title: Liver transplantation in haemophilia.
abstract: We report our UK single-centre experience of liver transplantation in haemophilia patients with chronic hepatitis C (HCV) infection. Between March 1990 and March 2001, 16 patients were referred for transplant assessment and 11 (mean age 46 years: nine haemophilia A, two haemophilia B) have been transplanted. Factor concentrate replacement was administered using a continuous infusion regimen following initial bolus dosing. Concentrate infusion was discontinued at a median of 36 h (range 24-72 h) post transplant. Nine patients remain alive at a median of 5 years post transplant (6 months to 11 years). One patient died 6 years post transplant from myocardial infarction. The other patient died of liver failure as a consequence of HCV infection 3 months following a second transplant, having developed HCV cirrhosis within 1 year of receiving his initial graft. Five of the seven patients who have had annual liver biopsy surveillance have developed histological changes of HCV hepatitis at a median of 3 years post transplant (1 year to 9 years). One of these patients progressed to cirrhosis at 3 years 5 months post transplant. Two patients have shown no evidence of HCV hepatitis at 2 years 8 months and 9 years post transplant respectively. The outcome of liver transplantation in haemophilic patients is good and is associated with relatively little morbidity.
authors.affiliation: West Midlands Adult Comprehensive Care Haemophilia Centre, University Hospital Birmingham NHS Trust, Edgbaston, Birmingham B15 2TH, UK. jonathan.wilde@university-b.wmids.nhs.uk
authors.forename: Jonathan
authors.initials: J
authors.lastname: Wilde
authors.forename: Paulo
authors.initials: P
authors.lastname: Teixeira
authors.forename: Simon R
authors.initials: SR
authors.lastname: Bramhall
authors.forename: Bridget
authors.initials: B
authors.lastname: Gunson
authors.forename: D
authors.initials: D
authors.lastname: Mutimer
authors.forename: Darius F
authors.initials: DF
authors.lastname: Mirza
mesh_terms: D000328:Adult; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality / Q000601:surgery; D006467:Hemophilia A / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000401:mortality / Q000601:surgery; D006801:Humans; D007432:Intraoperative Period; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D001779:Blood Coagulation Factors