Variables Associated With the Risk of Early Death After Liver Transplantation at a Liver Transplant Unit in a University Hospital

2015 ◽  
Vol 47 (4) ◽  
pp. 1008-1011 ◽  
Author(s):  
L.D. Azevedo ◽  
R.S. Stucchi ◽  
E.C. de Ataíde ◽  
I.F.S.F. Boin
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Early Death ◽  
University Hospital

scholarly journals SPECIALIST SERVICE IN LIVER TRANSPLANT IN A UNIVERSITY HOSPITAL: A CASE STUDY

2017 ◽  
Vol 26 (2) ◽  
Author(s):  
Sílvia Ferrazzo ◽  
Mara Ambrosina de Oliveira Vargas ◽  
Diana Coelho Gomes ◽  
Francine Lima Gelbcke ◽  
Karina Silveira de Almeida Hammerschimidt ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Care Service ◽  
University Hospital ◽  
Structured Interviews ◽  
Specialist Service ◽  
Immunosuppressed Patients ◽  
Structures Of Care ◽  
The Impact

ABSTRACT Objective: was to describe the flow of a specialist service in the care of liver transplant in a university hospital. Method: a qualitative research in the form of a case study, performed in a transplant service in southern Brazil. Data collection occurred from November 2013 to February 2014 through the triangulation of data, document analysis, structured interviews with 11 professional and semi direct observations interviews. Data analysis was performed by analysis of thematic content. Results: describes the flow of service and revealed the involvement of a multidisciplinary team in a cohesive manner, with competence recognized by patients and other sectors of the institution and structural deficiencies in care service for immunosuppressed patients. Conclusion: it was found that there is a need for studies that address the structures of care in liver transplantation services and to evaluate the impact of the quality of the life expectancy and proper recovery of persons undergoing liver transplantation.

Post-transplant lymphoproliferative disorder (PTLD) after liver transplantation: Report of 16 cases from a single center.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e19513-e19513
Author(s):  
Ayhan Ulusakarya ◽  
Beatrice Delmas Marsalet ◽  
Srimanta Misra ◽  
Nahla Cucherousset ◽  
Philippe Ichai ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Complete Remission ◽  
Liver Transplant ◽  
Rare Complication ◽  
Transplant Rejection ◽  
Immunosuppressive Treatment ◽  
Stage Iv ◽  
University Hospital ◽  
Standard Regimen ◽  
Poor General Health

e19513 Background: PTLD is a rare complication of organ transplantation, but it can jeopardize the transplantation outcome. Methods: Paul Brousse University Hospital is the largest liver transplantation center in France. We retrospectively analyzed data from all of the patients who experienced PTLD and treated in our hematology/oncology department in the last 10 years. Results: 16 cases of PTLD occurred after various intervals following the liver transplant without correlation with the type of underlying liver disease or immunosuppressive treatment. Overall, the patients had poor general health (ECOG 3-4: 69%), renal and/or hepatic failure (75%), and cytopenia (63%). PTLD were often of high grade (81%), B phenotype (94%), stage IV (75%), with high LDH (88%). The most frequent disease sites were liver (63%), subdiaphragmatic lymphadenopathy (69%), and extranodal (69%). After a reduction in the immunosuppressive treatment, the patients received their initial chemotherapy mostly with a combination of prednisolone, cyclophosphamide, vincristine, and rituximab. As soon as their general condition improved, R-CHOP was given as the standard regimen. All patients experienced severe and frequent complications during chemotherapy. Two patients had liver transplant rejection, lethal in one case. Six patients died: 4 of progression or relapse of PTLD, one after 4th liver transplantation, one of leukoencephalitis. Complete remission was obtained in 81% of patients. Ten patients (63%) are alive in complete remission after a median follow up of 6.5 years. Conclusions: Despite the clinical complexity of these patients, PTLD can be treated utilizing common lymphoma chemotherapy with treatment accommodations to poor ECOG, liver and renal dysfunctions.

Outcomes of Patients With Familial Transthyretin Amyloidosis After Liver Transplantation

2017 ◽  
Vol 27 (3) ◽  
pp. 246-250 ◽  
Author(s):  
Dipti Banerjee ◽  
Lindsey E. Roeker ◽  
Martha Grogan ◽  
Paul Swiecicki ◽  
John Poterucha ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Overall Survival ◽  
Liver Transplant ◽  
Research Question ◽  
Organ Transplant ◽  
Early Death ◽  
Multiple Organ ◽  
Orthotopic Liver Transplant ◽  
Transthyretin Amyloidosis ◽  
Organ Systems

Background: Familial transthyretin amyloidosis is a disease caused by misfolded transthyretin aggregates that can impair multiple organ systems. Liver transplantation is the first-line treatment for familial transthyretin amyloidosis. Research Question: Our objective is to study outcomes and survival among patients with familial transthyretin amyloidosis after transplantation. Design: All patients undergoing orthotopic liver transplant for familial transthyretin amyloidosis at Mayo Clinic between 1997 and 2012 were reviewed. Baseline clinical characteristics, organs transplanted, and posttransplant clinical course were assessed. Results: Of the 40 patients, 7 patients had the V30M mutation and 33 had other mutations. Nineteen patients received liver only, 19 liver and heart, and 2 combined liver, heart, and kidney transplants. The 5-year overall survival was 85% for those receiving multiple organ transplant and 52% for those receiving liver transplant only ( P = .057). There was no difference in overall survival based on mutation (V30M vs other mutations), but survival was confounded by varied disease involvement and organs transplanted. Those who had early death (≤24 months from liver transplant) had a higher incidence of baseline peripheral neuropathy, autonomic neuropathy, lower modified BMI, and higher alkaline phosphatase. Discussion: Outcomes of orthotopic liver transplant in familial transthyretin amyloidosis are variable due to heterogeneity in mutations and patient status at the time of transplant. Familial transthyretin amyloidosis can progress, despite liver transplantation. Patients receiving combined liver, heart/kidney transplant demonstrated improved survival compared to liver transplant alone.

scholarly journals Peritoneal Dialysis After Liver Transplantation: A Systematic Review

2021 ◽  
Vol 8 ◽  
pp. 205435812110297
Author(s):  
Jean Maxime Côté ◽  
Isabelle Ethier ◽  
Héloïse Cardinal ◽  
Marie-Noëlle Pépin
Keyword(s):  
Systematic Review ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Kidney Failure ◽  
Liver Graft ◽  
Transplant Recipients ◽  
Technique Survival ◽  
Liver Transplant Recipients

Background: Chronic kidney disease following liver transplantation is a major long-term complication. Most liver transplant recipients with kidney failure will be treated with dialysis instead of kidney transplantation due to noneligibility and shortage in organ availability. In this population, the role of peritoneal dialysis (PD) as a modality of kidney replacement therapy (KRT) remains unclear. Objective: To determine the feasibility regarding safety, technique survival, and dialysis efficiency of PD in liver transplant recipients requiring KRT for maintenance dialysis. Design: Systematic review. Setting: Interventional and observational studies reporting the use of PD after liver transplantation. Patients: Adult liver transplant recipients with kidney failure treated with maintenance KRT. Measurements: Extracted data included eligibility criteria, study design, demographics, and PD modality. The following outcomes of interest were extracted: rate of peritonitis and microorganisms involved, noninfectious peritoneal complications, technique survival, and kidney transplantation-censored technique survival. Non-PD complications included overall survival, liver graft dysfunction, and hospitalization rate. Methods: The following databases were searched until July 2020: MedLine/PubMed, EMBASE, CINAHL, and Cochrane Library. Two reviewers independently screening all titles and abstracts of all identified articles. Due to the limited sample size, observational designs and study heterogeneity expected, no meta-analysis was pre-planned. Descriptive statistics were used to report all results. Results: From the 5263 identified studies, 4 were included in the analysis as they reported at least 1 outcome of interest on a total of 21 liver transplant recipients, with an overall follow-up duration on PD of 19.0 (Interquartile range [IQR]: 9.5-29.5) months. Fifteen episodes of peritonitis occurred in a total cumulative PD follow-up of 514 patient-months, representing an incidence rate of 0.35 per year. These episodes did not result in PD technique failure, mortality, or impairment of liver graft function. Limitations: Limitations include the paucity of studies in the field and the small number of patients included in each report, a risk of publication bias and the impossibility to directly compare hemodialysis to PD in this population. These results, therefore, must be interpreted with caution. Conclusions: Based on limited data reporting the feasibility of PD in liver transplant recipients with kidney failure, no signal was associated with an increased risk of infectious complications. Long-term studies evaluating this modality need to be performed. Registration (PROSPERO): CRD42020218374.

scholarly journals Erythrocytosis after liver transplantation: The experience of a university hospital

2013 ◽  
Vol 19 (4) ◽  
pp. 420-424 ◽  
Author(s):  
Gabriella Cordone ◽  
Fabiana Zingone ◽  
Giuseppe Cardillo ◽  
Vincenzo Martinelli ◽  
Novella Pugliese ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
University Hospital

scholarly journals Risk factors predicting Cytomegalovirus infection in post liver transplant recipients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M G Abdelrahman ◽  
H A Mahmoud ◽  
M K Mohsen ◽  
M O Ali ◽  
A M N Mohamed
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Organ Transplantation ◽  
Chronic Rejection ◽  
Cytomegalovirus Infection ◽  
Transplant Recipients ◽  
Cmv Infection ◽  
Donor Liver Transplantation ◽  
Liver Transplant Recipients

Abstract Background Liver transplantation is considered to be the only curative treatment for patients with end stage liver disease. Postoperative infection remains to be one of the most common causes of morbidity and mortality throughout the past years. Cytomegalovirus (CMV) infection although considered to be a weak viral infection that usually passes asymptomatic in immunocompetent patients, however, it is considered one of the most common pathogens causing morbidities and mortality in liver transplant recipients. Multiple studies have been done to assess the risk factors for developing CMV infection. Objective Identification of risk factors predicting Cytomegalovirus infection in liver transplant recipients following transplantation. Methods This retrospective study was conducted on 194 patients and their donors who underwent living donor liver transplantation operation at Ain Shams centre for organ transplantation (ASCOT) at Ain Shams specialized hospital in the period between January 2010 and December 2016 with at least one year follow up period after operation for the recipient group. Results In our study, 194 patients undergoing liver transplantation at Ain shams centre for organ transplantation over seven years from January 2010 to December 2016 have been followed to assess risk factors affecting CMV infection development. Chronic rejection was found to be the most common factor associated with CMV infection followed by Cyclosporin (Neoral) as main postoperative immunosuppressant following liver transplantation. Other factors that were found to carry risk for CMV infection included younger age, advanced MELD score, positive CMV IgM status of the donors and recipients. Conclusion Differentiation of Cytomegalovirus disease from Cytomegalovirus infection isn’t always available as it requires tissue invasive techniques. Multiple risk factors have been attributed to cause Cytomegalovirus infection (viremia) . In our study, rejection (chronic rejection) was the factor that carries highest risk for Cytomegalovirus infection development followed by Cyclosporin .

scholarly journals HIV and Liver transplantation: The British Columbia Experience, 2004 to 2013

2014 ◽  
Vol 25 (3) ◽  
pp. 159-162 ◽  
Author(s):  
Clara Tan-Tam ◽  
Pamela Liao ◽  
Julio S Montaner ◽  
Mark W Hull ◽  
Charles H Scudamore ◽  
...  
Keyword(s):  
British Columbia ◽  
Liver Transplantation ◽  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Liver Transplant ◽  
Clinical Outcomes ◽  
Disease Status ◽  
Transplant Program ◽  
End Stage

BACKGROUND: The demand for definitive management of end-stage organ disease in HIV-infected Canadians is growing. Until recently, despite international evidence of good clinical outcomes, HIV-infected Canadians with end-stage liver disease were ineligible for transplantation, except in British Columbia (BC), where the liver transplant program of BC Transplant has accepted these patients for referral, assessment, listing and provision of liver allograft. There is a need to evaluate the experience in BC to determine the issues surrounding liver transplantation in HIV-infected patients.METHODS: The present study was a chart review of 28 HIV-infected patients who were referred to BC Transplant for liver transplantation between 2004 and 2013. Data regarding HIV and liver disease status, initial transplant assessment and clinical outcomes were collected.RESULTS: Most patients were BC residents and were assessed by the multidisciplinary team at the BC clinic. The majority had undetectable HIV viral loads, were receiving antiretroviral treatments and were infected with hepatitis C virus (n=16). The most common comorbidities were anxiety and mood disorders (n=4), and hemophilia (n=4). Of the patients eligible for transplantation, four were transplanted for autoimmune hepatitis (5.67 years post-transplant), nonalcoholic steatohepatitis (2.33 years), hepatitis C virus (2.25 years) and hepatitis B-delta virus coinfection (recent transplant). One patient died from acute renal failure while waiting for transplantation. Ten patients died during preassessment and 10 were unsuitable transplant candidates. The most common reason for unsuitability was stable disease not requiring transplantation (n=4).CONCLUSIONS: To date, interdisciplinary care and careful selection of patients have resulted in successful outcomes including the longest living HIV-infected post-liver transplant recipient in Canada.

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