Medical problems occurring after orthotopic liver transplantation

被引:27
作者
Carson, KL [1 ]
Hunt, CM [1 ]
机构
[1] DUKE UNIV,MED CTR,DEPT MED,DURHAM,NC 27710
关键词
orthotopic liver transplantation; immunosuppression posttransplantation lymphoproliferative disease; viral hepatitis;
D O I
10.1023/A:1018853213442
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Liver transplantation is complicated by specific medical problems. Diabetes mellitus occurs in 4-20% of patients undergoing liver transplantation. Patients with primary sclerosing cholangitis and ulcerative colitis experience up to a 13% incidence of colon cancer after transplantation. Lymphomas occur in 1-3% of patients after transplantation and account for 57% of malignancies occurring in adult patients. Atraumatic bone fractures occur in 22-38% of patients and neurological complications, including seizures, headache, and neuropathy occur in 19-47% of patients following liver transplantation. Patients undergoing liver transplantation may experience recurrence of their primary liver disease: hepatitis B, hepatitis C, primary biliary cirrhosis, autoimmune hepatitis, or primary sclerosing cholangitis. In patients not receiving immunoprophylaxis after transplantation for chronic hepatitis B, recurrent hepatitis B is seen in up to 90% of patients. This can be markedly reduced with hyperimmune globulin immunoprophylaxis. Recurrent hepatitis C is seen in the majority of patients; current treatment modalities are inadequate. Recurrence of primary biliary cirrhosis or primary sclerosing cholangitis in the allograft is infrequent. Autoimmune hepatitis may recur in up to 26% of patients following liver transplantation. Primary disease recurrence in the allograft and preventive strategies are discussed.
引用
收藏
页码:1666 / 1674
页数:9
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