BACKGROUND: Although orthotopic liver transplantation provides a therapeutic option for patients with Wilson's disease (WD) presenting fulminant liver failure or drug resistance, it is still unclear whether the living-related liver transplantation (LRLT) can result in long-term therapeutic effect on WD. METHODS: Here, we report a retrospective analysis of LRLT for 36 cases of WD patients. The indications for LRLT were fulminant hepatic failure in two patients and chronic advanced liver disease in 32 patients including 13 patients with Wilsonian neurologic manifestations. Two patients presented with severe Wilsonian neurologic manifestations even though their liver functions were stable. RESULTS: Results revealed that the survival of posttransplant patients or grafts at 1, 3, and 5 years was 91.7%, 83.3%, 75%, or 86.1%, 77.8%, 75%, respectively. Pretransplant intensive care unit-bound and model for end-stage liver disease score were indicated as independent factors predictive of patient survival. Patients with neurologic abnormalities showed significant improvement after liver transplant. CONCLUSION: Our results indicate LRLT is an excellent therapeutic modality for WD patients with end-stage liver disease. Better pretransplant conditions appeared to be advantageous in gaining better survival outcomes of patients undergoing LRLT.
BACKGROUND: Although orthotopic liver transplantation provides a therapeutic option for patients with Wilson's disease (WD) presenting fulminant liver failure or drug resistance, it is still unclear whether the living-related liver transplantation (LRLT) can result in long-term therapeutic effect on WD. METHODS: Here, we report a retrospective analysis of LRLT for 36 cases of WDpatients. The indications for LRLT were fulminant hepatic failure in two patients and chronic advanced liver disease in 32 patients including 13 patients with Wilsonian neurologic manifestations. Two patients presented with severe Wilsonian neurologic manifestations even though their liver functions were stable. RESULTS: Results revealed that the survival of posttransplant patients or grafts at 1, 3, and 5 years was 91.7%, 83.3%, 75%, or 86.1%, 77.8%, 75%, respectively. Pretransplant intensive care unit-bound and model for end-stage liver disease score were indicated as independent factors predictive of patient survival. Patients with neurologic abnormalities showed significant improvement after liver transplant. CONCLUSION: Our results indicate LRLT is an excellent therapeutic modality for WDpatients with end-stage liver disease. Better pretransplant conditions appeared to be advantageous in gaining better survival outcomes of patients undergoing LRLT.
Authors: Samuel Shribman; Gwilym Webb; Rhiannon Taylor; Thomas T Warner; Adam Duckworth; Alexander Gimson; Achuth Shenoy; William Griffiths Journal: JHEP Rep Date: 2020-03-09
Authors: Mohammed Al Fadda; Mohammed Al Quaiz; Hamad Al Ashgar; Khalid Al Kahtani; Ahmed Helmy; Ali Al Benmousa; Maheeba Abdulla; Musthafa Peedikayil Journal: Ann Saudi Med Date: 2012 Nov-Dec Impact factor: 1.526