Sirolimus‐based immunosuppression following liver transplantation for hepatocellular carcinoma

Michael A. Zimmerman, James F. Trotter, Michael Wachs, Tom Bak, Jeffrey Campsen, Afshin Skibba, Igal Kam – 6 March 2008 – Experience with sirolimus (SRL)‐based immunosuppression following orthotopic liver transplantation (OLT) is rapidly accumulating. In combination with calcineurin inhibitors (CNIs), SRL may reduce the incidence of acute rejection and lower overall required drug levels. This study sought to quantify long‐term outcome following OLT in patients with cirrhosis and concomitant hepatocellular carcinoma (HCC) who were treated with an SRL‐based regimen as a primary therapy.

Sustained and focused hepatitis B virus nucleocapsid–specific T‐cell immunity in liver transplant recipients compared to individuals with chronic and self‐limited hepatitis B virus infection

Florian Bihl, Elisabetta Loggi, John V. Chisholm, Maurizio Biselli, Maria C. Morelli, Carmela Cursaro, Norah A. Terrault, Mauro Bernardi, Antonio Bertoletti, Pietro Andreone, Christian Brander – 6 March 2008 – Hepatitis B virus (HBV) recurrence after orthotopic liver transplantation (OLT) is associated with poor graft‐ and patient‐survival. Treatment with HBV‐specific immunoglobulins (HBIG) in combination with nucleos(t)ide analogs is effective in preventing HBV reinfection of the graft and improving OLT outcome.

Utility of liver allograft biopsy obtained at procurement

Irene J. Lo, Jay H. Lefkowitch, Nikki Feirt, Barbara Alkofer, Cindy Kin, Benjamin Samstein, James V. Guarrera, John F. Renz – 6 March 2008 – Extended‐donor criteria (EDC) liver allografts potentiate the role of procurement biopsy in organ utilization. To expedite allocation, histologic evaluation is routinely performed upon frozen‐section (FS) specimens by local pathologists.

Should trichrome stain be used on all post–liver transplant biopsies with hepatitis c virus infection to estimate the fibrosis score?

David Tretheway, Ashok Jain, Randi LaPoint, Rajeev Sharma, Mark Orloff, Patricia Milot, Adel Bozorgzadeh, Charlotte Ryan – 6 March 2008 – Recurrent hepatitis C is virtually universal after liver transplantation; however, an individual patient's clinical course and disease burden are highly variable and difficult to predict. The fibrosis score determined on posttransplant biopsies appears to be a sensitive and specific marker of disease progression and severity.

Hepatitis C virus reinfection in liver transplant patients: Evaluation of liver damage progression with echo‐color doppler

Massimo Bolognesi, Cristina Quaglio, Giancarlo Bombonato, Maria Guido, Luisa Cavalletto, Liliana Chemello, Carlo Merkel, Massimo Rugge, Angelo Gatta, David Sacerdoti – 6 March 2008 – Liver transplant recipients are a model of rapid progression of hepatitis C virus (HCV)–related liver disease, from normal to cirrhosis. The aim of the study was the analysis of the relationship between portohepatic hemodynamics and modification in liver histology during the progression of HCV liver disease after transplant. Patients transplanted for HCV cirrhosis were considered for the study.

Prevalence and significance of occult hepatitis B in a liver transplant population with chronic hepatitis C

Kirti Shetty, Munira Hussain, Lei Nei, K. Rajender Reddy, Anna S.F. Lok – 6 March 2008 – Occult hepatitis B virus (HBV) infection is defined as the detection of HBV deoxyribonucleic acid (DNA) in the serum or liver tissue of individuals who test negative for hepatitis B surface antigen (HBsAg). We undertook a prospective study to evaluate the significance and course of occult HBV in patients with hepatitis C virus (HCV) cirrhosis undergoing orthotopic liver transplantation (OLT).

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