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Article: Role of liver biopsy in the management of liver dysfunction after hematopoietic stem-cell transplantation in a hepatitis B virus-prevalent patient population

TitleRole of liver biopsy in the management of liver dysfunction after hematopoietic stem-cell transplantation in a hepatitis B virus-prevalent patient population
Authors
Issue Date2003
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.transplantjournal.com
Citation
Transplantation, 2003, v. 76 n. 1, p. 169-176 How to Cite?
AbstractBackground. Derangement of liver function tests (LFT) is common after hematopoietic stem-cell transplantation (HSCT). The role of liver biopsy in such cases has not been defined in hepatitis B virus (HBV)-prevalent patients. The impact of liver biopsy in the management of LFT derangement after HSCT in an HBV-prevalent population was examined. Methods. Seventy-five liver biopsies, performed for 323 patients with LFT derangement post-HSCT (263 allogeneic, 60 autologous), were analyzed. The HBV carrier rate was 13.6%. Results. Significantly more LFT derangements and therefore liver biopsies occurred in allogeneic versus autologous HSCT. Before biopsy, graft-versus-host disease (GVHD) and HBV reactivation were clinically diagnosed in 70.6% and 25.3% of cases, respectively. A definite histopathologic diagnosis was obtained after biopsy in 53 cases, with GVHD, HBV hepatitis, and concomitant GVHD-HBV hepatitis found in 33%, 21%, and 8% of cases, respectively. The clinical and histopathologic diagnoses were concordant in 43 cases and discordant in 9 cases. Clinical management was altered in six of nine discordant cases, five of which were caused by HBV or hepatitis C virus (HCV) reactivation. Twenty-two biopsy specimens showed nondiagnostic histopathologic features. Twenty of these cases were successfully managed on the basis of clin ical diagnoses. The clinical-biochemical features of patients clinically diagnosed to have GVHD did not differ significantly whether or not they were HBV-HCV carriers. However, liver biopsies in HBV-HCV carriers resulted in significantly more treatment alterations as compared with noncarriers. Conclusions. Clinical diagnoses of LFT derangements post-HSCT might be adequate for initiation of treatment, but liver biopsies in HBV-HCV carriers were needed, as this might impact on management.
Persistent Identifierhttp://hdl.handle.net/10722/76289
ISSN
2015 Impact Factor: 3.69
2015 SCImago Journal Rankings: 1.699
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorMa, SYen_HK
dc.contributor.authorAu, WYen_HK
dc.contributor.authorNg, IOLen_HK
dc.contributor.authorLie, AKWen_HK
dc.contributor.authorLeung, AYHen_HK
dc.contributor.authorLiang, RHSen_HK
dc.contributor.authorLau, GKKen_HK
dc.contributor.authorKwong, YLen_HK
dc.date.accessioned2010-09-06T07:19:39Z-
dc.date.available2010-09-06T07:19:39Z-
dc.date.issued2003en_HK
dc.identifier.citationTransplantation, 2003, v. 76 n. 1, p. 169-176en_HK
dc.identifier.issn0041-1337en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76289-
dc.description.abstractBackground. Derangement of liver function tests (LFT) is common after hematopoietic stem-cell transplantation (HSCT). The role of liver biopsy in such cases has not been defined in hepatitis B virus (HBV)-prevalent patients. The impact of liver biopsy in the management of LFT derangement after HSCT in an HBV-prevalent population was examined. Methods. Seventy-five liver biopsies, performed for 323 patients with LFT derangement post-HSCT (263 allogeneic, 60 autologous), were analyzed. The HBV carrier rate was 13.6%. Results. Significantly more LFT derangements and therefore liver biopsies occurred in allogeneic versus autologous HSCT. Before biopsy, graft-versus-host disease (GVHD) and HBV reactivation were clinically diagnosed in 70.6% and 25.3% of cases, respectively. A definite histopathologic diagnosis was obtained after biopsy in 53 cases, with GVHD, HBV hepatitis, and concomitant GVHD-HBV hepatitis found in 33%, 21%, and 8% of cases, respectively. The clinical and histopathologic diagnoses were concordant in 43 cases and discordant in 9 cases. Clinical management was altered in six of nine discordant cases, five of which were caused by HBV or hepatitis C virus (HCV) reactivation. Twenty-two biopsy specimens showed nondiagnostic histopathologic features. Twenty of these cases were successfully managed on the basis of clin ical diagnoses. The clinical-biochemical features of patients clinically diagnosed to have GVHD did not differ significantly whether or not they were HBV-HCV carriers. However, liver biopsies in HBV-HCV carriers resulted in significantly more treatment alterations as compared with noncarriers. Conclusions. Clinical diagnoses of LFT derangements post-HSCT might be adequate for initiation of treatment, but liver biopsies in HBV-HCV carriers were needed, as this might impact on management.en_HK
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.transplantjournal.comen_HK
dc.relation.ispartofTransplantationen_HK
dc.rightsTransplantation. Copyright © Lippincott Williams & Wilkins.en_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshBiopsyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshGraft vs Host Disease - epidemiologyen_HK
dc.subject.meshHepatitis B - epidemiologyen_HK
dc.subject.meshHepatitis B Surface Antigens - blooden_HK
dc.subject.meshHong Kong - epidemiologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshImmunosuppressive Agents - therapeutic useen_HK
dc.subject.meshLeukemia - therapyen_HK
dc.subject.meshLiver - pathologyen_HK
dc.subject.meshLiver Diseases - etiology - pathologyen_HK
dc.subject.meshLymphoma - therapyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMultiple Myeloma - therapyen_HK
dc.subject.meshPlatelet Counten_HK
dc.subject.meshPrevalenceen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshStem Cell Transplantation - adverse effectsen_HK
dc.titleRole of liver biopsy in the management of liver dysfunction after hematopoietic stem-cell transplantation in a hepatitis B virus-prevalent patient populationen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0041-1337&volume=7691)&spage=169&epage=176&date=2003&atitle=Role+of+liver+biopsy+in+the+management+of+liver+dysfunction+after+hematopoietic+stem-cell+transplantation+in+a+hepatitis+B+virus-prevalent+patient+populationen_HK
dc.identifier.emailNg, IOL:iolng@hkucc.hku.hken_HK
dc.identifier.emailLeung, AYH:ayhleung@hku.hken_HK
dc.identifier.emailLiang, RHS:rliang@hku.hken_HK
dc.identifier.emailKwong, YL:ylkwong@hku.hken_HK
dc.identifier.authorityNg, IOL=rp00335en_HK
dc.identifier.authorityLeung, AYH=rp00265en_HK
dc.identifier.authorityLiang, RHS=rp00345en_HK
dc.identifier.authorityKwong, YL=rp00358en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/01.TP.0000072809.22740.A8en_HK
dc.identifier.pmid12865805-
dc.identifier.scopuseid_2-s2.0-0038638389en_HK
dc.identifier.hkuros83518en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0038638389&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume76en_HK
dc.identifier.issue1en_HK
dc.identifier.spage169en_HK
dc.identifier.epage176en_HK
dc.identifier.isiWOS:000184261000029-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridMa, SY=7403725725en_HK
dc.identifier.scopusauthoridAu, WY=7202383089en_HK
dc.identifier.scopusauthoridNg, IOL=7102753722en_HK
dc.identifier.scopusauthoridLie, AKW=24284842400en_HK
dc.identifier.scopusauthoridLeung, AYH=7403012668en_HK
dc.identifier.scopusauthoridLiang, RHS=26643224900en_HK
dc.identifier.scopusauthoridLau, GKK=7102301257en_HK
dc.identifier.scopusauthoridKwong, YL=7102818954en_HK

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