Results of combined and sequential liver‐kidney transplantation

Thomas Becker, Miguel Nyibata, Rainer Lueck, Hueseyin Bektas, Gülçin Demirci, Frank Lehner, Günter Tusch, Christian Strassburg, Anke Schwarz, Juergen Klempnauer, Bjoern Nashan – 30 December 2003 – Experience with combined liver‐kidney transplantation (L‐KTx) has increased, but controversy regarding this procedure continues because the indications are not clearly defined yet. Between 1984 and 2000, 38 patients underwent simultaneous L‐KTx and 9 patients underwent sequential transplantation, receiving either a liver before a kidney or a kidney before a liver.

Poor survival after liver retransplantation: Is hepatitis C to blame?

Kymberly D.S. Watt, Elizabeth R. Lyden, Timothy M. McCashland – 30 December 2003 – Data from 1990 to 1996 suggest that the prevalence of hepatitis C virus (HCV) infection in repeated orthotopic liver transplantation (re‐OLT) is increasing, and patient survival may be worse. Aims of the study are to: (1) assess the prevalence of HCV in re‐OLT, (2) compare survival between primary OLT and re‐OLT for HCV versus non‐HCV diseases, and (3) evaluate Model for End‐Stage Liver Disease (MELD) scores in re‐OLT.

Clinical relevance of adapting portal vein flow in living donor liver transplantation in adult patients

Roberto Troisi, Bernard de Hemptinne – 30 December 2003 – Size mismatching is a major concern in adult living donor liver transplantation (ALDLT). Graft hyperperfusion in these grafts is considered the main factor leading to graft dysfunction and poor survival. We describe the clinical significance of graft inflow modification (GIM) by splenic artery ligation in a series of 24 consecutive ALDLT. Between September 1999 and December 2001, 24 patients underwent ALDLT at our institution. Patients were divided into two groups: G1, n = 11 without GIM, and G2, n = 13 with GIM.

Effect of coadministered lopinavir and ritonavir (Kaletra) on tacrolimus blood concentration in liver transplantation patients

Ashokkumar B. Jain, Raman Venkataramanan, Bijan Eghtesad, Amadeo Marcos, Margaret Ragni, Ron Shapiro, Ann B. Rafail, John J. Fung – 30 December 2003 – With the advent of highly active antiretroviral therapy (HAART), HIV positivity is no longer a contraindication for liver transplantation. Some of the antiretroviral agents, particularly protease inhibitors (e.g., ritonavir, indinavir, and nelfinavir) have been described as potent inhibitors of the metabolism of certain immunosuppressive drugs.

Multivisceral and isolated intestinal procurement techniques

Hasan Yersiz, John F. Renz, Garrett M. Hisatake, Sherylin Gordon, Bob H. Saggi, Nicholas J. Feduska, Ronald W. Busuttil, Douglas G. Farmer – 30 December 2003 – Improved outcomes in multivisceral and isolated intestinal transplantation have generated increased demand for these procedures. Enhanced recognition of potential multivisceral/intestinal donors and widespread application of advanced organ procurement techniques is necessary in the current climate of organ scarcity.

A follow‐up analysis of the pattern and predictors of dropout from the waiting list for liver transplantation in patients with hepatocellular carcinoma: Implications for the current organ allocation policy

Francis Y. Yao, Nathan M. Bass, Bev Nikolai, Raphael Merriman, Timothy J. Davern, Robert Kerlan, Nancy L. Ascher, John P. Roberts – 30 December 2003 – Since our interim report of the intention‐to‐treat outcome of orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC), we have performed a follow‐up analysis of an expanded cohort of 70 patients to further assess whether the observed pattern and predictors of dropout are consistent with the rationale behind current HCC‐adjusted Model for End Stage Liver Disease (MELD) organ allocation scheme.

Isolation of human hepatocytes from livers rejected for liver transplantation on a national basis: Results of a 2‐year experience

Umberto Baccarani, Andrea Sanna, Alessio Cariani, Mauricio Sainz‐Barriga, Gian Luigi Adani, Anna Maria Zambito, Giuseppe Piccolo, Andrea Risaliti, Alessandro Nanni‐Costa, Lorenza Ridolfi, Mario Scalamogna, Fabrizio Bresadola, Annibale Donini – 30 December 2003 – The offer of liver transplantation to many patients affected by liver failure is limited by organ shortage.

Liver organ allocation for hepatocellular carcinoma: Are we sure?

J. Wallis Marsh, Igor Dvorchik – 30 December 2003 – Of patients with hepatocellular carcinoma (HCC), 70% to 90% present with cirrhosis. Accordingly, liver transplantation ∥LT), not liver resection, currently remains the only possibility of cure for these patients. Because there is a severe shortage of liver organ donors, not all patients in need can be offered LT. Therefore, transplant listing criteria simultaneously must determine the greatest number of suitable candidates for transplantation while rejecting the smallest number of those who could benefit from LT.

Projecting future complications of chronic hepatitis C in the United States

Gary L. Davis, James E. Albright, Suzanne F. Cook, Daniel M. Rosenberg – 30 December 2003 – Chronic hepatitis C virus (HCV) infection is common and often results in slowly progressive liver disease. Although acute hepatitis C is now uncommon, most patients with acute infection have developed chronic hepatitis, and, therefore, the pool of infected patients is large. We used a modification of a previously described natural history model for HCV infection to project the number of cases of HCV infection, cirrhosis, and liver failure over the next 40 years.

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