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.

Gastrointestinal transplantation: An update

Nagappan Kumar, David Grant – 30 December 2003 – Gastrointestinal transplantation is a life‐saving option for patients who have chronic intestinal failure and cannot tolerate total parenteral nutrition (TPN). Early referral is important because of the scarcity of donors and the increased risk of complications in debilitated recipients. One‐year patient survival rates range from 50% to 70%. Despite the use of intense immune suppression, most patients experience at least 1 episode of graft rejection. More than 80% of the survivors are able to stop TPN and resume an unrestricted oral diet.

Role of transarterial chemoembolization before liver resection for hepatocarcinoma

Giorgio Enrico Gerunda, Daniele Neri, Roberto Merenda, Franco Barbazza, Fabio Zangrandi, Francesco Meduri, Marco Bisello, Michele Valmasoni, Antonio Gangemi, Alvise Maffei Faccioli – 30 December 2003 – The aim of this study was to clarify whether chemoembolization (TACE) before liver resection (LR) can reduce postoperative hepatocellular carcinoma (HCC) recurrence and improve disease‐free and overall survival. Eighty‐nine patients with tumor‐stage (TNM) I‐II HCC were evaluated for LR. Patients were prospectively allocated to LR alone or TACE plus LR based on their place of residence.

Increased risk for posttransplant lymphoproliferative disease in recipients of liver transplants with hepatitis C

Kevin McLaughlin, Sandra Wajstaub, Paul Marotta, Paul Adams, David R. Grant, William J. Wall, Anthony M. Jevnikar, Kamilla S. Rizkalla – 30 December 2003 – Posttransplant lymphoproliferative disease (PTLD) is associated with immunosuppression and lymphotrophic viral infections. Hepatitis C virus (HCV) has been identified as a risk factor for non‐Hodgkin's lymphoma, but no association between HCV and PTLD has been shown.

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