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Home : Diagnostic References : Hepatobiliary Diseases : Liver Transplantation : Late Complications After Liver Transplantation
     
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Late Complications After Liver Transplantation
published: June, 1999
by: N. Bourgeois, Department of Gastroenterology and Hepatopancreatology, ULB-Erasme Hospital, Brussels
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Case History

CP was born in 1945. He is married, has two children and grandchildren. He works as an employee. He began to drink alcohol when he was 20 years; the daily alcohol consumption was 70 g/day from 1970 to 1992, when he stopped drinking.

In 1985, he presented with polyuria; diabetes mellitus was diagnosed. Insulin was begun. His mother and one of his brothers were also diabetic. His weight was 80 kgs at the beginning of the treatment with insulin, and slowly increased afterwards, reaching 89 kgs for 1m72 in 1990.

In 1992, he bled from esophageal varices. This bleeding allowed the diagnosis of alcoholic cirrhosis to be made. The varices were injected with glue and eradicated after 5 sessions. He was not given propranolol because of diabetes.

In March 1994, the patient was admitted to the hospital because of ascites, jaundice and encephalopathy. He had stopped drinking 7 months earlier because of fatigue.
He was amyotrophic.
His weight (with ascites) was 76 kgs.
He had no fever.
Foetor was marked.
Blood pressure was 105/85.
His abdomen was not distented but ascites was clinically obvious at percussion.

Laboratory

WBC 3.2x109/L N: 4-10x109/L
Hb 11.5 g/dL N: 12.5-15 g/dL
Platelets 57x109/L N: 150-300x109/L
BUN 14 mg/dL N: <40 mg/dL
Creatinine 0.6 mg/dL N: 0.2-1.2 mg/dL
Glycemia 160 mg/dL N: 70-110 mg/dL
Hb1AC 8% N: <6.5% of total Hb
Total bilirubin 6.2 mg/dL N: <1.5 mg/dL
AST 88 IU/L N: <30 IU/L
ALT 62 IU/L N: <35 IU/L
Albumin 3 g/dL N:  >4 g/dL
Gammaglobulins 3.2 g/dL N: 0.6-1.3 g/dL
Prothrombin time 52% N: 70-100%
aFP 8 ng/mL N: <15 ng/mL
Triglycerides 90 mg/dL N: 74-170 mg/dL
Cholesterol 135 mg/dL N: 100-250 mg/dL
 

Serology

HAV IgG > 80 mIU/mL
HBV HBsAg: negative
anti HBs: 60 mIU/mL
HCV No antibodies
PCR: negative
EBV VCA IgG: 1/640
IgM: negative
CMV IgG: 1/80
IgM: negative
Blood cultures Negative
Creatinine clearance 65 mL/min

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