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Felli E, Felli E, Muttillo EM, Memeo R, Giannelli V, Colasanti M, Pellicelli A, Diana M, Ettorre GM. Liver transplantation for sickle cell disease: a systematic review. HPB (Oxford) 2021; 23:994-999. [PMID: 33431265 DOI: 10.1016/j.hpb.2020.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 12/03/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Sickle cell disease is a group of autosomal recessive disorders characterised by haemolytic anaemia. Liver is one of the most affected organs, ranging from liver tests alterations to acute liver failure for which liver transplantation is the only life-saving treatment. METHODS This study aims to make a systematic review of the current literature to evaluate indications, timing, and results of liver transplantation for patients affected by SCD. RESULTS Twenty-nine patients in total were reported worldwide until 2018, the average patient age is 28.7 (0.42-56), all patients have a pre-transplant diagnosis of SCD. Cirrhosis at transplantation was present in six-teen (n = 16, 55.1%) patients. In ten patients (n = 10, 34.5%), acute liver failure arises from healthy liver and presented sickle cell intrahepatic cholestasis. Eleven patients (n = 11, 39.2%) died, three (n = 3, 10.7%) in the first postoperative month, and seven (n = 7, 25%) in the first year. Mean follow-up was 27 months (range: 7-96), one-year overall survival was 48.7%. DISCUSSION Liver transplantation for SCD has been increasingly reported with encouraging results. Indications are presently reserved for acute liver failure arising both in healthy liver and end-stage liver disease.
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Affiliation(s)
- Emanuele Felli
- Department of General, Digestive, and Endocrine Surgery, University Hospital of Strasbourg, Strasbourg, France; IHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France; Research Institute Against Digestive Cancer (IRCAD), Strasbourg, France; Institute of Viral and Liver Disease, Inserm U1110, Strasbourg, France.
| | - Eric Felli
- IHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France; Research Institute Against Digestive Cancer (IRCAD), Strasbourg, France
| | - Edoardo M Muttillo
- Department of General, Digestive, and Endocrine Surgery, University Hospital of Strasbourg, Strasbourg, France; Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Riccardo Memeo
- Division of Hepato-Pancreato-Biliary Surgery, "F. Miulli" General Hospital, Acquaviva Delle Fonti, Bari, Italy; Liver Transplant Unit, Policlinico di Bari, Bari, Italy
| | - Valerio Giannelli
- San Camillo Hospital, Department of Transplantation and General Surgery, Rome, Italy
| | - Marco Colasanti
- San Camillo Hospital, Department of Transplantation and General Surgery, Rome, Italy
| | - Adriano Pellicelli
- San Camillo Hospital, Department of Transplantation and General Surgery, Rome, Italy
| | - Michele Diana
- IHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France; Research Institute Against Digestive Cancer (IRCAD), Strasbourg, France; ICUBE Laboratory, Photonics Instrumentation for Health, University of Strasbourg, Strasbourg, France
| | - Giuseppe M Ettorre
- San Camillo Hospital, Department of Transplantation and General Surgery, Rome, Italy
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Feng LB, Xia D, Yan LN. Liver transplantation for hepatolithiasis: Is terminal hepatolithiasis suitable for liver transplantation? Clin Transplant 2016; 30:651-8. [PMID: 26947018 DOI: 10.1111/ctr.12731] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2016] [Indexed: 02/05/2023]
Abstract
Hepatolithiasis, originally as oriental cholangiohepatitis, especially prevails in Asia, but globalization and intercontinental migration have also converted the endemic disease dynamics around the world. Characterized by its high incidence of ineffective treatment and recurrence, hepatolithiasis, always, poses a therapeutic challenge to global doctors. Although the improved surgical and non-surgical techniques have evolved over the past decade, incomplete clearance and recurrence of calculi are always so common and disease-related mortality from liver failure and concurrent cholangiocarcinoma still exists in the treatment of hepatolithiasis. In the late stage of hepatolithiasis, is it suitable for liver transplantation (LT)? Herein, we propose a comprehensive review and analysis of the LTx currently in potential use to treat hepatolithiasis. In our subjective opinion, and as is objective from the literatures so far, also given the strict indications, LT remains one of the definitive treatments for terminal hepatolithiasis.
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Affiliation(s)
- Li-Bo Feng
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Sichuan Medical University, Luzhou, China
| | - Dong Xia
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Sichuan Medical University, Luzhou, China
| | - Lv-Nan Yan
- Department of General Surgery and Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, China
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Lin CC, Lin PY, Ko CJ, Chen YL, Chen ST, Kuo SJ. Hepatic resection for bilateral hepatolithiasis: a 20-year experience. ANZ J Surg 2012; 83:978-84. [PMID: 23013139 DOI: 10.1111/j.1445-2197.2012.06283.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND There is increasing evidence showing that hepatic resection is probably the best definitive treatment for unilateral hepatolithiasis. However, the role of hepatic resection for bilateral hepatolithiasis is rarely mentioned in the literature. METHODS We retrospectively reviewed 197 patients who underwent hepatic resection for hepatolithiasis in Changhua Christian Hospital from December 1987 to December 2007. A total of 156 patients with unilateral hepatolithiasis were defined as the UNI group (control group), and 41 patients with bilateral hepatolithiasis were defined as the BI group (study group). The short- and long-term outcomes were measured. RESULTS The BI group had longer operating time (200 min versus 173 min, P = 0.006), lower immediate stone clearance rate (56.1% versus 91.7%, P < 0.001), lower final stone clearance rate (75.6% versus 94.9%, P = 0.001), higher rate of stone recurrence (22.6% versus 6.1%, P = 0.009) and higher disease-related mortality (19.5% versus 5.1%, P = 0.006). Thirty patients with bilateral peripheral stones were indicated for bilateral hepatectomy, but only 20 (66.7%) of them actually underwent the proposed procedure. Of the patients who did not achieve immediate stone clearance, bilateral peripheral stones represented 88.9% (P = 0.044). Of the patients who had stone recurrence, patients less than 35 years old represented 42.9% (P = 0.007). CONCLUSION Bilateral hepatolithiasis has worse outcomes than unilateral hepatolithiasis after being treated with hepatic resection. Regarding bilateral peripheral stones, there is often a discrepancy between the extent of stone-affected parenchyma and that of final liver resection, resulting in a lower immediate stone clearance rate. A higher stone recurrence rate was observed among younger population.
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Affiliation(s)
- Chia-Cheng Lin
- Division of General Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
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