Liver transplantation in a patient with primary antiphospholipid syndrome and Budd-Chiari syndrome

Reshetnyak, T.; Середавкина, Н. В.; Сатыбалдыева, М. А.; Nasonov, E.; Reshetnyak, Vasiliy Ivanovich

doi:10.4254/wjh.v7.i19.2229

Cited by 18 publications

(7 citation statements)

References 27 publications

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“…The factors that cause BCS include chronic myeloproliferative syndromes (MPS), such as polycythemia vera, ET, paroxysmal nocturnal hemoglobinuria, hematologic and liver metabolic abnormalities, such as deficit of antithrombin, protein C and protein S, resistance to protein C activated, mutation of factor V Leiden, mutation G20210A of the gene that codifies the factor II, neoplasias, administration of oral contraceptive, pregnancy and the period of postpartum. The most frequent factor of risk prothrombotic is MPS, even if it was proved that almost half of the patients have multiple factors of risk prothrombotic [12][13][14]. Among the factors that cause it mentioned above, ET is associated with high risk of deep vein thrombosis.…”

Section: Resultsmentioning

confidence: 99%

Budd-Chiari Syndrome:Rare Cause, But Important of Portal Hypertension

G¹,

Pelin²,

Macovei³

et al. 2017

Rev. Chim.

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Budd-Chiari syndrome (BCS) (artery-occlusive hepatic disease) is a rare disease characterized by the obstruction of the blood flow at the level of the suprahepatic veins till their flow in the inferior vena cava (IVC) or at the level of IVC on the segment between the suprahepatic veins and the right atrium. The most frequent symptoms are abdominal pains, hepatomegaly and ascites. The imagistic investigations have an essential role in the early establishment of the diagnostic, evaluating the extension of disease and the management of BCS. Treatment depends on the presence or absence of symptoms and how acute the disease is.We present the case of a 43-years old woman, who had had for two month dyspeptic symptoms, increase of volume of the abdomen and oedema in the lower limbs. The biological investigations indicated hepatic dysfunction and thrombocytosis. The abdominal ultrasound showed modifications of chronic hepatopathy with signs of portal hypertension. The abdominal computer-tomography emphasized hepatomegaly with multiple nodules of regeneration, signs of portal hypertension (splenomegaly, moderate ascites), caudate lobe hypertrophy and thrombosis IVC. The patient was diagnosed with BCS and essential thrombocythemia. She started the medical treatment and was listed for liver transplantation. Budd-Chiari syndrome has to be taken into account every time we investigate the etiology of an acute or chronic hepatopathies, because the early diagnose can improve the patient�s prognostic.

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Section: Resultsmentioning

confidence: 99%

Budd-Chiari Syndrome:Rare Cause, But Important of Portal Hypertension

G¹,

Pelin²,

Macovei³

et al. 2017

Rev. Chim.

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“…Причиной поражения печени у этих больных были тромбофилические состояния (атипичный гемолитикоуремический синдром и наследственная тромбофилия). По данным литературы, поражение печени при наследственных и приобретенных тромбофилиях (среди которых основное место занимает АФС) чаще связано с развитием тромбозов печеночной артерии, воротной и печеночных вен, что может требовать проведения трансплантации печени [19,20]. По нашим данным, поражение печени у 2 пациенток не было вызвано гемодинамически значимым тромбозом крупных сосудов печени.…”

Section: Discussionunclassified

Liver involvement in patients with systemic lupus erythematosus

Панова

Авдеев

Krasnova

et al. 2021

Naučno-praktičeskaâ revmatologiâ

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Liver involvement in systemic lupus erythematosus is common and in most cases clinical course is asymptomatic, that makes diagnosis difficult. Determination of the cause of the liver involvement is important to select treatment and to evaluate the prognosis of the disease.The aim of the research was to characterize the clinical features of liver involvement in patients with systemic lupus erythematosus and identify the most significant clinical and laboratory parameters for the differential diagnosis of lupus hepatitis.Materials and methods. The study included 313 patients with systemic lupus erythematosus observed in the E.M. Tareev Clinic of Rheumatology, Internal Medicine and Occupational Diseases of I.M. Sechenov First Moscow State Medical University (Sechenov University) in the period from 2001 to 2019. The verification of diagnosis of systemic lupus erythematosus was based on the criteria of the American College of Rheumatology (1997). Patients examination included complete blood count, biochemical and immunological blood tests and an abdominal ultrasonography. In 13 cases hepatic autoantibodies (ASMA, anti-LKM-1, LC-1, SLA-LP, AMA-M2) were analyzed, in 4 – magnetic resonance cholangiopancreatography and in 6 – liver biopsy were made.Results. Liver involvement were represented by an increase of liver enzymes in 58 (18.5%) cases. Chronic viral hepatitis C was diagnosed in 4 (1.3%) patients. Drug-induced hepatitis was found in 17 (5.4%) patients. Autoimmune liver diseases occured in 2 (0.6%) patients. In 2 (0.6%) patients, liver damage was associated with thrombotic microangiopathy (atypical hemolytic uremic syndrome, hereditary thrombophilia). In 15 (4.8%) cases, the most likely diagnosis was NAFLD. Lupus hepatitis was the most likely cause in 18 (5.7%) patients. Differential diagnosis in cases of liver involvement in patients with systemic lupus erythematosus requires assessment of risk factors for various liver diseases, age of the patients, level of liver enzymes, lupus activity, ultrasound signs of liver steatosis and secondary antiphospholipid syndrome.Determining the cause of the liver involvement for the patients with the systemic lupus erythematosus allows establishing better treatment tactic and improvement of the prognosis.

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“…Liver transplant recipients represent a particularly complex population owing to their unique hemostatic physiology and variable metabolic function. Patients with clinically significant liver disease were generally excluded from randomized‐controlled trials that lead to FDA approval of the DOACs, and present published experience with DOAC use in liver transplant recipients has been limited to one small case series and several single case reports …”

Section: Discussionmentioning

confidence: 99%

Safety of direct‐acting oral anticoagulants relative to warfarin in a matched cohort of liver transplant recipients

Santeusanio

Weinberg

Florman

et al. 2019

Clinical Transplantation

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Despite increasingly widespread utilization of direct-acting oral anticoagulants (DOACs), there remains limited experience with the use of these agents following liver transplantation. We performed a single-center, retrospective review of liver transplant recipients prescribed DOACs or warfarin between January 2014 and January 2018. Patients receiving DOACs were matched with warfarin-treated controls based on discrete clinical parameters and followed from the time of anticoagulant prescription, until treatment discontinuation or study conclusion. The primary endpoint for this review was the incidence of clinically relevant major or non-major bleeding among the treatment groups. Twenty-seven patients prescribed DOACs were identified for inclusion in the review, of which 20 could be matched with suitable warfarin controls. At the conclusion of the study, warfarin-treated patients had a significantly higher incidence of clinically relevant bleeding (45% vs 15%; P = .01). No statistically significant differences were found in the rate of new or recurrent thrombotic events.Multivariable logistic regression demonstrated that warfarin treatment was associated with a significantly higher odds of a bleeding event compared to treatment with a DOAC (OR = 6.9; 95% CI, 1.1-44.6). DOAC use appears relatively safe compared with warfarin in select liver transplant recipients. Patient-specific factors still bear consideration when selecting between the various anticoagulant options. K E Y W O R D Salgorithm, anticoagulants, clotting, hemorrhage, liver transplantation

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Liver transplantation in a patient with primary antiphospholipid syndrome and Budd-Chiari syndrome

Cited by 18 publications

References 27 publications

Budd-Chiari Syndrome:Rare Cause, But Important of Portal Hypertension

Budd-Chiari Syndrome:Rare Cause, But Important of Portal Hypertension

Liver involvement in patients with systemic lupus erythematosus

Safety of direct‐acting oral anticoagulants relative to warfarin in a matched cohort of liver transplant recipients

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