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.

Volumetric and functional recovery of the liver after right hepatectomy for living donation

Silvio Nadalin, Giuliano Testa, Massimo Malagó, Mechtild Beste, Andrea Frilling, Thobias Schroeder, Christoph Jochum, Guido Gerken, Christoph E. Broelsch – 23 July 2004 – Our objective was to study the kinetics of recovery of the liver volume and liver function after right hepatectomy (RH) for living donation, comparing conventional and quantitative liver function tests, i.e., galactose elimination capacity (GEC). A total of 27 donors underwent RH averaging 61% of the whole liver volume.

Specific laboratory methodologies achieve higher model for endstage liver disease (MELD) scores for patients listed for liver transplantation

James F. Trotter, Brad Brimhall, Russ Arjal, Charles Phillips – 23 July 2004 – Priority for liver transplantation is currently based on the Model for Endstage Liver Disease (MELD) score, a mathematical function which includes the following objective variables: bilirubin, creatinine (Cr), and international normalized ratio (INR). We have noted that specific laboratory methodologies may yield consistently higher values of bilirubin, Cr, and INR.

Outcome of liver transplantation for hepatitis B in the United States

W. Ray Kim, John J. Poterucha, Walter K. Kremers, Michael B. Ishitani, E. Rolland Dickson – 23 July 2004 – Important innovations, such as hepatitis B immune globulin (HBIG) and lamivudine, have been introduced to the care of patients undergoing liver transplantation (OLT) for viral hepatitis B (HBV) (over the last 15 years). We analyzed survival of OLT recipients with HBV in the United States to examine the effect of these innovations.

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