Randomized trial comparing pulmonary alterations after conventional with venovenous bypass versus piggyback liver transplantation

Maria Rita Montenegro Isern, Paulo Celso Bosco Massarollo, Eliane Maria de Carvalho, Carlos Eduardo Sandoli Baía, Jorge Kavakama, Poliana de Andrade Lima, Sérgio Mies – 26 February 2004 – During the anhepatic phase of conventional liver transplantation (LT), the inferior vena cava (IVC) is cross‐clamped and venovenous bypass (VVB) is usually indicated for diversion of IVC and portal blood flow. VVB can theoretically lead to pulmonary complications due to the contact of the blood with the surfaces of the circuit. In the piggyback method, preservation of the IVC avoids VVB.

Aerobic capacity is associated with 100‐day outcome after hepatic transplantation

Scott K. Epstein, Richard B. Freeman, Ahmad Khayat, John N. Unterborn, Daniel S. Pratt, Marshall M. Kaplan – 26 February 2004 – The shortage of donor organs highlights the need to better identify patients most likely to benefit from hepatic transplantation. Reduced aerobic capacity (decreased peak oxygen consumption [V̇O2] during symptom‐limited cardiopulmonary exercise testing) is frequently present in cirrhosis. Peak V̇O2 during cardiopulmonary exercise testing may predict short‐term outcome after hepatic transplantation.

Altered hematologic profiles following donor right hepatectomy and implications for perioperative analgesic management

Roman Schumann, Luis Zabala, Michael Angelis, Iwona Bonney, Hocine Tighiouart, Daniel B. Carr – 26 February 2004 – Living liver donors for adult liver transplant recipients undergo extensive liver resection. Partial donor hepatectomies may alter postoperative drug metabolism and hemostasis; thus, the risks and the benefits of pain management for this unique patient population may need to be reassessed. The safety and efficacy of combined epidural analgesia and field infiltration in our initial living liver donor group are presented.

Pharmacokinetic and immunosuppressive effects of tacrolimus‐loaded biodegradable microspheres

Yasunori Miyamoto, Takeji Uno, Hiromitsu Yamamoto, Li Xiao‐Kang, Koh‐ichi Sakamoto, Hisakuni Hashimoto, Hirofumi Takenaka, Yoshiaki Kawashima, Hideo Kawarasaki – 26 February 2004 – The objective of this study was to characterize the pharmacokinetics and immunosuppression of a tacrolimus‐loaded biodegradable microsphere (TLBM) in rats. We prepared TLBM. DA/Slc rats were given TLBM at a dose of 1.6 mg/kg (n = 9), 2.4 mg/kg (n = 5), or 7.2 mg/kg (n = 7) tacrolimus contents by a single subcutaneous administration to achieve sustained release over a long period.

The role and limitation of living donor liver transplantation for hepatocellular carcinoma

Chung‐Mau Lo, Sheung‐Tat Fan, Chi‐Leung Liu, See‐Ching Chan, John Wong – 26 February 2004 – Liver transplantation for hepatocellular carcinoma (HCC) is restricted by the scarcity of cadaver grafts. Living donor liver transplantation (LDLT) may potentially increase the applicability but its role and limitation are not clear. We studied the outcome of a cohort of 51 patients with unresectable HCC who were accepted on list for both options of deceased donor liver transplantation (DDLT) and LDLT. Twenty‐five of 51 (49%) patients had voluntary living donors (group 1) and 26 did not (group 2).

Drop‐out rates of patients with hepatocellular cancer listed for liver transplantation: Outcome with chemoembolization

Yamini K. Maddala, Linda Stadheim, James C. Andrews, Lawrence J. Burgart, Charles B. Rosen, Walter K. Kremers, Gregory Gores – 26 February 2004 – Patients with hepatocellular carcinoma (HCC) are assigned model for end stage liver disease (MELD) scores to provide access to liver transplantation (LT). An equitable policy would equate HCC progression beyond acceptable transplantation criteria with death on the waiting list. However, limited information is available regarding this issue. Thus, our aim was to analyze drop‐out rates on the waiting list for patients with HCC.

Patient and graft survival in hepatitis C recipients after adult living donor liver transplantation in the United States

Mark W. Russo, Joseph Galanko, Kimberly Beavers, Michael W. Fried, Roshan Shrestha – 26 February 2004 – End stage liver disease from chronic hepatitis C is the leading indication for liver transplantation in the United States. Small studies suggest that recurrent hepatitis C may be more common and occur earlier after living donor liver transplantation compared to deceased donor liver transplantation.

Analysis of factors that predict alcohol relapse following liver transplantation

Sameer Jauhar, Jayant A. Talwalkar, Terry Schneekloth, Sheila Jowsey, Russell H. Wiesner, K. V. Narayanan Menon – 26 February 2004 – Alcoholic liver disease has become a major indication for liver transplantation in the United States. Factors that predict alcohol relapse after liver transplantation are poorly defined. The aim of our study was to identify predictors of alcohol relapse in patients undergoing liver transplantation for alcoholic liver disease.

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