Selection of candidates with HCC for transplantation in the MELD era

Margarita Sala, Maria Varela, Jordi Bruix – 21 September 2004 – Key Points 1Liver transplantation is the main option for patients with early HCC who are not optimal candidates for surgical resection.2Shortage of donors is its main limitation, as waiting for a liver allows the tumor to progress and induce exclusion from the waiting list and death.3The absence of randomized controlled trials hinders the establishment of the most effective therapy to prevent tumor progression while waiting.4Live donation may be a cost‐effective approach if optimal results are expected and the mortality risk fo

Evolving strategies to prevent HBV recurrence

Bruno Roche, Didier Samuel – 21 September 2004 – Key Points 1Long‐term prophylaxis with hepatitis B immune globulin (HBIG) significantly reduces the risk for hepatitis B virus (HBV) recurrence and increases survival. Patients with HBV cirrhosis and / or positive HBV DNA at the time of transplantation have a high risk for recurrence despite HBIG prophylaxis.2Pre–orthotopic liver transplantation (OLT) antiviral treatment using lamivudine (LAM) can suppress HBV replication before transplantation and may induce clinical improvement in a subset of patients.

Summary report of a national conference: Evolving concepts in liver allocation in the MELD and PELD era

Kim M. Olthoff, Robert S. Brown, Francis L. Delmonico, Richard B. Freeman, Sue V. McDiarmid, Robert M. Merion, J. Michael Millis, John P. Roberts, Abraham Shaked, Russell H. Wiesner, Michael R. Lucey – 21 September 2004 – A national conference was held to review and assess data gathered since implementation of MELD and PELD and determine future directions. The objectives of the conference were to review the current system of liver allocation with a critical analysis of its strengths and weaknesses.

Persistence of isolated antibodies to woodchuck hepatitis virus core antigen is indicative of occult infection

Carla S. Coffin, Tram N.Q. Pham, Patricia M. Mulrooney, Norma D. Churchill, Tomasz I. Michalak – 20 September 2004 – Antibodies against virus nucleocapsid (anticore) normally accompany hepadnaviral hepatitis but they may also occur in the absence of symptoms and other serological indicators of the infection. This situation can be encountered following a clinically and serologically unapparent exposure to hepatitis B virus (HBV) or after recovery from hepatitis B.

Impact of cirrhosis on the development of experimental hepatic metastases by B16F1 melanoma cells in C57BL/6 mice

Ke Qi, Hongming Qiu, Dongfeng Sun, Gerald Y. Minuk, Michael Lizardo, John Rutherford, F. William Orr – 20 September 2004 – Metastases rarely occur in human livers with cirrhosis in clinical studies. We postulated that this phenomenon would also occur in experimental cirrhosis. Cirrhosis was established in C57BL/6 mice by carbon tetrachloride (CCl4) gastrogavage. B16F1 melanoma cells were injected into the mesenteric vein to induce hepatic metastases. Contrary to our postulate, there was greater than 4‐fold increase in metastasis in animals with cirrhosis compared to controls.

Therapeutic efficacy of an angiotensin II receptor antagonist in patients with nonalcoholic steatohepatitis

Shiro Yokohama, Masashi Yoneda, Masakazu Haneda, Satoshi Okamoto, Mituyoshi Okada, Kazunobu Aso, Takenao Hasegawa, Yoshihiko Tokusashi, Naoyuki Miyokawa, Kimihide Nakamura – 20 September 2004 – The therapeutic efficacy of angiotensin II receptor antagonist, losartan, was studied in patients with nonalcoholic steatohepatitis (NASH). Seven patients with both NASH and hypertension were treated with losartan (50 mg/d) for 48 weeks.

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