PMID- 15618844
OWN - NLM
STAT- MEDLINE
DCOM- 20050317
LR  - 20190906
IS  - 0954-691X (Print)
IS  - 0954-691X (Linking)
VI  - 16
IP  - 12
DP  - 2004 Nov
TI  - Liver disease is a major cause of mortality following allogeneic bone-marrow 
      transplantation.
PG  - 1347-54
AB  - BACKGROUND: Liver disease is an important cause of morbidity and mortality among 
      recipients of bone-marrow transplantation (BMT). The aim of this retrospective 
      study was to determine the incidence, risk factors and clinical evolution of 
      liver disease following allogeneic BMT. METHODS: A total of 103 patients (mean 
      age 22.8 years (SD 10.9); 31.1% aged < 18 years; 66% males) transplanted in a 
      single institution were enrolled. Data on donors and recipients were collected, 
      including hematological disease, alanine transaminase, alkaline phosphatase, 
      bilirubin, hepatitis B virus (HBV) and hepatitis C virus (HCV) markers (including 
      HBV-DNA and HCV-RNA). RESULTS: Fifty six of 103 patients died, with liver disease 
      the main cause of death (27 of 56, 48%). Overall the incidence of liver failure 
      attributed to hepatic graft-versus-host-disease (GVHD) was 22.3% (23 of 103; 74% 
      HBV/HCV infected) and veno-occlusive disease (VOD) was 9.7% (10 of 103; 80% 
      HBV/HCV infected). Fourteen patients had hepatitis reactivations (four hepatic 
      GVHD and three VOD). Donors' HCV-RNA status and serum bilirubin above 2 mg/dl 
      were predictive of hepatic GVHD [adjusted odds ratio (AOR) 11.1, 95% confidence 
      interval (CI) 0.99-33.12; AOR 3.93, 95% CI 1.09-14.62; P < 0.05, respectively] 
      and an abnormal alkaline phosphatase could predict severe liver disease (AOR 
      2.78, 95% CI 1.01-7.54; P < 0.05). Development of severe liver disease (hepatic 
      GVHD or VOD) was a significant predictor of mortality (AOR 4.57, 95% CI 
      1.09-20.32; P < 0.05) with a low probability of survival (19.3%, SD 7.9%) 
      compared with those without liver disease (52.1%, SD 7.6%; log-rank P = 0.0003). 
      CONCLUSIONS: Hepatic GVHD is a common complication following BMT and an important 
      cause of liver-related mortality. The high prevalence of HCV and HBV may have 
      contributed to the outcome of hepatic GVHD and VOD. Therefore, antiviral therapy 
      should be considered early to prevent relentless progression of liver disease.
FAU - El-Sayed, Manal H
AU  - El-Sayed MH
AD  - Pediatric Department, Hematology/Oncology Division, Children's Hospital, Ain 
      Shams University, Cairo, Egypt. manalhelsayed@yahoo.com
FAU - El-Haddad, Alaa
AU  - El-Haddad A
FAU - Fahmy, Omar A
AU  - Fahmy OA
FAU - Salama, Iman I
AU  - Salama II
FAU - Mahmoud, Hossam K
AU  - Mahmoud HK
LA  - eng
PT  - Journal Article
PL  - England
TA  - Eur J Gastroenterol Hepatol
JT  - European journal of gastroenterology & hepatology
JID - 9000874
RN  - 0 (RNA, Viral)
RN  - RFM9X3LJ49 (Bilirubin)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Bilirubin/blood
MH  - Bone Marrow Transplantation/*adverse effects
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Graft vs Host Disease/etiology/mortality
MH  - Hepacivirus/isolation & purification
MH  - Hepatic Veno-Occlusive Disease/etiology/mortality
MH  - Hepatitis/etiology/mortality
MH  - Hepatitis B virus/isolation & purification
MH  - Humans
MH  - Liver Diseases/etiology/*mortality
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - RNA, Viral/blood
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Analysis
MH  - Transplantation, Homologous
EDAT- 2004/12/25 09:00
MHDA- 2005/03/18 09:00
CRDT- 2004/12/25 09:00
PHST- 2004/12/25 09:00 [pubmed]
PHST- 2005/03/18 09:00 [medline]
PHST- 2004/12/25 09:00 [entrez]
AID - 00042737-200412000-00019 [pii]
AID - 10.1097/00042737-200412000-00019 [doi]
PST - ppublish
SO  - Eur J Gastroenterol Hepatol. 2004 Nov;16(12):1347-54. doi: 
      10.1097/00042737-200412000-00019.