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Early living donor liver transplantation for alcohol-associated hepatitis.
Kulkarni, Anand V; Reddy, Raghuram; Arab, Juan Pablo; Sharma, Mithun; Shaik, Sameer; Iyengar, Sowmya; Kumar, Naveen; Gupta, Rajesh; Premkumar, Giri Vishwanathan; Menon, Balachandran Palat; Reddy, Duvvur Nageshwar; Rao, Padaki Nagaraja; Reddy, K Rajender.
Afiliação
  • Kulkarni AV; Department of Hepatology, AIG Hospitals, Hyderabad, India. Electronic address: dranand.v@aighospitals.com.
  • Reddy R; Department of Liver Transplantation, AIG Hospitals, Hyderabad, India. Electronic address: reddyr@pennmedicine.upenn.edu.
  • Arab JP; Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.
  • Sharma M; Department of Hepatology, AIG Hospitals, Hyderabad, India.
  • Shaik S; Department of Hepatology, AIG Hospitals, Hyderabad, India.
  • Iyengar S; Department of Hepatology, AIG Hospitals, Hyderabad, India.
  • Kumar N; Department of Psychiatry, AIG Hospitals, Hyderabad, India.
  • Sabreena; Department of Psychiatry, AIG Hospitals, Hyderabad, India.
  • Gupta R; Department of Hepatology, AIG Hospitals, Hyderabad, India.
  • Premkumar GV; Department of Liver Transplant Anesthesia, AIG Hospitals, Hyderabad, India.
  • Menon BP; Department of Liver Transplantation, AIG Hospitals, Hyderabad, India.
  • Reddy DN; Department of Hepatology, AIG Hospitals, Hyderabad, India.
  • Rao PN; Department of Hepatology, AIG Hospitals, Hyderabad, India.
  • Reddy KR; Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, USA. Electronic address: reddyr@pennmedicine.upenn.edu.
Ann Hepatol ; 28(4): 101098, 2023.
Article em En | MEDLINE | ID: mdl-37028597
INTRODUCTION AND OBJECTIVES: Lately, there has been a steady increase in early liver transplantation for alcohol-associated hepatitis (AAH). Although several studies have reported favorable outcomes with cadaveric early liver transplantation, the experiences with early living donor liver transplantation (eLDLT) are limited. The primary objective was to assess one-year survival in patients with AAH who underwent eLDLT. The secondary objectives were to describe the donor characteristics, assess the complications following eLDLT, and the rate of alcohol relapse. MATERIALS AND METHODS: This single-center retrospective study was conducted at AIG Hospitals, Hyderabad, India, between April 1, 2020, and December 31, 2021. RESULTS: Twenty-five patients underwent eLDLT. The mean time from abstinence to eLDLT was 92.4 ± 42.94 days. The mean model for end-stage liver disease and discriminant function score at eLDLT were 28.16 ± 2.89 and 104 ± 34.56, respectively. The mean graft-to-recipient weight ratio was 0.85 ± 0.12. Survival was 72% (95%CI, 50.61-88) after a median follow-up of 551 (23-932) days post-LT. Of the 18 women donors,11 were the wives of the recipient. Six of the nine infected recipients died: three of fungal sepsis, two of bacterial sepsis, and one of COVID-19. One patient developed hepatic artery thrombosis and died of early graft dysfunction. Twenty percent had alcohol relapse. CONCLUSIONS: eLDLT is a reasonable treatment option for patients with AAH, with a survival of 72% in our experience. Infections early on post-LT accounted for mortality, and thus a high index of suspicion of infections and vigorous surveillance, in a condition prone to infections, are needed to improve outcomes.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Fígado / Doença Hepática Terminal / COVID-19 / Hepatite Alcoólica Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Fígado / Doença Hepática Terminal / COVID-19 / Hepatite Alcoólica Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article