Achieving adequate cyclosporine exposure in liver transplant recipients: A novel strategy for monitoring and dosing using intravenous therapy

Rainer Lück, Jan Böger, Ernst Kuse, Jürgen Klempnauer, Björn Nashan – 20 April 2004 – It has been demonstrated that achieving therapeutic levels of cyclosporine (CsA) exposure in the first days posttransplant is critical for effective prevention of rejection. In patients receiving oral CsA, it has been shown that C2‐monitoring is superior to trough (trough level [C0]) measurement. Intravenous administration may overcome the problem of CsA absorption dysfunction seen in some patients. Currently, little evidence is available concerning CsA exposure after intravenous application.

Ascites after liver transplantation—A mystery

Charmaine A. Stewart, Jason Wertheim, Kim Olthoff, Emma E. Furth, Colleen Brensinger, James Markman, Abraham Shaked – 20 April 2004 – Ascites after liver transplantation, although uncommon, presents a serious clinical dilemma. The hemodynamic changes that support the development of ascites before liver transplantation are resolved after transplant; therefore, persistent ascites (PA) after liver transplantation is unexpected and poorly characterized. The aim of this study was to define the clinical factors associated with PA after liver transplantation.

Mitochondrial toxicity associated with HAART following liver transplantation in an HIV‐infected recipient

Charalambos Antoniades, Candice Macdonald, Alexander Knisely, Christopher Taylor, Suzanne Norris – 20 April 2004 – Antiretroviral therapy is not uncommonly associated with drug toxicities, and hepatotoxicity occurs in approximately 20% of individuals prescribed antiretroviral therapy. Mitochondrial toxicity causing lactic acidosis is a rare but fatal complication that has been described in some HIV‐infected patients treated with nucleoside analogue reverse transcriptase inhibitors.

Long‐term immune response after liver transplantation in patients with spontaneous or post‐treatment HCV‐RNA clearance

Teresa Casanovas‐Taltavull, M. Guadalupe Ercilla, Cecilia P. Gonzalez, Elias Gil, Odette Viñas, Concha Cañas, Aurora Casanova, Juan Figueras, Teresa Serrano, Luis A. Casais – 20 April 2004 – Recurrent HCV infection after liver transplantation is universal and sustained clearance of HCV‐RNA rarely occurs. The aim of this study was to characterize cell‐mediated immunity and cytokine production in HCV‐infected patients after liver transplant.

Direct bile duct visualization during the preparation of split livers

Silvio Balzan, Olivier Farges, Daniele Sommacale, Federica Dondero, Maryléne Plasse, Jacques Belghiti – 20 April 2004 – The split‐liver technique is an important means to alleviating donor shortage. Its development is, at least in part, hindered by the risk of biliary complications, particularly when splitting is performed ex situ. We present a simple technique aimed at improving the identification of the biliary anatomy at the hilar level and the safety of the procedure. (Liver Transpl 2004;10:703–705.)

Regionwide sharing for status 1 liver patients – beneficial impact on waiting time and pre‐ and posttransplant survival

Abhinav Humar, Khalid Khwaja, Brooke Glessing, Elizabeth Larson, Massimo Asolati, Brenda Durand, John Lake, William D. Payne – 20 April 2004 – On August 21, 1999, Region 7 of the United Network for Organ Sharing (UNOS) adopted a policy of regionwide sharing of cadaver livers for UNOS Status 1 recipients. We examined what impact this policy had at our center on their waiting times, waiting list mortality, and outcomes.

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