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العنوان
Hepatic and Cardiac Function Assessment in
Children following Liver Transplantation /
المؤلف
Abd El-Hamid, Salwa Amin.
هيئة الاعداد
باحث / Salwa Amin Abd El-Hamid
مشرف / Tawhida Yassin Abdel-Ghaffar
مشرف / Nevin Mohamed Mamdouh Habeeb
مناقش / Nedal Hegazy
تاريخ النشر
2018.
عدد الصفحات
178 P. :
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
طب الأطفال ، الفترة المحيطة بالولادة وصحة الطفل
تاريخ الإجازة
1/1/2018
مكان الإجازة
جامعة عين شمس - كلية الطب - قسم طب الاطفال
الفهرس
Only 14 pages are availabe for public view

from 178

from 178

Abstract

Liver transplantation (LT) is a life-saving procedure for patients with end stage liver disease. With improved long-term survival following LT, issues related to the assessment of the liver allograft in long-term survivors are becoming increasingly relevant.
On the other hand, following liver transplantation, there is an increased risk of adverse cardiac events especially with chronic intake of immunosuppressive agents.
The current study aimed to evaluate histological and biochemical changes in the liver as well as the cardiac functions post liver transplantation. This study was conducted on twenty one patients who underwent liver transplantation since 2001. All children included in this study were recruited from specialized Hepatology clinic at Ain Shams University hospital and Dr Yassin Abd El Ghaffar charity Center for Liver Disease and Research.
All patients were subjected to detailed history taking, clinical examination and laboratory investigations including: complete liver profile, lipid profile, tacrolimus level, creatinine clearance and NTProBNP. Twelve lead ECG & detailed echocardiography were done for twenty patient.
Histopathological evaluation of liver biopsies was done for twenty patients. The C4d was evaluated by immunohistochemical staining of the formalin-fixed, paraffin-embedded 17 biopsies.
The results of the present study showed that fibrosis was prevalent in 25% with no relation to recipient age, donor age at transplantation, donor recipient age ratio or post surgical complications.
Acute rejection was detected in 45%, however, chronic rejection was detected in 35% of patients. Normal histology was detected in 15% of patients.
Chronic rejection had significant relation with sex mismatching between donor & recipient (P value=0.032). ALT level was significantly higher in patients with acute rejection than others (P =0.049). Positive C4d immunostaining (for AMR detection) was detected in 3/17 patients (17.7%). 2 out of 9 (22.2%) of patients with acute rejection had positive C4d staining. While, 1 out of 7 (14.3%) of patients with chronic rejection had positive C4d staining.
As regard cardiological evaluation, this study showed a prolonged QTc interval in 40% of patients. No significant systolic or diastolic dyfsunction in our patient after transplantation but global strain was enhanced in 15% of the studied patients. However, NT-ProBNP was elevated in all patients with a highly significant negative correlation with creatinine clearance (P value = 0.007).