Conversion of liver transplant recipients on cyclosporine with renal impairment to mycophenolate mofetil

J. Ignacio Herrero, Jorge Quiroga, Bruno Sangro, Marcos Girala, Noemí Gómez‐Manero, Fernando Pardo, Javier Alvárez‐Cienfuegos, Jesús Prieto – 30 December 2003 – The management of liver transplant recipients with renal function impairment remains controversial because cyclosporine withdrawal from triple immunosuppression regimens may be followed by graft rejection. A nonnephrotoxic and powerful immunosuppressant such as mycophenolate mofetil (MMF) could allow a reduction of cyclosporine dosage or its withdrawal and an improvement in renal function in these patients.

Adenosine A2 receptor stimulation protects the predamaged liver from cold preservation through activation of cyclic adenosine monophosphate–protein kinase a pathway

Thomas Minor, Susanne Akbar, Yuzo Yamamoto – 30 December 2003 – The shortage of organ donors has led to reconsideration for the use of non–heart‐beating donors (NHBDs). However, graft injury caused by warm ischemia in livers from NHBDs strongly affects posttransplantation outcome. The aim of the present study is to investigate the role of adenosine A2 receptor with regard to hepatic viability after cold preservation of NHBD livers. Cardiac arrest was induced in Wistar rats by phrenotomy of the anesthetized nonheparinized animal.

Retransplantation for late liver graft failure: Predictors of mortality

Marcelo Facciuto, David Heidt, James Guarrera, Carol A. Bodian, Charles M. Miller, Sukru Emre, Stephen R. Guy, Thomas M. Fishbein, Myron E. Schwartz, Patricia A. Sheiner – 30 December 2003 – As patient survival after orthotopic liver transplantation (OLT) improves, late complications, including late graft failure, more commonly occur and retransplantation (re‐OLT) is required more often. Survival after re‐OLT is poorer than after primary OLT, and given the organ shortage, it is essential that we optimize our use of scarce donor livers.

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.

Hepatic venoplasty in right lobe live donor liver transplantation

Chi‐Leung Liu, Yi Zhao, Chung‐Mau Lo, Sheung‐Tat Fan – 30 December 2003 – Inclusion of the middle hepatic vein (MHV) in a right lobe graft is essential to guarantee uniform venous drainage and optimum function of the graft, but end‐to‐end recipient‐to‐donor MHV anastomosis may result in outflow obstruction. To avoid outflow obstruction, we designed the venoplasty technique. From September 2000 to November 2002, 65 adult patients received right lobe live donor liver transplantation (LDLT) with grafts containing the right hepatic vein (RHV) and MHV.

Von Willebrand factor‐cleaving protease activity in thrombotic microangiopathy after living donor liver transplantation: A case report

Yuichi Nakazawa, Yasuhiko Hashikura, Koichi Urata, Toshihiko Ikegami, Masaru Terada, Hideo Yagi, Hiromichi Ishizashi, Masanori Matsumoto, Yoshihiro Fujimura, Shinichi Miyagawa – 30 December 2003 – Defective plasma activity of Von Willebrand factor (VWF)‐cleaving protease (CP) and/or the inhibitors against this protease has been shown to have a pathological role in several forms of thrombotic microangiopathy (TMA). This report describes a patient for whom a diagnosis of TMA was made immediately after living donor liver transplantation.

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