Long‐term outcome of hepatitis C virus infection after liver transplantation

K. H. Böker, G. Dalley, M. J. Bahr, H. Maschek, H. L. Tillmann, C. Trautwein, K. Oldhaver, U. Bode, R. Pichlmayr, M. P. Manns – 30 December 2003 – We analyzed the long‐term clinical course of 71 patients with RNA‐positive hepatitis C virus (HCV) infection after liver transplantation. Patients with reinfection after transplantation for HCV‐related liver disease, or de novo infection at transplantation were followed for up to 12 years. Cumulative survival for patients with HCV infection at 2, 5, and 10 years after transplantation was 67%, 62%, and 62%, respectively.

Changes in adipose tissue composition in malnourished patients before and after liver transplantation: A carbon‐13 magnetic resonance spectroscopy and gas‐liquid chromatography study

E. L. Thomas, S. D. Taylor‐Robinson, M. L. Barnard, G. Frost, J. Sargentoni, B. R. Davidson, S. C. Cunnane, J. D. Bell – 30 December 2003 – We investigated adipose tissue fatty acid composition in 22 moderately to severely malnourished patients with cirrhosis and in 22 healthy volunteers by in vivo carbon‐13 magnetic resonance spectroscopy (MRS). Gas‐liquid chromatography (GLC) of adipose tissue samples was also performed in 11 of the patients and in 4 volunteers.

4‐hydroxynonenal levels are enhanced in fetal liver mitochondria by in utero ethanol exposure

J. J. Chen, S. Schenker, G. I. Henderson – 30 December 2003 – Lipid peroxidation has been implicated in ethanol‐induced liver injury and observed in fetal liver and brain after maternal ethanol consumption with mitochondria being the target organelles. This process generates a highly reactive and toxic product, 4‐hydroxynonenal (HNE). In the present study, HNE levels and metabolism were assessed in mitochondria of fetal and maternal liver after in vivo ethanol exposure.

Hepatic injury during ketoconazole therapy in patients with onychomycosis: A controlled cohort study

R. Chien, L. Yang, P. Lin, Y. Liaw – 30 December 2003 – To evaluate the incidence, severity, and course of ketoconazole‐ associated hepatic injury, 211 patients with onychomycosis were randomized by a ratio of 2:1 to receive either ketoconazole (137 patients) or griseofulvin (74 patients). All of them were seronegative for hepatitis B surface antigen (HBsAg) and anti‐hepatitis C virus (HCV) and had no biochemical abnormality before therapy. The two groups were comparable in age, sex, and pretherapy liver biochemical tests.

De novo hepatitis B after liver transplantation from hepatitis B core antibody—Positive donors in an area with high prevalence of anti‐HBc positivity in the donor population

Martín Prieto, María D. Gómez, Marina Berenguer, Juan Córdoba, José M. Rayón, Miguel Pastor, Antonio García‐Herola, David Nicolás, Domingo Carrasco, Juan F. Orbis, José Mir, Joaquín Berenguer – 30 December 2003 – Transmission of hepatitis B virus (HBV) infection from donors who are negative for hepatitis B surface antigen (HBsAg−) but positive for antibody to hepatitis B core antigen (anti‐HBc+) has been reported. However, previous studies were generally performed in geographic regions with a low prevalence of anti‐HBc positivity in the liver donor population.

Natural history of vancomycin‐resistant enterococcal colonization in liver and kidney transplant recipients

Robin Patel, Sharlene L. Allen, Janice M. Manahan, Alan J. Wright, Ruud A.F. Krom, Russell H. Wiesner, David H. Persing, Franklin R. Cockerill, Rodney L. Thompson – 30 December 2003 – At Mayo Medical Center (Rochester, MN), surveillance rectal (and other‐site) cultures have been routinely collected from liver transplant recipients as part of a selective bowel decontamination program. Beginning in 1995, vancomycin‐resistant enterococcus (VRE) colonization and infection were identified in Mayo Clinic liver and kidney transplant patients through our surveillance cultures.

The “privileged” liver and hepatic tolerogenicity

Thomas E. Starzl – 30 December 2003 – The mechanism underlying the immunological advantage of hepatic allografts relative to other organs is incompletely understood. We used molecular probes for the repetitive units on the Y chromosome, to identify an increasing number of male liver venous endothelial cells in needle biopsy samples of men who received female donor liver grafts. We have also shown repopulation of liver endothelium by bone marrow derived cells in a male to female mouse bone marrow transplant model.

Clinical usefulness of Epstein‐Barr viral load in solid‐organ transplantation

Chantal Buteau, Carlos V. Paya – 30 December 2003 – Epstein‐Barr virus (EBV) DNA was quantitated in peripheral blood mononuclear cells (PBMC) from 25 healthy subjects, 105 asymptomatic solid‐organ transplant (SOT) recipients, and 15 SOT recipients with symptomatic EBV infections by using a newly developed quantitative‐PCR technique. Patients with symptomatic EBV infections had significantly higher (P < 0.001) median EBV DNA levels than asymptomatic SOT recipients and immunocompetent individuals.

Posttransplantation hypertension related to calcineurin inhibitors

Stephen C. Textor, Sandra J. Taler, Vincent J. Canzanello, Lora Schwartz, Jo Ellen Augustine – 30 December 2003 – Calcineurin inhibitors are a mainstay of transplant immunosuppression and commonly induce hypertension. They are highly lipid soluble and penetrate vascular smooth muscle cell membranes readily. Changes in vascular tone are universally observed during administration of these agents, particularly within the kidney, leading to diminished glomerular filtration and enhanced sodium retention.

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