Positive T lymphocytotoxic cross‐match in living donor liver transplantation

Yasuhiko Sugawara, Masatoshi Makuuchi, Junichi Kaneko, Yoji Kishi, Shojiro Hata, Norihiro Kokudo – 30 December 2003 – The influence of lymphocytotoxic cross‐match on survival or acute rejection in living donor liver transplantation (LDLT) has not been well examined. We analyzed 133 consecutive adult LDLT cases and assessed patient survival and acute rejection rates. Patients with a positive T lymphocytotoxic cross‐match (n = 12) had a significantly higher chance of rejection within 6 weeks of LDLT (67% versus 28%, P < .001).

Endothelin‐A receptor antagonist reduces microcirculatory disturbances and transplant dysfunction after partial liver transplantation

Daniel Palmes, Tymotheus B. Budny, Udo Stratmann, Hermann Herbst, Hans‐Ullrich Spiegel – 30 December 2003 – Endothelin‐1 can induce microcirculatory disorders by mediating sinusoidal vasoconstriction, lowering the perfusion rate and promoting leukocyte adhesion, all of which may play a role in the pathogenesis of the damage sustained by partial liver transplants. In this pilot study, we investigated a selective endothelin‐A receptor antagonist (Darusentan; Knoll GmbH, Ludwigshafen, Germany) for its potential influence on the microcirculation in the setting of partial liver transplantation.

Surgical treatment of Budd‐Chiari syndrome

Andrew S. Klein, Ernesto P. Molmenti – 30 December 2003 – Shunting and transplantation are satisfactory methods of treating Budd‐Chiari syndrome (BCS). Selection of treatment is based on the degree of hepatic injury (clinical settings), liver biopsy results, potential for parenchymal recovery, and pressure measurements. Shunting is recommended in cases of preserved hepatic function and architecture.

Relationship between portal venous flow and liver regeneration in patients after living donor right‐lobe liver transplantation

Susumu Eguchi, Katsuhiko Yanaga, Nozomu Sugiyama, Sadayuki Okudaira, Junichiro Furui, Takashi Kanematsu – 30 December 2003 – The purpose of this study is to evaluate the relationship between portal venous (PV) velocity and degree of liver regeneration in humans after living donor liver transplantation (LDLT). Between July 1997 and September 2002, a total of 15 adult‐to‐adult LDLTs with right‐lobe grafts were performed, and 13 of these patients were enrolled in this study.

Acquired (non‐Wilsonian) hepatocerebral degeneration: Complex management decisions

Eelco F.M. Wijdicks, Russell H. Wiesner – 30 December 2003 – Portal systemic encephalopathy, in its many guises, can be reversible after medical management or liver transplantation. It is much less certain whether patients with a longstanding neurodegenerative syndrome (known in the medical vernacular as acquired hepatocerebral degeneration) can improve.

Small hepatocellular carcinoma in Child A cirrhotic patients: Hepatic resection versus transplantation

Jean‐Marc Bigourdan, Daniel Jaeck, Nicolas Meyer, Carole Meyer, Elie Oussoultzoglou, Philippe Bachellier, Jean‐Christophe Weber, Maxime Audet, Michel Doffoël, Philippe Wolf – 30 December 2003 – Hepatic resection (HR) is the treatment of choice for small hepatocellular carcinoma (HCC) in a noncirrhotic liver, whereas liver transplantation (LT) offers better results in patients with impaired hepatic function (Child B and C). However, it is still debated whether HR or LT is the best strategy for patients with Child A cirrhosis.

Human leukocyte antigen–C in short‐ and long‐term liver graft acceptance

Maria Rosa Moya‐Quiles, Manuel Muro, Alberto Torío, Francisco Sánchez‐Bueno, Manuel Miras, Luis Marín, Ana Maria García‐Alonso, Pascual Parrilla, Jean Dausset, María Rocío Álvarez‐López – 30 December 2003 – In liver transplantion, rejection is still an important problem, and the role of human leukocyte antigens (HLA) has not been clearly established. At present, the possible involvement of HLA‐C antigen in liver transplantation is still unexplored. The aim of this work was to analyze the influence of HLA‐C polymorphism on the outcome of liver transplantation.

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