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EQA

Liver transplant meeting 15th November 2012







Cambridge 1

Male 54 years

Transplanted 18 months ago for alpha 1 anti-trypsin cirrhosis. No post-op biopsies


192983


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Cambridge 2

Male 49 years

OLT for HCV April 2011. Rising ALT and Plk Phos. Mild cellular rejectin diagnosed two weeks ago on biopsy


192984


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KCH

Sex unknown age unknown

Explant 20 years after liver transplant for HBV/HIV


192985


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192986


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Leeds 1

Male 6 years

Slide 192987: 1st biopsy transplanted 8 days ago for PFIC - cirrhosis. Raised alk phos and GGT, ? acute rejection. Slide 192988: 2nd biopsy day 24 biopsy. Slide 192989: 3rd biopsy 16 months post transplant. Raised ALT, ? rejection. Slides 192990 and 192992: 4th biopsy 31 months post transplant. 'failure to thrive'


192987


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192988


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192989


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192990


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192992


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Leeds 2

Male 57 years

2 years post transplant for hepatitis C
recurrent hep C


192993


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Dublin

Female 56 years

Asian woman who underwent OLT for fulminant hepatic failure due to reactivation of HBV. The biopsy is from the graft 2 years post OLT, performed for abnormal liver function tests. She had developed type 2 diabetes post OLT. Serum iron 39.4umol/L, TIBC 46umol/L, transferrin saturation 86% and ferritin >1500umol/L


Birmingham

Male 47 years

Liver transplantation for cirrhosis due to alpha-1-antitrypsin deficiency. Side-to-side caval-caval anastomosis (modified piggy-back anastomosis). Problems with ascites, renal impairment, pleural effusions and peripheral oedema. Cause uncertain. Hepatic venography six weeks post-transplant showed patent hepatic veins. No evidence of pressure gradient. Slides submitted are from a transjugular liver biopsy obtained during hepatic venography. LFTs: Alk Phos 255 (normal 40-130), bilirubin 27 (normal < 22), ALT & AST normal


192996


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