Pathophysiology of renal disease associated with liver disorders: Implications for liver transplantation. Part I

Connie L. Davis, Thomas A. Gonwa, Alan H. Wilkinson – 30 December 2003 – Renal and hepatic function are often intertwined through both the existence of associated primary organ diseases and hemodynamic interrelationships. This connection occasionally results in the chronic failure of both organs, necessitating combined liver‐kidney transplantation (LKT). Since 1988, more than 850 patients in the United States have received such transplants, with patient survival somewhat less than that for patients receiving either organ alone.

Donor morbidity associated with right lobectomy for living donor liver transplantation to adult recipients: A systematic review

Kimberly L. Beavers, Robert S. Sandler, Roshan Shrestha – 30 December 2003 – The aim if this study is to determine donor morbidity associated with right lobectomy for living donor liver transplantation (LDLT) to adult recipients through a systematic review of the published literature. Data sources were English‐language reports on donor outcome after LDLT. MEDLINE (1995 to June 2001) was searched using the MeSH terms “living donors” and “liver transplantation.” Limits were set for human only and English language only.

Rapid improvement of autonomic and peripheral neuropathy after liver transplantation: A single case report

Alan John McDougall, Leo Davies, Geoffrey William McCaughan – 30 December 2003 – Peripheral and autonomic neuropathies are known but often unrecognized associations of cirrhosis from any cause. The pathogenesis of these effects are ill understood. Liver transplantation has been shown to reverse autonomic manifestations, but little evidence exists for an effect on peripheral neuropathy. This case report documents improvement in peripheral and autonomic neuropathy in a 40‐year‐old man with hepatitis B virus–related cirrhosis.

Mast cell hyperplasia in chronic rejection after liver transplantation

Cathal O'Keeffe, Alan W. Baird, Niamh Nolan, P. Aiden McCormick – 30 December 2003 – The pathogenesis of chronic hepatic allograft rejection is poorly understood. Recent studies suggested that hepatic mast cells may be involved in the pathogenesis of chronic cholestatic liver disease. Because chronic rejection after liver transplantation is predominantly a cholestatic process, the aim of this study is to determine whether hepatic mast cells are involved in its pathogenesis.

New venoplasty technique for the left liver plus caudate lobe in living donor liver transplantation

Yasuhiko Sugawara, Masatoshi Makuuchi, Junichi Kaneko, Takao Ohkubo, Yuichi Matsui, Hiroshi Imamura – 30 December 2003 – A new technique is reported for complete venous drainage for a left liver with caudate lobe graft when a short hepatic vein and left and middle hepatic veins are located close to each other.

Yes, hepatocellular cancer does occur in primary biliary cirrhosis

Gregory J. Gores – 30 December 2003 – Objectives: The prevalence of hepatocellular carcinoma (HCC) in primary biliary cirrhosis (PBC) is not well established, as some reports suggest a low risk, whereas others indicate that HCC may be no less frequent than in other types of cirrhosis. Methods: We compared the incidence of HCC in a series of 140 patients with PBC (five men, 135 women, mean age 54 ± 1.6 yr) followed‐up for a mean of period of 5.6 ± 0.4 yr with a group of patients with cirrhosis related to hepatitis C virus (HCV) who were matched for age, sex, and follow‐up period.

Management of the pediatric liver transplant patient

Sue V. McDiarmid – 30 December 2003 – Key Points 1In pretransplant management, the prevention and treatment of malnutrition is essential for pediatric patients as malnutrition is associated with both increased pre‐ and posttransplant mortality.2Technical complications, particularly hepatic artery thrombosis, after pediatric liver transplantation are relatively common given the small size of the majority of the recipients.

Occurrence and clinical outcome of lamivudine‐resistant hepatitis B infection after liver transplantation

Daniel Seehofer, Nada Rayes, Thomas Steinmüller, Andrea R. Müller, Utz Settmacher, Ruth Neuhaus, Cornelia Radke, Thomas Berg, Uwe Hopf, Peter Neuhaus – 30 December 2003 – Lamivudine treatment of hepatitis B after orthotopic liver transplantation (OLT) is often accompanied by fast viral‐resistance formation. Although no clinical data are available, in vitro data indicate that lamivudine‐resistant reinfection has a mild course because of defective viral replication. Between 1996 and 1999, a total of 34 patients were treated with lamivudine because of hepatitis B recurrence after OLT.

Temporary portocaval shunt during liver transplantation with vena cava preservation. Results of a prospective randomized study

Juan Figueras, Laura Llado, Emilio Ramos, Eduardo Jaurrieta, Antonio Rafecas, Juan Fabregat, Jaume Torras, Antonio Sabate, Antonia Dalmau – 30 December 2003 – This study aims to determine whether the use of a temporary portocaval shunt (PCS) improves hemodynamic and metabolic evolution during orthotopic liver transplantation (OLT). Preservation of the vena cava during OLT has gained wide acceptance. However, benefits of adding a temporary PCS to the piggyback technique during the anhepatic phase in patients with cirrhosis have not been shown.

Outcome of other organs recovered during in situ split‐liver procurements

Thiagarajan Ramcharan, Brooke Glessing, John R. Lake, William D. Payne, Abhinav Humar – 30 December 2003 – Split‐liver transplantation is becoming a useful technique to expand the donor pool. Whether the split should be performed in situ or ex situ is not clear. One potential disadvantage of in situ splits is that prolonged surgical time and increased blood loss may negatively affect the function of other solid organs (kidneys, pancreas, and heart) procured from the same donor. Therefore, we studied the function of other organs posttransplantation.

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