Isoleucine infusion during “simulated” upper gastrointestinal bleeding improves liver and muscle protein synthesis in cirrhotic patients

Steven W. M. Olde Damink, Rajiv Jalan, Nicolaas E. P. Deutz, Cornelis H. C. Dejong, Doris N. Redhead, Paula Hynd, Peter C. Hayes, Peter B. Soeters – 26 February 2007 – Upper gastrointestinal (GI) bleeding in cirrhotic patients has a high incidence of mortality and morbidity. Postbleeding catabolism has been hypothesized to be partly due to the low biological value of hemoglobin, which lacks the essential amino acid isoleucine.

Different methods of creatinine measurement significantly affect MELD scores

Evangelos Cholongitas, Laura Marelli, Andrew Kerry, Marco Senzolo, David W. Goodier, Devaki Nair, Michael Thomas, David Patch, Andrew K. Burroughs – 23 February 2007 – Bilirubin (Bil) interferes with creatinine (Cr) measurement. Different laboratory methods are used to overcome this problem. Model for end‐stage liver disease (MELD) scoring incorporates Cr and is used to prioritize patients for liver transplantation. Thus, MELD scores may vary with different Cr measurements influencing patients' priority.

De novo esophageal neoplasia after liver transplantation

Sabine J. Presser, Guido Schumacher, Ruth Neuhaus, Peter Thuss‐Patience, Jens Stieler, Peter Neuhaus – 22 February 2007 – The purpose of the study was to determine the incidence, risk factors, treatment, and influence on survival of patients with de novo esophageal cancer after liver transplantation (LT). From 1988 to 2006, 1,926 patients underwent LT in our institution. A total of 9 patients (0.5%) developed a de novo esophageal cancer and 1 patient a cancer of the cardia (0.05%).

Inflammation is an important determinant of levels of the endogenous nitric oxide synthase inhibitor asymmetric dimethylarginine (ADMA) in acute liver failure

Rajeshwar P. Mookerjee, R. Neil Dalton, Nathan A. Davies, Stephen J. Hodges, Charles Turner, Roger Williams, Rajiv Jalan – 22 February 2007 – Acute liver failure (ALF) is characterized by rapid progressive organ failure and poor outcome. The pathophysiology of multiorgan dysfunction in ALF remains unclear but increased systemic inflammatory response is believed to be an important determining factor. Asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, results from proteolysis and the liver is a major site for its metabolism.

Recurrence of hepatitis B is associated with cumulative corticosteroid dose and chemotherapy against hepatocellular carcinoma recurrence after liver transplantation

Nam‐Joon Yi, Kyung‐Suk Suh, Jai Young Cho, Choon Hyuck Kwon, Kwang‐Woong Lee, Jae Won Joh, Suk‐Koo Lee, Soon Il Kim, Kuhn Uk Lee – 22 February 2007 – The incidence of hepatitis B (HB) recurrence after a liver transplantation has been reduced by prophylaxis with hepatitis B immunoglobulin (HBIG) and lamivudine. However, the long‐term incidence of recurrence is <10%, and the factors associated with HB recurrence are unclear. This study analyzed the factors associated with HB recurrence in 203 recipients who underwent liver transplantation for HB in 3 major centers in Korea over 4 years.

Combined en bloc liver pancreas transplantation for children with CF

Kristin L. Mekeel, Max R. Langham, Regino Gonzalez‐Perralta, Alan Reed, Alan W. Hemming – 22 February 2007 – Cystic fibrosis (CF) is an inherited genetic defect in epithelial chloride transport that results a multisystem disease affecting the sweat glands and the pulmonary and digestive systems. Although pulmonary disease remains the primary cause of morbidity and mortality in these patients, up to 8% may develop focal biliary cirrhosis and portal hypertension. Liver transplantation is an accepted therapy for these patients.

Low risk of hepatitis B virus recurrence after withdrawal of long‐term hepatitis B immunoglobulin in patients receiving maintenance nucleos(t)ide analogue therapy

Stephen N. Wong, Chi‐Jen Chu, Chun‐Tao Wai, Terese Howell, Charles Moore, Robert J. Fontana, Anna S.F. Lok – 22 February 2007 – Hepatitis B virus (HBV) recurrence rates of 0‐16% had been reported in patients maintained on nucleoside analogues (NA) after hepatitis B immunoglobulin (HBIG) discontinuation after orthotopic liver transplantation (OLT). However, follow‐up in most studies was short. We aimed to determine the long‐term risk of HBV recurrence using this strategy.

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