Revised King's College score for liver transplantation in adult patients with Wilson's disease

Jan Petrasek, Milan Jirsa, Jan Sperl, Libor Kozak, Pavel Taimr, Julius Spicak, Karel Filip, Pavel Trunecka – 27 December 2006 – Fulminant Wilson's disease (WD) is almost invariably fatal, and liver transplantation is the only life‐saving treatment. Decompensated chronic WD usually responds to chelation therapy. Our aim was to validate 3 published scoring systems for deciding between chelation treatment and liver transplantation in patients with chronic decompensated and fulminant WD.

Acute graft‐versus‐host disease after liver transplantation: Role of withdrawal of immunosuppression in therapeutic management

Srinath Chinnakotla, Douglas M. Smith, Rana Domiati‐Saad, Edward D. Agura, David L. Watkins, George Netto, Tadahiro Uemura, Edmund Q. Sanchez, Marlon F. Levy, Goran B. Klintmalm – 27 December 2006 – Graft‐versus‐host disease (GVHD) after liver transplantation is rare but associated with a very high mortality (over 85%). Most treatments focus on increasing immunosuppression, addition of antibody preparations such as OKT3 and antithymocyte globulin to eliminate the donor lymphocytes, and supporting myelopoiesis by use of cytokines. However, the results are very poor.

Left ventricular dysfunction: A hidden risk in patients undergoing liver transplantation

James D. Perkins – 27 December 2006 – With improved survival after liver transplantation (LT), the referral of older candidates has increased. The increasing demand for, and the decreased supply of, liver donors makes careful preoperative cardiac risk assessment imperative. There is a paucity of information regarding the cardiac characteristics of patients being referred for LT in the current era.

MELD‐XI: A rational approach to “sickest first” liver transplantation in cirrhotic patients requiring anticoagulant therapy

Douglas M. Heuman, Anastasios A. Mihas, Adil Habib, HoChong S. Gilles, R. Todd Stravitz, Arun J. Sanyal, Robert A. Fisher – 27 December 2006 – Priority for “sickest first” liver transplantation (LT) in the United States is determined by the model for end‐stage liver disease (MELD). MELD is a good predictor of short‐term mortality in cirrhosis, but it can overestimate risk when international normalized ratio (INR) is artificially elevated by anticoagulation. An alternate prognostic index omitting INR is needed in this situation.

Wide gene expression profiling of ischemia‐reperfusion injury in human liver transplantation

Anna Conti, Simona Scala, Paola D'Agostino, Elena Alimenti, Daniele Morelli, Barbara Andria, Angela Tammaro, Chiara Attanasio, Floriana Della Ragione, Vincenzo Scuderi, Floriana Fabbrini, Maurizio D'Esposito, Ernesto Di Florio, Lucio Nitsch, Fulvio Calise, Antonio Faiella – 27 December 2006 – Ischemia‐reperfusion injury (IRI) causes up to 10% of early liver failures in humans and can lead to a higher incidence of acute and chronic rejection. So far, very few studies have investigated wide gene expression profiles associated with the IRI process.

Switch to 1.5 grams MMF monotherapy for CNI‐related toxicity in liver transplantation is safe and improves renal function, dyslipidemia, and hypertension

Giuseppe Orlando, Leonardo Baiocchi, Andrea Cardillo, Giuseppe Iaria, Nicola De Liguori, Linda De Luca, Benedetto Ielpo, Laura Tariciotti, Mario Angelico, Giuseppe Tisone – 27 December 2006 – Although mycophenolate mofetil (MMF) monotherapy has been successfully used in liver transplant recipients suffering from calcineurin‐inhibitor (CNI)‐related chronic toxicity, still no consensus has been reached on its safety, efficacy and tolerability.

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