Tenofovir-associated Fanconi Syndrome in liver transplant recipients with hepatitis B: A retrospective case series.

IF 8.9 2区 医学 Q1 SURGERY American Journal of Transplantation Pub Date : 2024-12-21 DOI:10.1016/j.ajt.2024.12.015
Erica Loon, Nicholas Lim, Giovanni A Roldan, John Lake
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Abstract

Tenofovir-associated Fanconi Syndrome (TAFS) is a proximal renal tubule disorder rarely reported in patients after liver transplantation (LT) for hepatitis B (HBV). In a retrospective review of 79 HBV-LT recipients, 8/66 (12.1%) on tenofovir post-LT developed TAFS. Primary laboratory findings were hypophosphatemia (100%) and proteinuria (87.5%). No patients required renal replacement therapy or died from TAFS. The majority (85.7%) of surviving patients achieved tubular recovery after stopping tenofovir (mean 13 weeks). In conclusion, TAFS is likely underdiagnosed in LT recipients. Regular screening for hypophosphatemia, proteinuria, and glucosuria is recommended for HBV-LT recipients on tenofovir, as most responded well to discontinuation.

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乙肝肝移植受者的替诺福韦相关范可尼综合征:回顾性病例系列
替诺福韦相关范可尼综合征(TAFS)是乙型肝炎(HBV)患者肝移植(LT)后很少报道的一种近端肾小管疾病。在79名HBV-LT受体的回顾性研究中,8/66(12.1%)接受替诺福韦治疗后出现TAFS。主要实验室结果为低磷血症(100%)和蛋白尿(87.5%)。没有患者需要肾脏替代治疗或死于TAFS。大多数存活患者(85.7%)在停用替诺福韦(平均13周)后实现了肾小管恢复。总之,肝移植受者的TAFS可能未被充分诊断。建议替诺福韦治疗的HBV-LT患者定期筛查低磷血症、蛋白尿和血糖,因为大多数患者停药后反应良好。
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来源期刊
CiteScore
18.70
自引率
4.50%
发文量
346
审稿时长
26 days
期刊介绍: The American Journal of Transplantation is a leading journal in the field of transplantation. It serves as a forum for debate and reassessment, an agent of change, and a major platform for promoting understanding, improving results, and advancing science. Published monthly, it provides an essential resource for researchers and clinicians worldwide. The journal publishes original articles, case reports, invited reviews, letters to the editor, critical reviews, news features, consensus documents, and guidelines over 12 issues a year. It covers all major subject areas in transplantation, including thoracic (heart, lung), abdominal (kidney, liver, pancreas, islets), tissue and stem cell transplantation, organ and tissue donation and preservation, tissue injury, repair, inflammation, and aging, histocompatibility, drugs and pharmacology, graft survival, and prevention of graft dysfunction and failure. It also explores ethical and social issues in the field.
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