Complications and Long-Term Outcomes in Adult Patients Undergoing Living Donor Liver Transplantation Because of Fulminant Hepatitis.


Journal

Transplantation proceedings
ISSN: 1873-2623
Titre abrégé: Transplant Proc
Pays: United States
ID NLM: 0243532

Informations de publication

Date de publication:
Jun 2023
Historique:
received: 14 12 2022
accepted: 05 01 2023
medline: 3 7 2023
pubmed: 4 5 2023
entrez: 3 5 2023
Statut: ppublish

Résumé

The present study investigates the complications that may occur during long-term follow-up in patients aged 18 years and older undergoing living donor liver transplantation (LDLT) in our clinic because of fulminant hepatitis. The study included patients aged 18 years and older with a minimum survival of 6 months who underwent an LDLT between June 2000 and June 2017. The demographic data of the patients were evaluated in terms of late-term complications. Of the 240 patients who met the study criteria, 8 (3.3%) underwent LDLT for fulminant hepatitis. The indication for transplantation in patients with fulminant hepatitis was cryptogenic liver hepatitis in 4 patients, acute hepatitis B infection in 2 patients, hemochromatosis in 1 patient, and toxic hepatitis in 1 patient. Of the 240 patients, 65 (27%) undergoing LDLT underwent a liver biopsy for suspected rejection because of an elevation in liver function test results during follow-up. Histopathologic scoring was carried out according to the Banff scoring system. A diagnosis of late acute rejection was made in only 1 of the 8 patients (12.5%) who underwent LDLT for fulminant hepatitis. Patients with fulminant hepatitis must be prepared for an LDLT, if available, while waiting for a cadaveric donor. The results of the present study suggest that LDLTs in patients with fulminant hepatitis are safe, and the outcomes are acceptable in terms of survival and complications.

Sections du résumé

BACKGROUND BACKGROUND
The present study investigates the complications that may occur during long-term follow-up in patients aged 18 years and older undergoing living donor liver transplantation (LDLT) in our clinic because of fulminant hepatitis.
METHODS METHODS
The study included patients aged 18 years and older with a minimum survival of 6 months who underwent an LDLT between June 2000 and June 2017. The demographic data of the patients were evaluated in terms of late-term complications.
RESULTS RESULTS
Of the 240 patients who met the study criteria, 8 (3.3%) underwent LDLT for fulminant hepatitis. The indication for transplantation in patients with fulminant hepatitis was cryptogenic liver hepatitis in 4 patients, acute hepatitis B infection in 2 patients, hemochromatosis in 1 patient, and toxic hepatitis in 1 patient. Of the 240 patients, 65 (27%) undergoing LDLT underwent a liver biopsy for suspected rejection because of an elevation in liver function test results during follow-up. Histopathologic scoring was carried out according to the Banff scoring system. A diagnosis of late acute rejection was made in only 1 of the 8 patients (12.5%) who underwent LDLT for fulminant hepatitis.
CONCLUSION CONCLUSIONS
Patients with fulminant hepatitis must be prepared for an LDLT, if available, while waiting for a cadaveric donor. The results of the present study suggest that LDLTs in patients with fulminant hepatitis are safe, and the outcomes are acceptable in terms of survival and complications.

Identifiants

pubmed: 37137763
pii: S0041-1345(23)00168-9
doi: 10.1016/j.transproceed.2023.01.037
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1186-1192

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Auteurs

Mücahit Özbilgin (M)

Department of General Surgery, Dokuz Eylül University Hospital, Hepatobiliary Surgery and Liver Transplantation Unit, Izmir, Turkey. Electronic address: mucahitozbilgin@gmail.com.

Tufan Egeli (T)

Department of General Surgery, Dokuz Eylül University Hospital, Hepatobiliary Surgery and Liver Transplantation Unit, Izmir, Turkey.

Cihan Ağalar (C)

Department of General Surgery, Dokuz Eylül University Hospital, Hepatobiliary Surgery and Liver Transplantation Unit, Izmir, Turkey.

Sevda Özkardeşler (S)

Department of Anesthesiology and Reanimation, Dokuz Eylül University Hospital, Izmir, Turkey.

Vildan Avkan Oğuz (VA)

Department of Infectious Diseases, Dokuz Eylül University Hospital, Izmir, Turkey.

Mesut Akarsu (M)

Department of Gastroenterology, Dokuz Eylül University Hospital, Izmir, Turkey.

Özgül Sağol (Ö)

Department of Pathology, Dokuz Eylül University Hospital, Izmir, Turkey.

Tarkan Ünek (T)

Department of General Surgery, Dokuz Eylül University Hospital, Hepatobiliary Surgery and Liver Transplantation Unit, Izmir, Turkey.

Sedat Karademir (S)

Department of General Surgery, Güven Hospital, Ankara, Turkey.

Ibrahim Astarcıoğlu (I)

Department of General Surgery, Memorial Bahçelievler Hospital, Istanbul, Turkey.

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