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- Okamoto, Sadahisa, et al.
(författare)
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Prognostic value of pre-transplant cardiomyopathy in Swedish liver transplanted patients for familial amyloidotic polyneuropathy
- 2011
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Ingår i: Amyloid : the international journal of experimental and clinical investigation : the official journal of the International Society of Amyloidosis. - Pearl River : Parthenon. - 1744-2818. ; 18 Suppl 1, s. 166-8
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Tidskriftsartikel (refereegranskat)abstract
- Liver transplantation (LTx) for familial amyloidotic polyneuropathy (FAP) is a recognized treatment for halting disease progression. Since cardiac complications are the main cause of postoperative death in FAP patients, we studied the potential relationship between pre-LTx amyloid heart disease and post-LTx mortality. Seventy-five Swedish patients who underwent LTx (72 Val30Met and 3 non-Val30Met patients) were available for the study. An intra-ventricular septal (IVS) thickness more than 15 mm at the pre-LTx evaluation was defined as cardiomyopathy. Nine patients out of 75 patients died, all were males and all belonged to the late onset group (age at onset ≥50 years). Four had cardiomyopathy at the pre-LTx evaluation. Survival rate was significantly higher in patients without cardiomyopathy at LTx compared to those with cardiomyopathy. Our results suggest that cardiomyopathy at LTx has an impact on the outcome of LTx for FAP.Read More: http://informahealthcare.com/doi/full/10.3109/13506129.2011.574354064
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- Schramm, Christoph, et al.
(författare)
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Primary liver transplantation for autoimmune hepatitis: a comparative analysis of the European Liver Transplant Registry.
- 2010
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Ingår i: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. - : Ovid Technologies (Wolters Kluwer Health). - 1527-6473. ; 16:4, s. 461-9
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Tidskriftsartikel (refereegranskat)abstract
- The principal aim of this study was to compare the probability of and potential risk factors for death and graft loss after primary adult and pediatric liver transplantation in patients undergoing transplantation for autoimmune hepatitis (AIH) to those in patients undergoing transplantation for primary biliary cirrhosis (PBC; used as the reference group) or alcoholic cirrhosis (used as an example of a nonautoimmune liver disease). The 5-year survival of patients undergoing transplantation for AIH (n = 827) was 0.73 [95% confidence interval (CI) = 0.67-0.77]. This was similar to that of patients undergoing transplantation for alcoholic cirrhosis (0.74, 95% CI = 0.72-0.76, n = 6424) but significantly worse than that of patients undergoing transplantation for PBC (0.83, 95% CI = 0.80-0.85, n = 1588). Fatal infectious complications occurred at an increased rate in patients with AIH (hazard ratio = 1.8, P = 0.002 with PBC as the reference). The outcome of pediatric AIH patients was similar to that of adult patients undergoing transplantation up to the age of 50 years. However, the survival of AIH patients undergoing transplantation beyond the age of 50 years (0.61 at 5 years, 95% CI = 0.51-0.70) was significantly reduced in comparison with the survival of young adult AIH patients (0.78 at 18-34 years, 95% CI = 0.70-0.86) and in comparison with the survival of patients of the same age group with PBC or alcoholic cirrhosis. In conclusion, age significantly affects patient survival after liver transplantation for AIH. The increased risk of dying of infectious complications in the early postoperative period, especially above the age of 50 years, should be acknowledged in the management of AIH patients with advanced-stage liver disease who are listed for liver transplantation. It should be noted that not all risk factors relevant to patient and graft survival could be analyzed with the European Liver Transplant Registry database.
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