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|Title:||Long-term results of liver transplant in patients with chronic viral hepatitis-related liver disease in Singapore|
|Authors:||Wai, C.T. |
Da Costa, M.
Chronic hepatitis B
Chronic hepatitis C
|Citation:||Wai, C.T., Da Costa, M., Sutedja, D., Lee, Y.M., Lee, K.H., Tan, K.C., Isaac, J., Wee, A., Prabhakaran, K., Lim, S.-G. (2006-07). Long-term results of liver transplant in patients with chronic viral hepatitis-related liver disease in Singapore. Singapore Medical Journal 47 (7) : 588-591. ScholarBank@NUS Repository.|
|Abstract:||Introduction: Liver disease from chronic hepatitis B (CHB) and C (CHC) constitutes 57 percent of adult liver transplant in Singapore. Their long-term results post-transplant may be affected by recurrence of the viral illness. This study aims to evaluate the long-term results and survival in patients transplanted for CHB- and CHC-related liver disease. Methods: Patients transplanted for CHB- and CHC-related disease from 1990 until March 2004, which included decompensated cirrhosis and hepatocellular carcinoma (HCC), were reviewed and analysed. Results: 25 patients were transplanted for CHB-related liver disease, with mean follow-up of 153 ± 25 weeks. Two- and four-year survival rates were 75 percent and 69 percent, respectively. Hepatitis B recurrence from YMDD mutants occurred in five patients, and four were treated successfully with adefovir dipivoxil, with resolution in transaminases and/or improvement in histology. One patient became non-compliant with follow-up and medications, and died 173 weeks post-transplant from reactivation of the wild-type hepatitis B virus. Nine patients were transplanted for CHC-related liver disease, with mean follow-up of 188 ± 40 weeks, and two- and four-year survival rates of 89 percent and 76 percent, respectively. Two patients developed hepatitis C recurrence and were treated with interferon and ribavarin. One responded with sustained response but the other remained viraemic and died of HCC recurrence two years post-transplant. Conclusion: Long-term results from CHB- and CHC-related liver diseases were satisfactory and comparable to major transplant centres in the USA and Europe. Recurrence of viral hepatitis post-transplant is controllable with current antiviral therapy.|
|Source Title:||Singapore Medical Journal|
|Appears in Collections:||Staff Publications|
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