title: Liver Transplantation for Incurable Alveolar Echinococcosis: An Analysis of Patients Hospitalized in Department of Tropical and Parasitic Diseases in Gdynia.
abstract: BACKGROUND
  Alveolar echinococcosis is a parasitic disease caused by the larval stage of tapeworm Echinococcus multilocularis. It usually involves the liver, but can spread to other organs. The treatment of choice is a surgical resection supported by antiparasitic drugs. In the advanced stages of the disease a liver transplantation is the only option.
  
  
  OBJECTIVE
  This article presents the problems related to care of patients after liver transplantation for advanced alveolar echinococcosis.
  
  
  METHODS
  Sixty-seven patients with alveolar echinococcosis were hospitalized in our clinic in the years 2000-2015. Liver transplantation has been a therapeutic option for 9 patients. We retrospectively analyzed data of qualification for the liver transplantation and the postoperative treatment.
  
  
  RESULTS
  Follow-up time after liver transplantation ranged from 7 months to 155 months (average, 6.4 years). One patient, with a history of advanced disease (P4N1M0), died due to liver failure. One patient was lost to follow-up. After liver transplantation all patients were receiving albendazole treatment. Two patients did not follow the medical recommendations. In 1 patient, who decided to stop therapy after 1 year, the relapse of alveolar echinococcosis in the left lobe of the transplanted liver passing through the diaphragm to the pericardium was detected. In another case we suspected a relapse of alveolar echinococcosis in transplanted liver due to positive serological tests.
  
  
  CONCLUSIONS
  The prognosis of patient after liver transplantation for alveolar echinococcosis is good. The main problem caused by immunosuppressive therapy is a recurrence of disease in the transplanted liver.
authors: Department of Tropical and Parasitic Diseases, Institute of Maritime and Tropical Medicine, Gdynia, Poland.
authors: M
authors: M
authors: Sulima
authors: Department of Occupational, Metabolic and Internal Medicine, Medical University of Gdansk, Gdynia, Poland. Electronic address: wolyniecwojtek@gmail.com.
authors: W
authors: W
authors: Wołyniec
authors: Department of Immunology, Transplant Medicine and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
authors: U
authors: U
authors: Oładakowska-Jedynak
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors: W
authors: W
authors: Patkowski
authors: Department of Tropical and Parasitic Diseases, Institute of Maritime and Tropical Medicine, Gdynia, Poland.
authors: N
authors: N
authors: Wasielak
authors: Department of Tropical and Parasitic Diseases, Institute of Maritime and Tropical Medicine, Gdynia, Poland.
authors: K
authors: K
authors: Witczak-Malinowska
authors: Department of Tropical and Parasitic Diseases, Institute of Maritime and Tropical Medicine, Gdynia, Poland.
authors: S
authors: S
authors: Borys
authors: Department of Tropical and Parasitic Diseases, Institute of Maritime and Tropical Medicine in Gdynia, Medical University of Gdansk, Gdynia, Poland.
authors: W
authors: W
authors: Nahorski
authors: Department of Tropical and Parasitic Diseases, Institute of Maritime and Tropical Medicine in Gdynia, Medical University of Gdansk, Gdynia, Poland.
authors: A
authors: A
authors: Wroczyńska
authors: Department of Tropical Parasitology, Institute of Maritime and Tropical Medicine in Gdynia, Medical University of Gdansk, Gdynia, Poland.
authors: B
authors: B
authors: Szostakowska
authors: Department of Tropical Parasitology, Institute of Maritime and Tropical Medicine in Gdynia, Medical University of Gdansk, Gdynia, Poland.
authors: A
authors: A
authors: Lass
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors: M
authors: M
authors: Krawczyk
mesh_terms: D000328:Adult; D000818:Animals; D004443:Echinococcosis; D004444:Echinococcosis, Hepatic / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome