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.

Occult hepatitis B virus infection in HBsAg negative patients undergoing liver transplantation: Clinical significance

Valeria Ghisetti, Alfredo Marzano, Fausto Zamboni, Anna Barbui, Alessandro Franchello, Silvia Gaia, Giovanna Marchiaro, Mauro Salizzoni, Mario Rizzetto – 26 February 2004 – Occult Hepatitis B virus (o‐HBV) infection has been reported in HB surface antigen (HBsAg)‐negative liver donors whose risk of transmitting HBV justifies a specific prophylaxis in liver recipients. The clinical significance of o‐HBV infection in HBsAg‐negative recipients and their need for prophylaxis is unknown.

Acute hepatic allograft rejection: A comparison of patients with and without centrilobular alterations during first rejection episode

Michael O. Lovell, K. Vincent Speeg, Glenn A. Halff, D. Kimberley Molina, Francis E. Sharkey – 26 February 2004 – The histologic diagnosis of acute hepatic allograft rejection is usually based upon the identification of characteristic portal tract features. In addition to these, centrilobular alterations such as central vein endothelialitis, zone 3 inflammation, and hepatocyte necrosis may also be seen during episodes of acute rejection.

Graft‐versus‐host disease following living donor liver transplantation

Yuji Soejima, Mitsuo Shimada, Taketoshi Suehiro, Shoji Hiroshige, Hisashi Gondo, Akiyoshi Takami, Shizuka Yasue, Yoshihiko Maehara – 26 February 2004 – Graft‐versus‐host disease (GVHD) is the most common and well‐known cause of morbidity and mortality following allogeneic bone marrow transplantation. Sporadic cases have been reported after cadaveric donor liver transplantation with usually fatal outcomes, however, the actual incidence and the characteristics of GVHD after living donor liver transplantation (LDLT) remain unknown.

Promising early results with immunosuppression using rabbit anti‐thymocyte globulin and steroids with delayed introduction of tacrolimus in adult liver transplant recipients

A. Joseph Tector, Jonathan A. Fridell, Richard S. Mangus, Ashesh Shah, Martin Milgrom, Paul Kwo, Naga Chalasani, Hwan Yoo, Dale Rouch, Suthat Liangpunsakul, Scott Herring, Lawrence Lumeng – 26 February 2004 – Induction therapy with T‐cell depleting drugs in liver transplantation is controversial. This study examined the use of rabbit antithymocyte globulin (RATG) with delayed introduction of tacrolimus in liver transplant recipients. Additional subgroup analysis compared patients with or without hepatitis C (HCV) cirrhosis. Over 17 months, 116 adults received 120 liver allografts.

Increased mononuclear cell activation and apoptosis early after human liver transplantation is associated with a reduced frequency of acute rejection

Julie R. Jonsson, Wenyi Gu, Daina M. Vanags, G. Alex Bishop, Geoffrey W. McCaughan, Jonathon Fawcett, Stephen V. Lynch, Glenda A. Balderson, Elizabeth E. Powell, Andrew D. Clouston – 26 February 2004 – Experimental models of orthotopic liver transplantation (OLT) have shown that the very early events post‐OLT are critical in distinguishing immunogenic and tolerogenic reactions. In rodents, increased leukocyte apoptosis and cytokine expression have been demonstrated in tolerogenic strain combinations. Information from human OLT recipients is less abundant.

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