scholarly journals Outcome of orthotopic liver transplantation in patients with haemophilia

Gut ◽  
1998 ◽  
Vol 42 (5) ◽  
pp. 744-749 ◽  
Author(s):  
F H Gordon ◽  
P K Mistry ◽  
C A Sabin ◽  
C A Lee
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Hepatitis C ◽  
Viral Hepatitis ◽  
Orthotopic Liver Transplantation ◽  
Clotting Factor ◽  
Bleeding Complications ◽  
Clotting Factors ◽  
Post Transplant

Background—Many patients with haemophilia have developed cirrhosis or hepatocellular carcinoma due to transfusion acquired chronic viral hepatitis.Aims—To assess the long term outcome of all haemophilic patients reported to have undergone orthotopic liver transplantation.Methods—Transplant centres of patients identified by medical database search were contacted and survival data assessed by Kaplan-Meier analysis.Results—Twenty six haemophilic men (median age 46 years, range 5–63 years) underwent orthotopic liver transplantation in 16 centres between 1982 and 1996. Indications for transplantation were hepatitis C cirrhosis (69%), hepatitis B with or without C cirrhosis (15%), viral hepatitis related hepatocellular carcinoma (12%), and biliary atresia (4%). Six patients (23%) were infected with human immunodeficiency virus (HIV). Postoperatively, the median time to normal clotting factor levels was 24 hours (range 0–48 hours) and exogenous clotting factors were stopped at a median of 24 hours (range 0–480 hours). Four patients (15%) had bleeding complications. The one and three year survival of HIV positive recipients (67% and 23%) was significantly poorer (p=0.0003) than that of HIV negative recipients (90% and 83%). Coagulopathy was cured in all patients surviving more than 12 days post-transplant. Six of the 20 patients (30%) with hepatitis C cirrhosis pretransplant had evidence of disease recurrence at a mean of nine months post-transplant.Conclusions—Hepatitis C cirrhosis is the most common indication for orthotopic liver transplantation in patients with haemophilia. Transplantation results in long term cure of haemophilia but may be complicated by the effects of HIV infection or recurrent viral hepatitis.

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

2006 ◽  
Vol 43 (1) ◽  
pp. 24-29 ◽  
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.

Quality of life in long-term survivors after liver transplantation: impact of recurrent viral hepatitis C virus hepatitis 1

2000 ◽  
Vol 14 (1) ◽  
pp. 48-54 ◽  
Author(s):  
David L Paterson ◽  
Timothy Gayowski ◽  
Cheryl F Wannstedt ◽  
Marilyn M Wagener ◽  
Ignazio R Marino ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Liver Transplantation ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Viral Hepatitis ◽  
Virus Hepatitis ◽  
Viral Hepatitis C ◽  
Long Term Survivors

scholarly journals Long-term care in orthotopic liver transplantation

2013 ◽  
pp. 230-238
Author(s):  
Maria C. Morelli ◽  
Antonio D. Pinna
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Orthotopic Liver Transplantation ◽  
Long Term Care ◽  
Original Research ◽  
Term Care ◽  
Term Survival ◽  
Post Transplant ◽  
Transplant Complications

Orthotopic liver transplantation is the treatment of choice for selected patients with end-stage liver disease or acute liver failure. Given the excellent long-term survival associated with this procedure, increasing emphasis is being placed on the recognition and prevention of post-transplant complications, detection of recurrent liver disease, and effective management of immunosuppressive drug therapy, which involves regular monitoring of blood levels and the identification of adverse effects and drug interactions. In this context, close interaction between the transplant surgeon, the hepatologist, and the family physician is of great value. The purpose of the present article is to review the multidisciplinary, long-term care of liver transplant recipients, the detection and management of the most common post-transplant complications, and the effects of immunosuppression. The article is based on a PubMed search for articles (original research, reviews, meta-analyses) published between 1995 and 2010. The search terms used were ‘‘liver transplantation’’ AND any of the following: cardiovascular complications, long-term complications, malignancy, post-transplant care.

Sign in / Sign up

Export Citation Format

Share Document