HIGH TECHNOLOGICAL MEDICAL CARE FOR CHRONIC VIRAL HEPATITIS IN THE REPUBLIC OF SAKHA (YAKUTIA)
Abstract
The prevalence of parenteral hepatitis is increased in the Republic of Sakha (Yakutia) and a large number of long-termcomplications, such as cirrhosis and hepatocellular carcinoma, are relevant on this issue. Liver transplantation is currentlythe only treatment for end-stage liver cirrhosis with etiology of the liver. Aim: to conduct a comparative assessment of clinical and laboratory indicators of liver function after liver transplantationin patients with chronic viral hepatitis in the Republic. Methods. This was experimentally investigated by general clinical, biochemical, serological methods. Molecular biologi-cal studies were used in the work to identify markers of viral hepatitis, as well as discharge epicrisis of patients. Data process-ing was conducted by descriptive statistics criteria and a graphical method of comparative analysis by MS Excel 2010. Results. Liver transplantation was performed in 60 patients with chronic viral hepatitis B, C, D with an outcome in livercirrhosis (81.6%) and primary liver cancer (18.4%).The main indication was the outcome of chronic HBV / HDV infection(81.7%) for a liver transplant. The average age of the operated persons was 44.5 years, where indigenous people predomi-nated (88.3%). The total mortality was 11.6% after surgery. Along with immunosuppressive therapy, all operated individualsreceived etiotropic therapy for HBV / HDV and HCV infections. Conducting antiviral therapy allowed achieving a stableviral response in 8 patients for people with chronic hepatitis C after liver transplantation, which increased the quality of lifeand survival time of recipients. Etiotropic therapy was prescribed in hepatitis B and D with nucleosic analogues. An improve-ment in clinical and laboratory parameters was noted in all patients with chronic viral liver lesions who underwent a livertransplant within 1 year after the operation, while maintaining positive dynamics in the future. Conclusion. The progressive course of chronic viral hepatitis with the formation of adverse outcomes (cirrhosis, cancer)is an indicator for liver transplantation. Among people who underwent liver transplantation from the Republic of Sakha(Yakutia), 96.6% of recipients showed a significant improvement in their general well-being and clinical and laboratoryparameters. Taking in account the unfavorable epidemiological situation of chronic viral hepatitis in the Republic of Sakha(Yakutia), it is necessary to strengthen measures to prevent the development of cirrhosis and liver cancer in people with HCV,HBV and HDV infection.
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