Prevention of portal hypertension: From variceal development to clinical decompensation

Julio D. Vorobioff, Roberto J. Groszmann – 9 June 2014 – Pharmacological treatment of portal hypertension (PH) has been exclusively devoted to gastroesophageal varices–related events at different frameworks, including prophylactic, emergency, or preventive therapy. The goals of treatment are to avoid the first bleeding episode, stop active bleeding, and prevent bleeding recurrence, respectively. The objective of preprimary prophylaxis (PPP) is to avoid variceal development, and therefore it necessarily deals with patients with cirrhosis at earlier stages of the disease.

Selection of a right posterior sector graft for living donor liver transplantation

Tomoharu Yoshizumi, Toru Ikegami, Koichi Kimura, Hideaki Uchiyama, Tetsuo Ikeda, Ken Shirabe, Yoshihiko Maehara – 3 June 2014 – Right posterior sector (RPS) grafts have been used to overcome graft size discrepancies, the major concern of living donor liver transplantation. Previous studies have reported the volumetry‐based selection of RPS grafts without anatomical exclusion. We reviewed our data and established selection criteria for RPS grafts. The procurement of RPS grafts [conventional (n = 3) and extended (n = 5)] was performed for 8 of 429 recipients at our center.

Pharmacodynamic monitoring of immunosuppressive effects indicates reduced cyclosporine activity during telaprevir therapy

Katja Roos, Daniel Gotthardt, Thomas Giese, Paul Schnitzler, Wolfgang Stremmel, David Czock, Christoph Eisenbach – 3 June 2014 – Drug interactions with immunosuppressive drugs are a major problem associated with protease inhibitor–based antiviral triple therapy for hepatitis C virus (HCV) reinfection after liver transplantation. In this retrospective cohort study, we analyzed biomarkers of the immunosuppressive effects of cyclosporine A (CSA) by quantifying nuclear factor of activated T cells (NFAT)–regulated gene expression during telaprevir (TVR) therapy in 5 liver transplant patients.

Growth hormone/insulin‐like growth factor 1 dynamics in adult living donor liver transplantation

Maximilian Jara, Antje Schulz, Maciej Malinowski, Gero Puhl, Johan Friso Lock, Daniel Seehofer, Peter Neuhaus, Martin Stockmann – 30 May 2014 – End‐stage liver disease is accompanied by decreased serum levels of insulin‐like growth factor 1 (IGF1) and inversely increased serum levels of growth hormone (GH). Previous reports have demonstrated rapid GH/IGF1 axis recovery after orthotopic liver transplantation.

Clinical applicability of rapid thrombelastography and functional fibrinogen thrombelastography to adult liver transplantation

Shu Yang Lu, Kenichi A. Tanaka, Ezeldeen Abuelkasem, Raymond M. Planinsic, Tetsuro Sakai – 30 May 2014 – Unlike kaolin thrombelastography (k‐TEG), the clinical utility of rapid thrombelastography (r‐TEG) and functional fibrinogen thrombelastography (FF‐TEG) has not been tested in liver transplantation (LT). These thrombelastography techniques were simultaneously performed at the time of the skin incision (the baseline) and 30 minutes after graft reperfusion (III + 30) for 27 consecutive adult LT patients.

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