scholarly journals Orthotopic Liver Transplantation in Human-Immunodeficiency-Virus-Positive Patients in Germany

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
E. Anadol ◽  
S. Beckebaum ◽  
K. Radecke ◽  
A. Paul ◽  
A. Zoufaly ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Viral Infections ◽  
Survival Rates ◽  
Hiv Positive ◽  
Post Transplantation ◽  
Immunodeficiency Virus ◽  
Chiari Syndrome ◽  
Hcv Coinfection ◽  
End Stage

Objectives. This summary evaluates the outcomes of orthotopic liver transplantation (OLT) of HIV-positive patients in Germany.Methods. Retrospective chart analysis of HIV-positive patients, who had been liver-transplanted in Germany between July 1997 and July 2011.Results. 38 transplantations were performed in 32 patients at 9 German transplant centres. The reasons for OLT were end-stage liver disease (ESLD) and/or liver failure due to hepatitis C (HCV) (), hepatitis B (HBV) (), multiple viral infections of the liver () and Budd-Chiari-Syndrome. In July 2011 19/32 (60%) of the transplanted patients were still alive with a median survival of 61 months (IQR (interquartile range): 41–86 months). 6 patients had died in the early post-transplantation period from septicaemia (), primary graft dysfunction (), and intrathoracal hemorrhage (). Later on 7 patients had died from septicaemia (), delayed graft failure (), recurrent HCC (), and renal failure (). Recurrent HBV infection was efficiently prevented in 11/12 patients; HCV reinfection occurred in all patients and contributed considerably to the overall mortality.Conclusions. Overall OLT is a feasible approach in HIV-infected patients with acceptable survival rates in Germany. Reinfection with HCV still remains a major clinical challenge in HIV/HCV coinfection after OLT.

scholarly journals Liver transplantation in HIV-positive patients: the position of the Brazilian groups

2005 ◽  
Vol 42 (3) ◽  
pp. 161-166 ◽  
Author(s):  
Ajacio Bandeira de Mello Brandão ◽  
Guilherme Mariante-Neto
Keyword(s):  
Liver Transplantation ◽  
Waiting Lists ◽  
Hiv Positive ◽  
Inclusion Criteria ◽  
Hiv Viral Load ◽  
Immunodeficiency Virus ◽  
End Stage ◽  
E Mail ◽  
Structured Questionnaire ◽  
Asymptomatic Hiv

BACKGROUND: Patients infected with the human immunodeficiency virus (HIV) have generally been excluded from consideration for liver transplantation. Recent advances in the management and prognosis of these patients suggest that this policy must be reevaluated. AIM: To identify the current position of Brazilian transplant centers concerning liver transplantation in asymptomatic HIV-infected patients with end-stage liver disease. METHODS: A structured questionnaire was submitted by e-mail to Brazilian groups who perform liver transplantation and were active in late 2003, according to the Brazilian Association of Organ Transplantation. RESULTS: Of the 53 active groups, 30 e-mail addresses have been found of professionals working in 41 of these groups. Twenty-one responses (70%) were obtained. Most of the professionals (62%) reported that they do not include HIV-infected patients in waiting lists for transplants, primarily on account of the limited world experience. They also reported, however, that this issue will soon be discussed by the group. Those who accept these patients usually follow the guidelines provided by the literature: patients must fulfill the same inclusion criteria as the other patients with end-stage liver diseases, present low or undetectable HIV viral load, and a CD4 count above 250/mm³. They reported that there are 10 HIV-infected patients in waiting list and that only one patient has received a liver transplant in the country. CONCLUSION: Most centers do not accept in waiting lists for liver transplantation patients with HIV infection, even asymptomatic ones. However, advances in the management of HIV-infected patients suggest that this policy must be reevaluated. In Brazil, there is practically no experience in liver transplantation in HIV-positive patients.

Clinical Outcome of Orthotopic Liver Transplantation

2002 ◽  
Vol 25 (10) ◽  
pp. 935-938 ◽  
Author(s):  
G.A. Berlakovich
Keyword(s):  
Liver Transplantation ◽  
Clinical Outcome ◽  
Orthotopic Liver Transplantation ◽  
Hepatic Failure ◽  
Patient Survival ◽  
Standard Procedure ◽  
Survival Rates ◽  
Acute Hepatic Failure ◽  
Term Survival ◽  
End Stage

Orthotopic liver transplantation (OLT) has become a standard procedure for end-stage cirrhosis. The purpose of this anlysis is to give a brief overview on the clinical outcome of OLT. According to a current survey of primary indications for liver transplantation in Europe, virus-induced cirrhosis represents the largest proportion with 25%. The next frequent indication is alcoholic cirrhosis with 19%. Cholestatic diseases amount to 13%, malignancy in cirrhosis 10%, and acute hepatic failure 10%. The outcome of these main indications will be discussed and critical considerations pointed out. Patient survival rates demonstrate for cirrhosis at 1-and 5-year about 80% and 70%, respectively. In acute hepatic failure, more patients are lost in the perioperative period. Not surprisingly, patients transplanted for malignancy show decreased long-term survival. Considering an average of 5-year survival in patients with end-stage liver disease of 20% or less, excellent patient survival can be achieved by liver transplantation.

Hematologic Recovery After Liver Transplantation

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1734-1734
Author(s):  
Christopher Seidler ◽  
Adel Bozorgzadeh ◽  
Cheryl Ferrante-Hersperger ◽  
Zeina Al-Mansour ◽  
Mridula George ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Orthotopic Liver Transplantation ◽  
Conflicts Of Interest ◽  
Test Method ◽  
Post Transplantation ◽  
Advanced Liver Disease ◽  
End Stage Liver Disease ◽  
Co Morbidity ◽  
End Stage

Abstract Introduction Chronic liver disease is a national problem with over 3 million American suffering from end stage liver disease. The majority of patients with advanced liver disease have pancytopenia due to multiple factors. Hematology consults generated by the hematologic effects of end stage liver disease comprise 10-20% of consults. The majority of patients undergoing orthotopic liver transplantation achieve some degree of partial or complete hematologic recovery. Methods 196 sequential records for patients undergoing orthotopic liver transplantation were analyzed. Complete data was available for 92 patients. Hematologic parameters were reviewed 1 month prior to transplantation, 1 month post, 1 year and 2 year post transplantation. A statistical analysis was performed using the two tailed t-test method. Results Rapid and sustained hematologic recovery occurred in the majority of patients and was significant except for WBC at 24 months. Conclusions Orthotopic liver transplantation results in rapid sustained hematologic response in the majority of patients. Rapid recovery of platelet counts was most significant and does not reflect Ssplenectomy. Co-morbidity and anti-rejection drugs also may lead to delayed marrow suppression. Further sub-set analysis and measure of additional factors will also be presented. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Orthotopic liver transplantation in human immunodeficiency virus (HIV)-positive patients: Outcome of 7 patients from the Bonn cohort

2005 ◽  
Vol 11 (12) ◽  
pp. 1515-1521 ◽  
Author(s):  
Martin Vogel ◽  
Esther Voigt ◽  
Nico Schäfer ◽  
Georg Goldmann ◽  
Nicolas Schwarz ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Hiv Positive ◽  
Immunodeficiency Virus

scholarly journals Liver Transplantation: Past Accomplishments and Future Challenges

1999 ◽  
Vol 13 (3) ◽  
pp. 257-263 ◽  
Author(s):  
William J Wall
Keyword(s):  
Liver Transplantation ◽  
Survival Rates ◽  
Alcoholic Cirrhosis ◽  
Liver Transplants ◽  
Recidivism Rates ◽  
Societal Challenges ◽  
Therapeutic Value ◽  
Future Challenges ◽  
Will Force ◽  
End Stage

Liver transplantation has evolved from a rare and risky operation of questionable therapeutic value to the preferred treatment for an extensive list of end-stage liver diseases. Superior immunosuppression (cyclosporine), and improvements in surgery and anesthesia brought liver grafting to its current level of success. Nearly 60,000 liver transplants have been performed, and survival rates are very good; however liver grafting faces serious immediate and long term challenges, mainly due to the widening gap between donor supply and recipient demand. Increasing numbers of sick candidates, recurrent disease (especially hepatitis C) and recidivism rates after transplantation for alcoholic cirrhosis will force increasingly difficult decisions on candidate selection and priority listing of potential recipients. Although xenotransplantation may be the ultimate solution, it has its own specific set of biological and societal challenges - the full extent of which should be revealed in the next several years.

Sign in / Sign up

Export Citation Format

Share Document