Skip to main content
SpringerLink
Log in

Cases 66–90

  • Chapter
  • First Online:
Hepatology and Transplant Hepatology

  • 1670 Accesses

Abstract

A 72-year old gentleman presents with abnormal liver enzymes on routine testing. Two months ago his liver enzymes had been essentially normal. He had undergone orthotopic liver transplant 2 years ago for alcoholic liver disease that had been complicated by ascites and a 2-cm hepatocellular carcinoma (HCC). He received a 63-year-old allograft with a duct-to-duct anastomosis. He was maintained on tacrolimus and prednisone immunosuppression. His posttransplant course has been unremarkable other than an episode of acute rejection several months after transplant that responded completely to a steroid recycle. He has remained abstinent of alcohol.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Graziadei IW, Schwaighofer H, Koch R et al. Long-term outcome of endoscopic treatment of biliary strictures after liver transplantation. Liver Transpl 2006;12:718–25.

    Article  PubMed  Google Scholar 

  2. Holt AP, Thorburn D, Mirza D et al. A prospective study of standardized nonsurgical therapy in the management of biliary anastomotic strictures complicating liver transplantation. Transplantation 2007;84:857–63.

    Article  PubMed  Google Scholar 

References

  1. Tuchman M, Lichtenstein GR, Rajagopal BS et al. Hepatic glutamine synthetase deficiency in fatal hyperammonemia after lung transplantation. Ann Intern Med 1997;127:446–9.

    PubMed  CAS  Google Scholar 

  2. Lichtenstein GR, Yang YX, Nunes FA et al. Fatal hyperammonemia after orthotopic lung transplantation. Ann Intern Med 2000;132:283–7.

    PubMed  CAS  Google Scholar 

  3. Ong JP, Aggarwal A, Krieger D et al. Correlation between ammonia levels and the severity of hepatic encephalopathy. Am J Med 2003;114:188–193.

    Article  PubMed  CAS  Google Scholar 

References

  1. Kubo T, Shibata T, Itoh K et al. Outcome of percutaneous transhepatic venoplasty for hepatic venous outflow obstruction after living donor liver transplantation. Radiology 2006;239:285–90.

    Article  PubMed  Google Scholar 

  2. Lee SS, Kim KW, Park SH et al. Value of CT and Doppler sonography in the evaluation of hepatic vein stenosis after dual-graft living donor liver transplantation. AJR Am J Roentgenol 2007;189:101–8.

    Article  PubMed  Google Scholar 

References

  1. Liebowitz D. Epstein-Barr virus and a cellular signaling pathway in lymphomas from immunosuppressed patients. N Engl J Med 1998;338:1413–21.

    Article  PubMed  CAS  Google Scholar 

  2. Leblond V, Davi F, Charlotte F et al. Posttransplant lymphoproliferative disorders not associated with Epstein-Barr virus: a distinct entity? J Clin Oncol 1998;16:2052–9.

    PubMed  CAS  Google Scholar 

  3. Starzl TE, Nalesnik MA, Porter KA et al. Reversibility of lymphomas and lymphoproliferative lesions developing under cyclosporin– steroid therapy. Lancet 1984;1(8377):583–7.

    Article  PubMed  CAS  Google Scholar 

  4. Leblond V, Dhedin N, Mamzer Bruneel MF et al. Identification of prognostic factors in 61 patients with posttransplantation lymphoproliferative disorders. J Clin Oncol 2001;19:772–8.

    PubMed  CAS  Google Scholar 

References

  1. de Vera ME, Lopez-Solis R, Dvorchik I et al. Liver transplantation using donation after cardiac death donors: long-term follow-up from a single center. Am J Transplant 2009;9:773–81.

    Google Scholar 

  2. Chan EY, Olson LC, Kisthard JA et al. Ischemic cholangiopathy following liver transplantation from donation after cardiac death donors. Liver Transpl 2008;14:604–10.

    Article  PubMed  Google Scholar 

  3. Selck FW, Grossman EB, Ratner LE et al. Utilization, outcomes, and retransplantation of liver allografts from donation after cardiac death: implications for further expansion of the deceased-donor pool. Ann Surg 2008;248:599–607.

    PubMed  Google Scholar 

References

  1. Dixon LR, Crawford JM. Early histologic changes in fibrosing cholestatic hepatitis C. Liver Transpl 2007;13:219–26.

    Article  PubMed  Google Scholar 

  2. Gopal DV, Rosen HR. Duration of antiviral therapy for cholestatic HCV recurrence may need to be indefinite. Liver Transpl 2003;9:348–53.

    Article  PubMed  Google Scholar 

References

  1. Wiesner RH, Batts KP, Krom RA, Evolving concepts in the diagnosis, pathogenesis, and treatment of chronic hepatic allograft rejection, Liver Transpl Surg 1999;5:388.

    Article  PubMed  CAS  Google Scholar 

  2. Sher LS, Cosenza CA, Michel J et al. Efficacy of tacrolimus as rescue therapy for chronic rejection in orthotopic liver transplantation: a report of the U.S. Multicenter Liver Study Group. Transplantation 1997;64:258–63.

    Article  PubMed  CAS  Google Scholar 

References

  1. Le Treut YP, Delpero JR, Dousset B et al. Results of liver transplantation in the treatment of metastatic neuroendocrine tumors. A 31-case French multicentric report. Ann Surg 1997;225:355–64.

    Article  PubMed  CAS  Google Scholar 

  2. van Vilsteren FG, Baskin-Bey ES, Nagorney DM et al. Liver transplantation for gastroenteropancreatic neuroendocrine cancers: Defining selection criteria to improve survival. Liver Transpl 2006;12:448–56.

    Article  PubMed  Google Scholar 

  3. Bilimoria K, Talamonti MS, Tomlinson JS et al. Prognostic score predicting survival after resection of pancreatic neuroendocrine tumors: analysis of 3851 patients. Ann Surg 2008;247:490–500.

    Article  PubMed  Google Scholar 

References

  1. Greif F, Bronsther OL, Van Thiel DH et al. The incidence, timing, and management of biliary tract complications after orthotopic liver transplantation. Ann Surg 1994;219:40–5.

    Article  PubMed  CAS  Google Scholar 

  2. Welling TH, Heidt DG, Englesbe MJ et al. Biliary complications following liver transplantation in the model for end-stage liver disease era: effect of donor, recipient, and technical factors. Liver Transpl 2008;14:73–80.

    Article  PubMed  Google Scholar 

References

  1. Ueno T, Jones G, Martin A et al. Clinical outcomes from hepatic artery stenting in liver transplantation. Liver Transpl 2006;12:422–7.

    Article  PubMed  Google Scholar 

  2. Saad WE, Davies MG, Sahler L et al. Hepatic artery stenosis in liver transplant recipients: primary treatment with percutaneous transluminal angioplasty. J Vasc Interv Radiol 2005;16:795–805.

    Article  PubMed  Google Scholar 

  3. Abbasoglu O, Levy MF, Vodapally MS et al. Hepatic artery stenosis after liver transplantation – incidence, presentation, treatment, and long term outcome. Transplantation 1997;63:250–5.

    Article  PubMed  CAS  Google Scholar 

References

  1. Greif F, Bronsther OL, Van Thiel DH et al. The incidence, timing, and management of biliary tract complications after orthotopic liver transplantation. Ann Surg 1994;219:40–5.

    Article  PubMed  CAS  Google Scholar 

  2. Pascher A, Neuhaus P. Biliary complications after deceased-donor orthotopic liver transplantation. J Hepatobiliary Pancreat Surg 2006;13:487–96.

    Article  PubMed  Google Scholar 

References

  1. Wiesner RH, Demetris AJ, Belle SH et al. Acute hepatic allograft rejection: incidence, risk factors, and impact on outcome. Hepatology 1998;28:638–45.

    Article  PubMed  CAS  Google Scholar 

  2. Banff schema for grading liver allograft rejection: an international consensus document. Hepatology 1997;25:658–63.

    Google Scholar 

  3. Volpin R, Angeli P, Galioto A et al. Comparison between two high-dose methylprednisolone schedules in the treatment of acute hepatic cellular rejection in liver transplant recipients: a controlled clinical trial. Liver Transpl 2002;8:527–34.

    Article  PubMed  Google Scholar 

  4. Charlton M, Seaberg E. Impact of immunosuppression and acute rejection on recurrence of hepatitis C: results of the National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplantation Database. Liver Transpl Surg 1999;5(4 Suppl 1):S107–14.

    PubMed  CAS  Google Scholar 

References

  1. Penn I. Posttransplantation de novo tumors in liver allograft recipients. Liver Transpl Surg 1996;2:52–9.

    Article  PubMed  CAS  Google Scholar 

  2. Yao FY, Gautam M, Palese C et al. De novo malignancies following liver transplantation: a case-control study with long-term follow-up. Clin Transplant 2006;20:617–23.

    Article  PubMed  Google Scholar 

  3. Tan-Shalaby J; Tempero M. Malignancies after liver transplantation: a comparative review. Semin Liver Dis 1995;15:156–64.

    Article  PubMed  CAS  Google Scholar 

References

  1. Contos, MJ, Cales W, Sterling RK et al. Development of nonalcoholic fatty liver disease after orthotopic liver transplantation for cryptogenic cirrhosis. Liver Transpl 2001;7:363–373.

    Article  PubMed  CAS  Google Scholar 

  2. Malik SM, deVera ME, Fontes P et al. Recurrent disease following liver transplantation for nonalcoholic Steatohepatitis cirrhosis. Liver Transpl 2009;15:1843–51.

    Article  PubMed  Google Scholar 

References

  1. Naber AH, Van Haelst U, Yap SH. Nodular regenerative hyperplasia of the liver: an important cause of portal hypertension in non-cirrhotic patients. J Hepatol 1991;12:94–9.

    Article  PubMed  CAS  Google Scholar 

  2. Gane E, Portmann B, Saxena R et al. Nodular regenerative hyperplasia of the liver graft after liver transplantation. Hepatology 1994;20:88–94.

    Article  PubMed  CAS  Google Scholar 

  3. Devarbhavi H, Abraham S, Kamath PS. Significance of nodular regenerative hyperplasia occurring de novo following liver transplantation. Liver Transpl 2007;13:1552–6.

    Article  PubMed  Google Scholar 

  4. S Malik, D Sass, J Behari et al. Nodular regenerative hyperplasia post solid organ (non-liver) transplant. Hepatology 2007;46:503A.

    Google Scholar 

References

  1. Moore DE, Feurer ID, Speroff T et al. Impact of donor, technical, and recipient risk factors on survival and quality of life after liver transplantation. Arch Surg 2005;140:273–7.

    Article  PubMed  Google Scholar 

  2. Hoofnagle JH, Lombardero M, Zetterman RK et al. Donor age and outcome of liver transplantation. Hepatology 1996;24:89–96.

    Article  PubMed  CAS  Google Scholar 

  3. Figueras J, Busquets J, Grande L et al. The deleterious effect of donor high plasma sodium and extended preservation in liver transplantation. A multivariate analysis. Transplantation 1996;61:410–3.

    Article  PubMed  CAS  Google Scholar 

  4. Feng S, Goodrich NP, Bragg-Gresham JL et al. Characteristics associated with liver graft failure: the concept of a donor risk index. Am J Transplant 2006;6:783–90.

    Article  PubMed  CAS  Google Scholar 

References

  1. Kumana CR, Ng M, Lin HJ et al. Herbal tea-induced hepatic veno-occlusive disease: Quantification of toxic alkaloid exposure in adults. Gut 1985;26:101.

    Article  PubMed  CAS  Google Scholar 

  2. McDonald GB, Hinds MS, Fisher LD, Schoch HG, Wolford JL, Banaji M, Hardin BJ, Shulman HM, Clift RA Veno-occlusive disease of the liver and multiorgan failure after bone marrow transplantation: a cohort study of 355 patients. Ann Intern Med 1993;118:255–67.

    PubMed  CAS  Google Scholar 

  3. McDonald GB, Sharma P, Matthews DE, Shulman HM, Thomas ED Venocclusive disease of the liver after bone marrow transplantation: diagnosis, incidence, and predisposing factors. Hepatology 1984;4:116–22.

    Article  PubMed  CAS  Google Scholar 

  4. DeLeve LD, Valla DC, Garcia-Tsao G. Vascular disorders of the liver. Hepatology 2009;49:1729.

    Article  PubMed  CAS  Google Scholar 

References

  1. Selbst MK, Ahrens WA, Robert ME et al. Spectrum of histologic changes in colonic biopsies in patients treated with mycophenolate mofetil. Mod Pathol 2009;22:737–43.

    PubMed  CAS  Google Scholar 

  2. Maes BD, Dalle I, Geboes K et al. Erosive enterocolitis in mycophenolate mofetil-treated renal-transplant recipients with persistent afebrile diarrhea. Transplantation 2003;75:665–72.

    Article  PubMed  CAS  Google Scholar 

References

  1. Dodson SF, Issa S, Araya V et al. Infectivity of hepatic allografts with antibodies to hepatitis B virus. Transplantation 1997;64:1582–4.

    Article  PubMed  CAS  Google Scholar 

  2. Dickson RC, Everhart JE, Lake JR et al. Transmission of hepatitis B by transplantation of livers from donors positive for antibody to hepatitis B core antigen. The National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplantation Database. Gastroenterology 1997;113:1668–74.

    Article  PubMed  CAS  Google Scholar 

  3. Yu L, Koepsell T, Manhart L, Ioannou G. Survival after orthotopic liver transplantation: the impact of antibody against hepatitis B core antigen in the donor. Liver Transpl 2009;15:1343–50.

    Article  PubMed  Google Scholar 

References

  1. Kamar N, Selves J, Mansuy JM et al. Hepatitis E virus and chronic hepatitis in organ-transplant recipients. N Engl J Med 2008;358:811–7.

    Article  PubMed  CAS  Google Scholar 

  2. Haagsma EB, van den Berg AP, Porte RJ et al. Chronic hepatitis E virus infection in liver transplant recipients. Liver Transpl 2008;14:547–53.

    Article  PubMed  Google Scholar 

References

  1. Stegall MD, Everson G, Schroter G et al. Metabolic complications after liver transplantation. Diabetes, hypercholesterolemia, hypertension, and obesity. Transplantation 1995;60:1057–60.

    PubMed  CAS  Google Scholar 

  2. Gonwa TA, Mai ML, Melton LB et al. End-stage renal disease (ESRD) after orthotopic liver transplantation (OLTX) using calcineurin-based immunotherapy: risk of development and treatment. Transplantation 2001;72:1934–9.

    Article  PubMed  CAS  Google Scholar 

  3. Dharancy S, Declerck N, Schneck AS et al. Mycophenolate mofetil monotherapy for severe side effects of calcineurin inhibitors following liver transplantation. Am J Transplant 2009;9:610–3.

    Article  PubMed  CAS  Google Scholar 

  4. Morard I, Dumortier J, Spahr L et al. Conversion to sirolimus-based immunosuppression in maintenance liver transplantation patients. Liver Transpl 2007;13:658–64.

    Article  PubMed  Google Scholar 

References

  1. Asberg A, Humar A, Rollag H et al. Oral valganciclovir is noninferior to intravenous ganciclovir for the treatment of cytomegalovirus disease in solid organ transplant recipients. Am J Transplant 2007;7:2106–13.

    Article  PubMed  CAS  Google Scholar 

  2. Kalil AC, Levitsky J, Lyden E et al. Meta-analysis: the efficacy of strategies to prevent organ disease by cytomegalovirus in solid organ transplant recipients. Ann Intern Med 2005;143:870–80.

    PubMed  Google Scholar 

References

  1. de Pagter PJ, Schuurman R, Visscher H et al. Human herpes virus 6 plasma DNA positivity after hematopoietic stem cell transplantation in children: an important risk factor for clinical outcome. Biol Blood Marrow Transplant 2008;14:831–9.

    Article  PubMed  Google Scholar 

  2. Piton G, Larosa F, Minello A et al. Infliximab treatment for steroid-refractory acute graft-versus-host disease after orthotopic liver transplantation: a case report. Liver Transpl 2009;15:682–5.

    Article  PubMed  Google Scholar 

  3. Kanehira K, Riegert-Johnson DL, Chen D et al. FISH diagnosis of acute graft-versus-host disease following living-related liver transplant. J Mol Diagn 2009;11:355–8.

    Article  PubMed  Google Scholar 

  4. Kohler S, Pascher A, Junge G et al. Graft versus host disease after liver transplantation – a single center experience and review of literature. Transpl Int 2008;21:441–51.

    Article  PubMed  CAS  Google Scholar 

References

  1. European FK506 Multicentre Liver Study Group. Randomised trial comparing tacrolimus (FK506) and cyclosporin in prevention of liver allograft rejection. Lancet 1994;344:423–8.

    Article  Google Scholar 

  2. The U.S. Multicenter FK506 Liver Study Group. A comparison of tacrolimus (FK 506) and cyclosporine for immunosuppression in liver transplantation. N Engl J Med 1994;331:1110–5.

    Article  Google Scholar 

References

  1. Tzakis AG, Gordon RD, Shaw BW Jr et al. Clinical presentation of hepatic artery thrombosis after liver transplantation in the cyclosporine era. Transplantation 1985;40:667–71.

    Article  PubMed  CAS  Google Scholar 

  2. Duffy JP, Hong JC, Farmer DG et al. Vascular complications of orthotopic liver transplantation: experience in more than 4,200 patients. J Am Coll Surg 2009;208:896–903.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Liver Diseases Recanati-Miller Transplantation Institute, Mount Sinai School of Medicine, New York, NY, USA

    Jawad Ahmad MD, FRCP (Associate Professor of Medicine)

Authors
  1. Jawad Ahmad MD, FRCP
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jawad Ahmad MD, FRCP .

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Ahmad, J. (2011). Cases 66–90. In: Hepatology and Transplant Hepatology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-7085-5_3

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-7085-5_3

  • Published:

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4419-7084-8

  • Online ISBN: 978-1-4419-7085-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation