Transplant legislation: Ethical and practical issues in liver allocation—The case of Switzerland

Zakiyah Kadry, Eberhard L. Renner, Pierre‐Alain Clavien – 30 December 2003 – Ethical and practical issues relating to liver allocation have been discussed in many countries. Several governments, including the United States, have attempted over the past few years to impose new legislation, which has resulted in virulent debates among individual centers, organ procurement agencies, states, and various groups of interest. This report discusses the current ongoing legislative process in Switzerland. In 1999, the people of Switzerland voted to develop transplant legislation.

Life‐threatening hypophosphatemia after right hepatic lobectomy for live donor adult liver transplantation

James J. Pomposelli, Elizabeth A. Pomfret, David L. Burns, Ann Lally, Andrea Sorcini, Fredric D. Gordon, W. David Lewis, Roger Jenkins – 30 December 2003 – Life‐threatening hypophosphatemia (phosphorus < 1.0 mg/dL) has been reported only once after liver resection for tumor and was associated with a significant increase in postoperative complications. Hypophosphatemia is associated with reversible cardiac dysfunction, hypoventilation, and impaired immunity.

Risk factors for acute rejection in pediatric living related liver transplantation: The impact of HLA matching

Yasuhiko Sugawara, Koichi Mizuta, Hideo Kawarasaki, Tadatoshi Takayama, Hiroshi Imamura, Masatoshi Makuuchi – 30 December 2003 – The influence of HLA compatibility on acute rejection in cadaveric liver transplantation is not clearly defined, and that in living related liver transplantation (LRLT) has only been poorly examined. Few studies have focused solely on a pediatric population. Fifty‐eight cases of pediatric LRLT were analyzed. Patient and graft survival rates and postoperative complications were assessed.

Liver transplantation for cholangiocellular carcinoma: Analysis of a single‐center experience and review of the literature

Mitsugi Shimoda, Douglas G. Farmer, Steven D. Colquhoun, Michael Rosove, R. Mark Ghobrial, Hasan Yersiz, Pauline Chen, Ronald W. Busuttil – 30 December 2003 – Cholangiocellular carcinoma (CCC) is a biliary malignancy that frequently presents in advanced unresectable stages. The role of liver transplantation (LT) as a surgical modality is unclear. The goal of this study is to evaluate outcomes of patients with CCC undergoing LT. A retrospective analysis of all patients undergoing LT was undertaken. Only those patients with the pathological diagnosis of CCC were included on the study.

Keratin, fas, and cryptogenic liver failure

Abraham J. Sorom, Scott L. Nyberg, Gregory J. Gores – 30 December 2003 – Background: About 10 percent of patients who undergo liver transplantation have cryptogenic liver disease. In animal models, the absence of heteropolymeric keratins 8 and 18 or the presence of mutant keratins in hepatocytes causes or promotes liver disease. We have previously described a mutation in the keratin 18 gene in a patient with cryptogenic cirrhosis, but the importance of mutations in the keratin 8 and keratin 18 genes in such patients is unclear.

Improved treatment response with basiliximab immunoprophylaxis after liver transplantation: Results from a double‐blind randomized placebo‐controlled trial

Peter Neuhaus, Pierre‐Alain Clavien, Dilip Kittur, Mauro Salizzoni, Antoni Rimola, Kamal Abeywickrama, Elke Ortmann, Lawrence Chodoff, Michael Hall, Alexander Korn, Björn Nashan – 30 December 2003 – Basiliximab, a high‐affinity chimeric monoclonal antibody, is effective in reducing acute rejection episodes in renal allograft recipients. We assessed the ability of this antibody to similarly improve the outcome in liver transplant recipients. Adult recipients of a primary cadaveric liver transplant were randomized to treatment, stratified by hepatitis C virus (HCV) seropositivity.

Outflow reconstruction in recipients of right liver graft from living donors

Yasuhiko Sugawara, Masatoshi Makuuchi, Hiroshi Imamura, Junichi Kaneko, Takao Ohkubo, Norihiro Kokudo – 30 December 2003 – Right‐lobe transplantation is now a commonly used procedure in living donor liver transplantation (LDLT) to adult recipients. However, the risk for outflow obstruction is still an issue in LDLT. The right hepatic vein (RHV) was anastomosed end to end to the graft hepatic vein without unfavorable tension on the anastomosis. The anterior wall of the recipient hepatic vein was incised longitudinally, and a V‐shaped vein graft was patched to form a wide and long orifice.

Fate of hepatocyte and sinusoidal lining cell function and kinetics after extended cold preservation and transplantation of the rat liver

Yusuke Miyagawa, Hiroshi Imamura, Junpei Soeda, Kotaro Matsunaga, Satoshi Mochida, Kenji Fujiwara, Yutaka Matsuyama, Seiji Kawasaki – 30 December 2003 – We investigated the chronological profile of graft damage and recovery after liver cold ischemia‐reperfusion (I/R) injury, with particular attention to the role of apoptosis on hepatocyte and sinusoidal endothelial cell (SEC) damage.

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