Should we still offer split‐liver transplantation for two adult recipients? A retrospective study of our experience

Alessandro Giacomoni, Andrea Lauterio, Matteo Donadon, Andrea De Gasperi, Luca Belli, Abdallah Slim, Bogdan Dorobantu, Iacopo Mangoni, Luciano De Carlis – 25 June 2008 – The role of split‐liver transplantation (SLT) for two adult recipients is still a matter of debate, and no agreement exists on indications, surgical techniques, and results. The aim of this study was to retrospectively analyze the outcome of our series of SLT. From May 1999 to December 2006, 16 patients underwent SLT at our unit. We used 9 full right grafts (segments 5‐8) and 7 full left grafts (segments 1‐4).

Identifying risk for recurrent hepatocellular carcinoma after liver transplantation: Implications for surveillance studies and new adjuvant therapies

Edie Y. Chan, Anne M. Larson, Oren K. Fix, Matthew M. Yeh, Adam E. Levy, Ramasamy Bakthavatsalam, Jeffrey B. Halldorson, Jorge D. Reyes, James D. Perkins – 25 June 2008 – The recurrence of hepatocellular carcinoma (HCC) is a major cause of mortality for patients transplanted with HCC. There currently exists no standard method for identifying those patients with a high risk for recurrence. Identification of factors leading to recurrence is necessary to develop an efficient surveillance protocol and address new potential adjuvant therapies.

Dichloroacetate stabilizes the intraoperative acid‐base balance during liver transplantation

Robert E. Shangraw, Deirdre Lohan‐Mannion, Agnes Hayes, Rose M. Moriarty, Rongwei Fu, Stephen T. Robinson – 25 June 2008 – Lactic acidosis occurs during orthotopic liver transplantation (OLT), especially during the anhepatic and early postreperfusion phases. Dichloroacetate (DCA) inhibits pyruvate dehydrogenase kinase‐1, indirectly activating mitochondrial pyruvate dehydrogenase. This, in turn, markedly reduces systemic lactate production and, to a lesser extent, increases hepatic lactate uptake. The result is moderation of lactic acidosis in many clinical conditions.

Nifedipine versus carvedilol in the treatment of de novo arterial hypertension after liver transplantation: Results of a controlled clinical trial

Alessandra Galioto, Andrea Semplicini, Giacomo Zanus, Silvano Fasolato, Antonietta Sticca, Patrizia Boccagni, Anna Chiara Frigo, Umberto Cillo, Angelo Gatta, Paolo Angeli – 25 June 2008 – The aim of this study was to compare nifedipine and carvedilol in the treatment of de novo arterial hypertension after orthotopic liver transplantation (OLT). The study included 50 patients who developed arterial hypertension after OLT. Twenty‐five patients received nifedipine (group A), and 25 received carvedilol (group B).

Noninvasive monitoring of cerebral perfusion pressure in patients with acute liver failure using transcranial doppler ultrasonography

Shushma Aggarwal, David M. Brooks, Yoogoo Kang, Peter K. Linden, John F. Patzer – 25 June 2008 – Elevated intracranial pressure (ICP) leads to loss of cerebral perfusion, cerebral herniation, and irreversible brain damage in patients with acute liver failure (ALF). Conventional techniques for monitoring ICP can be complicated by hemorrhage and infection. Transcranial doppler ultrasonography (TCD) is a noninvasive device which can continuously measure cerebral blood flow velocity, producing a velocity‐time waveform that indirectly monitors changes in cerebral hemodynamics, including ICP.

Overcoming the limitations of living donor and split liver transplantation: A proposal for adult recipients (the best of the east in the west)

Nigel Heaton, Parthi Srinivasan, Andreas Prachalias, Mohamed Rela – 25 June 2008 – A shortage of organs for liver transplantation has encouraged the development of advanced surgical strategies to increase the donor pool. We present a technical strategy that combines the established techniques of split liver transplantation and left lateral segment donation from living donors for adult recipients. This strategy could provide an additional source of organs for liver transplantation. Liver Transpl 14:932–934, 2008. © 2008 AASLD.

Comparison of the USCOM ultrasound cardiac output monitor with pulmonary artery catheter thermodilution in patients undergoing liver transplantation

Lai‐Sze Grace Wong, Boon‐Hun Yong, Karl Kang Young, Lee‐Sung Lau, King‐Lik Cheng, Jeff Siu‐Fan Man, Michael G. Irwin – 25 June 2008 – The aim of the study was to compare the standard technique of cardiac output determination by pulmonary artery catheter thermodilution (PAC‐TD) with a noninvasive ultrasound Doppler monitor (USCOM Pty., Ltd., Coffs Harbour, Australia) in surgery for liver transplantation.

Cancer stem cells in the blood: Possible therapeutic implications

James D. Perkins – 25 June 2008 – Increasing evidence has revealed the importance of cancer stem cells (CSCs) in carcinogenesis. Although liver CSCs have been identified in hepatocellular carcinoma (HCC) cell lines, no data have shown the presence of these cells in human settings. The present study was designed to delineate CSCs serially from HCC cell lines, human liver cancer specimens to blood samples, using CD90 as a potential marker. The number of CD90+ cells increased with the tumorigenicity of HCC cell lines.

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