Actualizaciones en el manejo general de pacientes postrasplante hepático y de sus complicaciones más frecuentes

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dc.catalogadorjlo
dc.contributor.authorDíaz Piga, Luis Antonio
dc.contributor.authorVillalón Friedrich, Alejandro Andrés
dc.contributor.authorOchoa, Gabriela
dc.contributor.authorGarcía Castillo, Sergio Adrián Nicolas
dc.contributor.authorSeverino Cuevas, Nicolás Felipe
dc.contributor.authorAyares Campos, Gustavo Ignacio
dc.contributor.authorIdalsoaga Ferrer, Francisco Javier
dc.contributor.authorDib Marambio, Martín Javier
dc.contributor.authorBriceño Valenzuela, Eduardo Andrés
dc.contributor.authorViñuela Fawaz, Eduardo Andrés
dc.contributor.authorMartínez Castillo, Jorge Arturo
dc.contributor.authorJarufe Cassis, Nicolás Patricio
dc.contributor.authorRabagliati Borie, Ricardo Miguel
dc.contributor.authorMeneses Quiroz, Luis Andrés
dc.contributor.authorMuñoz Schuffenegger, Pablo
dc.contributor.authorVargas Domínguez, José Ignacio
dc.contributor.authorEspino Espino, Alberto Antonio
dc.contributor.authorVera Alarcón, María Magdalena
dc.contributor.authorBenítez Gajardo, Carlos Esteban
dc.contributor.authorWolff Rojas, Rodrigo Mauricio
dc.contributor.authorNorero Muñoz, Blanca Gabriela
dc.contributor.authorBarrera Álvarez, Francisco Benjamín
dc.contributor.authorSoza Ried, Alejandro
dc.contributor.authorArrese Jiménez, Marco Antonio
dc.contributor.authorArab Verdugo, Juan Pablo
dc.date.accessioned2025-03-11T14:06:02Z
dc.date.available2025-03-11T14:06:02Z
dc.date.issued2024
dc.description.abstractLiver transplantation (LT) is a cost-effective therapy for advanced liver disease. Although LT significantly improves long-term survival, it requires strict control of immunosuppressants and their potential complications. Several available immunosuppressive drugs include glucocorticoids, calcineurin inhibitors, mycophenolate, mTOR inhibitors, and anti-CD25 antibodies. These drugs act particularly in T lymphocytes, depleting them, deviating their traffic, or blocking their response pathways. The main complications after LT include renal failure and infectious, immunological, biliary, vascular adverse events, metabolic, cardiovascular, and neoplastic diseases, especially during the first months. Bacteria, viruses, and fungi can cause infections in these patients. Prophylaxis against Herpes simplex virus, Varicella zoster virus, Cytomegalovirus, Pneumocystis jirovecii, Candida spp., and Aspergillus spp. should be considered according to the presence of risk factors. Among immunological complications, acute cellular rejection is common (30% of LT) but usually responds to immunosuppressive escalation. Also, chronic rejection appears in 3-17% of LT, but only half of the recipients respond to increased immunosuppressants. Appropriate treatment of the underlying etiology is essential, especially in autoimmune diseases, hepatitis B and C virus infection. Lifestyle changes must be encouraged in all patients, and alcohol consumption avoided (especially in alcohol use disorder). Due to the increased risk of cancer, neoplasms must be actively monitored, as well as osteoporosis and other metabolic disorders such as diabetes and cardiovascular disease.
dc.fechaingreso.objetodigital2025-03-11
dc.format.extent14 páginas
dc.fuente.origenSCOPUS
dc.identifier.doi10.4067/s0034-98872024000600704
dc.identifier.issn0034-9887
dc.identifier.scopusidSCOPUS_ID:85209888944
dc.identifier.urihttp://dx.doi.org/10.4067/s0034-98872024000600704
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/102483
dc.identifier.wosidWOS:001358134300007
dc.information.autorucEscuela de Medicina; Díaz Piga, Luis Antonio; 0000-0002-8540-4930; 179253
dc.information.autorucEscuela de Medicina; Villalón Friedrich, Alejandro Andrés; 0000-0003-0429-650X; 237951
dc.information.autorucEscuela de Medicina; García Castillo, Sergio Adrián Nicolas; 0000-0002-1238-3008; 1089215
dc.information.autorucEscuela de Medicina; Severino Cuevas, Nicolás Felipe; 0000-0002-9950-3606; 149398
dc.information.autorucEscuela de Medicina; Ayares Campos, Gustavo Ignacio; 0000-0002-8651-2255; 1033904
dc.information.autorucEscuela de Medicina; Idalsoaga Ferrer, Francisco Javier; S/I; 1017394
dc.information.autorucEscuela de Medicina; Dib Marambio, Martín Javier; S/I; 1103640
dc.information.autorucEscuela de Medicina; Briceño Valenzuela, Eduardo Andrés; S/I; 18751
dc.information.autorucEscuela de Medicina; Viñuela Fawaz, Eduardo Andrés; S/I; 93265
dc.information.autorucEscuela de Medicina; Martínez Castillo, Jorge Arturo; 0000-0001-5823-7308; 65778
dc.information.autorucEscuela de Medicina; Jarufe Cassis, Nicolás Patricio; S/I; 104492
dc.information.autorucEscuela de Medicina; Rabagliati Borie, Ricardo Miguel; 0000-0002-0574-8312; 59169
dc.information.autorucEscuela de Medicina; Meneses Quiroz, Luis Andrés; S/I; 10742
dc.information.autorucEscuela de Medicina; Muñoz Schuffenegger, Pablo; 0000-0002-9687-5404; 132763
dc.information.autorucEscuela de Medicina; Vargas Domínguez, José Ignacio; 0000-0002-1547-2292; 120713
dc.information.autorucEscuela de Medicina; Espino Espino, Alberto Antonio; 0000-0001-5707-6290; 146018
dc.information.autorucEscuela de Medicina; Vera Alarcón, María Magdalena; 0000-0002-2969-3408; 226652
dc.information.autorucEscuela de Medicina; Benítez Gajardo, Carlos Esteban; S/I; 9202
dc.information.autorucS/I; Wolff Rojas, Rodrigo Mauricio; S/I; 1012828
dc.information.autorucEscuela de Medicina; Norero Muñoz, Blanca Gabriela; S/I; 120978
dc.information.autorucEscuela de Medicina; Barrera Álvarez, Francisco Benjamín; S/I; 1240448
dc.information.autorucEscuela de Medicina; Soza Ried, Alejandro; 0000-0002-1136-9554; 461
dc.information.autorucEscuela de Medicina; Arrese Jiménez, Marco Antonio; 0000-0002-0499-4191; 76095
dc.information.autorucEscuela de Medicina; Arab Verdugo, Juan Pablo; 0000-0002-8561-396X; 132745
dc.issue.numero6
dc.language.isoes
dc.nota.accesocontenido completo
dc.pagina.final717
dc.pagina.inicio704
dc.revistaRevista Médica de Chile
dc.rightsacceso abierto
dc.subjectEnd Stage Liver Disease
dc.subjectImmunosuppression Therapy
dc.subjectInfections
dc.subjectLiver Transplantation
dc.subjectLiving Donors
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.titleActualizaciones en el manejo general de pacientes postrasplante hepático y de sus complicaciones más frecuentes
dc.title.alternativeUpdates in General Management and Frequent Complications Following Adult Liver Transplant
dc.typeartículo
dc.volumen152
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sipa.trazabilidadSCOPUS;2024-12-08
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