Effect of hospital volume and teaching status on outcomes of acute liver failure

Ashwin N. Ananthakrishnan, Emily L. McGinley, Kia Saeian – 28 August 2008 – Acute liver failure (ALF) often requires multidisciplinary support. Higher hospital volumes have been associated with better outcomes for surgical procedures, but whether such a relationship exists for ALF has not been explored previously. In this study, our aim was to examine if hospital volume affects mortality from ALF.

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.

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