Analyzer · Sparsifire

Analyze how specific documents activate the features of the SAE. Select a dataset, a run and a document to begin.

Dataset

SAE Model

Document

Active Features

1518

MIN ACTIVATION

0.0

Details List

#2845 Feature 2845

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#474 Surgical Procedures & Gastrointestinal Issues

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#2004 Feature 2004

#2243 Feature 2243

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#2180 Feature 2180

#2258 Feature 2258

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#1094 Feature 1094

#1792 Metastatic Cancer

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#1523 Feature 1523

#1213 Feature 1213

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#273 Feature 273

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#1420 Feature 1420

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#2554 Feature 2554

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#1770 Feature 1770

#2165 Feature 2165

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#2061 Feature 2061

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#227 Feature 227

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#1260 Feature 1260

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#2451 Feature #2451

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#2635 Feature 2635

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#1302 Sensing and Detection Technologies

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#2090 Feature 2090

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#1681 Feature 1681

#2112 Feature 2112

#237 Feature 237

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#1308 Feature 1308

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#342 Feature 342

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#715 Feature 715

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#400 Feature 400

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#186 Feature 186

#1370 Feature 1370

#2500 Feature 2500

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#650 Feature 650

#2521 Feature 2521

#2096 Feature 2096

#1403 Feature 1403

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Document Content

Should liver transplantation be performed for patients with hepatitis B?
Because of the almost universal recurrence of hepatitis B surface antigenemia (HBsAg) after liver transplantation, some centers have questioned whether these patients are appropriate allograft candidates. Since January 1984, 51 patients with hepatitis B (HBV) underwent OLT at our center. No therapy was given to prevent reinfection. Three patients underwent retransplantation. The indications for transplant included fulminant HBV (13 patients), chronic HBV (33 patients), and hepatocellular carcinoma (HCCA) in addition to HBV (5 patients). Incidental HCCA was found in 2 of the 33 patients thought to have only chronic HBV. Actuarial survival for the entire group was 57% at 1 year and 54% at 3 years. Of the 23 patients who died, only 4 deaths were attributable to recurrent HBV liver disease. Four patients survived less than 4 days due to primary graft nonfunction. Ten patients died in the first 3 months from sepsis. Although all patients who died beyond 30 days had recurrent HBsAg, only 4 deaths were attributable to recurrent HBV. The remaining 5 deaths were caused by portal vein thrombosis, bile leak, lymphoma, pancreatitis, and sepsis occurring at 15 months. Excluding the 4 patients who died from primary graft nonfunction, actuarial survival was 63% at 1 year and 60% at 3 years. Of the 28 survivors, 24 are HBsAg positive; however, only 5 have recurrent HBV liver disease. Multiple factors were evaluated to determine their influence on survival; i.e., HBV serology, United Network for Organ Sharing status, fulminant versus chronic HBV, incidence of rejection, immunosuppression, transfusion requirements, and presence of HCCA. Of these, only the presence of HCCA adversely affected outcome. Of the 7 patients with HCCA and HBV, 6 patients died within the first 6 months and 1 patient has recurrent HBV liver disease at 25 months. Actuarial survival excluding those patients with HCCA was 64% at 1 year and 61% at 3 years. Based on our results, patients with HBV and associated HCCA have a poorer prognosis and should probably be excluded from transplantation. Although the survival for patients with HBV undergoing liver transplantation is inferior to that expected in patients with some other diagnoses, long-term survival can be achieved in a majority of these patients despite recurrence of HBsAg. We believe that appropriately selected patients with a diagnosis of HBV alone should continue to be candidates for liver allografts.

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