Bone mineral density in long‐term survivors following pediatric liver transplantation

Stephen L. Guthery, John F. Pohl, John C. Bucuvalas, Maria H. Alonso, Frederick C. Ryckman, William F. Balistreri, James E. Heubi – 30 December 2003 – We sought to estimate the prevalence of reduced bone mass, defined by lumbar spine bone mineral density (LS‐BMD) (z‐score < −2.0), and to determine the factors associated with LS‐BMD after liver transplantation in children and adolescents. LS‐BMD z‐scores were measured in a sample of subjects who had undergone liver transplantation in childhood or adolescence using dual energy x‐ray absorptiometry (DXA).

The safety and outcome of joint replacement surgery in liver transplant recipients

Josh Levitsky, Helen S. Te, Stanley M. Cohen – 30 December 2003 – A small group of patients may require total hip arthroplasty, total knee arthroplasty, or other joint replacement surgery after OLT for osteoporotic fractures, osteonecrosis, and osteoarthritis. Although arthroplasty is safe in the general population, its safety in liver transplant recipients is unclear. The aim of the study was to determine the safety and outcome of joint replacement surgery in our liver transplant recipients.

Intragraft gene expression profiles by cDNA microarray in small‐for‐size liver grafts

Kwan Man, Chung‐Mau Lo, Terence Kin‐Wah Lee, Xian‐Liang Li, Irene Oi‐Lin Ng, Sheung‐Tat Fan – 30 December 2003 – The aim of this study is to identify the molecular mechanism of small‐for‐size graft injury through large‐scale expression measurement of intragraft gene profile by carrier DNA (cDNA) microarray screening in liver transplantation.

Evaluation of potential liver donors: Limits imposed by donor variables in liver transplantation

Ramón Rull, Oscar Vidal, Dulce Momblan, Francisco Xavier González, Miguel Angel López‐Boado, Jose Fuster, Luis Grande, Miguel Bruguera, Katiana Cabrer, Juan Carlos García‐Valdecasas – 30 December 2003 – The aim of this study was to evaluate the predictive value of different donor and recipient parameters that have been recognised previously as proven and to suggest prognostic factors for immediate liver function and final outcome after liver transplantation. We evaluated a total of 228 liver grafts transplanted in the last 3 years in our institution.

Predictive models of short‐ and long‐term survival in patients with nonbiliary cirrhosis

Gérald Longheval, Pierre Vereerstraeten, Philippe Thiry, Myriam Delhaye, Olivier le Moine, Jacques Devière, Nadine Bourgeois, Michael Adler – 30 December 2003 – The limited number of donor organs has placed a burden on the medical community to improve patient selection and timing of liver transplantation (LT). We aim to evaluate short‐ and long‐term survival of 124 consecutive patients with a diagnosis of nonbiliary cirrhosis. Seventeen clinical, biochemical, functional, and hemodynamic parameters were computed.

Clinical and ethnic differences in candidates listed for liver transplantation with and without potential living donors

Dianne LaPointe Rudow, Mark W. Russo, Sylvia Hafliger, Jean C. Emond, Robert S. Brown – 30 December 2003 – The shortage of cadaver livers and improved outcomes in partial liver transplants has led to an increase in adult living donor liver transplantation (LDLT). Only a fraction of potential liver recipients have donors. The characteristics of candidates who have volunteers for living donation may be different than those without donors. We compared adult patients on the waiting list who had potential living donors with those who did not have living donors.

A correlation between the pretransplantation MELD score and mortality in the first two years after liver transplantation

Nicholas N. Onaca, Marlon F. Levy, Edmund Q. Sanchez, Srinath Chinnakotla, Carlos G. Fasola, Mark J. Thomas, Jeffrey S. Weinstein, Natalie G. Murray, Robert M. Goldstein, Goran B. Klintmalm – 30 December 2003 – The Model for End‐Stage Liver Disease (MELD) score is now the criteria for allocation in liver transplantation for patients with chronic disease. Although the score has been effective in the prediction of mortality in patients awaiting liver transplantation, its abilities to predict posttransplantation outcome need study.

Outflow reconstruction in extended right liver grafts from living donors

Yasuhiko Sugawara, Masatoshi Makuuchi, Hiroshi Imamura, Junichi Kaneko, Norihiro Kokudo – 30 December 2003 – The risk of outflow obstruction in extended right liver grafts remains a concern. We developed two procedures to minimize torsion in venous anastomosis and to achieve a short warm ischemic time of the graft. When there were no major short hepatic veins in the graft, a square‐shaped vein graft was used to make a single orifice using the middle and right hepatic veins in the graft.

Effects of tacrolimus on ischemia‐reperfusion injury

Shawn D. St. Peter, Adyr A. Moss, David C. Mulligan – 30 December 2003 – In addition to efficacious immunosuppression for the benefit of organ transplantation, tacrolimus has diverse actions that result in amelioration of ischemia‐reperfusion injury. Knowledge is accumulating rapidly on the mechanisms through which tacrolimus exerts these cytoprotective effects, including alterations in microcirculation, free radical metabolism, calcium‐activated pathways, inflammatory cascades, mitochondrial stability, apoptosis, stress‐response proteins, and tissue recovery.

Tacrolimus as a liver flush solution to ameliorate the effects of ischemia/reperfusion injury following liver transplantation

Shawn D. St. Peter, David J. Post, Manuel I. Rodriguez‐Davalos, David D. Douglas, Adyr A. Moss, David C. Mulligan – 30 December 2003 – The goal of this report is to evaluate in a prospective randomized fashion the effect of flushing hepatic allografts with tacrolimus before transplantation. A prospective, double‐blinded, randomized trial was performed. Twenty patients receiving orthotopic liver transplants from October 2000 to October 2001 were randomized into two groups.

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