Subnormothermic machine perfusion protects steatotic livers against preservation injury: A potential for donor pool increase?

Mariapia Vairetti, Andrea Ferrigno, Filippo Carlucci, Antonella Tabucchi, Vittoria Rizzo, Eleonora Boncompagni, Daniele Neri, Enrico Gringeri, Isabel Freitas, Umberto Cillo – 24 December 2008 – We tested whether rat liver preservation performed by machine perfusion (MP) at 20°C can enhance the functional integrity of steatotic livers versus simple cold storage. We also compared MP at 20°C with hypothermic MP at 8°C, and 4°C. Obese and lean male Zucker rats were used as liver donors. MP was performed for 6 hours with a glucose and N‐acetylcysteine–supplemented Krebs‐Henseleit solution.

Intraoperative renal support during liver transplantation

Derek R. Townsend, Sean M. Bagshaw, Michael J. Jacka, David Bigam, Dominic Cave, R. T. Noel Gibney – 24 December 2008 – Acute kidney injury (AKI) is common in liver failure prior to orthotopic liver transplantation (OLT) and may complicate the intraoperative course. We describe the logistics of intraoperative continuous renal replacement therapy (CRRT) during OLT and the associated clinical outcomes.

Two different methods for donor hepatic transection: Cavitron ultrasonic surgical aspirator with bipolar cautery versus cavitron ultrasonic surgical aspirator with radiofrequency coagulator—A randomized controlled trial

Walid M. El Moghazy, Mohammed S. Hedaya, Toshimi Kaido, Hiroto Egawa, Shinji Uemoto, Yasutsugu Takada – 24 December 2008 – The aim of this study was to compare the Cavitron ultrasonic surgical aspirator (CUSA) with bipolar cautery (BP) to CUSA with a radiofrequency coagulator [TissueLink (TL)] in terms of efficacy and safety for hepatic transection in living donor liver transplantation. Twenty‐four living liver donors (n = 12 for each group) were randomized to undergo hepatic transection using CUSA with BP or CUSA with TL.

Abdominal drains in liver transplantation: Useful tool or useless dogma? A matched case‐control study

Olivier de Rougemont, Philipp Dutkowski, Markus Weber, Pierre‐Alain Clavien – 24 December 2008 – On the basis of the growing evidence from randomized trials that routine prophylactic drainage is unnecessary in liver surgery or even harmful in chronic liver disease, we challenged the concept of prophylactic drainage in orthotopic liver transplantation (OLT). Since September 2006, we omitted drains in every patient who underwent OLT, regardless of the procedure. Thirty‐five cadaveric OLTs were performed during a 12‐month period.

The validity of EQ‐5D US preference weights in liver transplant candidates and recipients

Robert T. Russell, Irene D. Feurer, Panarut Wisawatapnimit, C. Wright Pinson – 24 December 2008 – Health utility instruments assess patients' valuation of specific health states, which can be converted to quality‐adjusted life years for cost‐utility analysis. Data from the EQ‐5D, a generic health‐related quality of life questionnaire from EuroQoL, can be reported as 5 health status scores or as a single health preference weight (HPW). US population–based HPWs were published by Shaw and colleagues in 2005 (Med Care 2005;43:203‐220).

Pathobiology of biliary epithelia and cholangiocarcinoma: Proceedings of the Henry M. and Lillian Stratton basic research single‐topic conference

Alphonse E. Sirica, Michael H. Nathanson, Gregory J. Gores, Nicholas F. LaRusso – 24 November 2008 – In June 2008, the American Association for the Study of Liver Diseases (AASLD) sponsored the Henry M. and Lillian Stratton Basic Research Single‐Topic Conference on the Pathobiology of Biliary Epithelia and Cholangiocarcinoma, which was held in Atlanta, GA. Attendees from 12 different countries participated in this conference, making it a truly international scientific event.

Acute kidney injury in cirrhosis

Guadalupe Garcia‐Tsao, Chirag R. Parikh, Antonella Viola – 24 November 2008 – Acute renal failure (ARF), recently renamed acute kidney injury (AKI), is a relatively frequent problem, occurring in approximately 20% of hospitalized patients with cirrhosis. Although serum creatinine may underestimate the degree of renal dysfunction in cirrhosis, measures to diagnose and treat AKI should be made in patients in whom serum creatinine rises abruptly by 0.3 mg/dL or more (≥26.4 μmol/L) or increases by 150% or more (1.5‐fold) from baseline.

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