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.

Hepatic localization of endothelin‐1 in patients with idiopathic portal hypertension and cirrhosis of the liver

Patrick S. Kamath, Herschel A. Carpenter, Ricardo V. Lloyd, Michael A. McKusick, Jeffery L. Steers, David M. Nagorney, Virginia M. Miller – 30 December 2003 – Endothelin‐1 (ET‐1) may mediate increased resistance to hepatic sinusoidal blood flow. We evaluated the hepatic distribution of ET‐1 in patients with idiopathic portal hypertension (IPH), in which liver architecture may be normal, and in patients with cirrhosis, in which distortion of hepatic sinusoidal architecture is prominent.

Endoscopic management of biliary leaks after T‐tube removal in liver transplant recipients: Nasobiliary drainage versus biliary stenting

Sammy Saab, Paul Martin, George Y. Soliman, Gustavo A. Machicado, Bennett E. Roth, Gregg Kunder, Steven‐Huy B. Han, Douglas G. Farmer, R. Mark Ghobrial, Ronald W. Busuttil, Rudolph A. Bedford – 30 December 2003 – This study presents the long‐term sequelae of endoscopic retrograde cholangiopancreatography (ERCP)‐managed biliary leakage in patients who underwent orthotopic liver transplantation (OLT) and compares the relative efficacy, safety, and charges of nasobiliary drainage (NBD) versus biliary stenting (BS).

Cerebral blood flow and oxygenation in liver transplantation for acute or chronic hepatic disease without venovenous bypass

Pertti Pere, Krister Höckerstedt, Helena Isoniemi, Leena Lindgren – 30 December 2003 – The autoregulation of cerebral blood flow (CBF) is impaired in patients with end‐stage liver disease and encephalopathy. These patients are vulnerable to sudden deterioration of cerebral perfusion and oxygenation during liver transplantation. We compared CBF and metabolism during liver transplantation without venovenous bypass and 24 hours postoperatively in 9 patients with acute liver failure (ALF) and 16 patients with chronic liver disease.

Regional cerebral blood flow autoregulation in patients with fulminant hepatic failure

Fin Stolze Larsen, Gitte Strauss, Kirsten Møller, Bent Adel Hansen – 30 December 2003 – The absence of cerebral blood flow autoregulation in patients with fulminant hepatic failure (FHF) implies that changes in arterial pressure directly influence cerebral perfusion. It is assumed that dilatation of cerebral arterioles is responsible for the impaired autoregulation. Recently, frontal blood flow was reported to be lower compared with other brain regions, indicating greater arteriolar tone and perhaps preserved regional cerebral autoregulation.

Deficiency in virion secretion and decreased stability of the hepatitis B virus immune escape mutant G145R

Tatyana Kalinina, Alicja Iwanski, Hans Will, Martina Sterneck – 30 December 2003 – Hepatitis B virus with a G145R mutation in the small surface protein is considered the quintessential immune escape mutant because it frequently is found in vaccinated individuals with breakthrough infections and liver transplant recipients under anti‐hepatitis B surface antigen (HBsAg) immunoglobulin prophylaxis. Nowadays the prevalence of the variant progressively increases.

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