The use of hepatitis C viral RNA levels in liver tissue to distinguish rejection from recurrent hepatitis C

Michelle J. Gottschlich, Kay L. Aardema, Eileen M. Burd, Raouf E. Nakhleh, Kimberly A. Brown, Marwan S. Abouljoud, Kathryn Hirst, Dilip K. Moonka – 30 December 2003 – Persistence of hepatitis C virus (HCV) after orthotopic liver transplantation is almost universal in HCV‐infected patients. Histological examination of liver biopsy specimens can be variable in distinguishing between recurrent hepatitis C and acute cellular rejection.

A multicenter study of lamivudine treatment in 33 patients with hepatitis B after liver transplantation

Robert J. Fontana, Hie‐Won L. Hann, Teresa Wright, Gregory Everson, Alfred Baker, Eugene R. Schiff, Carolyn Riely, Gaya Anschuetz, Melanie Riker‐Hopkins, Nathaniel Brown – 30 December 2003 – Hepatitis B virus (HBV) infection after liver transplantation (LT) may lead to severe and rapidly progressive graft failure. Antiviral treatment may be of benefit in selected patients with recurrent hepatitis B post‐LT. The aim of this prospective open‐label study is to determine the safety and efficacy of lamivudine in 33 liver transplant recipients with active HBV infection.

Liver transplantation for hereditary hemochromatosis

David J. Brandhagen – 30 December 2003 – Although hereditary hemochromatosis (HHC) is relatively common, it is an uncommon indication for orthotopic liver transplantation (OLT). The diagnosis of HHC in patients with end‐stage liver disease is difficult because many of these patients have elevated serum and tissue iron levels. Of patients undergoing OLT with iron stores in the range typical for HHC, approximately 10% are homozygous for the C282Y mutation.

Frequency of nonalcoholic steatohepatitis as a cause of advanced liver disease

Michael Charlton, Pavla Kasparova, Shiobhan Weston, Keith Lindor, Yaakov Maor‐Kendler, Russell H. Wiesner, Charles B. Rosen, Kenneth P. Batts – 30 December 2003 – Although nonalcoholic steatohepatitis (NASH) has generally been considered a benign condition, the increasing prevalence and severity of obesity has heightened concerns about the frequency with which NASH progresses to end‐stage liver disease. The aim of this study is to determine the frequency, clinical features, and posttransplantation history of decompensated liver disease secondary to NASH.

Orthotopic liver transplantation using low‐dose tacrolimus and sirolimus

Vivian C. McAlister, Kevork M. Peltekian, Dickran A. Malatjalian, Shannon Colohan, Sara MacDonald, Hinrich Bitter‐Suermann, Allan S. MacDonald – 30 December 2003 – Although sirolimus (SRL) binds the immunophilin FK506‐binding protein‐12 (FKBP‐12) with greater avidity than tacrolimus (TAC), animal studies have shown that SRL and TAC act synergistically to prevent rejection. Dose‐related toxicity is more often the cause of TAC discontinuation than rejection.

Liver transplantation from situs inversus to situs inversus

Yasuhiko Sugawara, Masatoshi Makuuchi, Tadatoshi Takayama, Hiroyuki Yoshino, Koichi Mizuta, Hideo Kawarasaki – 30 December 2003 – Congenital anatomic anomalies often present technical obstacles during liver transplantation. Biliary atresia (BA) is the most common indication for liver transplantation in children, and up to 28% of children with situs inversus are complicated by BA. A boy aged 2 years 11 months with BA, situs inversus, and dextrocardia received a liver transplant from his father. The donor also had situs inversus and dextrocardia without other anomalies.

Small‐bowel herniation under the infrarenal arterial conduit in a liver transplant recipient

Vassilios Smyrniotis, Nikolaos Arkadopoulos, Georgia Kostopanagiotou, Manolis Manesis – 30 December 2003 – We report a case of herniation of the entire small bowel under an infrarenal conduit 8 months after orthotopic liver transplantation. The conduit was compressed by the mesentery and developed a stricture and thrombosis. Liver revascularization was accomplished by an urgent thrombectomy, resection of the stricture, and reanastomosis of the conduit.

De novo tumors after liver transplantation: A single‐institution experience

Edmund Q. Sanchez, Shigeru Marubashi, Ghapjoong Jung, Marlon F. Levy, Robert M. Goldstein, Ernesto P. Molmenti, Carlos G. Fasola, Thomas A. Gonwa, Linda W. Jennings, Barbara K. Brooks, Goran B. Klintmalm – 30 December 2003 – The aims of this analysis are to characterize the incidence and types of malignancies and tumor‐specific mortality in our institution. Retransplantation, rejection episodes, and OKT3 use were evaluated. Our single‐institution prospective database of 1,570 liver transplantations in 1,421 patients was analyzed.

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