Management of drug‐to‐drug interactions between cyclosporine A and the protease‐inhibitor lopinavir/ritonavir in liver‐transplanted HIV‐infected patients

Martin Vogel, Esther Voigt, Hans‐Christoph Michaelis, Thomas Sudhop, Martin Wolff, Andreas Türler, Tilman Sauerbruch, Jürgen Kurt Rockstroh, Ulrich Spengler – 29 June 2004 – Highly active antiretroviral therapy (HAART) has improved the life expectancy of HIV‐infected patients, allowing orthotopic liver transplantation as a reasonable treatment option for selected patients with terminal liver disease.

Outcomes of acute rejection after interferon therapy in liver transplant recipients

Sammy Saab, Denise Kalmaz, Nupoor A. Gajjar, Jonathan Hiatt, Francisco Durazo, Steven Han, Douglas G. Farmer, R. Mark Ghobrial, Hasan Yersiz, Leonard I. Goldstein, Charles R. Lassman, Ronald W. Busuttil – 29 June 2004 – Interferon alfa has been increasingly used against recurrent hepatitis C (HCV) disease in post‐liver transplant (LT) recipients. A serious potential adverse effect is acute rejection. We reviewed our experience using interferon‐based therapy (interferon or pegylated interferon with or without ribavirin) for treating recurrent HCV in LT recipients.

Tacrolimus ameliorates cerebral vasodilatation and intracranial hypertension in the rat with portacaval anastomosis and hyperammonemia

Thomas Dethloff, Bent Adel Hansen, Fin Stolze Larsen – 29 June 2004 – Arterial hyperammonemia and cerebral vasodilatation correlate with cerebral herniation in patients with fulminant hepatic failure (FHF). Tacrolimus is a calcineurin inhibitor that passes the blood‐brain barrier and may increase cerebrovascular tone and restrict cerebral ammonia influx. In this study, we determined if tacrolimus prevents cerebral vasodilatation and high intracranial pressure (ICP) in the rat with portacaval anastomosis (PCA) challenged to high arterial ammonia (NH4+) concentration.

Liver transplantation for hepatocellular carcinoma validation of present selection criteria in predicting outcome

Kirti Shetty, Kate Timmins, Colleen Brensinger, Emma E. Furth, Sushil Rattan, Weijing Sun, Mark Rosen, Michael Soulen, Abraham Shaked, K. Rajender Reddy, Kim M. Olthoff – 29 June 2004 – Appropriate patient selection is crucial in ensuring acceptable outcomes from orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC). The United Network for Organ Sharing (UNOS) has elected to prioritize HCC patients for OLT based on criteria of tumor burden.

Cyclosporine A–Induced reduction of bile salt synthesis associated with increased plasma lipids in children after liver transplantation

Christian V. Hulzebos, Charles M.A. Bijleveld, Frans Stellaard, Folkert Kuipers, Vaclav Fidler, Maarten J.H. Slooff, Paul M.J.G. Peeters, Pieter J.J. Sauer, Henkjan J. Verkade – 29 June 2004 – Hyperlipidemia is a common side effect of cyclosporine A (CsA) after solid organ transplantation. CsA also markedly reduces the synthesis rate of bile salts in rats and can inhibit biliary bile salt secretion. It is not known, however, whether CsA inhibits the synthesis of bile salts in humans, and whether the hyperlipidemic effects of CsA are related to bile salt metabolism.

Consumption of dietary supplements in a liver transplant population

Guy W. Neff, Christopher O'Brien, Marzia Montalbano, Antoinette DeManno, Stephanie Kahn, Kamran Safdar, Seigo Nishida, Andreas Tzakis – 29 June 2004 – The extensive use of alternative medicine products, herbal remedies, and vitamins in large doses has reached an all time high in the general public. Some agents are reported and advertised as immune stimulants and may interfere with patients suffering from immune modification, autoimmune diseases, or transplant recipients.

Pretransplant MELD score and post liver transplantation survival in the UK and Ireland

Mathew Jacob, Lynn P. Copley, James D. Lewsey, Alex Gimson, Giles J. Toogood, Mohamed Rela, Jan H. P. van der Meulen – 29 June 2004 – It has been shown that the model for end‐stage liver disease (MELD) score is an accurate predictor of survival in patients with liver disease without transplantation. Four recent studies carried out in the United States have demonstrated that the MELD score obtained immediately prior to transplantation is also associated with post‐transplant patient survival.

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