scholarly journals Successful twin pregnancy after orthotopic liver transplantation

2002 ◽  
Vol 39 (4) ◽  
pp. 246-247 ◽  
Author(s):  
Júlio Cezar Uili Coelho ◽  
Mônica Beatriz Parolin ◽  
Jorge E. Fouto Matias
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Twin Pregnancy ◽  
Immunosuppressive Agents ◽  
Normal Liver ◽  
Successful Pregnancy ◽  
Normal Children ◽  
Chiari Syndrome ◽  
Renal Function Tests ◽  
Transplantation Patient

AIM: Report of a case of successful twin pregnancy following liver transplantation. PATIENT AND METHOD: A 42-year-old nulliparous-woman was subjected to an orthotopic liver transplantation due to Budd-Chiari syndrome. Sixteen months after the transplantation, an ultrasonography revealed twin pregnancy. Her prenatal course was uneventful, except for mild arterial hypertension. The immunosuppressive agents used during pregnancy were cyclosporine and prednisone. RESULT: The patient gave birth to two healthy girls at 37 weeks of gestation. The patient's postpartum course was uneventful with normal liver and renal function tests. CONCLUSION: Following successful pregnancy, women may become pregnant and give birth to normal children, including twins

scholarly journals Recent Advances in Costimulatory Blockade to Induce Immune Tolerance in Liver Transplantation

2021 ◽  
Vol 12 ◽  
Author(s):  
Mingjie Ding ◽  
Yuting He ◽  
Shuijun Zhang ◽  
Wenzhi Guo
Keyword(s):  
Liver Transplantation ◽  
T Cell ◽  
Immune Tolerance ◽  
Immunosuppressive Agents ◽  
Normal Liver ◽  
Immunosuppressive Drugs ◽  
Costimulatory Molecules ◽  
Organ Rejection ◽  
Costimulatory Blockade ◽  
End Stage

Liver transplantation is an effective therapy for end-stage liver disease. However, most postoperative patients must take immunosuppressive drugs to prevent organ rejection. Interestingly, some transplant recipients have normal liver function and do not experience organ rejection after the withdrawal of immunosuppressive agents. This phenomenon, called immune tolerance, is the ultimate goal in clinical transplantation. Costimulatory molecules play important roles in T cell-mediated immune responses and the maintenance of T cell tolerance. Blocking costimulatory pathways can alter T cell responses and prolong graft survival. Better understanding of the roles of costimulatory molecules has facilitated the use of costimulatory blockade to effectively induce immune tolerance in animal transplantation models. In this article, we review the state of the art in costimulatory pathway blockade for the induction of immune tolerance in transplantation and its potential application prospects for liver transplantation.

scholarly journals Orthotopic Liver Transplantation in Human-Immunodeficiency-Virus-Positive Patients in Germany

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
E. Anadol ◽  
S. Beckebaum ◽  
K. Radecke ◽  
A. Paul ◽  
A. Zoufaly ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Viral Infections ◽  
Survival Rates ◽  
Hiv Positive ◽  
Post Transplantation ◽  
Immunodeficiency Virus ◽  
Chiari Syndrome ◽  
Hcv Coinfection ◽  
End Stage

Objectives. This summary evaluates the outcomes of orthotopic liver transplantation (OLT) of HIV-positive patients in Germany.Methods. Retrospective chart analysis of HIV-positive patients, who had been liver-transplanted in Germany between July 1997 and July 2011.Results. 38 transplantations were performed in 32 patients at 9 German transplant centres. The reasons for OLT were end-stage liver disease (ESLD) and/or liver failure due to hepatitis C (HCV) (), hepatitis B (HBV) (), multiple viral infections of the liver () and Budd-Chiari-Syndrome. In July 2011 19/32 (60%) of the transplanted patients were still alive with a median survival of 61 months (IQR (interquartile range): 41–86 months). 6 patients had died in the early post-transplantation period from septicaemia (), primary graft dysfunction (), and intrathoracal hemorrhage (). Later on 7 patients had died from septicaemia (), delayed graft failure (), recurrent HCC (), and renal failure (). Recurrent HBV infection was efficiently prevented in 11/12 patients; HCV reinfection occurred in all patients and contributed considerably to the overall mortality.Conclusions. Overall OLT is a feasible approach in HIV-infected patients with acceptable survival rates in Germany. Reinfection with HCV still remains a major clinical challenge in HIV/HCV coinfection after OLT.

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