Liver transplantation for non–hepatocellular carcinoma malignancy: Indications, limitations, and analysis of the current literature

Eric J. Grossman, J. Michael Millis – 27 July 2010 – Orthotopic liver transplantation (OLT) is currently incorporated into the treatment regimens for specific nonhepatocellular malignancies. For patients suffering from early‐stage, unresectable hilar cholangiocarcinoma (CCA), OLT preceded by neoadjuvant radiotherapy has the potential to readily achieve a tumor‐free margin, accomplish a radical resection, and treat underlying primary sclerosing cholangitis when present. In highly selected stage I and II patients with CCA, the 5‐year survival rate is 80%.

Pretransplant serum troponin levels are highly predictive of patient and graft survival following liver transplantation

Kymberly D. S. Watt, Elizabeth Coss, Rachel A. Pedersen, Ross Dierkhising, Julie K. Heimbach, Michael R. Charlton – 27 July 2010 – Optimizing the utility of liver transplantation requires the identification of factors that confer increased risk of posttransplant mortality. Elevated serum troponin (TN) levels are strongly predictive of posttransplant mortality after kidney transplantation.

Successful outcomes following living donor liver transplantation for portopulmonary hypertension

Mahesh Bandara, Fredric D. Gordon, Akmal Sarwar, M. Elizabeth Knauft, Elizabeth A. Pomfret, Richard B. Freeman, Joel A. Wirth – 27 July 2010 – Pulmonary arterial hypertension (PAH) associated with portal hypertension [portopulmonary hypertension (PPHTN)] occurs in 2% to 10% of patients with advanced liver disease and carries a very poor prognosis without treatment. Most hepatic transplantation centers consider moderate to severe PPHTN to be a contraindication to liver transplantation because of the high rate of perioperative complications.

Hepatocellular carcinoma: Ablate and wait versus rapid transplantation

John P. Roberts, Alan Venook, Robert Kerlan, Francis Yao – 27 July 2010 – This opinion piece explores an “ablate and wait” strategy for improving the 5‐year recurrence‐free outcome of liver transplantation in patients with hepatocellular carcinoma. The Milan criteria delimit by tumor size and number a population of patients who have good survival after liver transplantation.

Validation of a current definition of early allograft dysfunction in liver transplant recipients and analysis of risk factors

Kim M. Olthoff, Laura Kulik, Benjamin Samstein, Mary Kaminski, Michael Abecassis, Jean Emond, Abraham Shaked, Jason D. Christie – 27 July 2010 – Translational studies in liver transplantation often require an endpoint of graft function or dysfunction beyond graft loss. Prior definitions of early allograft dysfunction (EAD) vary, and none have been validated in a large multicenter population in the Model for End‐Stage Liver Disease (MELD) era. We examined an updated definition of EAD to validate previously used criteria, and correlated this definition with graft and patient outcome.

Rifaximin for the treatment of recurrent Clostridium difficile infection after liver transplantation: A case series

Guy Neff, Victoria Zacharias, Tiffany E. Kaiser, Amy Gaddis, Nyingi Kemmer – 27 July 2010 – Previous data have suggested that the nonsystemic antibiotic rifaximin may be effective for the treatment of Clostridium difficile infection (CDI). This single‐center retrospective study evaluated the efficacy of rifaximin for the treatment of CDI refractory to standard treatments in patients who had received liver transplants. Among 205 patients who had received liver transplants between July 2001 and December 2007, 3 patients with a confirmed diagnosis of C.

Endothelial cell toll‐like receptor 4 regulates fibrosis‐associated angiogenesis in the liver

Kumaravelu Jagavelu, Chittaranjan Routray, Uday Shergill, Steven P. O'Hara, William Faubion, Vijay H. Shah – 23 July 2010 – Angiogenesis defines the growth of new blood vessels from preexisting vascular endothelial networks and corresponds to the wound healing process that is typified by the process of liver fibrosis. Liver fibrosis is also associated with increased endotoxin within the gut lumen and its associated portal circulation.

Biliary secretion of S‐nitrosoglutathione is involved in the hypercholeresis induced by ursodeoxycholic acid in the normal rat

Carlos M. Rodríguez‐Ortigosa, Jesús M. Banales, Israel Olivas, Iker Uriarte, José J.G. Marín, Fernando J. Corrales, Juan F. Medina, Jesús Prieto – 23 July 2010 – Ursodeoxycholic acid (UDCA) induces bicarbonate‐rich hypercholeresis by incompletely defined mechanisms that involve the stimulation of adenosine triphosphate (ATP) release from cholangiocytes. As nitric oxide (NO) at a low concentration can stimulate a variety of secretory processes, we investigated whether this mediator could be implicated in the choleretic response to UDCA.

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