Conversion from intravenous to intramuscular hepatitis B immune globulin in combination with lamivudine is safe and cost‐effective in patients receiving long‐term prophylaxis to prevent hepatitis B recurrence after liver transplantation

Steven‐Huy Han, Paul Martin, Marc Edelstein, Rena Hu, Gregg Kunder, Curtis Holt, Sammy Saab, Francisco Durazo, Leonard Goldstein, Douglas Farmer, Rafik M. Ghobrial, Ronald W. Busuttil – 30 December 2003 – Recurrent hepatitis B infection after liver transplantation was previously frequent and associated with significant allograft failure and mortality. Recurrence rates of hepatitis B were improved with the use of passive immunoprophylaxis with hepatitis B immune globulin, and later, lamivudine monotherapy.

Toward better outcomes with tacrolimus therapy: Population pharmacokinetics and individualized dosage prediction in adult liver transplantation

Christine E. Staatz, Charlene Willis, Paul J. Taylor, Stephen V. Lynch, Susan E. Tett – 30 December 2003 – Patient outcomes in transplantation would improve if dosing of immunosuppressive agents was individualized. The aim of this study is to develop a population pharmacokinetic model of tacrolimus in adult liver transplant recipients and test this model in individualizing therapy. Population analysis was performed on data from 68 patients. Estimates were sought for apparent clearance (CL/F) and apparent volume of distribution (V/F) using the nonlinear mixed effects model program (NONMEM).

Predominance of pre‐S1 mutated hepatitis B virus in a patient following treatment with adefovir dipivoxil

Erica Villa, Valentina Boarino, Antonella Grottola, Roberta Gelmini, Nicole G. Lama – 30 December 2003 – A liver transplant recipient reinfected with a lamivudine‐resistant mixed wild‐type/pre‐S1–deleted hepatitis B virus (HBV) strain and rescued with adefovir dipivoxil was still HBV DNA positive after more than 1 year of therapy. Analysis of serum HBV DNA, amplified by polymerase chain reaction and directly sequenced by dideoxy nucleotide chain‐termination method, showed that adefovir inhibited the wild type, but not the pre‐S1–deleted HBV.

Systemic hemodynamic effects of treatment with the molecular adsorbents recirculating system in patients with hyperacute liver failure: A prospective controlled trial

Lars E. Schmidt, Lars Peter Wang, Bent A. Hansen, Fin Stolze Larsen – 30 December 2003 – The aim of the study is to evaluate the effect of a single treatment with the molecular adsorbents recirculating system (MARS) on systemic hemodynamics and oxygen consumption (VO2) in patients with hyperacute liver failure (HALF). In a controlled design, eight patients with HALF were assigned to a 6‐hour MARS treatment, and five patients, to a control group that was mechanically cooled to match the MARS group. Systemic hemodynamic variables were determined hourly during the study period.

Recombinant adeno‐associated virus vector: Is it ideal for gene delivery in liver transplantation?

Zhen‐Fan Yang, Xiao‐Bing Wu, Tung‐Yu Tsui, Yun‐De Hou, John M. Luk, Sheung‐Tat Fan – 30 December 2003 – Recombinant adeno‐associated virus vector (rAAV) is an effective and safe gene‐delivery tool. However, its application in solid‐organ transplantation has not been addressed.

Liver transplantation for HCV‐associated liver cirrhosis: Predictors of outcomes in a population with significant genotype 3 and 4 distribution

A Zekry, P Whiting, DH Crawford, PW Angus, GP Jeffrey, RT Padbury, EJ Gane, GW McCaughan – 30 December 2003 – End‐stage liver disease associated with hepatitis C virus (HCV) infection is now the leading indication for liver transplantation in adults. However, reinfection of the graft is universal. We aimed to determine predictors of outcome of HCV‐liver transplant recipients in the Australian and New Zealand communities. The following variables were analysed: demographic factors, coexistent pathology at the time of transplantation, HCV genotype, and donor age. Outcomes measures were: 1.

Minimally invasive repair of recurrent strangulated umbilical hernia in cirrhotic patient with refractory ascites

Cohen Sarit, Avinoah Eliezer, Solly Mizrahi – 30 December 2003 – To repair a recurrent strangulated umbilical hernia in a cirrhotic patient with refractory ascites, we used a minimally invasive procedure. The laparoscopic repair included a release of the incarcerated small bowel loop and secure of a dual Gortex mesh onto the fascial rim. Our satisfactory long‐term results should encourage surgeons to adapt this surgical approach

Hepatic allograft‐derived Kupffer cells regulate T cell response in rats

Zhaoli Sun, Tatehiko Wada, Kosei Maemura, Keiichiro Uchikura, Sumito Hoshino, Anna Mae Diehl, Andrew S. Klein – 30 December 2003 – In liver transplantation, the development of tolerance is associated with an increased rate of apoptosis of T lymphocytes in the portal inflammatory infiltrate and the presence of an intragraft Th2‐like T cell population. Underlying mechanisms are poorly understood. Kupffer cells (KC), which reside in the hepatic sinosoids, can directly interact with circulating T lymphocytes and thus are uniquely positioned to play a role in immunomodulation.

A retrospective review of sirolimus (Rapamune) therapy in orthotopic liver transplant recipients diagnosed with chronic rejection

Guy W. Neff, Marzia Montalbano, Gabriel Slapak‐Green, Thierry Berney, Pablo A. Bejarano, Anand Joshi, Mike Icardi, Jose Nery, Nishida Seigo, David Levi, Debbie Weppler, Peter Pappas, Jose Ruiz, Eugene R. Schiff, Andreas G. Tzakis – 30 December 2003 – Treatment options are limited for orthotopic liver transplant (OLT) recipients suffering from chronic rejection (CR). We performed a retrospective review of OLT recipients diagnosed with CR and treated with sirolimus.

Subscribe to