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Yoo, Keon Hee,Lee, Soo Hyun,Sung, Ki Woong,Koo, Hong Hoe,Chung, Nak Gyun,Cho, Bin,Kim, Hack Ki,Kang, Hyoung Jin,Shin, Hee Young,Ahn, Hyo Seop,Baek, Hee Jo,Han, Dong Kyun,Kook, Hoon,Hwang, Tai Ju,Kim, Wiley Subscription Services, Inc., A Wiley Company 2011 American journal of hematology Vol.86 No.1
<P><B>Abstract</B></P><P>We report the outcome of 236 pediatric umbilical cord blood transplantations (UCBT) performed in Korea. Given that the sources of the grafts were mostly unrelated donors (<I>n</I> = 226; 95.8%), only the results of unrelated UCBT were included for all statistics. The most frequent primary disease was acute leukemia (<I>n</I> = 167). In total, 91.7% of recipients were seropositive for cytomegalovirus (CMV). The median doses of nucleated cells and CD34+ cells were 4.84 × 10<SUP>7</SUP>/kg and 2.00 × 10<SUP>5</SUP>/kg, respectively. The median times to neutrophil (>0.5 × 10<SUP>9</SUP>/L) and platelet recovery (>20 × 10<SUP>9</SUP>/L) were 18 and 45 days, respectively. Grade 2–4 acute graft‐versus‐host‐disease (GVHD) and chronic GVHD developed in 41.1 and 36.1% of cases, respectively. Forty‐five patients developed CMV disease. The 5‐year overall and event‐free survival were 47.5 and 36.9%, respectively. Multivariate analysis revealed that adverse factors for survival of the whole cohort were total body irradiation‐based conditioning (<I>P</I> = 0.007), salvage transplant (<I>P</I> = 0.001), failure to achieve early complete chimerism (<I>P</I> < 0.0005), and CMV disease (<I>P</I> = 0.001). The outcomes of the single‐ and double‐unit UCBT (<I>n</I> = 64) were similar, while double‐unit recipients were heavier (<I>P</I> < 0.0005) and older (<I>P</I> < 0.0005). We conclude that double‐unit UCBT is a reasonable option for older or heavier children and that the thorough surveillance of CMV infection and the development of an effective CMV therapeutic strategy may be especially important for Korean children, whose CMV seroprevalence exceeds 90%. Am. J. Hematol., 2011. © 2010 Wiley‐Liss, Inc.</P>
( Hee Yeon Kim ),( Jong Young Choi ),( Dong Goo Kim ),( Myoung Soo Kim ),( Soon Il Kim ),( Shin Hwang ),( Sung Gyu Lee ),( Kwang Woong Lee ),( Kyung Suk Suh ),( Young Seok Han ),( Dong Lak Choi ),( Se 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-
Background: The outcome of hepatitis B virus (HBV) infection after liver transplantation (LT) was improved by hepatitis B immunoglobulin (HBIG) and nucles(t)ide analogue (NUA). However, HBV recurrence after LT is critical because the recurrence is occasionally accompanied by a progressive destruction of graft and poor survival. The aims of this study were to investigate the significance HBV recurrence and identity factors associated with HBV recurrence. Methods: From October 1999 to February 2011, a total of 2684 consecutive LT recipients who underwent HBV-associated LT were retrospectively enrolled from 7 transplantation centers in Korea. Results: Prophylaxis regimens were HBIG monotherapy (67.7%) or a combination of HBIG with NUA (22.3%). The recurrence rate of HBV was 6.1% (164 recipients) during mean follow-up duration of 10.9 years. The median time from transplantation to recurrence was 2.1 years (0.1-7.9 years). Of the 1,071 patients with hepatocellular carcinoma (HCC) prior to LT, 155 patients (14.5%) had HCC recurrence after transplantation, and 48 patients (31.0%) had HBV recurrence. Of the 48 patients with recurrence of both HBV and HCC, 25 patients (52.1%) experienced HBV recurrence after HCC recurrence. In the multivariate analysis, pretransplant HCC, pretransplant HBV DNA above 5.5 log copies/mL was independent clinical factors influencing HBV recurrence after LT. The mortality rate among the recipients with HBV recurrence was 34.1% (56 recipients). Mean overall survival was 6.4 years in the HBV-recurrence group and 9.9 years in the HBV-nonrecurrence group (p<0.001). HBV recurrence was not an independent prognostic factor for overall survival. HCC recurrence was the most important factor for overall survival. Conclusions: The overall outcome of LT in HBV-related liver disease was excellent with the current prophylaxis regimen Choon Hyuck David Kwon,8 Suk-Koo Lee8 Pretransplant HBV DNA and HCC were important factors for HBV recurrence. HBV recurrence after LT did not significantly influence on the overall survival without combining of HCC recurrence.