Journal of Pharmaceutical Care 2016. 4(1-2):14-20.

Evaluation of Risk Factors for Hepatic Complications after Allogeneic Hematopoietic Stem Cell Transplantation
Zahrasadat Mirmoezi, Molouk Hadjibabaie, Ava Mansouri, Hamidreza Taghvaye Masoumi, Zahra Jahangard-Rafsanjani, Hossein Kamranzadeh

Abstract


Background:  Hepatic dysfunction in patients who have undergone allogeneic haematopoietic stem cell transplantation (HSCT) is a major cause of morbidity and mortality. The aim of this study is to evaluate the incidence of post-transplantation hepatic complications in these patients.

Methods: A total of 121 patients (age above 15 with no abnormality in their hepatic tests) participated in the study. The influence of a variety of risk factors on the incidence, type, and pattern of hepatic dysfunction as well as the length of hospital stay related to these complications were studied.

Results:  As a whole, 76 patients (62%)—44 males and 32 females—were diagnosed with hepatic dysfunction after transplantation. As many as 31(25%) of the patients showed increased measures in their hepatic enzyme, while 45(37%) of them ended up with both abnormal enzyme measure and clinical symptoms including diarrhoea, skin rash, jaundice, and anorexia. The hepatic dysfunction rates owing to drug toxicity and GVHD (21.5% and 16.5%, respectively) proved to be the highest in our study. Analysing risk factors, the immunosuppressive regimen could affect the type of hepatic dysfunction—i.e., less patients with GVHD were found in the group who received ATG in their regimen (p-value =0.034).

Conclusion: According to these findings, the immunosuppressive regimen can play a role in preventing the incidence of GVHD. Less occurrence of hepatic complications, especially GVHD, may lead to less clinical symptoms and time of hospital stay.


Keywords


hepatotoxicity, HSCT, risk factors

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