Liver Transplantation in a Hemophilia Patient With Acquired Immunodeficiency Syndrome

Ragni, Margaret V.; Dodson, S. Forrest; Hunt, Susan; Bontempo, Franklin A.; Fung, John J.

doi:10.1182/blood.v93.3.1113

Cited by 57 publications

(19 citation statements)

References 3 publications

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“…Since then, multiple liver transplantations have been successful, with factor infusions provided preoperatively, perioperatively and postoperatively. Various regimes were utilized from bolus dosing to continuous infusion therapy [8,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. Factor replacement therapies achieved normal levels within 12-49 h resulting in no further need for factor replacement.…”

Section: Transplantationmentioning

confidence: 99%

Liver transplantation in the haemophilia patient

Lambing¹,

Kachalsky²,

Kuriakose³

2011

Haemophilia

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Hepatitis C is a chronic condition that many persons with haemophilia contracted in the 1980s due to the infusion of factor concentrates which did not have viral inactivation processes in place. Many patients with haemophilia are now living longer lives, well into 80 years of age, due to the improvement of their care. The effects of the HCV on the liver over time are now being realized as this population ages. Although the new treatments for hepatitis C have a prolonged response, as demonstrated by a persistent negative viral load, many haemophilia patients have either not responded to the therapy or had significant side-effects to the treatment, preventing continued therapy. Of these infected haemophiliacs with liver disease, many have demonstrated a slow progressive decline resulting in liver failure, cirrhosis or liver cancer. Liver transplant then becomes their only option. This article will review liver transplantation in the haemophilia patient highlighting three case studies demonstrating the effectiveness of specific short-term factor infusions and other haemostatic support to minimize bleeding during the surgical period. These cases confirm the opportunity for successful liver transplantation for haemophilia patients utilizing specific factor recommendations with minimal bleeding risk.

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Section: Transplantationmentioning

confidence: 99%

Liver transplantation in the haemophilia patient

Lambing¹,

Kachalsky²,

Kuriakose³

2011

Haemophilia

View full text Add to dashboard Cite

show abstract

“…Since then, multiple liver transplantations have been successful, with factor infusions provided preoperatively, peri-operatively and postoperatively. Various regimes were utilized from bolus dosing to continuous infusion therapy [8,9,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Factor replacement therapies achieved normal levels within 12-49 h resulting in no further need for factor replacement.…”

Section: Review Of the Literaturementioning

confidence: 99%

Liver transplantation in the haemophilia patient

2011

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Summary. Hepatitis C is a chronic condition that many persons with haemophilia contracted in the 1980s due to the infusion of factor concentrates that did not have viral inactivation processes in place. Many patients with haemophilia are now living longer lives, well into their eighties due to the improvement of their care. The effects of the hepatitis C virus on the liver over time are now being realized as this population ages. Although the new treatments for hepatitis C have a prolonged response, as demonstrated by a persistent negative viral load, many haemophilia patients have either not responded to the therapy or had significant side effects to treatment, which prevented continued therapy. Of these infected haemophiliacs with liver disease, many have demonstrated a slow progressive decline resulting in liver failure, cirrhosis or liver cancer. Liver transplant then becomes their only option. This article will review liver transplantation in the haemophilia patient highlighting three case studies demonstrating the effectiveness of specific short-term factor infusions and other haemostatic support to minimize bleeding during the surgical period. These cases confirm the opportunity for successful liver transplantation for haemophilia patients utilizing specific factor recommendations with minimal bleeding risk.

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“…As a result, an increasing number of HIV-positive patients are being considered for (or have received) renal or hepatic transplantation, usually because of AIDS-associated glomerulopathy or co-infection with hepatitis C. Transplantation of these patients has been associated with short-and medium-term results similar to those in HIV-negative recipients. [23][24][25][26][27][28][29] In this setting, it may be appropriate to expand the donor pool to include HIVpositive donors in select circumstances. 29 -31 Although it is highly likely that patients receiving an organ from such donors will develop HIV/AIDS, the counter-argument is that AIDS is a manageable problem and the use of such organs may offer survival opportunities to critically ill patients.…”

Section: Human Immunodeficiency Virus and Organ Transplantationmentioning

confidence: 99%

“…Similarly, corticosteroid dose should be limited whenever possible. 24,26,27 Finally, the use of HIV-positive donors would probably result in a small increase in the donor pool, but transplantation would result in increased risk and complexity of post-operative care. If such donors are to be considered, then clear guidelines should be established detailing the situations in which such organs could be used.…”

Section: Risk Of Progression To Aidsmentioning

confidence: 99%