File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Conference Paper: Indications for liver transplantation in patients with chronic hepatitis B and C virus infection and hepatocellular carcinoma

TitleIndications for liver transplantation in patients with chronic hepatitis B and C virus infection and hepatocellular carcinoma
Authors
Issue Date2000
PublisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JGH
Citation
Journal Of Gastroenterology And Hepatology, 2000, v. 15 SUPPL. MAY, p. E181-E186 How to Cite?
AbstractPatients with chronic hepatitis B virus (HBV) infection were not accepted for liver transplantation in Asia in the past because the hepatitis B immune globulin (HBIG) used to prevent post-transplantation recurrence was very expensive and it was generally believed that Asians with hepatitis B fared worse than Caucasians after liver transplantation. The availability of lamivudine has altered the indication of liver transplantation for these patients. Twenty-five Chinese patients with chronic HBV infection were given lamivudine as primary prophylaxis against HBV re-infection before transplantation. Five patients died within 40 days of transplantation. After a median follow-up period of 14 months (range, 5-39), 17 patients had lost serum HBsAg from 4 days to 27 months post transplantation, but it reappeared in three patients 4-12 months later. Antibody to HBsAg was detected periodically in the serum of 11 patients who had lost HBsAg. At the last follow-up, six patients were HBsAg-positive and HBV DNA was detected in only one of them. The indication for liver transplantation for chronic hepatitis C virus (HCV) infection is not as strict as for patients with chronic HBV infection because the long-term survival is similar to that of non-hepatitis C patients, even though re-infection by HCV in the recipients is nearly universal. The main issue in the selection of patients with HCV for liver transplantation is therefore identification of criteria that can predict re- infection and development of cirrhosis. These include factors such as multiple episodes of rejection, use of OKT3, pre-transplant viral load and genotype, but reports are not consistent and so there are no well-defined selection criteria. The selection criteria for patients with hepatocellular carcinoma are now well defined. Many studies have confirmed that a tumour > 5 cm, and showing vascular invasion, and poor differentiation adversely affects survival. In practice, only patients with a turnout < 5 cm and Child's C cirrhosis are accepted for liver transplantation. Transarterial oily chemoembolization and intralesional alcohol injection are used to control or down-stage the tumour while patients wait for a cadaveric liver graft. (C) 2000 Blackwell Science Asia Pty Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/84279
ISSN
2015 Impact Factor: 3.322
2015 SCImago Journal Rankings: 1.190
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorFan, STen_HK
dc.contributor.authorCheung, STen_HK
dc.contributor.authorLo, CMen_HK
dc.date.accessioned2010-09-06T08:51:04Z-
dc.date.available2010-09-06T08:51:04Z-
dc.date.issued2000en_HK
dc.identifier.citationJournal Of Gastroenterology And Hepatology, 2000, v. 15 SUPPL. MAY, p. E181-E186en_HK
dc.identifier.issn0815-9319en_HK
dc.identifier.urihttp://hdl.handle.net/10722/84279-
dc.description.abstractPatients with chronic hepatitis B virus (HBV) infection were not accepted for liver transplantation in Asia in the past because the hepatitis B immune globulin (HBIG) used to prevent post-transplantation recurrence was very expensive and it was generally believed that Asians with hepatitis B fared worse than Caucasians after liver transplantation. The availability of lamivudine has altered the indication of liver transplantation for these patients. Twenty-five Chinese patients with chronic HBV infection were given lamivudine as primary prophylaxis against HBV re-infection before transplantation. Five patients died within 40 days of transplantation. After a median follow-up period of 14 months (range, 5-39), 17 patients had lost serum HBsAg from 4 days to 27 months post transplantation, but it reappeared in three patients 4-12 months later. Antibody to HBsAg was detected periodically in the serum of 11 patients who had lost HBsAg. At the last follow-up, six patients were HBsAg-positive and HBV DNA was detected in only one of them. The indication for liver transplantation for chronic hepatitis C virus (HCV) infection is not as strict as for patients with chronic HBV infection because the long-term survival is similar to that of non-hepatitis C patients, even though re-infection by HCV in the recipients is nearly universal. The main issue in the selection of patients with HCV for liver transplantation is therefore identification of criteria that can predict re- infection and development of cirrhosis. These include factors such as multiple episodes of rejection, use of OKT3, pre-transplant viral load and genotype, but reports are not consistent and so there are no well-defined selection criteria. The selection criteria for patients with hepatocellular carcinoma are now well defined. Many studies have confirmed that a tumour > 5 cm, and showing vascular invasion, and poor differentiation adversely affects survival. In practice, only patients with a turnout < 5 cm and Child's C cirrhosis are accepted for liver transplantation. Transarterial oily chemoembolization and intralesional alcohol injection are used to control or down-stage the tumour while patients wait for a cadaveric liver graft. (C) 2000 Blackwell Science Asia Pty Ltd.en_HK
dc.languageengen_HK
dc.publisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JGHen_HK
dc.relation.ispartofJournal of Gastroenterology and Hepatologyen_HK
dc.titleIndications for liver transplantation in patients with chronic hepatitis B and C virus infection and hepatocellular carcinomaen_HK
dc.typeConference_Paperen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0815-9319&volume=15 &issue=Suppl&spage=E181&epage=186&date=2000&atitle=Indications+for+liver+transplantation+in+patients+with+chronic+hepatitis+B+and+C+virus+infection+and+hepatocellular+carcinomaen_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailCheung, ST: stcheung@hkucc.hku.hken_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityCheung, ST=rp00457en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1046/j.1440-1746.2000.02119.xen_HK
dc.identifier.pmid10921405en_HK
dc.identifier.scopuseid_2-s2.0-0033946748en_HK
dc.identifier.hkuros51634en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0033946748&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume15en_HK
dc.identifier.issueSUPPL. MAYen_HK
dc.identifier.spageE181en_HK
dc.identifier.epageE186en_HK
dc.identifier.isiWOS:000088361800034-
dc.publisher.placeAustraliaen_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridCheung, ST=7202473497en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats