The liver as an immunological organ

Vito Racanelli, Barbara Rehermann – 30 January 2006 – The liver is a unique anatomical and immunological site in which antigen‐rich blood from the gastrointestinal tract is pressed through a network of sinusoids and scanned by antigen‐presenting cells and lymphocytes. The liver's lymphocyte population is selectively enriched in natural killer and natural killer T cells which play critical roles in first line immune defense against invading pathogens, modulation of liver injury and recruitment of circulating lymphocytes.

Apoptosis and necrosis in the liver: A tale of two deaths?

Harmeet Malhi, Gregory J. Gores, John J. Lemasters – 30 January 2006 – Death of hepatocytes and other hepatic cell types is a characteristic feature of liver diseases as diverse as cholestasis, viral hepatitis, ischemia/reperfusion, liver preservation for transplantation and drug/toxicant‐induced injury. Cell death typically follows one of two patterns: oncotic necrosis and apoptosis. Necrosis is typically the consequence of acute metabolic perturbation with ATP depletion as occurs in ischemia/reperfusion and acute drug‐induced hepatotoxicity.

Kinetics of hepatitis C virus reinfection after liver transplantation

Kimberly A. Powers, Ruy M. Ribeiro, Keyur Patel, Stephen Pianko, Lisa Nyberg, Paul Pockros, Andrew J. Conrad, John McHutchison, Alan S. Perelson – 30 January 2006 – Improved understanding of hepatitis C virus (HCV) dynamics during and after liver transplantation can be useful in optimizing antiviral therapy in transplant recipients. We analyzed serum HCV ribonucleic acid (RNA) levels during and after cadaveric liver transplantation in 6 HCV patients.

Allograft TNFβ and IL16 polymorphisms influence HCV recurrence and severity after liver transplantation

Pam Kimball, Melissa Baker, Robert A. Fisher – 30 January 2006 – Hepatitis C (HCV) recurrence after liver transplantation is universal although severity varies. We explored whether certain donor cytokine gene polymorphisms may be useful markers of susceptibility to severe recurrence. Allograft tumor necrosis factor (TNF) β and interleukin (IL) 16 gene polymorphisms were correlated with l‐yr clinical outcome among HCV+ recipients. Recipients of donor TNFβ2,2 (n = 8) experienced less recurrence (50% vs. 71%, P < 0.05), less fibrosis (25% vs. 76%, P < 0.01), and less rejection (25% vs.

Low circulating regulatory T‐cell levels after acute rejection in liver transplantation

Ahmet Demirkiran, Alice Kok, Jaap Kwekkeboom, Johannes G. Kusters, Herold J. Metselaar, Hugo W. Tilanus, Luc J.W. van der Laan – 30 January 2006 – Immune regulatory CD4+CD25+ T cells play a crucial role in inducing and maintaining allograft tolerance in experimental models of transplantation (Tx). In humans, the effect of Tx and immunosuppression on the function and homeostasis of CD4+CD25+ regulatory T cells (Tregs) is not well characterized.

Outcome of donors with a remnant liver volume of less than 35% after right hepatectomy

Jai Young Cho, Kyung‐Suk Suh, Choon Hyuck Kwon, Nam‐Joon Yi, Hwan Hyo Lee, Jean Wan Park, Kwang‐Woong Lee, Jae Won Joh, Suk‐Koo Lee, Kuhn Uk Lee – 30 January 2006 – To overcome the barrier of size match, right lobe graft has been widely used in living donor liver transplantation (LDLT). We assessed donor outcome, with a focus on remnant liver volume (RLV) after right hepatectomy based on the experiences of 2 LDLT centers, as a means of guiding the establishment of safe RLV limits for donor right hepatectomy.

Clinicopathologic findings and outcomes of liver transplantation using grafts from donors with unrecognized and unusual diseases

Surakit Pungpapong, Murli Krishna, Susan C. Abraham, Andrew P. Keaveny, Rolland C. Dickson, Raouf E. Nakhleh – 30 January 2006 – Despite certain strict criteria for suitable organ donors, some unrecognized and unusual diseases have been transmitted through liver transplantation to recipients. In the current series, we review our experience with 14 patients who underwent liver transplantation using donor grafts with unusual pathology, including amyloidosis (6), schistosomiasis (3), iron overload (2), and α‐1 antitrypsin deficiency (3).

Indications for chronic albumin infusion

James D. Perkins – 30 January 2006 – While transjugular intrahepatic portosystemic shunt (TIPS) is a common therapy for cirrhotic patients with diuretic‐resistant or diuretic‐refractory ascites, some patients are unsuitable for the procedure for technical or medical reasons. We report our experience with the use of chronic intravenous albumin infusions to achieve diuresis in this difficult patient population and review the historic experience of chronic albumin infusions as a treatment for ascites.

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