Hepatic resection of noncolorectal nonneuroendocrine metastases

Alan W. Hemming, Tim D. Sielaff, Steven Gallinger, Mark S. Cattral, Bryce R. Taylor, Paul D. Greig, Bernard Langer – 30 December 2003 – Because hepatic resection is generally a safe procedure, the indications for resection of noncolorectal nonneuroendocrine (NCNNE) hepatic metastases have broadened. The prognostic features of NCNNE metastases treated surgically were reviewed to define better the value of resection. A retrospective review of patients undergoing liver resection for NCNNE metastases between 1978 and 1998 was undertaken. Thirty‐seven patients were identified.

Predicting bacteremia and bacteremic mortality in liver transplant recipients

Nina Singh, David L. Paterson, Timothy Gayowski, Marilyn M. Wagener, Ignazio R. Marino – 30 December 2003 – Predictors of bacteremia and mortality in bacteremic liver transplant recipients were prospectively assessed. One hundred eleven consecutive episodes of fever or infections were documented in 59 patients over a 4‐year period. Forty‐nine percent (29 of 59 patients) of the patients had bacteremia, 39% (23 of 59 patients) had nonbacteremic infections, and 12% (7 of 59 patients) had fever of noninfectious cause.

Influence of human fulminant hepatic failure sera on endogenous retroviral expression in pig hepatocytes

Scott L. Nyberg, Jonathan R. Hibbs, Joseph A. Hardin, Jeffrey J. Germer, Jeffrey L. Platt, Carlos V. Paya, Russell H. Wiesner – 30 December 2003 – A porcine endogenous retrovirus (PERV) has been shown to infect human embryonic kidney 293 (HEK293) cells in vitro. The PERV proviral sequence exists in the genome of all porcine cells, including hepatocytes used in a bioartificial liver (BAL). We examined the possibility of PERV infection in HEK293 cells during exposure to supernatant from cultured pig hepatocytes.

Autonomic dysfunction in end‐stage liver disease manifested as defecation syncope: Impact of orthotopic liver transplantation

Brian M. Parker, Sanjay Bhatia, Zobair Younossi, J. Michael Henderson, John E. Tetzlaff – 30 December 2003 – Patients with end‐stage liver disease (ESLD) may be at increased risk for syncopal episodes based on their circulatory physiological state. Although a definitive cause for this is not known, several mechanisms have been proposed. In patients with ESLD, defecation syncope may result from a failure of short‐term neurocirculatory adaptation to the Valsalva maneuver in the face of a hyperdynamic circulatory state and a decreased effective intravascular volume.

Evidence of continuing bone recovery at a mean of 7 years after liver transplantation

Robert B. Feller, Jennifer A. McDonald, Kenneth J. Sherbon, Geoffrey W. McCaughan – 30 December 2003 – Patients with end‐stage liver disease have low bone‐turnover osteoporosis, and there is often further bone loss of 20% to 30% after orthotopic liver transplantation (OLT). Bone recovery after OLT has been reported, but data are limited. We undertook studies to determine whether bone recovery continues in the long term. Twenty‐eight adult patients alive at least 5 years after OLT were studied (14 men, 14 women).

Long‐term follow‐up after liver transplantation in patients with hepatic iron overload

Bruce Y. Tung, Frank J. Farrell, Timothy M. McCashland, Robert G. Gish, Bruce R. Bacon, Emmet B. Keeffe, Kris V. Kowdley – 30 December 2003 – Patients with hepatic iron overload who undergo orthotopic liver transplantation (OLT) have a worse 1‐year survival than those who undergo transplantation for other indications; the long‐term outcome in this population is unknown. The purpose of this study is to report long‐term follow‐up after OLT in a cohort of patients with hepatic iron overload.

Progression of cardiomyopathy and neuropathy after liver transplantation in a patient with familial amyloidotic polyneuropathy caused by tyrosine‐77 transthyretin variant

Antonio García‐Herola, Martín Prieto, Sonia Pascual, Marina Berenguer, Bartolomé López‐Viedma, José Mir, Juan Jes Vilchez, Joaquín Berenguer – 30 December 2003 – Familial amyloidotic polyneuropathy is an inherited form of amyloidosis associated with a mutant form of a protein called transthyretin. The Methionine‐30 variant is the most frequent mutation observed. This disorder is caused by deposition of this protein as amyloid in several organs, such as the heart, kidneys, and peripheral nervous system.

Management of liver adenomatosis: Results with a conservative surgical approach

Afonso Ribeiro, Lawrence J. Burgart, David M. Nagorney, Gregory J. Gores – 30 December 2003 – Liver adenomatosis is defined by the presence of multiple hepatic adenomas (more than three lesions). The natural history and treatment of liver adenomatosis are not yet well defined. The Mayo Clinic (Rochester, MN) experience with liver adenomatosis in the past 11 years was reviewed and a rational treatment approach is presented. Records from patients with liver adenomatosis and hepatic adenoma seen at the Mayo Clinic from January 1986 to June 1997 were reviewed.

Dobutamine stress echocardiography for preoperative cardiac risk stratification in patients undergoing orthotopic liver transplantation

Jeffrey S. Plotkin,, R. Michael Benitez, Paul C. Kuo, Mary J. Njoku, Linda A. Ridge, James W. Lim, Charles D. Howell, Jacqueline M. Laurin, Lynt B. Johnson – 30 December 2003 – This study attempts to evaluate the efficacy of dobutamine stress echocardiography for preoperative cardiac risk stratification in patients undergoing orthotopic liver transplantation. Two hundred twenty consecutively submitted patients were evaluated in preparation for orthotopic liver transplantation. Dobutamine stress echocardiography was performed in 80 patients with known or suspected coronary artery disease.

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