Nelfinavir, a protease inhibitor, increases sirolimus levels in a liver transplantation patient: A case report

Ashok Kumar B. Jain, Raman Venkataramanan, Jonathan A. Fridell, Mary Gadomski, Leslie M. Shaw, Margaret Ragni, Magdalena Korecka, John Fung – 30 December 2003 – With the increasing success of liver transplantation and the proven effectiveness of highly active retroviral therapy in HIV‐positive patients, liver transplantation has been performed successfully in selected HIV‐positive recipients with CD4 and an HIV viral load response to highly active antiretroviral therapy. In these patients, an interaction between a protease inhibitor (nelfinavir) and tacrolimus has been shown.

Management and outcome of major bile duct injuries after laparoscopic cholecystectomy: From therapeutic endoscopy to liver transplantation

Arno Nordin, Leena Halme, Heikki Mäkisalo, Helena Isoniemi, Krister Höckerstedt – 30 December 2003 – Laparoscopic cholecystectomy is associated with a higher rate of bile duct injuries than an open cholecystectomy. The annual incidence of bile duct injuries has remained almost constant and these injuries tend to be more serious, making demands on the method of repair. We wanted to report the management and outcome of major bile duct injuries after laparoscopic cholecystectomy in patients referred to a hepatobiliary and liver transplantation unit.

Treatment of recurrent hepatitis B infection in liver transplant recipients

Norah A. Terrault – 30 December 2003 – 1Therapeutic decisions are guided by a patient's clinical status (severity of disease and presence of comorbidities) and previous drug‐exposure history.2Lamivudine is safe and effective in liver transplant recipients with recurrent hepatitis B virus (HBV) infection caused by wild‐type virus or failure of hepatitis B immunoglobulin therapy.

Treatment of recurrent hepatitis C

Ed Gane – 30 December 2003 – 1Treatment of established recurrent hepatitis C with interferon‐α monotherapy does not achieve sustained virologic response (SVR).2Treatment of established recurrent hepatitis C with combination interferon plus ribavirin achieves SVR rates of 17% to 27%, but dropout rates approach 30%.3Pretransplant prophylaxis against recurrent hepatitis C with combination interferon plus ribavirin is poorly tolerated in patients with decompensated hepatitis C cirrhosis.4Posttransplant prophylaxis with combination interferon plus ribavirin prevents both recurrent viremia and he

Combination of HBIG and lamivudine‐resistant mutations: A formula for trouble?

Robert J. Fontana, Anna S.F. Lok – 30 December 2003 – Background & Aims: Lamivudine has become a main therapeutic option for treating hepatitis B virus (HBV) infection. Although drug resistance develops, the clinical course after selection of antiviral‐resistant HBV mutants seems to be benign. However, we observed a severe clinical course of hepatitis B infection in several liver transplant recipients after the emergence of lamivudine resistance. This was associated with high viral load in the blood.

Detection of hepatitis C virus sequences in brain tissue obtained in recurrent hepatitis C after liver transplantation

Hugo E. Vargas, Tomasz Laskus, Marek Radkowski, Jeff Wilkinson, Vijay Balan, David D. Douglas, M. Edwyn Harrison, David C. Mulligan, Kevin Olden, Debra Adair, Jorge Rakela – 30 December 2003 – Patients with chronic hepatitis C frequently report tiredness, easy fatigability, and depression. The aim of this study is to determine whether hepatitis C virus (HCV) replication could be found in brain tissue in patients with hepatitis C and depression. We report two patients with recurrent hepatitis C after liver transplantation who also developed severe depression.

Can early liver biopsies predict long‐term outcome of the graft?

Lydia M. Petrovic – 30 December 2003 – Background: Chronic rejection (CR) in liver allografts show a rapid onset and progressive course, leading to graft failure within the first year after transplantation. Most cases are preceded by episodes of acute cellular rejection (AR), but histological features predictive for the transition toward CR are not well documented. Method: We assessed the predictive value of centrilobular necrosis, central vein endothelialitis (CVE), central vein fibrosis, and lobular inflammation in the development of CR.

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