Indications for Liver Tranplantation in British Columbia’s Aboriginal Population: A 10-Year Retrospective Analysis

OBJECTIVES: To study the indications for liver transplantation among British Columbia’s First Nation population.MATERIALS AND METHODS: A retrospective analysis of the British Columbia Transplant Society’s database of Aboriginal and non-Aboriginal liver transplant recipients from 1989 to 1998 was undertaken. For primary biliary cirrhosis (PBC), the transplant assessment database (patients with and without transplants) was analyzed using a binomial distribution and compared with published census data regarding British Columbia’s proportion of Aboriginal people.RESULTS: Between 1989 and 1998, 203 transplantations were performed in 189 recipients. Fifteen recipients were Aboriginal (n=15; 7.9%). Among all recipients, the four most frequent indications for liver transplantation were hepatitis C virus (HCV) infection (n=57; 30.2%), PBC (n=34; 18.0%), alcohol (n=22; 11.6%) and autoimmune hepatitis (n=14; 7.4%). Indications for liver transplantation among Aboriginal people were PBC (n=8; 53.3%; P<0.001 compared with non-Aboriginal people), autoimmune hepatitis (n=4; 26.67%; P=0.017), acute failure (n=2; 13.3%) and HCV (n=1). Among all patients referred for liver transplantation with PBC (n=43), 29 (67.44%) were white and 11 (25.6%) were Aboriginal. A significant difference was found between the proportion of Aboriginal people referred for liver transplantation and the proportion of Aboriginal people in British Columbia (139,655 of 3,698,755 [3.8%]; 1996 Census, Statistics Canada) (P<0.001).CONCLUSIONS: Aboriginal people in British Columbia are more likely to be referred for liver transplantation with a diagnosis of PBC but are less likely to receive a liver transplant because of HCV or alcohol than are non-Aboriginal people.

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

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2014/373898 ◽

2014 ◽

Vol 25 (3) ◽

pp. 159-162 ◽

Cited By ~ 5

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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Recurrence of primary biliary cirrhosis and development of autoimmune hepatitis after liver transplant: A blind histologic study

Hepatology Research ◽

10.1111/j.1872-034x.2008.00483.x ◽

2009 ◽

Vol 39 (6) ◽

pp. 577-584 ◽

Cited By ~ 15

Author(s):

Prodromos Hytiroglou ◽

Julio A. Gutierrez ◽

Maria Freni ◽

Joseph A. Odin ◽

Carmen M. Stanca ◽

...

Keyword(s):

Primary Biliary Cirrhosis ◽

Liver Transplant ◽

Autoimmune Hepatitis ◽

Biliary Cirrhosis ◽

Histologic Study

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Living donor liver transplantation for primary biliary cirrhosis: retrospective analysis of 50 patients in a single center

Transplant International ◽

10.1111/j.1432-2277.2005.00129.x ◽

2005 ◽

Vol 18 (7) ◽

pp. 794-799 ◽

Cited By ~ 10

Author(s):

Kiyoshi Hasegawa ◽

Yasuhiko Sugawara ◽

Hiroshi Imamura ◽

Mami Ikeda ◽

Norihiro Kokudo ◽

...

Keyword(s):

Liver Transplantation ◽

Primary Biliary Cirrhosis ◽

Retrospective Analysis ◽

Living Donor ◽

Living Donor Liver Transplantation ◽

Biliary Cirrhosis ◽

Single Center ◽

Donor Liver ◽

Donor Liver Transplantation

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Pleural Effusions Following Liver Transplantation: A Single-Center Experience

Journal of Intensive Care Medicine ◽

10.1177/0885066620932448 ◽

2020 ◽

pp. 088506662093244

Author(s):

Justin K. Lui ◽

Lidia Spaho ◽

Shahrad Hakimian ◽

Michael Devine ◽

Rosa Bui ◽

...

Keyword(s):

Risk Factors ◽

Liver Transplantation ◽

Liver Transplant ◽

Hospital Length Of Stay ◽

Transplant Recipients ◽

Single Center ◽

Pleural Effusions ◽

Post Transplantation ◽

Significant Difference ◽

Liver Transplant Recipients

Introduction: This was a single-center retrospective study to evaluate incidence, prognosis, and risk factors in patients with postoperative pleural effusions, a common pulmonary complication following liver transplantation. Methods: A retrospective review was performed on 374 liver transplantation cases through a database within the timeframe of January 1, 2009 through December 31, 2015. Demographics, pulmonary and cardiac function testing, laboratory studies, intraoperative transfusion/infusion volumes, postoperative management, and outcomes were analyzed. Results: In the immediate postoperative period, 189 (50.5%) developed pleural effusions following liver transplantation of which 145 (76.7%) resolved within 3 months. Those who developed pleural effusions demonstrated a lower fibrinogen (149.6 ± 66.3 mg/dL vs 178.4 ± 87.3 mg/dL; P = .009), total protein (5.8 ± 1.0 mg/dL vs 6.1 ± 1.2 mg/dL; P = .04), and hemoglobin (9.8 ± 1.8 mg/dL vs 10.3 ± 1.9 mg/dL; P = .004). There was not a statistically significant difference in 1-year all-cause mortality and in-hospital mortality between liver transplant recipients with and without pleural effusions. Liver transplant recipients who developed pleural effusions had a longer hospital length of stay (16.4 ± 10.9 days vs 14.0 ± 16.5 days; P = .1), but the differences were not statistically significant. However, there was a significant difference in tracheostomy rates (11.6% vs 5.4%; P = .03) in recipients who developed pleural effusions compared to recipients who did not. Conclusions: In summary, pleural effusions are common after liver transplantation and are associated with increased morbidity. Pre- and intraoperative risk factors can offer both predictive and prognostic value for post-transplantation pleural effusions. Further prospective studies will be needed to further evaluate the relevance of these findings to limit instances of postoperative pleural effusions.

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