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.

Liver transplantation in patients with severe portopulmonary hypertension treated with preoperative chronic intravenous epoprostenol

Henkie P. Tan, Jay S. Markowitz, Robert A. Montgomery, William T. Merritt, Andrew S. Klein, Paul J. Thuluvath, F. Fred Poordad, Warren R. Maley, Bradford Winters, Seda B. Akinci, Sean P. Gaine – 30 December 2003 – Portopulmonary hypertension (PPHTN) is no longer an absolute contraindication to orthotopic liver transplantation (OLT). The pre‐OLT management of patients with PPHTN requires early diagnosis and chronic therapy with intravenous epoprostenol to decrease pulmonary vascular resistance (PVR).

Successful outcome after transplantation of a donor liver with focal nodular hyperplasia

Michael Tan, Antonio Di Carlo, Patrick Robinson, Jean I. Tchervenkov, Jeffrey S.T. Barkun, Peter Metrakos – 30 December 2003 – Because of the increasing gap in the number of patients awaiting organ transplantation and the supply of organ donors, reevaluation of donor criteria is an important issue in clinical transplantation. It has become necessary to make maximal use of the currently available donor pool.

Postreperfusion biopsies are useful in predicting complications after liver transplantation

Juli Busquets, Juan Figueras, Teresa Serrano, Jaume Torras, Emilio Ramos, Antonio Rafecas, Juan Fabregat, Carmen Lama, Xavier Xiol, Carme Baliellas, Eduardo Jaurrieta – 30 December 2003 – Biliary complications after orthotopic liver transplantation (OLT) may occur because of preservation injury (PI). In this study, we examine findings on routine reperfusion biopsy specimens in relation to the occurrence of biliary complications and graft outcome. From 1997 to 2000, a total of 193 OLTs were performed in our center.

Posttransplantation dialysis–associated infections: Morbidity and impact on outcome in liver transplant recipients

Nina Singh, Timothy Gayowski, Marilyn M. Wagener – 30 December 2003 – The aim of this study is to assess the predictors, impact on infectious morbidity, and outcome of posttransplantation dialysis in liver transplant recipients and to compare the results with data from patients who did not require dialysis after transplantation. The study sample included 176 consecutive patients undergoing liver transplantation; the median follow‐up was 4.3 years. All patients were administered tacrolimus as primary immunosuppression.

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