MELD / PELD and the allocation of deceased donor livers for status 1 recipients with acute fulminant hepatic failure, primary nonfunction, hepatic artery thrombosis, and acute Wilson's disease

Russell H. Wiesner – 21 September 2004 – Key Points 1Historical perspective of donor allocation to patients with fulminant hepatic failure (FHF).2Predicting prognosis in patients with FHF using the London and Clichy criteria.3Model for end‐stage liver disease (MELD) is a predictor of mortality in patients with FHF.4Outcomes of adults listed as Status 1 in the United States.5Outcomes of pediatric candidates listed as Status 1 in the United States.6Proposed redefinition for Status 1 in adult and pediatric candidates. (Liver Transpl 2004;10:S17–S22.)

Does MELD work for relisted candidates?

Erick Edwards, Ann Harper – 21 September 2004 – Key Points 1Based on OPTN data, the ability of the model for end‐stage liver disease (MELD) to predict short‐term pretransplant and posttransplant outcomes was assessed.2Concordance with pretransplant mortality was excellent.3Concordance with pretransplant mortality was better for candidates listed for a primary transplant.4Of the MELD components, there were no statistically significant differences in the effects on pretransplant mortality between candidates listed for a primary or a repeat transplant.5Concordance with posttranplant outcomes w

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.

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.

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.

Liver transplantation without steroid induction in HIV‐infected patients

Antonio Rafecas, Gabriel Rufí, Juan Figueras, Juan Fabregat, Xavier Xiol, Emilio Ramos, Jaime Torras, Laura Lladó, Teresa Serrano – 16 September 2004 – Until recently, human immunodeficiency virus (HIV) infection was considered an absolute contraindication for liver transplantation in Spain. We present the first 4 cases of liver transplantation (LT) carried out in our center in patients infected with HIV and coinfected by the hepatitis C virus (HCV), immunosuppressed with cyclosporine A (CyA) and basiliximab, but without steroids.

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