Living donor liver transplant recipients achieve relatively higher immunosuppressant blood levels than cadaveric recipients

James F. Trotter, Nancy Stolpman, Michael Wachs, Thomas Bak, Marcelo Kugelmas, Igal Kam, Gregory T. Everson – 30 December 2003 – Two recent brief reports suggest that recipients of living donor liver transplants achieve higher levels of immunosuppressive agents than cadaveric (CAD) liver transplant recipients administered the same dose. These results could have important implications regarding the dosing of immunosuppressives in living donor liver transplant recipients.

Donor safety in living related liver transplantation: Underestimation of the risks for deep vein thrombosis and pulmonary embolism

François Durand, Giuseppe Maria Ettorre, Richard Douard, Marie‐Hélène Denninger, Alireza Kianmanesh, Daniele Sommacale, Olivier Farges, Dominique Valla, Jacques Belghiti – 30 December 2003 – Optimal safety for donors is a necessary condition for living related liver transplantation to expand. Although the risks for complications directly related to surgical intervention have been carefully evaluated, the extent and nature of other complications, such as pulmonary embolism, associated with living donation have not been clearly anticipated.

The relevance of anxiety, depression, and coping in patients after liver transplantation

Ralf Nickel, Andreas Wunsch, Ulrich T. Egle, Ansgar W. Lohse, Gerd Otto – 30 December 2003 – The aim of this study is to investigate the effects of anxiety, depression, and coping on quality of life in patients after liver transplantation. Patients were asked to fill out a postal survey. Two hundred thirty‐six of 375 patients (63%) who entered the study returned the questionnaires, and 186 of these patients could be included in the assessment.

Hepatopulmonary syndrome occurring after orthotopic liver transplantation

Christopher E. Avendano, Patrick A. Flume, Prabhakar Baliga, David N. Lewin, Charlie Strange, Adrian Reuben – 30 December 2003 – Hepatopulmonary syndrome (HPS) is an infrequent complication of liver cirrhosis. Orthotopic liver transplantation (OLT) has gained increasing acceptance as a treatment modality for HPS, although there have been reports of HPS developing after OLT with documented recurrence of cirrhosis. We describe the case of a 9‐year‐old boy who underwent OLT at 7 months of age because of biliary atresia.

Critical graft size in adult‐to‐adult living donor liver transplantation: Impact of the recipient's disease

Menahem Ben‐Haim, Sukru Emre, Thomas M. Fishbein, Patricia A. Sheiner, Carol A. Bodian, Leona Kim‐Schluger, Myron E. Schwartz, Charles M. Miller – 30 December 2003 – The aim of this study is to analyze the impact of the recipient's disease severity on graft size requirements and outcome in adult‐to‐adult living donor liver transplantation. A limiting factor in adult‐to‐adult living donor liver transplantation has been adequacy of graft size. A minimal graft‐recipient weight ratio (GRWR) of 0.8% to 1% has been suggested, without taking the recipient's disease into account.

Neurotoxicity of immunosuppressive drugs

Eelco F.M. Wijdicks – 30 December 2003 – The clinical profile of neurotoxicity caused by immunosuppression has changed. When toxic levels are reached, both cyclosporine and tacrolimus may produce a clinical spectrum that varies from tremor and acute confusional state to status epilepticus and major speech or language abnormalities. Coma has become an unusual manifestation. Magnetic resonance imaging has been better defined, and abnormalities may be more widespread than those in the posterior lobes.

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