Hepatobiliary Infections After Solid Organ or Hematopoietic Cell Transplantation

Larson, Anne M.; McDonald, George B.

doi:10.1007/978-3-319-28797-3_36

Cited by 3 publications

(1 citation statement)

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“…2 However, due to immunosuppression, the serologic pattern of HBV infection may be atypical in HCT survivors and clearance of HBV surface antigen (HBsAg) may be observed; this is more likely to occur if the donor was positive for antibodies to the HBV surface antigen (anti-HBs) as a result of prior HBV infection. 2,11,62,64,65 When immunosuppression is tapered or reduced, patients who remain HBsAg positive after HCT are at risk of an HBV flare and should receive oral antiviral agents, such as tenofovir disoproxil fumarate (TDF), tenofovir alafenamide (TAF), or entecavir for viral prophylaxis for at least 1 year after completion of all immunosuppressive therapy. [66][67][68] The choice of antiviral therapy is largely dependent on the overall condition of the patient and evidence of renal insufficiency, as TAF is preferred in patients with compromised renal function and can be used in patients with a creatinine clearance greater than or equal to 15 ml/min.…”

Section: Liver Complicationsmentioning

confidence: 99%

Long‐term Follow‐up of Hematopoietic Stem Cell Transplant Survivors: A Focus on Screening, Monitoring, and Therapeutics

et al. 2020

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Annually, ~50,000 patients undergo hematopoietic stem cell transplantation (HCT) worldwide with almost 22,000 of these patients receiving HCT in the United States. HCT is a curative option for a wide range of hematologic malignancies, and advances in transplantation medicine have resulted in an increase in HCT survivors. It is anticipated that the number of HCT survivors will more than double from 242,000 in 2020 to ~500,000 in 2030. Survivors of HCT are at an increased risk of developing late complications due to exposure to chemotherapy and/or radiation in the pre‐, peri‐, and post‐HCT phases and these cumulative exposures have the potential to damage normal tissue. This tissue damage leads to the early onset of chronic health conditions resulting in premature mortality in HCT survivors, who have a 15‐year cumulative incidence of severe or life‐threatening chronic health conditions exceeding 40%. Due to the significant burden of morbidity in HCT survivors and the delay in the development of long‐term complications, this delicate patient population requires life‐long monitoring due to the risk for neuropsychological, cardiac, pulmonary, renal, hepatic, ocular, skeletal, cardiac, endocrine, fertility, and sexual health complications, as well as secondary neoplasms. This review will focus on recent advances in screening, monitoring, and therapeutics for late‐occurring or long‐term complications in HCT survivors.

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