Ammonia and the neutrophil in the pathogenesis of hepatic encephalopathy in cirrhosis

Debbie L. Shawcross, Shabnam S. Shabbir, Nicholas J. Taylor, Robin D. Hughes – 13 October 2009 – Hepatic encephalopathy (HE) constitutes a neuropsychiatric syndrome which remains a major clinical problem in patients with cirrhosis. In the severest form of HE, cirrhotic patients may develop varying degrees of confusion and coma. Ammonia has been regarded as the key precipitating factor in HE, and astrocytes have been the most commonly affected cells neuropathologically.

Emergency adult‐to‐adult living‐donor liver transplantation for acute liver failure in a hepatitis B virus endemic area

Soo Jung Park, Young‐Suk Lim, Shin Hwang, Nae Yun Heo, Han Chu Lee, Dong Jin Suh, Eunsil Yu, Sung Gyu Lee – 13 October 2009 – The outcomes of patients with acute liver failure (ALF) vary greatly according to etiology. Emergency adult‐to‐adult living‐donor liver transplantation (adult LDLT) would help address the shortage of available organs for patients with ALF, especially in hepatitis B virus (HBV)‐endemic areas. We analyzed a prospective database of 110 consecutive adult patients with ALF.

Hepatocytes do not undergo epithelial‐mesenchymal transition in liver fibrosis in mice

Kojiro Taura, Kouichi Miura, Keiko Iwaisako, Christoph H. Österreicher, Yuzo Kodama, Melitta Penz‐Österreicher, David A. Brenner – 13 October 2009 – The origin of fibrogenic cells in liver fibrosis remains controversial. We assessed the emerging concept that hepatocytes contribute to production of extracellular matrix (ECM) in liver fibrosis through epithelial‐mesenchymal transition (EMT).

Rapamycin inhibits hepatic fibrosis in rats by attenuating multiple profibrogenic pathways

Kim R. Bridle, Claudia Popa, Maelle L. Morgan, Amy L. Sobbe, Andrew D. Clouston, Linda M. Fletcher, Darrell H. G. Crawford – 29 September 2009 – Hepatic stellate cell transdifferentiation, epithelial‐mesenchymal cell transition, and the ductular reaction each contribute to the development of hepatic fibrosis in cholestatic liver diseases. Inhibitors of mammalian target of rapamycin have antifibrotic properties.

The use of preoperative nutritional interventions to protect against hepatic ischemia‐reperfusion injury

Tessa M. van Ginhoven, James R. Mitchell, Marielle Verweij, Jan H. J. Hoeijmakers, Jan N. M. Ijzermans, Ron W. F. de Bruin – 29 September 2009 – Preoperative fasting was introduced in the 19th century to reduce the risk of aspiration pneumonia while patients were under general anesthesia. During the last decades, the value of preoperative fasting has been questioned, and more liberal guidelines have been proposed, such as the use of preoperative carbohydrate‐rich drinks.

Mesenchymal stem cells as immunomodulators after liver transplantation

Felix C. Popp, Philipp Renner, Elke Eggenhofer, Przemyslaw Slowik, Edward K. Geissler, Pompiliu Piso, Hans J. Schlitt, Marc H. Dahlke – 29 September 2009 – Mesenchymal stem cells (MSCs) are promising candidate cells for immunomodulation therapy that are currently being tested in the preclinical and clinical setting. MSCs suppress the immune response in a variety of in vitro and disease models and may thus be of benefit for patients suffering from autoimmune disorders or transplant rejection.

Acute liver failure at 26 weeks' gestation in a patient with sickle cell disease

Mara Greenberg, Tami J. Daugherty, Arvand Elihu, Ravi Sharaf, Waldo Concepcion, Maurice Druzin, Carlos O. Esquivel – 29 September 2009 – Orthotopic liver transplantation (OLT) for acute liver failure (ALF) during pregnancy is an uncommon occurrence with variable outcomes. In pregnancy‐related liver failure, prompt diagnosis and immediate delivery are essential for a reversal of the underlying process and for maternal and fetal survival. In rare cases, the reason for ALF during pregnancy is either unknown or irreversible, and thus OLT may be necessary.

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