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The importance of uninterrupted albendazole treatment in patients with unresectable alveolar echinococcosis undergoing liver transplantation
Author(s) -
Zavoikin Valerij D.,
Zelya Olga P.,
Tumolskaya Nelli I.
Publication year - 2020
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13291
Subject(s) - medicine , albendazole , liver transplantation , transplantation , magnetic resonance imaging , echinococcosis , chemotherapy , radiology , surgery
Background This study focused on the monitoring of patients who had undergone liver transplantation (LT) because of unresectable alveolar echinococcosis (AE). The role of long‐term administration of albendazole (ABZ) in patients with residual/recurrent AE lesions and without AE lesions was evaluated. Methods Albendazole therapy was prescribed to patients diagnosed with AE 4‐6 weeks after LT on the background of continuous suppressive therapy while following the protocol for managing patients after LT. Clinical data (general condition, blood counts, and level of hepatic transaminases), ultrasound scans (USs), magnetic resonance imaging (MRI) or multispiral computed tomography (MSCT), and serological data were collected from four patients with residual/recurrent AE lesions and without AE lesions. The results of the USs, MRI, and MSCT examinations at diagnosis and at the end of follow‐up were retrospectively reviewed for all patients. Results Observation of patients over a long period (up to 10 years) showed that the continuous (without interruption) use of ABZ restrained the development of metacestodes. Interruptions in taking the drug, associated with the manifestation of hepatotoxicity in some patients, led to the development of lesions in other organs in which the parasite had not previously been detected. No new foci were found in the transplanted livers of the patients. Conclusion Liver transplantation, together with continuous anti‐relapse chemotherapy, prolongs the patient's life, both in the absence and in the presence of metastases in other organs.