Disease recurrence following liver transplantation.
Virtually all liver diseases that necessitate orthotopic liver transplantation (OLT) can recur, and recurrent disease has the potential to become the most serious problem facing transplantation in the future. In addition, recurrence following transplantation provides a model to study pathogenic mechanisms of these diseases. While some interventions (e.g., HBIG) have been shown to alter the natural history of recurrent disease, most of these disease processes are not modified by our currently available therapies. In addition, the role of different immunosuppressive protocols on disease recurrence requires further definition. As a varying proportion of the first generation of liver transplant patients develop severe recurrence and graft failure, policies of organ allocation for retransplantation will be challenged.
Division of Gastroenterology/Hepatology, Liver Transplantation Program, Portland Veterans Affairs, Oregon Health Sciences University, Portland, Oregon, USA. hugo.rosen@med.va.gov
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D019694:Hepatitis B, Chronic; D019698:Hepatitis C, Chronic; D006801:Humans; D008113:Liver Neoplasms; D016031:Liver Transplantation; D011183:Postoperative Complications; D012008:Recurrence; D012086:Reoperation