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• W2059654811 abstract "AIMS: Study of incidence and causes of late disfunction of liver grafts. METHODS: One hundred -nine children whose graft survived over one year after transplantation were selected for the study. Immunosuppression consisted of steroids with cyclosporine (n=99) or tacrolimus (n=10). Postransplantation follow-up was 48±29 months (range 14-127).Routinary clinical and analytical asessments were performed with 3 month intervals. Late disfunction was defined as any event with ALT>50 U/L or GGT>50U/L, regardless of symptoms, occurring after 12th month. The study included serology and abdominal ultrasound in all cases. Selected patients underwent liver biopsy, cholangiography and/or angiography. RESULTS: Graft function was normal during the entire follow-up in 56 children (51.3%). Twenty-five patients (23%) had some transient period of graft disfunction. Chronic liver disfunction was noted in 27 patients (24.7%). ACUTE DISFUNCTION (n=49 episodes): The cause was identified in n=24: cholangitis (n=11), cellular rejection (n=4), CMV hepatitis (n=4), toxic esteatosis (n=1), lymphoma (n=1), liver abscess (n=1), portal thrombosis (n=1) and hepatic artery thrombosis (n=1).Five patients had a cryptogenic disorder with minimal histological changes. A definite diagnose was not achieved in 20 episodes, further study was discarded due to a prompt evolution to normal function with adjustment of cyclosporine level if required. CHRONIC DISFUNCTION (n=27): Chronic HCV infection accounted for n=13 cases (48%), biliary strictures for n=4 (15%) and a cryptogenic process in n= 10 (37%). Idiopatic chronic disfunction showed in liver biopsy: mild cytolytic foci and/or portal lymphoid infiltrate in n=3, intrahepatic cholestasis and portal fibrosis in n=1, and esteatosis in n=1; biopsy was not performed in 5 cases with mild disturbances. OUTCOME: Graft disfunction caused death in one child (cryptogenic cholestasis and portal fibrosis).Two children died due to general disease during which the graft was affected (lymphoma, enterocholitis with secondary liver abscess). One hundred-four children (95.4%) survive without the need of retransplantation; n=26 maintain graft disfunction but all are asymptomatic and none has jaundice nor severe analitycal disturbances. CONCLUSIONS: During the late follow-up of liver transplanted patients. 47.7% show graft disfunction, but only in 2% of affected children the process directly led to liver failure or death." @default.
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• W2059654811 date "1997-04-01" @default.
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• W2059654811 title "GRAFT DISFUNCTION OCCURRING TO CHILDREN OVER ONE YEAR AFTER LIVER TRANSPLANTATION." @default.
• W2059654811 doi "https://doi.org/10.1097/00005176-199704000-00144" @default.
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