End‐stage liver disease candidates at the highest model for end‐stage liver disease scores have higher wait‐list mortality than status‐1A candidates

Pratima Sharma, Douglas E. Schaubel, Qi Gong, Mary Guidinger, Robert M. Merion – 24 August 2011 – Candidates with fulminant hepatic failure (Status‐1A) receive the highest priority for liver transplantation (LT) in the United States. However, no studies have compared wait‐list mortality risk among end‐stage liver disease (ESLD) candidates with high Model for End‐Stage Liver Disease (MELD) scores to those listed as Status‐1A.

Intensive care of the patient with cirrhosis

Jody C. Olson, Julia A. Wendon, David J. Kramer, Vicente Arroyo, Rajiv Jalan, Guadalupe Garcia‐Tsao, Patrick S. Kamath – 24 August 2011 – Acute deterioration of patients with cirrhosis manifests as multiple organ failure requiring admission to an intensive care unit. Precipitating events may be viral hepatitis, typically in Asia, and drug or alcoholic hepatitis and variceal hemorrhage in the West. Patients with cirrhosis in the intensive care unit have a high mortality, and each admission is associated with a mean charge of US $116,200.

Genetic interactions between hepatocyte nuclear factor‐6 and notch signaling regulate mouse intrahepatic bile duct development in vivo

Charles Vanderpool, Erin E. Sparks, Kari A. Huppert, Maureen Gannon, Anna L. Means, Stacey S. Huppert – 24 August 2011 – Notch signaling and hepatocyte nuclear factor‐6 (HNF‐6) are two genetic factors known to affect lineage commitment in the bipotential hepatoblast progenitor cell (BHPC) population. A genetic interaction involving Notch signaling and HNF‐6 in mice has been inferred through separate experiments showing that both affect BHPC specification and bile duct morphogenesis.

Feasibility and diagnostic performance of the FibroScan XL probe for liver stiffness measurement in overweight and obese patients

Robert P. Myers, Gilles Pomier‐Layrargues, Richard Kirsch, Aaron Pollett, Andres Duarte‐Rojo, David Wong, Melanie Beaton, Mark Levstik, Pam Crotty, Magdy Elkashab – 24 August 2011 – Failure of liver stiffness measurement (LSM) by transient elastography (TE, FibroScan) and unreliable results occur in ≈5% and 15% of patients, respectively, mainly due to obesity.

Toll‐like receptor 2–mediated innate immune response in human nonparenchymal liver cells toward adeno‐associated viral vectors

Marianna Hösel, Mathias Broxtermann, Hanna Janicki, Knud Esser, Silke Arzberger, Pia Hartmann, Sonja Gillen, Jörg Kleeff, Dirk Stabenow, Margarete Odenthal, Percy Knolle, Michael Hallek, Ulrike Protzer, Hildegard Büning – 24 August 2011 – Adeno‐associated viral vectors (rAAV) are frequently used in gene therapy trials. Although rAAV vectors are of low immunogenicity, humoral as well as T cell responses may be induced. While the former limits vector reapplication, the expansion of cytotoxic T cells correlates with liver inflammation and loss of transduced hepatocytes.

Factors associated with the postoperative status of donor patients for living donor liver transplantation

Yoshufumi Wakata, Naoki Nakashima, Akinobu Taketomi, Ken Shirabe, Yoshihiko Maehara, Akihito Hagihara – 24 August 2011 – Deceased donor liver transplantation has been an established surgical procedure since the 1960s. More recently, the technique of living donor liver transplantation (LDLT) was introduced, and it is being performed with increasing frequency. However, there is a paucity of information on the clinical outcomes of donor patients.

Submaximal cardiopulmonary exercise testing predicts 90‐day survival after liver transplantation

James M. Prentis, Derek M. D. Manas, Michael I. Trenell, Mark Hudson, David J. Jones, Chris P. Snowden – 24 August 2011 – Liver transplantation has a significant early postoperative mortality rate. An accurate preoperative assessment is essential for minimizing mortality and optimizing limited donor organ resources. This study assessed the feasibility of preoperative submaximal cardiopulmonary exercise testing (CPET) for determining the cardiopulmonary reserve in patients being assessed for liver transplantation and its potential for predicting 90‐day posttransplant survival.

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