ORIGINAL DISEASE RECURRENCE AFTER ADULT TO ADULT LIVING DONOR LIVER TRANSPLANTATION (A-ALDLT), SINGLE CENTER EXPERIENCE | ||
| The Egyptian Journal of Surgery | ||
| Volume 33, Issue 1, January 2014, Pages 19-31 PDF (810.08 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2014.366637 | ||
| Authors | ||
| Emad Hamdy Gad; Maher Osman; Ibrahim Abdelkader Salama; Hesham Abdeldayem; Khaled Abou El-Ella; Tarek Ibrahim; Amr Helmy | ||
| Hepatobiliary Surgery Department, National Liver Institute, Menoufiya University, Egypt | ||
| Abstract | ||
| Background and Aim: The recurrence of the original disease affects liver transplantation (LT) outcome. Recurrence of viral and non-viral liver disease results in graft failure. This study aimed to analyze the factors responsible for disease recurrence after A-A LDLT and the effect of disease recurrence and its management on the outcome of LT. Subjects and Methods: After exclusion of 6 months mortality and pediatrics, thirty one alive transplanted patients were enrolled in the analysis in the follow up duration from 6 months to 60 months post transplantation. Univariate analysis and then multivariate analysis were done to detect the relationship between (demographic, preoperative, intraoperative and postoperative data) and overall recurrence and between recurrence variables and total survival in the follow up period. Results: Sixty nine patients underwent LDLT in our institute from April 2003 until the end of December 2009. The present retrospective study included 31 patients in the follow up duration and the incidence of recurrence was 15/31(48.4%) of patients (10 hepatitis C virus (HCV), 3 hepatocellular carcinoma (HCC) and 2 primary sclerosing cholangitis (PSC)). On univariate analysis, there was no statistically significant predictors of recurrence regarding (demographic, Preoperative, intraoperative and postoperative data). The overall 1-, 3- and 5- year survivals of patients were 90.3%, 87.1% and 83.9% respectively, while the overall 1-, 3- and 5- year survivals of patients with and without recurrence were 86.7%, 80% and 73.3% and 93.8%, 93.8% and 93.8% respectively. Conclusion: Recurrence of primary disease after LDLT is confirmed in our study with the highest incidence in HCV patients. On the other hand HCV recurrence was higher in the following patients (Cytomegalovirus (CMV) infections and with acute rejection). While HCC recurrence was higher in the following patients (Beyond Milan, with Alfa feto protein (AFP) >200 and patients with moderate tumor differentiation). Recurrence of primary disease after liver transplantation decreases post transplantation Survival. However its effective management improves survival. | ||
| Keywords | ||
| Living donor liver transplantation; Hepatitis C virus recurrence; HCC recurrence | ||
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