tailieunhanh - Fatty Liver Disease : Nash and Related Disorders - part 10

Kết quả đã chứng minh rằng khóa học mô bệnh học của những bệnh nhân này đã được thay đổi. Một phần ba tiến triển đến xơ hóa và 10% đã có một sự tiến triển nhanh chóng đến xơ hóa tiên tiến. Những dữ liệu này kết hợp xác nhận báo cáo trước đây rằng sự phát triển của xơ hoặc xơ gan | RECENT ADVANCES NAFLD and 106 patients with alcoholic steatosis followed for a median of 17 and years respectively. While only one 1 NAFLD patient progressed to cirrhosis 22 21 of the patients with alcoholic steatosis did so. Another study 53 compared sequential liver biopsies mean of years between biopsies obtained in 22 patients with NAFLD of whom 19 had NASH. The results demonstrated that the histopathological course of these patients was variable. One-third progressed to fibrosis and 10 had a rapid progression to advanced fibrosis. These combined data confirm previous reports that the development of fibrosis or cirrhosis in NAFLD is related to the histopathology found in the index biopsy. Further cirrhosis develops much more frequently in alcoholic steatosis than in non-alcoholic steatosis. A report from Younossi et al. 54 investigated the impact of type 2 diabetes in the development of cirrhosis and liver-related death in NAFLD patients 44 with and 88 without diabetes. Cirrhosis 25 versus and liver-related death versus occurred more frequently in the diabetic group. Hepatic steatosis in living donor livers The effect of donor weight reduction on hepatic steatosis There is a consensus that livers showing total steatosis of 30 of hepatocytes should not be used for living donor transplantation this has led to the exclusion of many potential donors. This growing problem led Hwang et al. 55 to encourage nine potential living donors who had excessive hepatic steatosis and or were overweight to lose 9 of their body weight. None of the initial liver biopsies showed features of NASH seven showed NAFLD type 2 while the remaining two showed steatosis and mild portal inflammation. The nine volunteers lost 2 of initial body weight during a 2-6 month period. The BMI reduced from 25 to 24 and hepatic steatosis especially microvesicular steatosis decreased significantly from 49 26 to 20 16 after weight loss. All nine became donors and all .

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