow,
The Russian Federation
Objectives. To improve the results of treating patients with liver cirrhosis by intrahepatic injection of cryoprecipitate, stimulating regeneration of cirrhotic liver.
Methods. The study included 72 patients who suffered from hepatitis B virus (HBV) and hepatitis C virus (HCV) and toxic liver cirrhosis. 32 (44%) patients had liver cirrhosis grading Child-Pugh class B, and 40 (56%) patients – class C. Cryoprecipitate injected percutaneously into the liver by puncture method under ultrasound guidance. Dynamics of clinical and laboratory parameters, portal blood flow in all patients, morphological changes in the liver biopsy were evaluated in 42 (58%) patients and immunological parameters – in 38 (53%) patients before and after administration of cryoprecipitate.
Results. The improvements of clinical and laboratory parameters were registered in 3, 6, and 12 months after the administration of cryoprecipitate in most patients. After a year 7 patients had liver cirrhosis grading Child-Pugh class C (out of 40 patients). Diameters of the portal and splenic vein significantly decreased in 65 (90%) patients in a year, the congestion index decreased in 11 patients (15%), splenoportal index – in 18 (25%). During the morphological study of the liver biopsy 1 year afterward, a positive dynamics observed by a decrease in cellular infiltration and inflammatory signs so as signs of regeneration were found in 40 (95%) out of 42 patients and decrease of the severity of the stepped necrosis of hepatocytes was registered in 29 (69%) patients.
Conclusion. Cryoprecipitate injected percutaneously under ultrasound guidance is considered to be safe due to its potential to avoid damage of large liver vessels. The stimulatory effect of cryoprecipitate on liver regeneration was studied so as it improves its functional activity and extends terms prior liver transplantation.
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119991, Russian Federation, Moscow,
B. Pirogovskaya str. 6/1
University Clinical Hospital N1,
Department of Faculty Surgery N1
Tel .: +7 499 248 76 10,
Radmila V. Karpova
Chernousov A.F. Academician of RAMS, MD, Professor, Head of department of faculty surgery N1 of the medical faculty, FSBEE HE “I.M.Sechenov First Moscow State Medical University”.
Khorobrykh T.V. Professor of department of faculty surgery N1 of the medical faculty, FSBEE HE “I.M.Sechenov First Moscow State Medical University”.
Karpova R.V. MD, Professor of department of faculty surgery N1 of the medical faculty, FSBEE HE “I.M.Sechenov First Moscow State Medical University”.
Zenkova K.I. A 5-year student of the medical faculty, FSBEE HE “I.M.Sechenov First Moscow State Medical University”.