Reduced use of intensive care after liver transplantation: Influence of early extubation

M. Susan Mandell, Dennis Lezotte, Igal Kam, Stacy Zamudio – 30 December 2003 – Postoperative ventilation and admission to the intensive care unit (ICU) is the standard of care in liver transplantation and comprises a significant proportion of transplantation costs. Because immediate postoperative extubation has been reported previously in a selected group of liver transplant recipients, we questioned whether this protocol could be extended to a larger group of patients.

Differential allograft gene expression in acute cellular rejection and recurrence of hepatitis C after liver transplantation

Raghavakaimal Sreekumar, Deborah L. Rasmussen, Russell H. Wiesner, Michael R. Charlton – 30 December 2003 – Treatment of acute cellular rejection (ACR) is associated with increased viral load, more severe histologic recurrence, and diminished patient and graft survival after liver transplantation for hepatitis C virus (HCV). Recurrence of HCV may be difficult to distinguish histologically from ACR .

Safety of right lobectomy in living donor liver transplantation

Kyung‐Suk Suh, Seong Hoon Kim, Sang Beom Kim, Hyuk‐Joon Lee, Kuhn Uk Lee – 30 December 2003 – The goal of this study was to examine the safety and effectiveness of right lobectomy in living donor liver transplantation (LDLT). From January 1999 to January 2002, 100 cases of LDLT were performed at Seoul National University Hospital; 45 involved right lobectomy (RL), 17 involved extended left lobectomy (ELL), 37 involved left lateral segmentectomy (LLS), and 1 involved right posterior segmentectomy. The outcome of RL was compared with those of other types of hepatectomy.

Ribavirin dose modification based on renal function is necessary to reduce hemolysis in liver transplant patients with hepatitis C virus infection

Ashok B. Jain, Bijan Eghtesad, Raman Venkataramanan, Paulo A. Fontes, Randeep Kashyap, Igor Dvorchik, A. Obaid Shakil, Leah Kingery, John J. Fung – 30 December 2003 – Hepatitis C virus (HCV) is currently the most common etiology for liver transplantation (LTx) in the United States. A significant number of patients develop recurrent HCV after LTx. Although there is no completely satisfactory treatment for recurrent HCV, a combination of interferon‐α (INF) and ribavirin remains the most widely used.

The optimal number of donor biopsy sites to evaluate liver histology for transplantation

Wendy L. Frankel, Jason G. Tranovich, Laura Salter, Ginny Bumgardner, Peter Baker – 30 December 2003 – Macrovesicular steatosis (MaS), fibrosis, and inflammation have been associated with poor graft function after liver transplantation. We evaluated histological variation in livers to determine the optimal number of biopsies to estimate pathological characteristics in livers for transplantation. Specimens from autopsies performed during 3 months in 16‐ to 70‐years‐olds without known liver disease or drug and/or alcohol abuse were examined.

The effect of donor body mass index on primary graft nonfunction, retransplantation rate, and early graft and patient survival after liver transplantation

Hwan Y. Yoo, Ernesto Molmenti, Paul J. Thuluvath – 30 December 2003 – Previous studies have suggested that moderate donor liver steatosis is associated with an increased incidence of primary graft nonfunction (PGNF), delayed graft function, early graft loss, and retransplantation rates. The objective of our study was to determine the effect of donor body mass index (dBMI), after adjusting for other known confounding variables, on PGNF, early graft failure, retransplantation rate, and patient survival.

Systemic and regional changes in plasma endothelin following transient increase in portal pressure

Dharmesh Kapoor, Doris N. Redhead, Peter C. Hayes, David J. Webb, Rajiv Jalan – 30 December 2003 – An acute increase in portal pressure or reduction in portal inflow has been shown to decrease renal plasma flow (RPF). The aim of the study was to evaluate regional and systemic hemodynamics after acute occlusion of a transjugular intrahepatic portosystemic stent‐shunt (TIPSS) and study the effect of the same on plasma endothelin (ET‐1) levels in the systemic circulation, renal vein, and hepatic vein. Sixteen patients attending for portography after previous TIPSS placement were studied.

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