ABSTRACT
BACKGROUND: Spinal epidural hematomas are rare conditions. Although the exact cause remains unknown in up to 40% of cases, anticoagulation therapy, neoplasm, thrombolytic therapy, internal jugular vein thrombosis, and prolonged Valsalva maneuvers associated with pregnancy may be contributing factors. The source of bleeding appears to be the dorsal internal vertebral venous plexus (IVVP). CASE DESCRIPTION: A 65-year-old female patient with hepatitis C-related cirrhosis underwent orthotopic liver transplantation (OLT). The patient developed SSEH due to congestion of the IVVP in the peri-transplant period. Concurrent spinal cord infarction occurred, likely secondary to hypoperfusion during a cardiac arrest. CONCLUSION: This case study should increase awareness of SSEH as a complication of OLT.
ABSTRACT
The management of hepatitis B in liver transplantation has evolved significantly over the past 2 decades. Introduction of hepatitis B immune globulin and subsequently nucleos(t)ide analogues has revolutionized transplantation for hepatitis B virus (HBV), increasing survival for patients transplanted for this indication. With the availability of new and potent antivirals for HBV, the need for liver transplant should continue to decrease in the coming years. Moreover, the newer antivirals with high resistance barriers will allow effective long-term viral prophylaxis and therefore, prevention of recurrence.
Subject(s)
Hepatitis B virus/isolation & purification , Hepatitis B, Chronic/surgery , Liver Transplantation , Antiviral Agents/therapeutic use , Drug Therapy, Combination , Female , Hepatitis B virus/drug effects , Hepatitis B virus/genetics , Hepatitis B, Chronic/complications , Hepatitis B, Chronic/drug therapy , Humans , Immunoglobulins/therapeutic use , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Interferons/therapeutic use , Lamivudine/therapeutic use , Male , Secondary Prevention , Treatment Outcome , Viral LoadABSTRACT
Providing appropriate treatment and follow-up to hepatitis B virus (HBV)-infected mothers and their newborns is critical in preventing HBV mother-to-child transmission (MTCT) and eradicating HBV infection. Although highly effective in preventing MTCT, standard passive-active immunoprophylaxis with hepatitis B immunoglobulin and the hepatitis B vaccine may have a failure rate as high as 10% to 15%. Antiviral treatment has been used during pregnancy and may decrease MTCT. Several issues must be addressed in future clinical studies before universal recommendations for antiviral therapy for pregnant women can be made.
