Table 2.

Clinical and Histologic Features of 31 Patients With Cirrhosis

UPN Age at BMT (yrs) Gender Years Posttransplant to Diagnosis of CirrhosisClinical Features of Liver Disease at PresentationHepatitis Viruses Liver Histology Years Posttransplant to Death,* Follow-Up, or OLT†Cause of Death
209  16  F  24.9  Firm, fibrotic liver at laparotomy‡ None  Early cirrhosis/steatosis  25.2  
756  37  M  19.4 Jaundice, ascites, metastatic adenocarcinoma stomach HCV + HBV  Cirrhosis  19.4* Adenocarcinoma stomach  
299  19  M  19.3  Variceal hemorrhage HCV  Cirrhosis/CH  24.0  
765  29  F  18.2 Variceal hemorrhage  HCV  CH  19.6  
387  30  F 16.8  Asymptomatic, abnormal LFTs  HCV  Cirrhosis/CH 22.4  
911  28  M  16.0  Asymptomatic, abnormal LFTs HCV  Early cirrhosis/CH  18.6  
171  21  M  15.7 Ascites, SBP, encephalopathy, thrombocytopenia  HCV + HBV Cirrhosis/CH  17.0* Liver failure  
1028  26  M 14.6  Ascites, jaundice  HCV  Cirrhosis/CH  16.0† OLT complications  
859  32  M  13.8 Asymptomatic, abnormal LFTs  HCV  Cirrhosis  19.0  
264 28  M  13.4  Mass in liver  HCV  Cirrhosis/HCC 15.5* Hepatocellular carcinoma  
838  30 F  12.6  Liver failure  HCV  Cirrhosis/CH  16.3† 
1782  22  F  12.3  Asymptomatic, abnormal LFTs  HCV Cirrhosis/siderosis  14.8  
1391  27  F  12.2 Splenomegaly  HCV  Cirrhosis/CH  16.2  
1055  2.5 F  12.0  Ascites, encephalopathy  HCV  Cirrhosis 12.1* Liver failure  
1989  24  M  11.7 Asymptomatic, abnormal LFTs  HCV + HBV  Early cirrhosis/CH 14.2  
2393  33  M  10.1  Asymptomatic, abnormal LFTs HCV  Cirrhosis/siderosis  13.2  
1595  46  M  9.2 Hypersplenism  HCV + HBV  Cirrhosis  15.4  
3859 46  M  7.5  Ascites, esophageal varices, hypersplenism HCV  Cirrhosis/CH  9.6† 
1244  56  F  7.4 Ascites, SBP, encephalopathy, hypersplenism  None  No biopsy 16.9* Liver failure  
4669  13  F  5.9 Asymptomatic, abnormal LFTs  HCV  Early cirrhosis  8.5 
5084  34  F  5.4  Jaundice, splenomegaly  None cGHVD/marked siderosis  7.9  
3331  32  F 4.6  Ascites, SBP, encephalopathy, coagulopathy, renal failure HCV  Cirrhosis/CH  4.9* Liver failure  
3254 41  F  4.1  Ascites, jaundice, encephalopathy HCV + HBV  Cirrhosis/CH  4.4* Liver failure 
2831  37  F  3.7  Jaundice, encephalopathy  HCV Cirrhosis/cGVHD  3.7* Liver failure  
3576  23 F  3.0  Hypersplenism  HCV  Cirrhosis  10.5 
69772-153 26  F  2.5  Jaundice  None Cirrhosis/cGVHD  2.6* Liver failure  
4978  53 F  2.0  Ascites, varices  HCV  Cirrhosis/CH  5.3* Ovarian carcinoma  
1971  34  M  1.8  Variceal hemorrhage, multiorgan failure  HCV  Early cirrhosis/cGVHD 2.0* Liver failure  
36622-155 23  M  1.8 Ascites, SBP, renal failure  HCV  Cirrhosis  2.0* Liver failure  
6616  40  M  1.8  Variceal hemorrhage, ascites, renal failure  None  cGVHD, dense portal tract fibrosis  2.9* Liver failure  
72292-154 42 F  1.2  Jaundice, ascites  None  Severe ductopenia, diffuse fibrosis  2.9* Liver failure 
UPN Age at BMT (yrs) Gender Years Posttransplant to Diagnosis of CirrhosisClinical Features of Liver Disease at PresentationHepatitis Viruses Liver Histology Years Posttransplant to Death,* Follow-Up, or OLT†Cause of Death
209  16  F  24.9  Firm, fibrotic liver at laparotomy‡ None  Early cirrhosis/steatosis  25.2  
756  37  M  19.4 Jaundice, ascites, metastatic adenocarcinoma stomach HCV + HBV  Cirrhosis  19.4* Adenocarcinoma stomach  
299  19  M  19.3  Variceal hemorrhage HCV  Cirrhosis/CH  24.0  
765  29  F  18.2 Variceal hemorrhage  HCV  CH  19.6  
387  30  F 16.8  Asymptomatic, abnormal LFTs  HCV  Cirrhosis/CH 22.4  
911  28  M  16.0  Asymptomatic, abnormal LFTs HCV  Early cirrhosis/CH  18.6  
171  21  M  15.7 Ascites, SBP, encephalopathy, thrombocytopenia  HCV + HBV Cirrhosis/CH  17.0* Liver failure  
1028  26  M 14.6  Ascites, jaundice  HCV  Cirrhosis/CH  16.0† OLT complications  
859  32  M  13.8 Asymptomatic, abnormal LFTs  HCV  Cirrhosis  19.0  
264 28  M  13.4  Mass in liver  HCV  Cirrhosis/HCC 15.5* Hepatocellular carcinoma  
838  30 F  12.6  Liver failure  HCV  Cirrhosis/CH  16.3† 
1782  22  F  12.3  Asymptomatic, abnormal LFTs  HCV Cirrhosis/siderosis  14.8  
1391  27  F  12.2 Splenomegaly  HCV  Cirrhosis/CH  16.2  
1055  2.5 F  12.0  Ascites, encephalopathy  HCV  Cirrhosis 12.1* Liver failure  
1989  24  M  11.7 Asymptomatic, abnormal LFTs  HCV + HBV  Early cirrhosis/CH 14.2  
2393  33  M  10.1  Asymptomatic, abnormal LFTs HCV  Cirrhosis/siderosis  13.2  
1595  46  M  9.2 Hypersplenism  HCV + HBV  Cirrhosis  15.4  
3859 46  M  7.5  Ascites, esophageal varices, hypersplenism HCV  Cirrhosis/CH  9.6† 
1244  56  F  7.4 Ascites, SBP, encephalopathy, hypersplenism  None  No biopsy 16.9* Liver failure  
4669  13  F  5.9 Asymptomatic, abnormal LFTs  HCV  Early cirrhosis  8.5 
5084  34  F  5.4  Jaundice, splenomegaly  None cGHVD/marked siderosis  7.9  
3331  32  F 4.6  Ascites, SBP, encephalopathy, coagulopathy, renal failure HCV  Cirrhosis/CH  4.9* Liver failure  
3254 41  F  4.1  Ascites, jaundice, encephalopathy HCV + HBV  Cirrhosis/CH  4.4* Liver failure 
2831  37  F  3.7  Jaundice, encephalopathy  HCV Cirrhosis/cGVHD  3.7* Liver failure  
3576  23 F  3.0  Hypersplenism  HCV  Cirrhosis  10.5 
69772-153 26  F  2.5  Jaundice  None Cirrhosis/cGVHD  2.6* Liver failure  
4978  53 F  2.0  Ascites, varices  HCV  Cirrhosis/CH  5.3* Ovarian carcinoma  
1971  34  M  1.8  Variceal hemorrhage, multiorgan failure  HCV  Early cirrhosis/cGVHD 2.0* Liver failure  
36622-155 23  M  1.8 Ascites, SBP, renal failure  HCV  Cirrhosis  2.0* Liver failure  
6616  40  M  1.8  Variceal hemorrhage, ascites, renal failure  None  cGVHD, dense portal tract fibrosis  2.9* Liver failure  
72292-154 42 F  1.2  Jaundice, ascites  None  Severe ductopenia, diffuse fibrosis  2.9* Liver failure 

Abbreviations: BMT, bone marrow transplantation; cGVHD, chronic graft-versus-host disease; CH, chronic hepatitis; HBV, hepatitis B virus; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; LFTs, liver function tests; OLT, orthotopic liver transplantation; SBP, spontaneous bacterial peritonitis; UPN, unique patient number.

*

Patients who died.

†

Patients who had OLT.

‡

Patient with stage IV breast adenocarcinoma. Several hepatic lesions on imaging presumed due to metastases. Laparotomy performed for attempted resection; however, cirrhosis demonstrated on frozen section biopsy and procedure abandoned. No evidence of hepatic decompensation or portal hypertension.

F2-153

Patient developed severe autoimmune hepatitis 16 months posttransplant after treatment with interferon-α for cytogenetic relapse of chronic myelogenous leukemia. Hepatitis resolved with corticosteroids. At 29 months posttransplant, another episode of cytogenetic relapse was treated with donor lymphocyte infusion that was complicated by severe liver GVHD leading to progressive liver failure and death.

F2-155

Patient had history of heavy alcohol consumption for many years before marrow transplantation.

F2-154

Patient developed progressive jaundice and ascites 4 weeks after treatment with amoxicillin/clavulanic acid (Augmentin). There was no evidence of GVHD in other organs and there was poor response to therapy with cyclosporine and prednisone.

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