Predictors of survival after liver transplantation for hepatocellular carcinoma associated with Hepatitis C

Mitsugi Shimoda, Rafik M. Ghobrial, Ian C. Carmody, Dean M. Anselmo, Douglas G. Farmer, Hasan Yersiz, Pauline Chen, Sherfield Dawson, Francisco Durazo, Steve Han, Leonard I. Goldstein, Sammy Saab, Jonathan Hiatt, Ronald W. Busuttil – 19 November 2004 – The efficacy of orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC) associated with hepatitis C virus (HCV) is not well defined. This study examines the variables that may determine the outcome of OLT for HCC in HCV patients. From 1990 to 1999, 463 OLTs were performed for HCV cirrhosis.

The transplanted liver graft is capable of clearing asymmetric dimethylarginine

Michiel P.C. Siroen, Michiel C. Warlé, Tom Teerlink, Robert J. Nijveldt, Ernst J. Kuipers, Herold J. Metselaar, Hugo W. Tilanus, Dirk J. Kuik, Joost R.M. van der Sijp, Sybren Meijer, Ben van der Hoven, Paul A.M. van Leeuwen – 19 November 2004 – Asymmetric dimethylarginine (ADMA) has been recognized as an endogenous inhibitor of the arginine–nitric oxide (NO) pathway. Its concentration is tightly regulated by urinary excretion and degradation by the enzyme dimethylarginine dimethylaminohydrolase (DDAH), which is highly expressed in the liver.

Combined orthotopic heart and liver transplantation: The need for exception status listing1

Paige M. Porrett, Shashank S. Desai, Kathleen J. Timmins, Carol R. Twomey, Seema S. Sonnad, Kim M. Olthoff – 19 November 2004 – Through May 2004, 33 combined orthotopic heart‐liver transplants (OHT/OLT) have been performed nationwide. No published data exist to date regarding outcomes of patients awaiting such transplants, although progression of two organ disease processes may contribute to premature death for waiting patients.

Factors that identify survival after liver retransplantation for allograft failure caused by recurrent hepatitis C infection

Guy W. Neff, Christopher B. O'Brien, Jose Nery, Norah J. Shire, Seigo Nishida, Julia delaGarza, Marzia Montalbano, Kamran Safdar, Phillip Ruiz, Eric Rideman, Jose A. Gascon, Andreas G. Tzakis, Juan Madariaga, Steven M. Rudich – 19 November 2004 – Hepatitis C virus (HCV) is becoming the most common indication for liver retransplantation (ReLTx). This study was a retrospective review of the medical records of liver transplant patients at our institution to determine factors that would identify the best candidates for ReLTx resulting from allograft failure because of HCV recurrence.

Hepatocellular proliferation and changes in microarchitecture of right lobe allografts in adult transplant recipients

Ruoqing Huang, Thomas D. Schiano, May Jennifer Amolat, Charles M. Miller, Swan N. Thung, Romil Saxena – 19 November 2004 – Imaging studies show complete restoration of liver volume in adult recipients of right lobe allografts within 2–3 weeks of living donor transplantation (LDLT). However, it is not known if this growth is associated with restoration of hepatic microarchitecture. We compared 21 biopsies without significant pathology from LDLT recipients with 23 biopsies from adult recipients of cadaveric donor liver transplantation (CDLT) performed within 3 months of transplantation.

Living donor liver transplant with clinical tolerance, laboratory evidence of chimerism, and spontaneous clearance of HBV

James J. Stone, Seong‐Hwan Chang, Pamela M. Kimball, R. Todd Stravitz, Robert A. Fisher – 20 October 2004 – We present a case of functional and histopathologic tolerance, chimerism, and spontaneous clearance of HBV in a patient four years after living donor liver transplant (LDLT). A 19‐year‐old male patient underwent a LDLT for HBV cirrhosis. He voluntarily ceased immunosuppression and antiviral therapy after 6 months. He is now four years status post transplant without any episodes of rejection or clinical manifestation of liver disease.

Ability to pay and geographical proximity influence access to liver transplantation even in a system with universal access

P. Aiden McCormick, Marie O'Rourke, Deirdre Carey, Marie Laffoy – 20 October 2004 – Ireland, in common with many countries, has a mixed private and public health care system. Concern has been expressed that this system may lead to inequity in access to medical treatment. To investigate this concern, all contacts and first admissions to the national liver transplant unit were identified between April 1, 2000, and March 31, 2002. The effects of private health insurance and area of residence on the likelihood of receiving a liver transplant were assessed.

Posttransplant survival in pediatric fulminant hepatic failure: The SPLIT experience

Prabhakar Baliga, Sergio Alvarez, Anne Lindblad, Lan Zeng – 20 October 2004 – Pediatric patients with fulminant hepatic failure (FHF) tend to be the sickest and have the most urgent need for a liver transplant. The purpose of this analysis was to identify factors associated with posttransplant survival in this subset of patients. Data on all FHF patients registered in the Studies of Pediatric Liver Transplantation (SPLIT) registry from 1995 to 2002 were analyzed. Demographics such as age, gender, race, weight, and etiology of liver disease were recorded.

Applicability of histidine‐tryptophan‐ketoglutarate solution in right lobe adult‐to‐adult live donor liver transplantation

See Ching Chan, Chi Leung Liu, Chung Mau Lo, Sheung Tat Fan – 20 October 2004 – In a consecutive series of 60 right lobe adult‐to‐adult live donor liver transplantations (ALDLTs), safety and efficacy of the University of Wisconsin (UW) and histidine‐tryptophan‐ketoglutarate (HTK) solution were evaluated. The first 30 liver grafts were perfused with UW solution and the subsequent 30 by HTK solution. Donor and recipient characteristics of both groups were comparable.

Preoperative evaluation of biliary anatomy in adult live liver donors with volumetric mangafodipir trisodium enhanced magnetic resonance cholangiography

Juan R. Ayuso, Carmen Ayuso, Ernest Bombuy, Carmen De Juan, Josep M. Llovet, Teresa M. De Caralt, Marcel Sánchez, Mario Pagés, Jordi Bruix, Juan C. García‐Valdecasas – 20 October 2004 – Accurate preoperative depiction of biliary anatomy is not always adequately accomplished by imaging techniques in living donor liver transplantation (LDLT). We present the results of a prospective study designed to evaluate the ability of mangafodipir trisodium (Mn‐DPDP)‐enhanced magnetic resonance (MR) cholangiography (MRC) for this purpose in a series of 25 adult living liver donors (LLDs).

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