Cargando…
Nodular Regenerative Hyperplasia After Liver Transplant; It’s All in the Presentation
There is a paucity of data on nodular regenerative hyperplasia after liver transplant. We aim to define the clinical disease trajectory and identify predictors of outcome for this rare diagnosis. This is a retrospective review of postulated risk factors and outcome in patients with nodular regenerat...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9152168/ https://www.ncbi.nlm.nih.gov/pubmed/35656084 http://dx.doi.org/10.3389/fsurg.2022.876818 |
_version_ | 1784717586712231936 |
---|---|
author | Chen, Allen K. Lunow-Luke, Tyler Yamaguchi, Seiji Praglin, Claudia Agudelo, Eliana Mehta, Neil Dirks, Rachel Braun, Hillary J. Gardner, James M. Roberts, John P. Syed, Shareef M. Roll, Garrett R. |
author_facet | Chen, Allen K. Lunow-Luke, Tyler Yamaguchi, Seiji Praglin, Claudia Agudelo, Eliana Mehta, Neil Dirks, Rachel Braun, Hillary J. Gardner, James M. Roberts, John P. Syed, Shareef M. Roll, Garrett R. |
author_sort | Chen, Allen K. |
collection | PubMed |
description | There is a paucity of data on nodular regenerative hyperplasia after liver transplant. We aim to define the clinical disease trajectory and identify predictors of outcome for this rare diagnosis. This is a retrospective review of postulated risk factors and outcome in patients with nodular regenerative hyperplasia. Patients were classified as having a late presentation if nodular regenerative hyperplasia was diagnosed > 48 months from transplant, and symptomatic if portal hypertensive symptoms were present. Forty-nine of 3,711 (1.3%) adult recipients developed nodular regenerative hyperplasia, and mortality was 32.7% with an average follow up of 84.6 months. The MELD-Na 6 months after diagnosis did not change significantly. Patients with symptomatic portal hypertension at the time of diagnosis had a significantly higher risk of mortality (51.8%) compared to patients with liver test abnormalities alone (10.5%). 44.9% of patients had no previously postulated risk factor. Anastomotic vascular complications do not appear to be the etiology in most patients. The results suggest the vast majority of patients presenting with liver test abnormalities alone have stable disease and excellent long term survival, in contrast to the 56.3% mortality seen in patients that present more than 48 months after LT with symptomatic portal hypertension at diagnosis. |
format | Online Article Text |
id | pubmed-9152168 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-91521682022-06-01 Nodular Regenerative Hyperplasia After Liver Transplant; It’s All in the Presentation Chen, Allen K. Lunow-Luke, Tyler Yamaguchi, Seiji Praglin, Claudia Agudelo, Eliana Mehta, Neil Dirks, Rachel Braun, Hillary J. Gardner, James M. Roberts, John P. Syed, Shareef M. Roll, Garrett R. Front Surg Surgery There is a paucity of data on nodular regenerative hyperplasia after liver transplant. We aim to define the clinical disease trajectory and identify predictors of outcome for this rare diagnosis. This is a retrospective review of postulated risk factors and outcome in patients with nodular regenerative hyperplasia. Patients were classified as having a late presentation if nodular regenerative hyperplasia was diagnosed > 48 months from transplant, and symptomatic if portal hypertensive symptoms were present. Forty-nine of 3,711 (1.3%) adult recipients developed nodular regenerative hyperplasia, and mortality was 32.7% with an average follow up of 84.6 months. The MELD-Na 6 months after diagnosis did not change significantly. Patients with symptomatic portal hypertension at the time of diagnosis had a significantly higher risk of mortality (51.8%) compared to patients with liver test abnormalities alone (10.5%). 44.9% of patients had no previously postulated risk factor. Anastomotic vascular complications do not appear to be the etiology in most patients. The results suggest the vast majority of patients presenting with liver test abnormalities alone have stable disease and excellent long term survival, in contrast to the 56.3% mortality seen in patients that present more than 48 months after LT with symptomatic portal hypertension at diagnosis. Frontiers Media S.A. 2022-05-17 /pmc/articles/PMC9152168/ /pubmed/35656084 http://dx.doi.org/10.3389/fsurg.2022.876818 Text en Copyright © 2022 Chen, Lunow-Luke, Yamaguchi, Praglin, Agudelo, Mehta, Dirks, Braun, Gardner, Roberts, Syed and Roll. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Surgery Chen, Allen K. Lunow-Luke, Tyler Yamaguchi, Seiji Praglin, Claudia Agudelo, Eliana Mehta, Neil Dirks, Rachel Braun, Hillary J. Gardner, James M. Roberts, John P. Syed, Shareef M. Roll, Garrett R. Nodular Regenerative Hyperplasia After Liver Transplant; It’s All in the Presentation |
title | Nodular Regenerative Hyperplasia After Liver Transplant; It’s All in the Presentation |
title_full | Nodular Regenerative Hyperplasia After Liver Transplant; It’s All in the Presentation |
title_fullStr | Nodular Regenerative Hyperplasia After Liver Transplant; It’s All in the Presentation |
title_full_unstemmed | Nodular Regenerative Hyperplasia After Liver Transplant; It’s All in the Presentation |
title_short | Nodular Regenerative Hyperplasia After Liver Transplant; It’s All in the Presentation |
title_sort | nodular regenerative hyperplasia after liver transplant; it’s all in the presentation |
topic | Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9152168/ https://www.ncbi.nlm.nih.gov/pubmed/35656084 http://dx.doi.org/10.3389/fsurg.2022.876818 |
work_keys_str_mv | AT chenallenk nodularregenerativehyperplasiaafterlivertransplantitsallinthepresentation AT lunowluketyler nodularregenerativehyperplasiaafterlivertransplantitsallinthepresentation AT yamaguchiseiji nodularregenerativehyperplasiaafterlivertransplantitsallinthepresentation AT praglinclaudia nodularregenerativehyperplasiaafterlivertransplantitsallinthepresentation AT agudeloeliana nodularregenerativehyperplasiaafterlivertransplantitsallinthepresentation AT mehtaneil nodularregenerativehyperplasiaafterlivertransplantitsallinthepresentation AT dirksrachel nodularregenerativehyperplasiaafterlivertransplantitsallinthepresentation AT braunhillaryj nodularregenerativehyperplasiaafterlivertransplantitsallinthepresentation AT gardnerjamesm nodularregenerativehyperplasiaafterlivertransplantitsallinthepresentation AT robertsjohnp nodularregenerativehyperplasiaafterlivertransplantitsallinthepresentation AT syedshareefm nodularregenerativehyperplasiaafterlivertransplantitsallinthepresentation AT rollgarrettr nodularregenerativehyperplasiaafterlivertransplantitsallinthepresentation |