Aprotinin in orthotopic liver transplantation: Evidence for a prohemostatic, but not a prothrombotic, effect

I. Quintus Molenaar, Cristina Legnani, Theo H.N. Groenland, Gualtiero Palareti, Bruno Begliomini, Onno T. Terpstra, Robert J. Porte – 30 December 2003 – Aprotinin reduces blood transfusion requirements in orthotopic liver transplantation (OLT). Concern has been voiced about the potential risk for thrombotic complications when aprotinin is used. The aim of this study is to evaluate the effects of aprotinin on the two components of the hemostatic system (coagulation and fibrinolysis) in patients undergoing OLT.

Hemodynamic changes during a single treatment with the molecular adsorbents recirculating system in patients with acute‐on‐chronic liver failure

Lars E. Schmidt, Vibeke Rømming Sørensen, Lars Bo Svendsen, Bent A. Hansen, Fin Stolze Larsen – 30 December 2003 – The aim of this pilot study is to evaluate the circulatory safety of treatment with the molecular adsorbents recirculating system (MARS) by determining the effect on systemic hemodynamics of a single MARS treatment in patients with acute‐on‐chronic liver failure (AOCLF). In eight patients admitted with AOCLF, a single 10‐hour MARS treatment was performed. Systemic hemodynamic variables were determined before and during treatment.

Anti–Interleukin‐2 receptor therapy in combination with mycophenolate mofetil is associated with more severe hepatitis C recurrence after liver transplantation

David R. Nelson, Consuelo Soldevila‐Pico, Alan Reed, Manal F. Abdelmalek, Alan W. Hemming, Willem J. van der Werf, Richard Howard, Gary L. Davis – 30 December 2003 – The pathogenesis of hepatitis C virus (HCV) recurrence after liver transplantation (LT) is poorly understood, but the cellular immune response is likely to have a major role. Daclizumab, an interleukin‐2 receptor (IL‐2R) antibody that blunts T‐cell activation, leading to a decreased risk for cellular rejection, is used frequently in transplant recipients.

Is D‐penicillamine useful in fulminat Wilson's disease?

Jorge Rakela, Hugo Vargas, Juan Arenas – 30 December 2003 – Background: Wilson's disease, heralded by severe hepatic insufficiency, is a rare disorder for which emergency liver transplantation is considered to be the only effective therapy. Aims: To report the features of Wilson's disease with severe hepatic insufficiency in a series of 17 patients and, during the second period of the study, to assess the efficacy of a policy consisting of early administration of D‐penicillamine. Patients: Seventeen consecutive patients with Wilson's disease were studied.

Hepatitis C quasispecies and severity of recurrence: Cause, consequence, or coincidence?

Hugo R. Rosen, Jonathan M. Schwartz – 30 December 2003 – Recurrence of hepatitis C virus (HCV) infection after liver transplantation is almost universal and usually leads to chronic hepatitis with different degrees of severity. The pathogenic mechanisms underlying the variable outcome of HCV infection recurrence are not well defined, but recent data suggest that the dynamics of HCV quasispecies may be involved.

Timing of reinfection and mechanisms of hepatocellular damage in transplanted hepatitis C virus–reinfected liver

Giorgio Ballardini, Emilio De Raffele, Paolo Groff, Paulette Bioulac‐Sage, Alberto Grassi, Sabrina Ghetti, Micaela Susca, Mario Strazzabosco, Roberto Bellusci, Rosa Maria Iemmolo, Gianluca Grazi, Daniela Zauli, Antonino Cavallari, Francesco Bianco Bianchi – 30 December 2003 – Pathogenic mechanisms and dynamics of hepatitis C virus (HCV) reinfection in orthotopic liver transplantation (OLT) are poorly defined.

Aberrations in hemostasis and coagulation in untreated discordant hepatic xenotransplantation: Studies in the dog‐to‐pig model

A. Joseph Tector, Jonathan A. Fridell, Nahel Elias, Taichi Watanabe, Julie Salazar, Doris Greinke, Peter Metrakos, Jean I. Tchervenkov – 30 December 2003 – Discordant liver xenotransplantation is a poorly explored entity. Data from the few large animal studies of hepatic xenotransplantation suggest that severe hemorrhage is encountered. The purpose of the studies described here is to characterize the nature of the hemorrhage that accompanies liver xenotransplantation. Canine livers were transplanted into porcine recipients, and lethal hemorrhage was encountered.

Model for end‐stage liver disease and Child‐Turcotte‐Pugh score as predictors of pretransplantation disease severity, posttransplantation outcome, and resource utilization in United Network for Organ Sharing status 2A patients

Robert S. Brown, K. Shiva Kumar, Mark W. Russo, Milan Kinkhabwala, Dianne L. Rudow, Patricia Harren, Steven Lobritto, Jean C. Emond – 30 December 2003 – The Model for End‐Stage Liver Disease (MELD) has been proposed as a replacement for the Child‐Turcotte‐Pugh (CTP) classification to stratify patients for prioritization for orthotopic liver transplantation (OLT).

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