Hepatic complications of hematopoietic cell transplantation.
Acute and chronic liver disease contributes significantly to morbidity and mortality following hematopoietic cell transplantation (HCT). The best prognostic indicator for the development of severe liver dysfunction is an early rise in liver function test results after HCT. The leading causes soon after HCT are acute graft-versus-host disease (GVHD), sinusoidal obstruction syndrome, drug and total parenteral nutrition hepatotoxicity, sepsis, and viral infection. Hepatic herpesvirus and fungal infections after HCT, though uncommon, can be life-threatening and warrant immediate diagnosis and treatment. Hepatitis B, hepatitis C virus, iron overload, and chronic GVHD are among the most common causes for chronic liver disease after HCT. Because treatments are directed at the underlying etiology of liver disease, prompt diagnosis by means of laboratory tests, hepatic imaging, and often liver biopsy is required after HCT.
Levitsky
Josh
J
Department of Medicine, Division of Hepatology, Northwestern University Feinberg School of Medicine, 675 N. St. Clair, 15-250, Chicago, IL 60611, USA. j-levitsky@northwestern.edu
Sorrell
Michael F
MF
D001660:Biliary Tract Diseases; D064420:Drug-Related Side Effects and Adverse Reactions; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006504:Hepatic Veno-Occlusive Disease; D006525:Hepatitis, Viral, Human; D006801:Humans; D019190:Iron Overload; D008107:Liver Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D009181:Mycoses; D010289:Parenteral Nutrition, Total; D012307:Risk Factors; D018805:Sepsis