Preoperative characteristics and intraoperative transfusion and vasopressor requirements in patients with low vs. high MELD scores

Victor W. Xia, Bin Du, Michelle Braunfeld, Gundappa Neelakanta, Ke‐Qin Hu, Hamid Nourmand, Philip Levin, Ronald Enriquez, Jonathan R. Hiatt, R. Mark Ghobrial, Douglas G. Farmer, Ronald W. Busuttil, Randolph H. Steadman – 22 March 2006 – Recent changes in organ allocation based on the model for end‐stage liver disease (MELD) prioritize the most ill patients on the waiting list for liver transplantation. While patients undergoing liver transplantation in the MELD era are more acutely ill, the impact of the policy changes on perioperative management has not been completely assessed.

Attenuation of acute phase shear stress by somatostatin improves small‐for‐size liver graft survival

Xiao Xu, Kwan Man, Shu Sen Zheng, Ting Bo Liang, Terence K. Lee, Kevin T. Ng, Sheung Tat Fan, Chung Mau Lo – 22 March 2006 – The major concern of living donor liver transplantation is small‐for‐size graft injury at the early phase after transplantation. Novel therapeutic strategies should be developed. To investigate the protective effect of somatostatin related to hemodynamic stress on small‐for‐size liver graft injury, we applied a treatment regimen of low‐dose somatostatin in a rat orthotopic liver transplantation model using small‐for‐size grafts (median, 38.7%; range, 35–42%).

Late graft dysfunction and autoantibodies after liver transplantation in children: Preliminary results of an italian experience

Silvia Riva, Aurelio Sonzogni, Michela Bravi, Alessandro Bertani, Maria Grazia Alessio, Manila Candusso, Paola Stroppa, Maria L. Melzi, Marco Spada, Bruno Gridelli, Michele Colledan, Giuliano Torre – 22 March 2006 – Late graft dysfunction (GD) associated with the development of autoantibodies is a common event after pediatric liver transplantation (OLTx) and can present in 2 clinicohistological subsets: de novo autoimmune hepatitis (DNAH) and early chronic rejection (ECR). Sixty out of 247 children developed autoantibodies after OLTx.

Trends over a decade of pediatric liver transplantation in the United States

Sandy Feng, Ming Si, Sarah E. Taranto, Maureen A. McBride, Christine Mudge, Susan Stritzel, John P. Roberts, Philip Rosenthal – 22 March 2006 – During the last 10 to 15 years, medical and surgical innovations have established pediatric liver transplantation as the optimal therapy for children suffering acute and chronic liver disease. We hypothesized that the profile of current pediatric liver transplant recipients would differ significantly from that of an earlier era.

The association of HLA‐DR13 with lower graft survival rates in hepatitis B and primary sclerosing cholangitis caucasian patients receiving a liver transplant

Yasuro Futagawa, Kayo Waki, Junchao Cai – 22 March 2006 – We investigated an association of human leukocyte antigen (HLA)‐DR13 to graft survival in liver transplantation among Caucasian recipients. 28,708 deceased liver transplants performed between January 1990 and December 2002 in the United States as reported to the United Network for Organ Sharing registry were utilized to compare survival rates. We utilized Caucasian adult patients (>20 years) by Kaplan‐Meier curves, log‐rank tests, and Cox proportional hazard analyses.

Effect of ischemic preconditioning in whole liver transplantation from deceased donors. A pilot study

Matteo Cescon, Gian Luca Grazi, Alberto Grassi, Matteo Ravaioli, Gaetano Vetrone, Giorgio Ercolani, Giovanni Varotti, Antonietta D'Errico, Giorgio Ballardini, Antonio Daniele Pinna – 22 March 2006 – The effect of ischemic preconditioning (IPC) in orthotopic liver transplantation (OLT) has not yet been clarified. We performed a pilot study to evaluate the effects of IPC in OLT by comparing the outcomes of recipients of grafts from deceased donors randomly assigned to receive (IPC+ group, n = 23) or not (IPC− group, n = 24) IPC (10‐min ischemia + 15‐min reperfusion).

Minimizing oxidative stress by gene delivery of superoxide dismutase accelerates regeneration after transplantation of reduced‐size livers in the rat

Thorsten G. Lehmann, Tom Luedde, Robert F. Schwabe, Hartwig Bunzendahl, R. Jude Samulski, John J. Lemasters, David A. Brenner – 22 March 2006 – Transplantation of reduced‐size livers may lead to a hypermetabolic state and increased production of oxygen radicals. Since oxygen radicals may cause liver injury and impair liver regeneration, we tested the hypothesis that overexpression of superoxide dismutase (SOD) in reduced‐size livers (RSL) would accelerate regeneration and reduce injury in a rat model of transplantation of RSL.

Live donor liver transplantation

Sander Florman, Charles M. Miller – 22 March 2006 – With ever‐increasing demand for liver replacement, supply of organs is the limiting factor and a significant number of patients die while waiting. Live donor liver transplantation has emerged as an important option for many patients, particularly small pediatric patients and those adults that are disadvantaged by the current deceased donor allocation system. Ideally there would be no need to subject perfectly healthy people in the prime of their lives to a potentially life‐threatening operation to procure transplantable organs.

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