Recurrencia de la enfermedad hepática primaria después del trasplante hepático

Liver transplantation has become a standard option in the management of patients with end-stage liver disease. It is now evident that the most common etiology of long-term graft dysfunction is the recurrence of the primary liver disease. Autoimmune liver disorders such as autoimmune hepatitis, prima...

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Autor principal:	RAKELA B,JORGE
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2010
Materias:	Liver cirrhosis, biliary Liver transplantation Recurrence
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000400017
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spelling	oai:scielo:S0034-988720100004000172010-06-30Recurrencia de la enfermedad hepática primaria después del trasplante hepáticoRAKELA B,JORGE Liver cirrhosis, biliary Liver transplantation Recurrence Liver transplantation has become a standard option in the management of patients with end-stage liver disease. It is now evident that the most common etiology of long-term graft dysfunction is the recurrence of the primary liver disease. Autoimmune liver disorders such as autoimmune hepatitis, primary biliary cirrhosis, and primary sclerosing cholangitis recur between 15 to 30% of the graft recipients. The clinical expression of this recurrence tends to be milder; the diagnosis is only established in many patients by fndings in the liver biopsy. This milder clinical expression may be due to the use of immunosuppressive therapy for the prevention of organ rejection and it may also be modulating immune mechanisms that underlie these conditions. The recurrence of hepatitis C virus infection is characterized by an accelerated progression towards cirrhosis and hepatic failure due to the lack of an effective immunoprophylaxis program and an effective antiviral therapy. The recurrence of hepatitis B is uncommon due to the availability on an effective immunoprophylaxis program with effective antiviral agents. The familial amyloidotic polyneuropathy is a genetic condition residing in the hepatocyte that produces a mutation of transthyretin; this abnormal protein is deposited in peripheral nerves, gastrointestinal tract, heart, and kidneys. The liver from these patients, apart from producing this abnormal protein, is otherwise normal, and has been used as an organ for recipients in dire need of a liver transplant, such as patients with hepatocellular carcinoma. This approach is known as domino liver transplantation. As these recipients are followed long term, they may develop de novo amyloidosis. In summary, the underlying liver condition that led to endstage liver disease and liver transplantation may recur after liver transplantation. The clinical expression of the recurrence of the hepatic disease is modulated by the immunosuppression program unless we have an effective immunoprophylaxis and antiviral agents such as in hepatitis B.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.138 n.4 20102010-04-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000400017es10.4067/S0034-98872010000400017
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Liver cirrhosis, biliary Liver transplantation Recurrence
spellingShingle	Liver cirrhosis, biliary Liver transplantation Recurrence RAKELA B,JORGE Recurrencia de la enfermedad hepática primaria después del trasplante hepático
description	Liver transplantation has become a standard option in the management of patients with end-stage liver disease. It is now evident that the most common etiology of long-term graft dysfunction is the recurrence of the primary liver disease. Autoimmune liver disorders such as autoimmune hepatitis, primary biliary cirrhosis, and primary sclerosing cholangitis recur between 15 to 30% of the graft recipients. The clinical expression of this recurrence tends to be milder; the diagnosis is only established in many patients by fndings in the liver biopsy. This milder clinical expression may be due to the use of immunosuppressive therapy for the prevention of organ rejection and it may also be modulating immune mechanisms that underlie these conditions. The recurrence of hepatitis C virus infection is characterized by an accelerated progression towards cirrhosis and hepatic failure due to the lack of an effective immunoprophylaxis program and an effective antiviral therapy. The recurrence of hepatitis B is uncommon due to the availability on an effective immunoprophylaxis program with effective antiviral agents. The familial amyloidotic polyneuropathy is a genetic condition residing in the hepatocyte that produces a mutation of transthyretin; this abnormal protein is deposited in peripheral nerves, gastrointestinal tract, heart, and kidneys. The liver from these patients, apart from producing this abnormal protein, is otherwise normal, and has been used as an organ for recipients in dire need of a liver transplant, such as patients with hepatocellular carcinoma. This approach is known as domino liver transplantation. As these recipients are followed long term, they may develop de novo amyloidosis. In summary, the underlying liver condition that led to endstage liver disease and liver transplantation may recur after liver transplantation. The clinical expression of the recurrence of the hepatic disease is modulated by the immunosuppression program unless we have an effective immunoprophylaxis and antiviral agents such as in hepatitis B.
author	RAKELA B,JORGE
author_facet	RAKELA B,JORGE
author_sort	RAKELA B,JORGE
title	Recurrencia de la enfermedad hepática primaria después del trasplante hepático
title_short	Recurrencia de la enfermedad hepática primaria después del trasplante hepático
title_full	Recurrencia de la enfermedad hepática primaria después del trasplante hepático
title_fullStr	Recurrencia de la enfermedad hepática primaria después del trasplante hepático
title_full_unstemmed	Recurrencia de la enfermedad hepática primaria después del trasplante hepático
title_sort	recurrencia de la enfermedad hepática primaria después del trasplante hepático
publisher	Sociedad Médica de Santiago
publishDate	2010
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000400017
work_keys_str_mv	AT rakelabjorge recurrenciadelaenfermedadhepaticaprimariadespuesdeltrasplantehepatico
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Recurrencia de la enfermedad hepática primaria después del trasplante hepático

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