Objective: Allogeneic hematopoietic stem cell transplantation is a treatment that enable a considerable rate of complete cure chance in hematological disorders. Hepatic complications are common causes of morbidity and mortality affecting the survival after stem cell transplantation. This study was conducted in order to identify risk factors for hepatic dysfunction and related potential factors influencing survival in patients undergoing allogeneic hematopoietic stem cell transplantation.
Method: We retrospectively evaluated the data from 300 allogeneic hematopoietic stem cell transplantation recipients between March 2004 and May 2014 in Erciyes University Hematology and Bone Marrow Transplantation Center, Turkey. The study included 300 patients and their serial monitorization of liver function tests, which were examined before and after transplantation.
Results: Transplantation of thirty patients were performed from haploidentical donors and 13 patients from unrelated donors. We identified liver function abnormalities in 71.7% of patients in post-transplantation period. The most common causes were graft versus host disease (43.6%), drug toxicity (24.7%), and sepsis (13.9%). Post-transplantation liver abnormalities were more common in patients with acute leukemia (p=0.02), iron overload (p<0,001) and who have transaminitis in pre-transplantation period as well (p<0,001); Relapsed underlying disease (p<0,001), iron overload and bilirubin level>2 mg/dL in association with hepatic dysfunction at post-transplant period were identified as major factors influencing mortality after transplantation (p<0,001)
Conclusion: We concluded that liver function abnormalities are frequent in hematopoietic stem cell transplantation process. For a successful management, it is important to monitor liver function and to identify additional risk factors before and after transplantation.