Liver disease during and after hematopoietic stem cell transplantation in adults: a single-center Egyptian experience
Abstract Background Hepatic complications are a well-known cause of both early and late mortality and morbidity in hematopoietic stem cell transplant (HSCT) recipients. Early diagnosis and management of hepatic complications is important in order to commence appropriate therapy. Conditioning regimen...
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doaj-4a35deef8104498ea6779b9cf18360152020-11-25T02:17:57ZengSpringerOpenJournal of the Egyptian National Cancer Institute2589-04092020-02-013211810.1186/s43046-020-0020-1Liver disease during and after hematopoietic stem cell transplantation in adults: a single-center Egyptian experienceHaitham Abdelbary0Rasha Magdy1Mohammed Moussa2Inas Abdelmoaty3Department of Clinical Hematology and Bone Marrow Transplantation, Ain Shams UniversityDepartment of Clinical Hematology and Bone Marrow Transplantation, Ain Shams UniversityDepartment of Clinical Hematology and Bone Marrow Transplantation, Ain Shams UniversityDepartment of Clinical Hematology and Bone Marrow Transplantation, Ain Shams UniversityAbstract Background Hepatic complications are a well-known cause of both early and late mortality and morbidity in hematopoietic stem cell transplant (HSCT) recipients. Early diagnosis and management of hepatic complications is important in order to commence appropriate therapy. Conditioning regimens, acute and chronic graft versus host disease, sinusoidal obstruction syndrome, and infections among others represent major hepatic complications for the transplant recipient. We assessed liver function tests, viral markers, polymerase chain reaction, abdominal ultrasound, portal, and hepatic venous duplex in 88 patients underwent autologous and 102 patients underwent allogeneic transplant as well as liver biopsy in selected patients in this retrospective study and evaluated early and late hepatic complications and their impact on transplant outcome. Results The major cause of hepatic injury in allogeneic patients is the conditioning regimen (38.8%) followed by acute GVHD (14.7%), after day +100 chronic hepatic GVHD is the primary cause of liver injury which occurred in about 40% of allogeneic patients. In autologous patients, the first cause of hepatotoxicity is also conditioning regimen involving 27.9% of patients followed by flare of viral hepatitis in 7.9% and sepsis in 6.3% of cases. The prevalence of HCV, HBV, and CMV is 19%, 16%, and 8%, respectively. Conclusion In our study, conditioning regimens, acute and chronic hepatic GVHD are frequent causes of hepatic injury following allogeneic HSCT while conditioning regimens, flare of viral hepatitis, and sepsis represent the most common causes of hepatic injury following autologous HSCT.http://link.springer.com/article/10.1186/s43046-020-0020-1Hematopoietic stem cell transplantationHepatotoxicityGraft versus host diseaseSinusoidal obstruction syndrome |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Haitham Abdelbary Rasha Magdy Mohammed Moussa Inas Abdelmoaty |
spellingShingle |
Haitham Abdelbary Rasha Magdy Mohammed Moussa Inas Abdelmoaty Liver disease during and after hematopoietic stem cell transplantation in adults: a single-center Egyptian experience Journal of the Egyptian National Cancer Institute Hematopoietic stem cell transplantation Hepatotoxicity Graft versus host disease Sinusoidal obstruction syndrome |
author_facet |
Haitham Abdelbary Rasha Magdy Mohammed Moussa Inas Abdelmoaty |
author_sort |
Haitham Abdelbary |
title |
Liver disease during and after hematopoietic stem cell transplantation in adults: a single-center Egyptian experience |
title_short |
Liver disease during and after hematopoietic stem cell transplantation in adults: a single-center Egyptian experience |
title_full |
Liver disease during and after hematopoietic stem cell transplantation in adults: a single-center Egyptian experience |
title_fullStr |
Liver disease during and after hematopoietic stem cell transplantation in adults: a single-center Egyptian experience |
title_full_unstemmed |
Liver disease during and after hematopoietic stem cell transplantation in adults: a single-center Egyptian experience |
title_sort |
liver disease during and after hematopoietic stem cell transplantation in adults: a single-center egyptian experience |
publisher |
SpringerOpen |
series |
Journal of the Egyptian National Cancer Institute |
issn |
2589-0409 |
publishDate |
2020-02-01 |
description |
Abstract Background Hepatic complications are a well-known cause of both early and late mortality and morbidity in hematopoietic stem cell transplant (HSCT) recipients. Early diagnosis and management of hepatic complications is important in order to commence appropriate therapy. Conditioning regimens, acute and chronic graft versus host disease, sinusoidal obstruction syndrome, and infections among others represent major hepatic complications for the transplant recipient. We assessed liver function tests, viral markers, polymerase chain reaction, abdominal ultrasound, portal, and hepatic venous duplex in 88 patients underwent autologous and 102 patients underwent allogeneic transplant as well as liver biopsy in selected patients in this retrospective study and evaluated early and late hepatic complications and their impact on transplant outcome. Results The major cause of hepatic injury in allogeneic patients is the conditioning regimen (38.8%) followed by acute GVHD (14.7%), after day +100 chronic hepatic GVHD is the primary cause of liver injury which occurred in about 40% of allogeneic patients. In autologous patients, the first cause of hepatotoxicity is also conditioning regimen involving 27.9% of patients followed by flare of viral hepatitis in 7.9% and sepsis in 6.3% of cases. The prevalence of HCV, HBV, and CMV is 19%, 16%, and 8%, respectively. Conclusion In our study, conditioning regimens, acute and chronic hepatic GVHD are frequent causes of hepatic injury following allogeneic HSCT while conditioning regimens, flare of viral hepatitis, and sepsis represent the most common causes of hepatic injury following autologous HSCT. |
topic |
Hematopoietic stem cell transplantation Hepatotoxicity Graft versus host disease Sinusoidal obstruction syndrome |
url |
http://link.springer.com/article/10.1186/s43046-020-0020-1 |
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