The real incidence of biliary tract complications after adult liver transplantation: the role of the prospective routine use of cholangiography during post‐transplant follow‐up

2020 ◽  
Author(s):  
Julie Navez ◽  
Samuele Iesari ◽  
Dhoha Kourta ◽  
Kente Baami‐Mariza ◽  
Marwan Nadiri ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Biliary Tract ◽  
Adult Liver ◽  
The Real ◽  
Post Transplant

scholarly journals Chronic Rejection and Extrahepatic Biliary Tract Obstruction 8 Years After Orthotopic Liver Transplantation Using the Gallbladder-Conduit Technique

HPB Surgery ◽  
1991 ◽  
Vol 5 (1) ◽  
pp. 17-22 ◽  
Author(s):  
J. Lerut ◽  
A. Zimmermann ◽  
Ph. Gertsch ◽  
R. Preisig ◽  
L. H. Blumgart
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Biliary Tract ◽  
Significant Role ◽  
Allograft Rejection ◽  
Chronic Rejection ◽  
Biliary Obstruction ◽  
Chronic Allograft Rejection ◽  
Extrahepatic Biliary Obstruction

A case of delayed biliary obstruction and cholangitis, occurring in the setting of chronic allograft rejection, 8 years after liver transplantation using the gallbladder-conduit, is presented. Extrahepatic biliary obstruction may be seen in the late follow-up of liver grafting and rejection phenomena may play a significant role in the development of such obstruction.

Retrospective Comparison of Using or Not Using Donor Lymphocyte Transfusion in the Treatment of Hematological Relapse after Allogeneic Stem Cell Transplantation in 489 Adults with Acute Myeloid Leukemia.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 298-298
Author(s):  
Christoph Schmid ◽  
Myriam Labopin ◽  
Juergen Finke ◽  
Gerhard Ehninger ◽  
Olle Ringden ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
De Novo ◽  
Patient Age ◽  
Entire Cohort ◽  
Post Transplant ◽  
Patient Âgé ◽  
Retrospective Comparison ◽  
De Novo Aml

Abstract Relapsed AML after allogeneic SCT has a poor prognosis. So far, no standard therapy could be defined. Donor lymphocyte transfusion (DLT) has been effective in a minority, however, no data is available to identify patients who will benefit from the procedure. Neither, the outcome of patients treated with or without DLT have been compared. We retrospectively evaluated overall survival (OS) of 489 adults with de novo AML in hematological relapse after SCT, receiving DLT (n=190) or not (n=299). DLT and noDLTgroups were well balanced in terms of patient age (median:37y in both groups), donor age, cytogenetics (good:5vs7%, intermediate:83vs79%, poor:12%vs14%), WBC at diagnosis, donor type (geno-id:71vs72%, MUD:18% both, mismatched:11vs10%), status at transplantation (CR1:38vs41%, CR2:13vs15%, advanced:49vs44%), conditioning, source of stem cells, and time from transplant to relapse (5vs4.5 months). However, DLT patients had a median of 39% BM blasts, as compared to 54% for the noDLT group (p=0.03). Follow-up was 32 and 30 months. Within the DLT group, chemotherapy was additionally given in 130 cases. Nevertheless, only 33% of patients received DLT in CR or aplasia, 67% had measurable disease. AGvHD developed in 41% of patients following DLT. CR and PR were achieved in 31.1% and 4.8% of DLT patients. In a multivariate analysis, younger patient age (<36 years) (HR=1.53,p=0.02) and a longer interval (> 5 months) from transplant to relapse (HR=7.74,p=0.002) were associated with better OS after DLT. When comparing the outcome of patients receiving or not DLT, OS at 2 years was 10±1% for the entire cohort, 18±3% for DLT and 6±1% for noDLT (p<.0001). In a multivariate analysis, use of DLT (HR=2.11,p<0.0001); recipient’s age<36 y (HR=1.69, p<0.001); longer interval (>5 months) from transplant to relapse (HR=2.40, p<0.0001) and number of BM blasts (<48%) at relapse (HR=1.56,p=0.002) were favorable for OS. In this retrospective analysis the results suggest that DLT may be of advantage in the treatment of AML relapse post transplant, at least in younger patients with a longer post transplant remission and relapsing with smaller amounts of blasts in BM. However, patients receiving DLT might represent a positive selection among all relapsed cases, since a considerable number from the noDLT cohort had died too early to proceed to DLT. An intetion-to-treat analysis and further prospective studies should investigate the role of DLT and other approaches, such as second reduced intensity SCT.

De novo cancers and post-transplant lymphoproliferative disorder in adult liver transplantation

2006 ◽  
Vol 56 (11) ◽  
pp. 712-715 ◽  
Author(s):  
Paolo Aseni ◽  
Maurizio Vertemati ◽  
Luciano De Carlis ◽  
Cosimo Vincenzo Sansalone ◽  
Edgardo Bonacina ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Lymphoproliferative Disorder ◽  
De Novo ◽  
Adult Liver ◽  
Post Transplant

scholarly journals Autologous Stem Cell Transplantation for Primary Mediastinal B Cell Lymphoma in the Rituximab Era: A Retrospective Study By the EBMT Lymphoma Working Party

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1195-1195
Author(s):  
Irit Avivi ◽  
Ariane Boumendil ◽  
Hervé Hervé Finel ◽  
Arnon Nagler ◽  
Aïda Sousa Bothello ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Stem Cell ◽  
Retrospective Study ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Refractory Disease ◽  
Post Transplant ◽  
The Impact

Abstract Introduction: The addition of rituximab to induction therapy had improved the outcome of patients with primary mediastinal B cell lymphoma (PMBCL). For those patients who are primary refractory or relapse after having achieved a remission, high-dose therapy and autologous stem cell transplantation (ASCT) is considered as standard treatment. Only scanty information, however, is available regarding the role of ASCT in patients with relapsed / refractory PMBCL in the rituximab era. Moreover, the impact of pre- and post-transplant irradiation remains uncertain. The objective of the current study was to investigate the results of ASCT for PMBCL in the rituximab era, identify variables predictive for outcome, and assess the role of adjuvant radiotherapy. Patients and methods: For this retrospective study, all EBMT registered patients with PMBCL aged between 18 and 70 years who were treated with a first ASCT between 2000 and 2012 were eligible. Baseline patient, disease, and transplant data were collected from MED-A forms. Centers with potentially eligible patients were contacted to provide additional treatment and follow-up information including a written histopathology report. Statistical analysis used log rank test to assess the impact of baseline characteristics on survival endpoints. In multivariate analysis, the relevance of prognostic factors was estimated using Cox regression models. Curves of cumulative incidence of relapse (IR) were compared by Gray's test. Multivariate analysis of IR used Fine and Gray models. Results: 86 patients with confirmed PMBCL were eligible and had the full data set required for this analysis. 51% were female, median age was 34 years (range 20-69). Median time from diagnosis to ASCT was 12 months (12-299). 63.5% of the patients presented with a bulky mediastinal mass, larger than 10cm at diagnosis, 30.5% had stage IV disease, and 44% had B symptoms. 92% had received at least 2 lines of therapies, 85% had rituximab and 30% had received radiotherapy prior to transplantation. At ASCT, 11% still had a mass greater than 10 cm, and 19% a mass of 5-10cm. Remission status at ASCT was CR/PR1 in 21% of the patients, CR/PR>1 in 51%, and refractory disease in 28%. 31 patients (41%) received irradiation post-transplant. Thirteen patients of 24 patients (54%) transplanted in PR attained CR at day +100 post ASCT. With a median follow-up of 39 months (24-73), 3-year non-relapse mortality, IR, event-free survival (EFS) and overall survival (OS) for the whole series were 9%, 33%, 58% and 71%, respectively. By univariate analysis, refractory disease at ASCT and residual mass > 5cm at ASCT were significant adverse predictors for IR, EFS, and OS. 3-year EFS was 35% in refractory subjects vs 66% in chemosensitive patients (p=0.001), and 100% in those autografted in CR/PR1 vs 60% in those transplanted in more advanced response p=0.018. Notably, patients transplanted with refractory disease with a history of irradiation prior to ASCT had a superior outcome compared with non-irradiated refractory patients.Multivariate analysis suggested post-transplant irradiation to be associated with a significantly reduced IR (HR=0.24; p=0.028) and improved EFS (HR=0.24; p=0.018) and OS (HR=0.21; p=0.032). Discussion: In conclusion, this analysis gives first specific evidence that ASCT can provide durable remissions in patients with relapsed / refractory PMBCL in the rituximab era. Pre or post-transplant irradiation appears to be important, though deserves further studies. Disclosures No relevant conflicts of interest to declare.

Biliary tract complications in orthotopic adult liver transplantation

1989 ◽  
Vol 158 (1) ◽  
pp. 68-70 ◽  
Author(s):  
Barbara J. Wilson ◽  
J.Wallis Marsh ◽  
Leonard Makowka ◽  
Andrei C. Stieber ◽  
Babu Koneru ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Biliary Tract ◽  
Adult Liver

scholarly journals Diagnostic role of colour Doppler US at 1-year follow-up after orthotopic liver transplantation

2010 ◽  
Vol 115 (8) ◽  
pp. 1304-1313 ◽  
Author(s):  
C. Gazzera ◽  
G. Isolato ◽  
S. Stola ◽  
F. Avogliero ◽  
A. Ricchiuti ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Colour Doppler ◽  
Doppler Us ◽  
Diagnostic Role

scholarly journals POST-TRANSPLANT DIABETES MELLITUS INCIDENCE AND RISK FACTORS IN ADULT LIVER TRANSPLANTATION RECIPIENTS

2020 ◽  
Vol 104 (S3) ◽  
pp. S533-S533
Author(s):  
Nazli Gulsoy Kirnap ◽  
Pulat Sultanov ◽  
Omar AlShalabi ◽  
Mahir Kirnap ◽  
Neslihan Bascil Tutuncu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Liver Transplantation ◽  
Adult Liver ◽  
Post Transplant
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