Post liver transplant complications of Budd-Chiari syndrome

Asl, Ali Ansari; Lankarani, Kamran Bagheri; Nikeghbalian, Saman; Kazemi, Kourosh; Shamsaieefar, Alireza; Alizade-Naini, Mahvash; Fattahi, Mohammad Reza; Taghavi, Seyed Alireza; Niknam, Ramin; Ejtehadi, Fardad; Dehghan, Masood; Sivandzadeh, Gholamreza; Ghahramani, Sulmaz; Malek-Hosseini, Seyed Ali

doi:10.1007/s12664-020-01139-3

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…When untreated BCS can progress to fulminant liver failure, hepatorenal syndrome, hepatocellular carcinoma, and hepatic encephalopathy amongst other complications. In 2021, Asl et al [ 129 ] retrospectively reported on complications associated with liver transplantation (LT) in 4225 patients. 108 patients had BCS and were matched with a non-BCS group of 108 patients.…”

Section: Differential Diagnosis Prognosis and Complications Of Budd-c...mentioning

confidence: 99%

Budd-Chiari syndrome in myeloproliferative neoplasms: A review of literature

Găman¹,

Cozma²,

Manan³

et al. 2023

World J Clin Oncol

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Myeloproliferative neoplasms (MPNs) are defined as clonal disorders of the hematopoietic stem cell in which an exaggerated production of terminally differentiated myeloid cells occurs. Classical, Philadelphia-negative MPNs, i.e. , polycythemia vera, essential thrombocythemia and primary myelofibrosis, exhibit a propensity towards the development of thrombotic complications that can occur in unusual sites, e.g. , portal, splanchnic or hepatic veins, the placenta or cerebral sinuses. The pathogenesis of thrombotic events in MPNs is complex and requires an intricate mechanism involving endothelial injury, stasis, elevated leukocyte adhesion, integrins, neutrophil extracellular traps, somatic mutations ( e.g. , the V617F point mutation in the JAK2 gene), microparticles, circulating endothelial cells, and other factors, to name a few. Herein, we review the available data on Budd-Chiari syndrome in Philadelphia-negative MPNs, with a particular focus on its epidemiology, pathogenesis, histopathology, risk factors, classification, clinical presentation, diagnosis, and management.

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Section: Differential Diagnosis Prognosis and Complications Of Budd-c...mentioning

confidence: 99%

Budd-Chiari syndrome in myeloproliferative neoplasms: A review of literature

Găman¹,

Cozma²,

Manan³

et al. 2023

World J Clin Oncol

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“…Although anticoagulation is the mainstay of management, the majority of patients need invasive treatment including transjugular intrahepatic portosystemic shunt (TIPS) and liver transplantation (LT). Asl et al from Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran present a retrospective experience of outcomes following LT for BCS vs. LT for other etiologies (NBC) [6]. Among 4225 patients receiving LT, 108 had BCS and an age-and gender-matched control group consisted of 108 NBC cases with comparable mean model for end-stage liver disease (MELD) scores (19.1 ± 3 and 20 ± 3) for BCS and NBC groups, respectively.…”

Section: Post-liver Transplant Complications Of Budd-chiari Syndromementioning

confidence: 99%

Editorial commentary on the Indian Journal of Gastroenterology– May–June 2021

Limdi

2021

Indian J Gastroenterol

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Serum C-reactive protein and neutrophil to lymphocyte ratio as predictors of survival in cirrhotic patients with systemic inflammatory response syndrome and bacterial infection Patients with liver cirrhosis are at risk of significant morbidity and mortality from infectious complications [1]. Data on biochemical surrogates as predictors of infection are scarce. Tapadia et al. from Gleneagles Global Health City, Chennai, India assessed the predictive value of C-reactive protein (CRP) and the neutrophil-lymphocyte ratio (NLR) alone and in combination in predicting infection in a cohort of 208 consecutive hospitalized patients with cirrhosis [2].In addition to standard assessments (laboratory, ultrasound and appropriate cultures), CRP and NLR were also obtained. Investigators noted an infection rate of 62% with 58.5% culture positivity and mortality of 30.8%. Optimal cut-off values for NLR and CRP to predict infection were 5.86 and 33.7, respectively. One-month mortality risk was 2-3 times with NLR and CRP above these cut-off values. The combination of NLR + CRP (≥5.86 and ≥ 33.7) increased specificity and diagnostic accuracy for infection suggesting that these may have a role in predicting infection and even culture positivity. Prospective controlled studies are needed to validate this interesting observation.

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Recent outcomes of liver transplantation for Budd-Chiari syndrome: A study of the European Liver Transplant Registry (ELTR) and affiliated centers

Dongelmans,

Erler,

Adam

et al. 2024

Hepatology

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Background and aims: Management of Budd-Chiari Syndrome (BCS) has improved over the last decades. The main aim was to evaluate the contemporary post-liver transplant (LT) outcomes in Europe. Approach and results: Data from all transplanted patients from 1976-2020 was obtained from the European Liver Transplantation Registry (ELTR). Patients<16yrs, with secondary BCS or hepatocellular carcinoma were excluded. Patient- (PS) and graft survival (GS) before and after 2000 were compared. Multivariate Cox regression-analysis identified predictors of PS and GS after 2000. Supplementary data was requested from all ELTR-affiliated centers and received from 44. 808 patients were transplanted between 2000-2020. One-, five- and ten-year PS was 84%, 77% and 68% and GS was 79%, 70% and 62%, respectively. Both significantly improved, compared to outcomes before 2000 (p<0.001). Median follow up was 50 months and re-transplantation rate was 12%. Recipient age (aHR:1.04,95%CI:1.02-1.06) and MELD-score (aHR:1.04,95%CI:1.01-1.06), especially above 30, were associated with worse PS, while male sex had better outcomes (aHR:0.63,95%CI:0.41-0.96). Donor age was associated with worse PS (aHR:1.01,95%CI:1.00-1.03) and GS (aHR:1.02,95%CI:1.01-1.03). In 353 patients (44%) with supplementary data, 33% had myeloproliferative neoplasm, 20% underwent TIPS pre-LT and 85% used anticoagulation post-LT. Post-LT anticoagulation was associated with improved PS (aHR:0.29,95%CI:0.16-0.54) and GS (aHR:0.48,95%CI:0.29-0.81). Hepatic artery thrombosis and portal vein thrombosis occurred in 9% and 7%, while recurrent BCS was rare (3%). Conclusion: LT for BCS results in excellent patient- and graft survival. Older recipient or donor age, and higher MELD are associated with poorer outcomes, while long-term anticoagulation improves both patient and graft outcomes.

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Post liver transplant complications of Budd-Chiari syndrome

Cited by 3 publications

References 14 publications

Budd-Chiari syndrome in myeloproliferative neoplasms: A review of literature

Budd-Chiari syndrome in myeloproliferative neoplasms: A review of literature

Editorial commentary on the Indian Journal of Gastroenterology– May–June 2021

Recent outcomes of liver transplantation for Budd-Chiari syndrome: A study of the European Liver Transplant Registry (ELTR) and affiliated centers

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