Use of model for end‐stage liver disease exception points for early liver transplantation and successful reversal of hepatic myelopathy with a review of the literature

Cary Caldwell, Norman Werdiger, Sofia Jakab, Michael Schilsky, Antonios Arvelakis, Sanjay Kulkarni, Sukru Emre – 25 June 2010 – Hepatic myelopathy (HM) is a rarely reported disorder characterized by progressive spastic paraparesis due to impaired corticospinal tract function in the setting of cirrhosis or portosystemic shunting. HM has not to date been recognized as a Model for End‐Stage Liver Disease (MELD) exception for transplantation.

Improvement in hepatopulmonary syndrome after methadone withdrawal: A case report with implications for disease mechanism

Edmund M. T. Lau, Geoffrey McCaughan, Paul J. Torzillo – 25 June 2010 – Spontaneous resolution of hepatopulmonary syndrome (HPS) without liver transplantation or improvement in the underlying liver disease has rarely been reported in the literature. Increased endogenous production of nitric oxide has been implicated in the pathogenesis of HPS. We report the case of a 50‐year‐old man with hepatitis C cirrhosis who demonstrated dramatic improvement in HPS after withdrawal from chronic methadone therapy.

Prospects for stem cell transplantation in the treatment of hepatic disease

Benjamin M. Stutchfield, Stuart J. Forbes, Stephen J. Wigmore – 25 June 2010 – Stem cell therapy has the potential to provide a valuable adjunct to the management of hepatic disease. Preclinical studies have demonstrated a range of endogenous repair processes that can be exploited through stem cell therapy. Initial translational studies have been encouraging and have suggested improved liver function in advanced chronic liver disease and enhanced liver regeneration after portal vein embolization.

Recurrent low gamma‐glutamyl Transpeptidase cholestasis following liver transplantation for bile salt export pump (BSEP) disease (posttransplant recurrent BSEP disease)

Leah Siebold, Andre A. S. Dick, Richard Thompson, Giuseppe Maggiore, Emanuel Jacquemin, Ronald Jaffe, Sandra Strautnieks, Tassos Grammatikopoulos, Simon Horslen, Peter F. Whitington, Benjamin L. Shneider – 25 June 2010 – Bile salt export pump (BSEP) deficiency is a hereditary cholestatic syndrome that results from mutations in the ABCB11 (ATP‐binding cassette B11) gene. Severely affected patients develop end‐stage liver disease in the first decade of life. Liver transplantation has traditionally been thought of as curative for BSEP disease.

Long‐term results of urgent revascularization for hepatic artery thrombosis after pediatric liver transplantation

Nienke Warnaar, Wojciech G. Polak, Koert P. de Jong, Marieke T. de Boer, Henkjan J. Verkade, Egbert Sieders, Paul M. J. G. Peeters, Robert J. Porte – 25 June 2010 – Hepatic artery thrombosis (HAT) after pediatric orthotopic liver transplantation (OLT) is a serious complication resulting in bile duct necrosis and often requiring retransplantation. Immediate surgical thrombectomy/thrombolysis has been reported to be a potentially successful treatment for restoring blood flow and avoiding urgent retransplantation. The long‐term results of this strategy remain to be determined.

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