Drug‐Induced Liver Injury After Liver Transplantation

Drug‐induced liver injury (DILI) is an adverse reaction to many drugs in common use that in a liver transplantation (LT) recipient may cause graft dysfunction and may even lead to graft loss and the need for retransplantation. However, several potential clinical scenarios, such as graft rejection an...

Full description

Saved in:
Bibliographic Details
Published in:Liver transplantation 2020-09, Vol.26 (9), p.1167-1176
Main Authors: Jiménez‐Pérez, Miguel, González‐Grande, Rocío, García‐Cortés, Miren, Andrade, Raúl J.
Format: Article
Language:English
Subjects:
Chemical and Drug Induced Liver Injury - diagnosis
Chemical and Drug Induced Liver Injury - epidemiology
Chemical and Drug Induced Liver Injury - etiology
Drug-Related Side Effects and Adverse Reactions
Drugs
Genetic diversity
Graft rejection
Hepatitis B
Humans
Immunosuppressive agents
Liver
Liver Diseases
Liver transplantation
Liver Transplantation - adverse effects
Liver transplants
Prospective Studies
Risk factors
Transplants & implants
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Drug‐induced liver injury (DILI) is an adverse reaction to many drugs in common use that in a liver transplantation (LT) recipient may cause graft dysfunction and may even lead to graft loss and the need for retransplantation. However, several potential clinical scenarios, such as graft rejection and infection, can confound the diagnosis of suspected DILI in the setting of LT. This makes causal assessment of a new liver injury more uncertain and has traditionally precluded collection of bona fide cases of DILI affecting LT patients in prospective DILI registries and cohorts. Although no studies have yet determined a greater susceptibility of the transplant patient to DILI, these patients nevertheless present certain risk factors that can theoretically increase the risk of DILI. These include the fact that these patients are polymedicated, use drugs that are potentially hepatotoxic, and can have coexisting hepatitis B or C viruses in addition to other factors found in nontransplant patients, such as genetic variants. Therefore, awareness is crucial of any potential hepatotoxic effect of drugs used in the LT recipient and their possible implication in any case of liver dysfunction. In the present article, we review the most common drugs used in LT recipients from a liver safety perspective and address the main pitfalls in attributing causality in this clinical setting. We also affirm the need for further research and collaboration in this somewhat neglected topic in the field of DILI. www.wileyhealthlearning.com/aasld.aspx
ISSN:1527-6465
1527-6473
DOI:10.1002/lt.25804