The Impact of Donor Variables on the Outcome of Orthotopic Liver Transplantation for Hepatitis C

The liver has the outstanding ability to regenerate itself and restore parenchymal tissue after injury. The most common cell source in liver growth/regeneration is replication of preexisting hepatocytes although liver progenitor cells have been postulated to participate in liver regeneration in cases of massive injury. Bone marrow derived hematopoietic stem cells (BM-HSC) have the formal capacity to act as a source for hepatic regeneration under special circumstances; however, the impact of this process in liver tissue maintenance and regeneration remains controversial. Whether BM-HSC are involved in liver regeneration or not would be of particular interest as the cells have been suggested to be an alternative donor source for the treatment of liver failure. Data from murine models of liver disease show that BM-HSC can repopulate liver tissue and restore liver function; however, data obtained from human liver transplantation show only little evidence for liver regeneration by this mechanism. The cell source for liver regeneration seems to depend on the nature of regeneration process and the extent of injury; however, the precise mechanisms still need to be resolved. Current data suggest, that in human orthotopic liver transplantation, liver regeneration by BM-HSC is a rather rare event and therefore not of clinical relevance.

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Orthotopic liver transplantation (OLT) using hepatitis C (HCV) viraemic donor organs for hepatitis C non‐viraemic recipients: A single‐centre experience

GastroHep ◽

10.1002/ygh2.428 ◽

2020 ◽

Vol 2 (6) ◽

pp. 327-335

Author(s):

Naemat Sandhu ◽

Rohit Nathan ◽

Eyob Feyssa ◽

Nikolaos Chandolias ◽

Victor Navarro ◽

...

Keyword(s):

Liver Transplantation ◽

Hepatitis C ◽

Orthotopic Liver Transplantation ◽

Single Centre ◽

Single Centre Experience ◽

Donor Organs

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Hepatocellular carcinoma in patients undergoing orthotopic liver transplantation: radiological findings with anatomopathological correlation in Brazil

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032006000100008 ◽

2006 ◽

Vol 43 (1) ◽

pp. 24-29 ◽

Cited By ~ 3

Author(s):

Antônio Carlos Maciel ◽

Carlos Thadeu Cerski ◽

Roger Klein Moreira ◽

Vinicius Labrea Resende ◽

Maria Lúcia Zanotelli ◽

...

Keyword(s):

Computed Tomography ◽

Hepatocellular Carcinoma ◽

Liver Transplantation ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Orthotopic Liver Transplantation ◽

Imaging Techniques ◽

Arterial Phase ◽

Hepatitis C Virus Infection ◽

Cirrhotic Patients

BACKGROUND: Hepatocellular carcinoma is one of the most common malignant tumors worldwide. Imaging techniques, specially computed tomography and ultrasound, are among the most useful diagnostic tools, although the accuracy of these methods may have a significant variability. AIMS: To determine the prevalence of hepatocellular carcinoma in cirrhotic patients undergoing orthotopic liver transplantation at "Santa Casa de Misericórdia" of Porto Alegre, RS, Brazil; to estimate the sensitivity of computed tomography and ultrasound in pretransplantation detection of hepatocellular carcinoma in this population; to correlate the radiological characteristics with anatomopathological findings. MATERIALS AND METHODS: Retrospective prevalence study. Population: adult, cirrhotic patients undergoing orthotopic liver transplantation from January 1990 to July 2003. Among the 292 transplanted patients, 31 cases of hepatocellular carcinoma were diagnosed, of which 29 were included in the study. Tumor characteristics in both ultrasound and computed tomography were compared to those observed in anatomopathological examination. RESULTS: Prevalence of hepatitis C virus infection among patients with diagnosis of hepatocellular carcinoma was 93.5%, and the prevalence of hepatocellular carcinoma among transplanted patients was 10.6%. The overall sensitivity of the imaging techniques was 70.3% for computed tomography and 72% for ultrasound. CONCLUSION: The prevalence of hepatocellular carcinoma at our institution, as well as the sensitivity of both ultrasound and computed tomography to detect such tumors at pretransplantation screening were similar to those found by other authors, while the prevalence of hepatitis C virus infection, the most common etiological agent for liver disease in our patients, is one of the highest ever reported in literature. Factors influencing hepatocellular carcinoma detection rates were: time from examination to liver transplantation; acquisition of computed tomography images during arterial phase; lesion size. Arterial phase proved to be the most useful part of computed tomography examination in this study.

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