1.Immunosuppression status of liver transplant recipients with hepatitis C affects biopsy-proven acute rejection.
Jong Man KIM ; Kwang Woong LEE ; Gi Won SONG ; Bo Hyun JUNG ; Hae Won LEE ; Nam Joon YI ; ChoonHyuck David KWON ; Shin HWANG ; Kyung Suk SUH ; Jae Won JOH ; Suk Koo LEE ; Sung Gyu LEE
Clinical and Molecular Hepatology 2016;22(3):366-371
BACKGROUND/AIMS: The relationship between patient survival and biopsy-proven acute rejection (BPAR) in liver transplant recipients with hepatitis C remains unclear. The aims of this study were to compare the characteristics of patients with and without BPAR and to identify risk factors for BPAR. METHODS: We retrospectively reviewed the records of 169 HCV-RNA-positive patients who underwent LT at three centers. RESULTS: BPAR occurred in 39 (23.1%) of the HCV-RNA-positive recipients after LT. The 1-, 3-, and 5-year survival rates were 92.1%, 90.3%, and 88.5%, respectively, in patients without BPAR, and 75.7%, 63.4%, and 58.9% in patients with BPAR (P<0.001). Multivariate analyses showed that BPAR was associated with the non-use of basiliximab and tacrolimus and the use of cyclosporin in LT recipients with HCV RNA-positive. CONCLUSION: The results of the present study suggest that the immunosuppression status of HCV-RNA-positive LT recipients should be carefully determined in order to prevent BPAR and to improve patient survival.
Antibodies, Monoclonal/therapeutic use
;
Biopsy
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Cyclosporine/therapeutic use
;
Drug Therapy, Combination
;
Genotype
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Graft Rejection/mortality/*prevention & control
;
Hepacivirus/genetics/isolation & purification
;
Hepatitis C/drug therapy/*virology
;
Humans
;
Immunosuppressive Agents/*therapeutic use
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*Liver Transplantation/adverse effects
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Polymerase Chain Reaction
;
RNA, Viral/blood
;
Recombinant Fusion Proteins/therapeutic use
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Recurrence
;
Retrospective Studies
;
Survival Rate
;
Tacrolimus/therapeutic use
2.Intraoperative abortion of adult living donor liver transplantation: 15 cases from 1,179 cases in 20 years of experience in a single center.
Jungchan PARK ; Gyu Seong CHOI ; Mi Sook GWAK ; Justin Sangwook KO ; Sangbin HAN ; Bobae HAN ; Jae Won JOH ; Sung Joo KIM ; Suk Koo LEE ; Choonhyuck David KWON ; Jongman KIM ; Chan Woo CHO ; Gaab Soo KIM
Annals of Surgical Treatment and Research 2018;95(4):213-221
PURPOSE: This study aimed to report intraoperative abortion of adult living donor liver transplantation (LDLT). METHODS: From June 1997 to December 2016, 1,179 adult LDLT cases were performed. 15 cases (1.3%) of intraoperative abortions in LDLT were described. RESULTS: Among 15 cases, 5 intraoperative abortions were donor-related, and remaining 10 cases were recipient-related. All donor-related abortions were due to unexpected steatohepatitis. Among remaining 10 recipient-related intraoperative abortions, unexpected extension of hepatocellular carcinoma was related in 5 cases. Two cases of intraoperative abortions were related to bowel inflammation, and 2 cases were associated with severe adhesion related to previous treatment. One recipient with severe pulmonary hypertension was also aborted. CONCLUSION: Complete prevention of aborted LDLT is still not feasible. In this regard, further efforts to minimize intraoperative abortion are required.
Adult*
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Carcinoma, Hepatocellular
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Fatty Liver
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Humans
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Hypertension, Pulmonary
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Inflammation
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Liver Transplantation*
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Liver*
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Living Donors*
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Postoperative Care