Immune response to influenza vaccine in adult liver transplant recipients

Andrea Duchini, R. Michael Hendry, Lisa M. Nyberg, M. Eric Viernes, Paul J. Pockros – 30 December 2003 – Influenza virus infection may cause significant complications in liver transplant recipients, and whether vaccination is effective in these patients is controversial. We performed a study to assess the immune response to influenza vaccine in liver transplant recipients and patients with cirrhosis compared with healthy controls.

Use of intraoperative Doppler ultrasound to diagnose hepatic venous obstruction in a right lobe living donor liver transplant

Robert S. Shapiro, Thomas Fishbein, Myron Schwartz, Charles M. Miller – 30 December 2003 – Right lobe liver transplantation is a relatively new and technically challenging method of living donor transplantation. Integrity of the hepatic venous anastomosis is crucial for successful transplantation. We describe the use of intraoperative Doppler sonography to diagnose stenosis of the hepatic vein anastomosis, with associated compromise of venous drainage and graft perfusion.

Hepatic artery thrombosis after orthotopic liver transplantation: A review of nonsurgical causes

Sabrina Pastacaldi, Rosangela Teixeira, Paolo Montalto, Keith Rolles, Andrew K. Burroughs – 30 December 2003 – Hepatic artery thrombosis (HAT) is one of the principal causes of morbidity and graft loss following liver transplantation. There are several risk factors for the development of HAT; technical aspects of the arterial anastomosis are important particularly for early thrombosis, but the improvement of surgical technique has lessened this problem.

Recurrent autoimmune hepatitis after orthotopic liver transplantation

Alvaro González‐Koch, Albert J. Czaja, Herschel A. Carpenter, Stuart K. Roberts, Michael R. Charlton, Michael K. Porayko, Charles B. Rosen, Russell H. Wiesner – 30 December 2003 – To determine the frequency, risk factors, and consequences of recurrent autoimmune hepatitis after liver transplantation, 41 patients with type 1 disease were monitored after surgery in accordance with a surveillance protocol. Tacrolimus or cyclosporine plus prednisone were administered to each patient, and liver biopsy examinations were performed at least annually according to protocol.

High levels of hepatitis C virus RNA in native livers correlate with the development of cholestatic hepatitis in liver allografts and a poor outcome

Vikram Deshpande, Eileen Burd, Kay L. Aardema, Chan K. Ma, Dilip K. Moonka, Kimberly A. Brown, Marwan S. Abouljoud, Raouf E. Nakhleh – 30 December 2003 – A subset of hepatitis C virus (HCV)‐positive liver transplant recipients develop cholestatic hepatitis (CH). We investigated the role of pretransplantation disease activity (estimated by Knodell score and HCV RNA quantitation) in the native liver explant on the development of CH and graft and patient outcome.

Biliary stricture secondary to donor B‐cell lymphoma after orthotopic liver transplantation

Pedro W. Baron, Michael A. Heneghan, Paul V. Suhocki, J. Dean Nuckols, J Elizabeth Tuttle‐Newhall, David N. Howell, Pierre‐Alain Clavien – 30 December 2003 – Biliary complications after orthotopic liver transplantation (OLT) lead to considerable morbidity and occasional mortality after surgery. Bile duct strictures secondary to localized lymphoproliferative disorder of the porta hepatis is rare, with only 12 cases reported in the English literature. Posttransplant lymphoproliferative disorder develops in up to 9% of liver allograft recipients.

Successful reversal of recalcitrant hepatic allograft rejection by photopheresis

Michael S. Lehrer, Eduardo Ruchelli, Kim M. Olthoff, Lars E. French, Alain H. Rook – 30 December 2003 – Extracorporeal photopheresis (ECP) is an immunologic modality that has shown efficacy in the treatment of clonal T‐cell diseases, including Sézary syndrome and allograft rejection. In this case report, we expand on this observation to include recalcitrant hepatic allograft rejection. A 14‐year‐old boy with hepatic allograft rejection refractory to high‐dose corticosteroid and lymphocytolytic therapy was treated with 4 sessions of ECP over a 6‐week period.

Influenza infection in patients before and after liver transplantation

Andrea Duchini, R. Michael Hendry, David C. Redfield, Paul J. Pockros – 30 December 2003 – Infection with influenza virus poses specific problems in pediatric and adult liver transplant recipients, both before and after liver transplantation. These include a higher rate of pulmonary and extrapulmonary complications, development of rejection with graft dysfunction, prolonged shedding of influenza virus, and increased drug‐resistance. Hepatic decompensation may occur during influenza infection in patients with cirrhosis.

Utility of standard nutritional parameters in detecting body cell mass depletion in patients with end‐stage liver disease

Fatima A. Figueiredo, E. Rolland Dickson, Tousif M. Pasha, Michael K. Porayko, Terry M. Therneau, Michael Malinchoc, Sara R. DiCecco, Nickie M. Francisco‐Ziller, Pavla Kasparova, Michael R. Charlton – 30 December 2003 – Protein‐calorie malnutrition, best measured by body cell mass (BCM) depletion, has been associated with adverse outcomes in patients with end‐stage liver disease.

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