Living Donor Liver Transplantations in HIV- and Hepatitis C Virus-Coinfected Hemophiliacs: Experience in a Single Center.

[Guest guest]

Transplantation. 2011 Jun 15;91(11):1261-1264.

Living Donor Liver Transplantations in HIV- and Hepatitis C Virus-Coinfected

Hemophiliacs: Experience in a Single Center.

Tsukada K, Sugawara Y, Kaneko J, Tamura S, Tachikawa N, Morisawa Y, Okugawa S,

Kikuchi Y, Oka S, Kimura S, Yatomi Y, Makuuchi M, Kokudo N, Koike K.

Source

1Department of Infectious Diseases, Graduate School of Medicine, the University

of Tokyo, Bunkyo-Ku, Tokyo. 2AIDS Clinical Center, National Center for Global

Health and Medicine, Shinjuku-ku, Tokyo, Japan. 3Division of Artificial Organ

and Transplantation, Department of Surgery, the University of Tokyo, Bunkyo-Ku,

Tokyo. 4Yokohama Municipal Citizens Hospital, Yokohama, Japan. 5Department of

Infection Control, Jichi Medical School, Tochigi-ken, Japan. 6Tokyo Teishin

Hopital, Chiyoda-ku, Tokyo, Japan. 7Department of Clinical Laboratory Medicine,

the University of Tokyo, Bunkyo-Ku, Tokyo. 8Japanese Red Cross Hospital,

Shibuya-Ku, Tokyo, Japan. 9Department of Gastroenterology, Graduate School of

Medicine, the University of Tokyo, Bunkyo-Ku, Tokyo.

Abstract

BACKGROUND.: Although almost all human immunodeficiency virus (HIV)-infected

Japanese hemophiliacs are coinfected with hepatitis C virus (HCV), the outcome

of living donor liver transplantation (LDLT) in such patients in terms of

survival rate, perioperative complications, and recovery of coagulation activity

is poorly understood. PATIENTS AND METHODS.: Six HIV-positive hemophiliacs

underwent LDLT for HCV-associated advanced cirrhosis. The mean CD4 T-cell count

at transplantation was 376±227/ìL. RESULTS.: The 1-, 3-, and 5-year survival

rates were 66%, 66%, and 50%, respectively. Fatal perioperative bleeding related

to hemophilia was not observed. Two patients died within 6 months after

transplantation due to graft failure. HIV infection was well controlled in all

patients who survived longer than 6 months. Two patients (genotype 2a and 2+3a)

achieved a sustained viral response and both of them were alive at the end of

follow-up period, whereas one patient (genotype 1a+1b) died of decompensated

cirrhosis 4 years after transplantation due to recurrent HCV infection.

CONCLUSIONS.: HIV/HCV-coinfected hemophiliacs can safely undergo LDLT.

Hemophilia was clinically cured after successful transplantation. A good outcome

can be expected as long as postoperative hepatitis C is controlled with

interferon/ribavirin combination therapy.

PMID: 21593704 [PubMed - as supplied by publisher]

[Guest guest]

Transplantation. 2011 Jun 15;91(11):1261-1264.

Living Donor Liver Transplantations in HIV- and Hepatitis C Virus-Coinfected

Hemophiliacs: Experience in a Single Center.

Tsukada K, Sugawara Y, Kaneko J, Tamura S, Tachikawa N, Morisawa Y, Okugawa S,

Kikuchi Y, Oka S, Kimura S, Yatomi Y, Makuuchi M, Kokudo N, Koike K.

Source

1Department of Infectious Diseases, Graduate School of Medicine, the University

of Tokyo, Bunkyo-Ku, Tokyo. 2AIDS Clinical Center, National Center for Global

Health and Medicine, Shinjuku-ku, Tokyo, Japan. 3Division of Artificial Organ

and Transplantation, Department of Surgery, the University of Tokyo, Bunkyo-Ku,

Tokyo. 4Yokohama Municipal Citizens Hospital, Yokohama, Japan. 5Department of

Infection Control, Jichi Medical School, Tochigi-ken, Japan. 6Tokyo Teishin

Hopital, Chiyoda-ku, Tokyo, Japan. 7Department of Clinical Laboratory Medicine,

the University of Tokyo, Bunkyo-Ku, Tokyo. 8Japanese Red Cross Hospital,

Shibuya-Ku, Tokyo, Japan. 9Department of Gastroenterology, Graduate School of

Medicine, the University of Tokyo, Bunkyo-Ku, Tokyo.

Abstract

BACKGROUND.: Although almost all human immunodeficiency virus (HIV)-infected

Japanese hemophiliacs are coinfected with hepatitis C virus (HCV), the outcome

of living donor liver transplantation (LDLT) in such patients in terms of

survival rate, perioperative complications, and recovery of coagulation activity

is poorly understood. PATIENTS AND METHODS.: Six HIV-positive hemophiliacs

underwent LDLT for HCV-associated advanced cirrhosis. The mean CD4 T-cell count

at transplantation was 376±227/ìL. RESULTS.: The 1-, 3-, and 5-year survival

rates were 66%, 66%, and 50%, respectively. Fatal perioperative bleeding related

to hemophilia was not observed. Two patients died within 6 months after

transplantation due to graft failure. HIV infection was well controlled in all

patients who survived longer than 6 months. Two patients (genotype 2a and 2+3a)

achieved a sustained viral response and both of them were alive at the end of

follow-up period, whereas one patient (genotype 1a+1b) died of decompensated

cirrhosis 4 years after transplantation due to recurrent HCV infection.

CONCLUSIONS.: HIV/HCV-coinfected hemophiliacs can safely undergo LDLT.

Hemophilia was clinically cured after successful transplantation. A good outcome

can be expected as long as postoperative hepatitis C is controlled with

interferon/ribavirin combination therapy.

PMID: 21593704 [PubMed - as supplied by publisher]

[Guest guest]

Transplantation. 2011 Jun 15;91(11):1261-1264.

Living Donor Liver Transplantations in HIV- and Hepatitis C Virus-Coinfected

Hemophiliacs: Experience in a Single Center.

Tsukada K, Sugawara Y, Kaneko J, Tamura S, Tachikawa N, Morisawa Y, Okugawa S,

Kikuchi Y, Oka S, Kimura S, Yatomi Y, Makuuchi M, Kokudo N, Koike K.

Source

1Department of Infectious Diseases, Graduate School of Medicine, the University

of Tokyo, Bunkyo-Ku, Tokyo. 2AIDS Clinical Center, National Center for Global

Health and Medicine, Shinjuku-ku, Tokyo, Japan. 3Division of Artificial Organ

and Transplantation, Department of Surgery, the University of Tokyo, Bunkyo-Ku,

Tokyo. 4Yokohama Municipal Citizens Hospital, Yokohama, Japan. 5Department of

Infection Control, Jichi Medical School, Tochigi-ken, Japan. 6Tokyo Teishin

Hopital, Chiyoda-ku, Tokyo, Japan. 7Department of Clinical Laboratory Medicine,

the University of Tokyo, Bunkyo-Ku, Tokyo. 8Japanese Red Cross Hospital,

Shibuya-Ku, Tokyo, Japan. 9Department of Gastroenterology, Graduate School of

Medicine, the University of Tokyo, Bunkyo-Ku, Tokyo.

Abstract

BACKGROUND.: Although almost all human immunodeficiency virus (HIV)-infected

Japanese hemophiliacs are coinfected with hepatitis C virus (HCV), the outcome

of living donor liver transplantation (LDLT) in such patients in terms of

survival rate, perioperative complications, and recovery of coagulation activity

is poorly understood. PATIENTS AND METHODS.: Six HIV-positive hemophiliacs

underwent LDLT for HCV-associated advanced cirrhosis. The mean CD4 T-cell count

at transplantation was 376±227/ìL. RESULTS.: The 1-, 3-, and 5-year survival

rates were 66%, 66%, and 50%, respectively. Fatal perioperative bleeding related

to hemophilia was not observed. Two patients died within 6 months after

transplantation due to graft failure. HIV infection was well controlled in all

patients who survived longer than 6 months. Two patients (genotype 2a and 2+3a)

achieved a sustained viral response and both of them were alive at the end of

follow-up period, whereas one patient (genotype 1a+1b) died of decompensated

cirrhosis 4 years after transplantation due to recurrent HCV infection.

CONCLUSIONS.: HIV/HCV-coinfected hemophiliacs can safely undergo LDLT.

Hemophilia was clinically cured after successful transplantation. A good outcome

can be expected as long as postoperative hepatitis C is controlled with

interferon/ribavirin combination therapy.

PMID: 21593704 [PubMed - as supplied by publisher]

[Guest guest]

Transplantation. 2011 Jun 15;91(11):1261-1264.

Living Donor Liver Transplantations in HIV- and Hepatitis C Virus-Coinfected

Hemophiliacs: Experience in a Single Center.

Tsukada K, Sugawara Y, Kaneko J, Tamura S, Tachikawa N, Morisawa Y, Okugawa S,

Kikuchi Y, Oka S, Kimura S, Yatomi Y, Makuuchi M, Kokudo N, Koike K.

Source

1Department of Infectious Diseases, Graduate School of Medicine, the University

of Tokyo, Bunkyo-Ku, Tokyo. 2AIDS Clinical Center, National Center for Global

Health and Medicine, Shinjuku-ku, Tokyo, Japan. 3Division of Artificial Organ

and Transplantation, Department of Surgery, the University of Tokyo, Bunkyo-Ku,

Tokyo. 4Yokohama Municipal Citizens Hospital, Yokohama, Japan. 5Department of

Infection Control, Jichi Medical School, Tochigi-ken, Japan. 6Tokyo Teishin

Hopital, Chiyoda-ku, Tokyo, Japan. 7Department of Clinical Laboratory Medicine,

the University of Tokyo, Bunkyo-Ku, Tokyo. 8Japanese Red Cross Hospital,

Shibuya-Ku, Tokyo, Japan. 9Department of Gastroenterology, Graduate School of

Medicine, the University of Tokyo, Bunkyo-Ku, Tokyo.

Abstract

BACKGROUND.: Although almost all human immunodeficiency virus (HIV)-infected

Japanese hemophiliacs are coinfected with hepatitis C virus (HCV), the outcome

of living donor liver transplantation (LDLT) in such patients in terms of

survival rate, perioperative complications, and recovery of coagulation activity

is poorly understood. PATIENTS AND METHODS.: Six HIV-positive hemophiliacs

underwent LDLT for HCV-associated advanced cirrhosis. The mean CD4 T-cell count

at transplantation was 376±227/ìL. RESULTS.: The 1-, 3-, and 5-year survival

rates were 66%, 66%, and 50%, respectively. Fatal perioperative bleeding related

to hemophilia was not observed. Two patients died within 6 months after

transplantation due to graft failure. HIV infection was well controlled in all

patients who survived longer than 6 months. Two patients (genotype 2a and 2+3a)

achieved a sustained viral response and both of them were alive at the end of

follow-up period, whereas one patient (genotype 1a+1b) died of decompensated

cirrhosis 4 years after transplantation due to recurrent HCV infection.

CONCLUSIONS.: HIV/HCV-coinfected hemophiliacs can safely undergo LDLT.

Hemophilia was clinically cured after successful transplantation. A good outcome

can be expected as long as postoperative hepatitis C is controlled with

interferon/ribavirin combination therapy.

PMID: 21593704 [PubMed - as supplied by publisher]