TY - JOUR
T1 - Liver transplantation at the Sun Yat-Sen University of Medical Sciences in China
AU - Huang, Jiefu
AU - He, Xiaoshun
AU - Chen, Guihua
AU - Zhu, Xiaofeng
AU - Lu, Mingqiang
AU - Wang, Guodong
AU - Fu, Yuyang
AU - Yang, Yang
AU - Guan, Xiangdong
PY - 2002
Y1 - 2002
N2 - Objectives. To summarize the results of liver transplantation for various end-stage liver diseases at the Sun Yat-Sen University of Medical Sciences (SUMS), define the role of liver transplantation in the treatment of hepatocellular carcinoma and fulminant hepatitis B, and assess the efficiency of lamivudine on preventing HBV recurrence. Methods. Seventy liver transplants performed at the SUMS between April 1993 and December 2000 were retrospectively analyzed. The main indications for liver transplant were hepatocellular carcinoma (26 cases), liver cirrhosis (21 cases), fulminant hepatitis B (12 cases), sclerosing cholangitis (4 cases) and other terminal liver diseases (7 cases). Lamivudine was used in twelve patients suffering from fulminant hepatitis B. Logistic multivariate regression analysis was applied to determine the risk factors predicting liver transplantation outcomes. Results. Fifty-four patients survived for more than one month, and 16 patients died within 30 days after orthotopic liver transplantation (OLT). The overall hospital survival rate was 77.1%. The hospital survival rates in the Child's A and B patients were 87.5% and 83.3%, respectively. Those rates were superior to those of the Child's C patients (P < 0.05). The outcome of patients with small hepatocellular carcinoma (HCC) was superior to that of patients with large HCC. Preoperative APACE III scores, the severity of ascites and serum creatine level had independent influence on outcome. Of the patients with fulminant HBV infection, 9 recipients survived for a follow-up period of 2 - 24 months. Treatment with lamivudine monotherapy was both well tolerated and efficacious in patients with fulminant hepatitis B. Conclusions. The results indicate that orthotopic liver transplantation could provide long-term cure and palliation for patients with HCC, and that patient selection is extremely important in predicting outcome. The results support the continued application of liver transplantation as a therapeutic modality for various end-stage liver diseases and that lamivudine is an effective and safe monotherapy in OLT for patients with HBV infection.
AB - Objectives. To summarize the results of liver transplantation for various end-stage liver diseases at the Sun Yat-Sen University of Medical Sciences (SUMS), define the role of liver transplantation in the treatment of hepatocellular carcinoma and fulminant hepatitis B, and assess the efficiency of lamivudine on preventing HBV recurrence. Methods. Seventy liver transplants performed at the SUMS between April 1993 and December 2000 were retrospectively analyzed. The main indications for liver transplant were hepatocellular carcinoma (26 cases), liver cirrhosis (21 cases), fulminant hepatitis B (12 cases), sclerosing cholangitis (4 cases) and other terminal liver diseases (7 cases). Lamivudine was used in twelve patients suffering from fulminant hepatitis B. Logistic multivariate regression analysis was applied to determine the risk factors predicting liver transplantation outcomes. Results. Fifty-four patients survived for more than one month, and 16 patients died within 30 days after orthotopic liver transplantation (OLT). The overall hospital survival rate was 77.1%. The hospital survival rates in the Child's A and B patients were 87.5% and 83.3%, respectively. Those rates were superior to those of the Child's C patients (P < 0.05). The outcome of patients with small hepatocellular carcinoma (HCC) was superior to that of patients with large HCC. Preoperative APACE III scores, the severity of ascites and serum creatine level had independent influence on outcome. Of the patients with fulminant HBV infection, 9 recipients survived for a follow-up period of 2 - 24 months. Treatment with lamivudine monotherapy was both well tolerated and efficacious in patients with fulminant hepatitis B. Conclusions. The results indicate that orthotopic liver transplantation could provide long-term cure and palliation for patients with HCC, and that patient selection is extremely important in predicting outcome. The results support the continued application of liver transplantation as a therapeutic modality for various end-stage liver diseases and that lamivudine is an effective and safe monotherapy in OLT for patients with HBV infection.
KW - Fulminant hepatitis B
KW - Hepatocellular carcinoma
KW - Lamivudine
KW - Orthotopic liver transplantation
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M3 - Article
C2 - 12133294
AN - SCOPUS:0036102182
SN - 0366-6999
VL - 115
SP - 543
EP - 548
JO - Chinese Medical Journal
JF - Chinese Medical Journal
IS - 4
ER -