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Treatment of hepati...
Treatment of hepatic venoocclusive disease with recombinant human tissue plasminogen activator or orthotopic liver transplantation after allogeneic bone marrow transplantation
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- Hägglund, H (författare)
- Karolinska Institutet
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- Ringdén, O (författare)
- Karolinska Institutet
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- Ericzon, B G (författare)
- Karolinska Institutet
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- Duraj, Frans (författare)
- Department of Transplantation Surgery, Huddinge Hospital, Karolinska Institute, Stockholm, Sweden
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- Ljungman, P (författare)
- Karolinska Institutet
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Lönnqvist, B (författare)
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- Winiarski, J (författare)
- Karolinska Institutet
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- Tydén, G (författare)
- Karolinska Institutet
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(creator_code:org_t)
- Ovid Technologies (Wolters Kluwer Health), 1996
- 1996
- Engelska.
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Ingår i: Transplantation. - : Ovid Technologies (Wolters Kluwer Health). - 0041-1337 .- 1534-6080. ; 62:8, s. 1076-1080
- Relaterad länk:
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https://urn.kb.se/re...
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http://kipublication...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Ten allogeneic bone marrow transplant (BMT) recipients with hepatic venoocclusive disease (VOD) were treated with recombinant human tissue plasminogen activator (rt-PA). Two of them subsequently underwent orthotopic liver transplantation (OLT). One additional patient with VOD underwent OLT without prior rt-PA treatment. Treatment with rt-PA was started a median of 14 (1--35) days after BMT. The dose of rt-PA given to adults was 10-50 mg i.v. and that given to children was 3-10 mg i.v. Treatment was given for 2-4 days. In three patients, the dose was administered over a longer period or it was repeated. Four patients responded to rt-PA therapy and six did not. Eight patients suffered from hemorrhages, one intracranial and three gastrointestinal. Four patients required blood transfusions. Four had minor subcutaneous hemorrhages and/or epistaxis. One patient died of intracranial hemorrhage and five from hepatic and/or multiorgan failure. Two patients treated with rt-PA, 10 mg/day for 4 days, are alive; one is alive and well 3 months after BMT, the other has relapsed after 7 months. The three patients undergoing OLT died of chronic hepatic failure, cerebral edema, and pneumonia. Our experience suggests that rt-PA should not be administered in high doses and that the treatment should not be given over a longer period, because of the risk of severe hemorrhages.
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- art (ämneskategori)
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