John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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An algorithm for the management of hepatic dysfunction in hematology Volume 26, issue 2, Février 2019

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Authors
1 Centre Hospitalier Cochin Port Royal, Service d’hépatologie, 27 rue du Faubourg Saint Jacques, 75014 Paris
2 Fred Hutchinson Cancer Research Center, Gastroenterology/Hepatology Section (D5-114), 1100 Fairview Avenue North, Seattle, WA 98109-1024, USA
* Correspondance

The evaluation and management of liver diseases is essential to improve the survival of hematology patients, especially after transplantation of allogeneic hematopoietic cells. The consulting hepatologist may never see a more complex patient than a patient with cancer who develops jaundice, fluid retention, fever, liver pain, and abnormal serum liver tests – and in contrast to the situation where patients have a single diagnosis, there may be multiple causes of liver dysfunction in such a patient. However, medical progress in liver imaging and molecular methods of viral diagnosis have made evaluations more straight-forward, such that liver biopsy can be confined to the most puzzling cases. Diagnostic and therapeutic algorithms are clearer in guiding the clinician and starting treatment quickly, but one long-term goal should be to prevent liver injury in the first place. Hematology is a growing specialty and many drugs are coming to the market without their liver safety being fully understood. The purpose of this review is to provide the reader with the keys to be a knowledgeable practitioner in the field of liver disease in hematology patients.

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