Hemodynamic and metabolic efficacy of dopamine versus norepinephrine in a brain‐dead swine model

Ahmed Zaky, Ernesto A. Pretto, Steven A. Earle, Emanuele Piraccini, Jennifer E. Zuccarelli, Kristopher L. Arheart, Kenneth G. Proctor – 28 August 2008 – We tested the hypothesis that hepatosplanchnic and systemic hemodynamics are improved with equi‐effective doses of dopamine (DA) versus norepinephrine (NE) in a brain‐dead swine model. Pigs (n = 18) were anesthetized and ventilated. Brain death was induced by epidural balloon inflation, hypoventilation, and hypoxia. After 30 minutes, mechanical ventilation was restored without anesthesia.

The utility of the model for end‐stage liver disease score: A reliable guide for liver transplant candidacy and, for select patients, simultaneous hospice referral

Valentina Medici, Lorenzo Rossaro, Jacob A. Wegelin, Amit Kamboj, Junko Nakai, Kelli Fisher, Frederick J. Meyers – 30 July 2008 – Patients with chronic liver disease are referred late to hospice or never referred. There are several barriers to timely referral. First, liver transplantation (LT) and hospice care have always been perceived as mutually exclusive. Yet the criteria for hospice referral and for LT are more similar than different (for example, advanced liver disease and imminent death). Second, physicians, patients, and families have not had a reliable metric to guide referral.

Role and support for hepatologists at liver transplant programs in the United States

Mitchell L. Shiffman, Don C. Rockey – 30 July 2008 – Liver transplantation has evolved into a successful option for patients with end‐stage liver disease. Transplant hepatologists are involved in the management of patients with end‐stage liver disease both before and after liver transplantation. The goals of this study were to evaluate the roles that transplant hepatologists play at liver transplantation programs in the United States and the demand for and institutional support provided for these physicians.

Pilot study of pentoxifylline in hepatopulmonary syndrome

Rajasekhar Tanikella, George M. Philips, Dorothy K. Faulk, Steven M. Kawut, Michael B. Fallon – 30 July 2008 – Hepatopulmonary syndrome (HPS) results when chronic liver disease or portal hypertension causes intrapulmonary microvascular dilatation with hypoxemia. In experimental HPS, tumor necrosis factor alpha (TNF‐α) overproduction contributes to vasodilatation, which is improved by pentoxifylline, a TNF‐α inhibitor. The effectiveness of pentoxifylline in humans is unknown.

Anatomical variations of the origin of the segment 4 hepatic artery and their clinical implications

Guang Yu Jin, Hee Chul Yu, Hyung‐Sun Lim, Jang Il Moon, Jeong Hun Lee, Jin Wook Chung, Baik Hwan Cho – 30 July 2008 – The threat of ischemic complications following massive resection, especially in living donor hepatectomy or split liver transplantation, has been haunting surgeons for many years. Postmortem dissections of 62 livers were performed to investigate anatomical variations of the principal artery for segment 4 (A4). The origin of A4 was examined separately in the liver with (n = 46) or without (n = 16) an aberrant left hepatic artery (abLHA).

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