The impact of disease recurrence on graft survival following liver transplantation: a single centre experience

Rowe, Ian; Webb, Kerry; Gunson, Bridget K.; Mehta, Naimish; Haque, Sayeed; Neuberger, James

doi:10.1111/j.1432-2277.2007.00628.x

Cited by 190 publications

(137 citation statements)

References 30 publications

Supporting

Mentioning

127

Contrasting

Unclassified

Order By: Relevance

“…The primary liver diseases tend to recur with highly variable frequency (Table 2) (37)(38)(39). Hepatitis C and hepatocellular carcinoma recurrence have the highest clinical relevance (4,5).…”

Section: Hepatic Complicationsmentioning

confidence: 99%

“…In patients transplanted for PSC, primary biliary cirrhosis, or autoimmune liver disease, a finding of recurrence of disease based solely on liver graft biopsy does not necessarily affect patient survival. Although a return to some level of alcohol use is not uncommon among patients transplanted for alcoholic liver disease, patient or graft loss from alcohol abuse is much rarer (< 5%) than patient or graft loss from the recurrence of such liver diseases as hepatitis C, hepatocellular carcinoma, and PSC (Table 2) (39,41).…”

Section: Hepatic Complicationsmentioning

confidence: 99%

See 1 more Smart Citation

Long-Term Results of Liver Transplantation

2011

View full text Add to dashboard Cite

Liver transplantation (Lt) is an established therapy associated with a dramatic improvement in patients' life expectancy. With improved early-term management, current 10-year patient survival rates in many indications exceed 70%. Life-long immunosuppressive therapy may, however, be accompanied by considerable long-term toxicity: most importantly, renal dysfunction, cardiovascular disease, and cancer, which, in addition to recurrence of the primary liver disease, emerge as key contributors to late mortality. chronic kidney disease cumulatively affects up to 28% of patients by ten years after Lt. various factors can contribute to renal impairment, but perioperative acute kidney injury, calcineurin inhibitor toxicity, hypertension, and diabetes are considered most important. Lt patients demonstrate 3-fold risk for cardiovascular events, which seems to result mostly from an excess of traditional risk factors, mainly hypertension and diabetes. the cumulative cancer incidence reaches 16-42% by 20 years after Lt, and cancer rates are 2-to 4-fold higher among Lt patients than among matched controls. Highest rates are for nonmelanoma skin cancer (3-to 70-fold) and lymphoma (8-to 29-fold). the liver graft usually displays uncomplicated function in the long term. most common causes for chronic graft dysfunction include disease recurrence and biliary problems. Lt generally restores patients' quality of life to a level comparable with that of the general population, with only minor deficits in some areas. thus, long-term survival after Lt is impressive, and despite these long-term complications, patients' quality of life remains comparable with that of the general population.

show abstract

Section: Hepatic Complicationsmentioning

confidence: 99%

Section: Hepatic Complicationsmentioning

confidence: 99%

Long-Term Results of Liver Transplantation

2011

View full text Add to dashboard Cite

show abstract

“…Graft re-infection is universal with 25% to 30% graft loss from recurrent HCV with progressive fibrosis [41][42][43][44]. Profound graft dysfunction may occur after viral clearance, which necessitates immediate management [45]. Efforts to define criteria for diagnosis, therapy, optimal timing, duration to treat recurrence, are important.…”

Section: Discussionmentioning

confidence: 99%

Hepatotoxicity after Sevoflurane Exposure in a Patient with Chronic Hepatitis C

Shah¹

2015

Glob J Medical Clin Case Rep

View full text Add to dashboard Cite

Sevoflurane is considered a safe inhaled anesthetic of choice in patients with liver disease. Compared to other halogenated inhaled anesthetics, Sevoflurane is reported to lessen the severity of decreased hepatic blood flow and undergoes a different mechanism of hepatic metabolism. In patients with preexisting liver disease, there is potential for low-flow Sevoflurane to induce acute liver damage through other mechanisms. Limited data exists to guide clinical decision-making when quantifying the severity of cirrhosis in patients with hepatitis C and its relationship to anesthesia choice. Previous studies have found that exposure to general anesthesia during abdominal surgery may increase the risk of hepatorenal failure. This study has raised a concern that anesthetics may interfere with various hepatic functions secondary to viral infection. The generation of abnormal liver enzymes and hypercoagulation has provided further exploration for such toxicity.laboratory were ordered according to best practice guidelines. Given this patient history of Hepatitis C, Complete metabolic panel and coagulation panel were ordered (Table 1). On admission, the patient had decreased platelet count (98 x 109/L) and hematocrit (35.7%). Liver aminotransferases and alkaline phosphatase were elevated as well as slightly elevated PT/INR (Table 1). Serum electrolytes and kidney function tests were within normal ranges. Preoperative sedation with Midazolam 2mg was administered. The operation happened as planned. Initially it took about 30 minutes of lysis of adhesions due to his prior hernia. Attention was focused on the hernia repair, therefore no effort was made to lyse adhesions that did not interfere with the procedure, or to explore the rest of the abdomen. However, a portion of the liver, which was readily visible, revealed a hard and nodular appearance, consistent with cirrhosis. During the separation of components, the cutaneous flaps were not excessive, and the external oblique release provided enough length to achieve

show abstract

“…Graft re-infection is universal with 25% to 30% graft loss from recurrent HCV with progressive fibrosis [23][24][25][26]. Profound graft dysfunction may occur after viral clearance, which necessitates immediate management [27]. Efforts to define criteria for diagnosis, therapy, optimal timing, duration to treat recurrence, are important.…”

Section: Discussionmentioning

confidence: 99%