Alloimmunization to red blood cell antigens affects clinical outcomes in liver transplant patients

Scott D. Boyd, Fabien Stenard, Donald K.K. Lee, Lawrence T. Goodnough, Carlos O. Esquivel, Magali J. Fontaine – 28 November 2007 – Transfusion therapy of liver transplant patients remains a challenge. High volumes of intraoperative blood transfusion have been shown to increase the risk of poor graft or patient survival. We conducted a retrospective study of 209 consecutive liver transplant cases at our institution. Only patients receiving their first liver transplant, with no other simultaneous organ transplants, were included.

Venous outflow obstruction in liver transplantation is associated with the anastomotic technique

James D. Perkins – 28 November 2007 – The outflow venovenous anastomosis represent a crucial aspect during orthotopic liver transplantation (OLT) with inferior vena cava (IVC) preservation. The modified Belghiti liver hanging maneuver applied to the last phase of hepatectomy, lifting the liver, provides a better exposure of the suprahepatic region and allows easier orthogonal clamping of the three suprahepatic veins with a minimal portion of IVC occlusion.

Toll‐like receptor‐mediated control of HBV replication by nonparenchymal liver cells in mice

Jun Wu, Mengji Lu, Zhongji Meng, Martin Trippler, Ruth Broering, Agnes Szczeponek, Frank Krux, Ulf Dittmer, Michael Roggendorf, Guido Gerken, Joerg F. Schlaak – 28 November 2007 – Hepatitis B virus (HBV) infection is one of the most frequent causes of chronic liver disease worldwide. Because recent studies have suggested that Toll‐like receptor (TLR)‐based therapies may be a promising approach in the treatment of HBV infection, we studied the role of the local innate immune system of the liver as a possible mediator of this effect.

Biliary complications and outcomes of liver transplantation from donors after cardiac death

Anurag Maheshwari, Warren Maley, Zhiping Li, Paul J. Thuluvath – 28 November 2007 – Biliary complications after liver transplantation (LT) using organs retrieved from donors after cardiac death are not well characterized. The aim of this study was to evaluate the severity of biliary complications and outcomes after donation after cardiac death liver transplantation (DCD‐LT). A retrospective evaluation of 20 DCD‐LTs from 1997–2006 was performed. The recipient age was 53 ± 8.7, and the donor age was 35 ± 11 years.

Validation of limited sampling strategy for the estimation of mycophenolic acid exposure in Chinese adult liver transplant recipients

Chen Hao, Chen Erzheng, Mao Anwei, Yu Zhicheng, Shen Baiyong, Deng Xiaxing, Zhang Weixia, Peng Chenghong, Li Hongwei – 28 November 2007 – Mycophenolate mofetil (MMF) is indicated as immunosuppressive therapy in liver transplantation. The abbreviated models for the estimation of mycophenolic acid (MPA) area under the concentration‐time curve (AUC) have been established by limited sampling strategies (LSSs) in adult liver transplant recipients. In the current study, the performance of the abbreviated models to predict MPA exposure was validated in an independent group of patients.

Arterial ammonia and clinical risk factors for encephalopathy and intracranial hypertension in acute liver failure

William Bernal, Catherine Hall, Constantine J. Karvellas, Georg Auzinger, Elizabeth Sizer, Julia Wendon – 28 November 2007 – High circulating ammonia concentrations are common in patients with acute liver failure (ALF) and are associated with hepatic encephalopathy (HE) and intracranial hypertension (ICH). Other risk factors are poorly characterized. We evaluated the relation of the admission arterial ammonia concentration and other clinical variables with the development of HE and ICH.

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