Liver transplantation in the haemophilia patient

Lambing, Angela; Kuriakose, Philip; Kachalsky, E.

doi:10.1111/j.1365-2516.2011.02631.x

Cited by 13 publications

(10 citation statements)

References 26 publications

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“…Of our series' 12 HCC patients, eight underwent surgery, including four liver transplantations, without any bleeding complications. These results confirm the procedure's safety, as previously reviewed [19,20]. Other transplantations, such as autologous stem cell transplantation [21] and cord blood haematopoietic stem cell transplantation, were reported not to be associated with bleeding complications [22].…”

Section: Discussionsupporting

confidence: 84%

Cancer detection and management in patients with haemophilia: a retrospective European multicentre study

et al. 2013

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Lymphomas or hepatocarcinomas related to blood-borne transmitted diseases are well-known malignancies in persons with haemophilia (PWH). However, rising life expectancy has increased the number of PWH suffering from other malignancies. This study aimed to collect cancer occurrence data in PWH followed in five European haemophilia treatment centres (Brussels, Geneva, Marseille, Montpellier and Paris-Bicêtre) over the last 10 years and to analyse some particular features of cancer occurring in PWH. In total, 45 malignancies were diagnosed in 1067 PWH. The most common malignancies were hepatocellular carcinoma (12/45) and urogenital tract tumours (9/45). Bleeding at presentation or changes in bleeding pattern was indicative of cancer in four patients. Three patients with mild haemophilia developed anti-factor VIII inhibitors after intensive substitution therapy prior to surgery or invasive procedures. There was no bleeding associated with chemotherapy or radiotherapy. A few bleeding complications occurred following invasive (3/39) or surgical procedures (2/27) as a result of insufficient hemostatic coverage or in spite of adequate substitution. No bleeding was noted after liver or prostate biopsies. Following cancer diagnosis, five patients were switched from on-demand to prolonged prophylaxis substitution. In the majority of cases, the standard cancer treatment protocol was not modified on account of concomitant haemophilia. Thus, oncological treatments are not contraindicated and should not be withheld in PWH assuming that adequate haemostasis correction is undertaken. As shown by our study results, a change in bleeding pattern in adult PWH should raise suspicion of a malignancy. Intensive substitution must be considered a risk factor for inhibitor development.

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Section: Discussionsupporting

confidence: 84%

Cancer detection and management in patients with haemophilia: a retrospective European multicentre study

et al. 2013

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“…Indications for liver transplantation in PWH with HCV and outcomes are the same as for other groups of HCV-infected patients when adequate coagulation factor replacement is provided [26][27][28]. Eleven patients in this cohort have successfully undergone OLT, 2 were HIV coinfected.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C infection and outcomes in the Scottish haemophilia population

et al. 2013

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Patients with bleeding disorders previously frequently became infected with hepatitis C virus. We identified the number of patients infected in Scotland and assessed several aspects of the outcomes of HCV infection and its treatment comparing these with cohorts infected for other reasons. We calculated the number of individuals infected in Scotland (cohort A) starting with the total number of patients treated in Scottish haemophilia centres registered on the UKHCDO database between 1970 and 1989. Cases were then removed or added based on additional information from centre records. A second cohort B, consisted of 255 patients from cohort A and 47 patients HCV infected outside Scotland, but with follow-up data from Scottish centres around their HCV infection. We estimate that 455 patients with bleeding disorders became infected by coagulation factor provided by NHS Scotland. In 302 individuals with documented HCV infection, rates of natural clearance (17.4%), genotype spread (64% genotype 1) and responses to antiviral therapy (14.5% with monotherapy; 38.8% with combination therapy) were similar to those in other cohorts. Thirty-four liver biopsies were performed without adverse event and liver transplantation has been performed in 11 patients, seven for liver failure, four for hepatocellular carcinoma. Around 455 patients with bleeding disorders became HCV infected in Scotland before 1989. The natural history of HCV infection and responses to treatment are similar to those in other HCV-infected cohorts. Liver transplantation has been used successfully for the treatment of end-stage liver failure and hepatocellular carcinoma.

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“…However, lifelong therapy is expensive, and patients can develop antibodies against the replacement factor. As most coagulation factors are produced by the liver, haemophilas can be cured by OLT [79].…”

Section: Coagulation Factor Deficienciesmentioning

confidence: 99%

Hepatocyte transplantation for inherited metabolic diseases of the liver

et al. 2012

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Inherited metabolic diseases of the liver are characterized by deficiency of a hepatic enzyme or protein often resulting in life-threatening disease. The remaining liver function is usually normal. For most patients, treatment consists of supportive therapy, and the only curative option is liver transplantation.Hepatocyte transplantation is a promising therapy for patients with inherited metabolic liver diseases, which offers a less invasive and fully reversible approach. Procedure-related complications are rare. Here, we review the experience of hepatocyte transplantation for metabolic liver diseases and discuss the major obstacles that need to be overcome to establish hepatocyte transplantation as a reliable treatment option in the clinic.

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Liver transplantation in the haemophilia patient

Cited by 13 publications

References 26 publications

Cancer detection and management in patients with haemophilia: a retrospective European multicentre study

Cancer detection and management in patients with haemophilia: a retrospective European multicentre study

Hepatitis C infection and outcomes in the Scottish haemophilia population

Hepatocyte transplantation for inherited metabolic diseases of the liver

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