Cost‐minimization analysis of MRC versus ERCP for the diagnosis of primary sclerosing cholangitis

Jayant A. Talwalkar, Paul Angulo, C. Daniel Johnson, Bret T. Petersen, Keith D. Lindor – 30 June 2004 – Investigations examining the use of magnetic resonance cholangiography (MRC) for the diagnosis of primary sclerosing cholangitis (PSC) have described comparable accuracy when compared to endoscopic retrograde cholangiopancreatography (ERCP). The effectiveness of MRC based on overall cost, however, remains unknown. Our aim was to determine the average cost per correct diagnosis using MRC or ERCP as the initial testing strategy for the diagnosis of PSC.

Sildenafil for portopulmonary hypertension in a patient undergoing liver transplantation

Heikki Makisalo, Anu Koivusalo, Anne Vakkuri, Krister Hockerstedt – 29 June 2004 – Liver transplantation (LT) may be indicated in cirrhotic patients with underlying pulmonary artery hypertension. However, severe pulmonary artery hypertension with mean pulmonary artery pressure (mPAP) above 50 mmHg has even been considered a contraindication to LT. We present a cirrhotic patient with an mPAP of 56 mmHg measured using right heart catheterization (RHC) and with severely compromised physical capacity.

Bacteremias in liver transplant recipients: Shift toward gram‐negative bacteria as predominant pathogens

Nina Singh, Marilyn M. Wagener, Asia Obman, Thomas V. Cacciarelli, Michael E. de Vera, Timothy Gayowski – 29 June 2004 – During the 1990s, gram‐positive bacteria emerged as major pathogens after liver transplantation. We sought to determine whether the pathogens associated with bacteremias in liver transplant recipients have changed. Patients included 233 liver transplant recipients transplanted between 1989 and 2003. The proportion of all infections due to bacteremias increased significantly over time (P < .0001).

Recovery from a variegate porphyria by a liver transplantation

Nathalie Stojeba, Carole Meyer, Catherine Jeanpierre, Frédéric Perrot, Christine Hirth, Thierry Pottecher, Jean‐Charles Deybach – 29 June 2004 – The porphyrias are a group of inherited or acquired enzymatic defects of heme biosynthesis. Each type of porphyria has a characteristic pattern of overproduction and accumulation of heme precursors based on the location of dysfunctional enzyme in the heme synthetic pathway.

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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