Liver transplantation for acute liver failure from drug induced liver injury in the United States

Mark W. Russo, Joseph A. Galanko, Roshan Shrestha, Michael W. Fried, Paul Watkins – 23 July 2004 – Studies of acute liver failure from drugs have included cases mostly attributed to acetaminophen (APAP) but have reported limited data on other drugs. We used the United Network for Organ Sharing (UNOS) liver transplant database from 1990 to 2002 to identify recipients and estimate a U.S. population‐based rate of liver transplantation due to acute liver failure from drugs. Patients were identified if their diagnosis was acute hepatic necrosis from an implicated drug at the time of transplant.

Hepatitis C etiology of liver disease is strongly associated with early acute rejection following liver transplantation

Ryan A. McTaggart, Norah A. Terrault, Andrew J. Vardanian, Alan Bostrom, Sandy Feng – 23 July 2004 – Although recurrent hepatitis C (HCV) occurs universally after liver transplantation (LT), its tempo and severity are variable and unpredictable. Diagnosis and treatment of early acute rejection (EAR) likely affect the course of recurrent HCV disease. We have studied a contemporary cohort of LT recipients to reexamine risk factors for EAR. We hypothesized that HCV etiology may represent a significant risk factor for EAR for many reasons.

Cold preservation of isolated sinusoidal endothelial cells in MMP 9 knockout mice: Effect on morphology and platelet adhesion

Stefan A. Topp, Gundumi A. Upadhya, Steven M. Strasberg – 23 July 2004 – Cold preservation of rat sinusoidal endothelial cells causes actin disassembly, cell rounding, matrix metalloproteinase (MMP) secretion, and platelet adhesiveness. Studies in rats suggest that gelatinases MMP2 and MMP9 are the key mediators of the injury. We created a model of cold preservation injury in mouse sinusoidal endothelial cell (MSEC) to examine the effect of cold on MSEC, specifically on MSEC from genetically deleted mice (MMP9/KO) mice.

Alterations in glucose metabolism associated with liver cirrhosis persist in the clinically stable long‐term course after liver transplantation

Uwe J.F. Tietge, Oliver Selberg, Andreas Kreter, Matthias J. Bahr, Matthias Pirlich, Wolfgang Burchert, Manfred J. Müller, Michael P. Manns, Klaus H.W. Böker – 23 July 2004 – With increasing long‐term survival rates after orthotopic liver transplantation (OLT), metabolic alterations complicating the clinical course, such as diabetes mellitus (DM), become increasingly important. Liver cirrhosis is associated with severe alterations in glucose metabolism. However, it is currently unclear whether these changes are reversed by successful OLT.

Use of fenoldopam to control renal dysfunction early after liver transplantation

Gianni Biancofiore, Giorgio Della Rocca, Lucia Bindi, Anna Romanelli, Massimo Esposito, Luca Meacci, Lucio Urbani, Franco Filipponi, Franco Mosca – 23 July 2004 – With the aim of assessing whether fenoldopam can help to preserve renal function after liver transplantation, we randomized 140 consecutive recipients with comparable preoperative renal function to receive fenoldopam 0.1 μg/kg/minute (group F, 46 patients), dopamine 3 μg/kg/minute (group D, 48 patients), or placebo (group P, 46 patients) from the time of anesthesia induction to 96 hours postoperatively.

Immunoglobulin‐G subclass antidonor reactivity in transplant recipients

Zu‐hua Gao, Vivian C. McAlister, James R. Wright, Chloe C. McAlister, Kevork Peltekian, Allan S. MacDonald – 23 July 2004 – Outcomes may differ after kidney transplantation compared to combined liver‐kidney transplantation. In animal models, distinct patterns of antidonor immunoglobulin (Ig) G subclasses are associated with either rejection or transplant tolerance. Flow cytometry has increased the sensitivity of antidonor immunoglobulin detection. We compared antidonor IgG subclass responses in kidney transplant recipients to those in recipients of liver or multiorgan grafts.

Waiting for a liver—Hidden costs of the organ shortage

Donald A. Brand, Deborah Viola, Pretam Rampersaud, Patricia A. Patrick, William S. Rosenthal, David C. Wolf – 23 July 2004 – Discussion about the economics of end‐stage liver disease has typically focused on the high cost of liver transplantation, but the management of complications in patients waiting for an organ can also be very expensive. Our research considered the hypothesis that an increase in the number of organ grafts would decrease health care costs in patients with liver disease by eliminating the cost of waiting for an organ.

Use of CT cholangiography to evaluate the biliary tract after liver transplantation: Initial experience

Gregg A. Miller, Benjamin M. Yeh, Richard S. Breiman, John P. Roberts, Aliya Qayyum, Fergus V. Coakley – 23 July 2004 – Evaluation of the biliary tract after liver transplantation, particularly when a Roux‐en‐Y hepatojejunostomy precludes endoscopic retrograde cholangiography, may be challenging. We present five cases of suspected biliary obstruction after liver transplantation in which multidetector‐row computed tomography (CT) cholangiography was used.

Older age and liver transplantation: A review

Rajesh N. Keswani, Aijaz Ahmed, Emmet B. Keeffe – 23 July 2004 – Patients older than 60 are undergoing transplantation with increasing frequency. Reports from several transplant centers document that overall short‐term patient survival rates in seniors undergoing liver transplantation are comparable to survival rates of younger adults. However, specific subgroups of older patients may not fare as well. Seniors with far‐advanced end‐stage liver disease are high‐risk for liver transplantation and have poor survival rates.

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