Chronic Lithium Treatment Protects Against Liver Ischemia/Reperfusion Injury in Rats

Anding Liu, Haoshu Fang, Uta Dahmen, Olaf Dirsch – 21 May 2013 – Lithium has long been widely used in the treatment of bipolar mood disorders. Recent studies have demonstrated that lithium is able to decrease ischemia/reperfusion (I/R) injury in the brain, kidneys, and heart. Because lithium may act on a number of stress and survival pathways, it is of great interest to explore this compound also in the setting of liver I/R injury. In this study, we aimed to evaluate the effects of lithium in a model of liver I/R injury in rats.

Intraoperative hypercoagulability during liver transplantation as demonstrated by thromboelastography

Dominik Krzanicki, Anita Sugavanam, Susan Mallett – 21 May 2013 – Thrombotic complications are more common in liver disease than might be expected because of the coagulopathy described by conventional coagulation tests. Some of these complications may be life‐threatening. The phenomenon of hypercoagulation is associated with complications in many populations, but the incidence in liver transplant recipients is unclear. We performed a retrospective database review of intraoperative thromboelastography (TEG) for 124 liver transplant recipients.

Acute‐on‐chronic liver failure: Excellent outcomes after liver transplantation but high mortality on the wait list

Armin Finkenstedt, Karin Nachbaur, Heinz Zoller, Michael Joannidis, Johann Pratschke, Ivo W. Graziadei, Wolfgang Vogel – 21 May 2013 – Acute‐on‐chronic liver failure (ACLF) is characterized by high short‐term mortality. Liver transplantation (LT) is a potential therapy for patients who do not improve with supportive measures, but the efficacy of LT has not been shown. The aim of this study was to investigate the feasibility of LT and to determine the postoperative outcomes of patients with ACLF. All patients referred to our liver unit between 2002 and 2010 were registered in a database.

Early use of renal‐sparing agents in liver transplantation: A closer look

James F. Trotter, Monica Grafals, Angel E. Alsina – 21 May 2013 – Renal dysfunction is a critical issue for liver transplant candidates and recipients. Acute nephrotoxicity and chronic nephrotoxicity, however, are the compromises for the potent immunosuppression provided by calcineurin inhibitors (CNIs). To maintain the graft and patient survival afforded by CNIs while minimizing renal dysfunction in liver transplant patients, the reduction, delay, or elimination of CNIs in immunosuppression regimens is being implemented more frequently by clinicians.

Expedited liver allocation in the United States: A critical analysis

Milan Kinkhabwala, Joel Lindower, John F. Reinus, Anita L. Principe, Paul J. Gaglio – 21 May 2013 – The fate of donor livers allocated via an out‐of‐sequence expedited placement (EP) pathway has not been previously examined. We determined the originating and receiving United Network for Organ Sharing (UNOS) regions of all donor livers procured between January 1, 2010 and October 31, 2012 and placed out of sequence with UNOS bypass code 863 (EP attempt) or 898 (miscellaneous).

Efficacy of liver graft washout as a function of the perfusate, pressure, and temperature

Ivo C. J. H. Post, Marcel C. Dirkes, Michal Heger, Joanne Verheij, Kora M. Bruin, Dirk Korte, Roelof J. Bennink, Thomas M. Gulik – 21 May 2013 – Donor graft washout can be impaired by colloids in organ preservation solutions that increase the viscosity and agglutinative propensity of red blood cells (RBCs) and potentially decrease organ function.

Randomized, multicenter trial comparing tacrolimus plus mycophenolate mofetil to tacrolimus plus steroids in hepatitis C virus–positive recipients of living donor liver transplantation

Yasutsugu Takada, Toshimi Kaido, Katsuhiro Asonuma, Hiroyuki Sakurai, Shoji Kubo, Tetsuya Kiuchi, Yukihiro Inomata, Shuji Isaji, Hayami Tsumura, Satoshi Teramukai, Yoshihiro Matsubara, Satomi Sakabayashi, Shinji Uemoto – 21 May 2013 – The purpose of this prospective, randomized, multicenter trial was to evaluate the effects of a steroid‐avoiding immunosuppression protocol on hepatitis C virus (HCV)–positive recipients of living donor liver transplantation (LDLT).

Deceased Donor Liver Transplantation in Infants and Small Children: Are Partial Grafts Riskier Than Whole Organs?

Ryan P. Cauley, Khashayar Vakili, Kristina Potanos, Nora Fullington, Dionne A. Graham, Jonathan A. Finkelstein, Heung Bae Kim – 21 May 2013 – Infants have the highest wait‐list mortality of all liver transplant candidates. Although previous studies have demonstrated that young children may be at increased risk when they receive partial grafts from adult and adolescent deceased donors (DDs), with few size‐matched organs available, these grafts have increasingly been used to expand the pediatric donor pool.

Respiratory risk score for the prediction of 3‐month mortality and prolonged ventilation after liver transplantation

Moritz Kleine, Florian W. R. Vondran, Kai Johanning, Kai Timrott, Hüseyin Bektas, Frank Lehner, Juergen Klempnauer, Harald Schrem – 21 May 2013 – Survival of critically ill patients is significantly affected by prolonged ventilation. The goal of this study was the development of a respiratory risk score (RRS) for the prediction of 3‐month mortality and prolonged ventilation after liver transplantation (LT). Two hundred fifty‐four consecutive LT patients from a single center were retrospectively randomized into a training group for model design and a validation group.

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