Retransplantation for late liver graft failure: Predictors of mortality

Marcelo Facciuto, David Heidt, James Guarrera, Carol A. Bodian, Charles M. Miller, Sukru Emre, Stephen R. Guy, Thomas M. Fishbein, Myron E. Schwartz, Patricia A. Sheiner – 30 December 2003 – As patient survival after orthotopic liver transplantation (OLT) improves, late complications, including late graft failure, more commonly occur and retransplantation (re‐OLT) is required more often. Survival after re‐OLT is poorer than after primary OLT, and given the organ shortage, it is essential that we optimize our use of scarce donor livers.

Adenosine A2 receptor stimulation protects the predamaged liver from cold preservation through activation of cyclic adenosine monophosphate–protein kinase a pathway

Thomas Minor, Susanne Akbar, Yuzo Yamamoto – 30 December 2003 – The shortage of organ donors has led to reconsideration for the use of non–heart‐beating donors (NHBDs). However, graft injury caused by warm ischemia in livers from NHBDs strongly affects posttransplantation outcome. The aim of the present study is to investigate the role of adenosine A2 receptor with regard to hepatic viability after cold preservation of NHBD livers. Cardiac arrest was induced in Wistar rats by phrenotomy of the anesthetized nonheparinized animal.

Conversion of liver transplant recipients on cyclosporine with renal impairment to mycophenolate mofetil

J. Ignacio Herrero, Jorge Quiroga, Bruno Sangro, Marcos Girala, Noemí Gómez‐Manero, Fernando Pardo, Javier Alvárez‐Cienfuegos, Jesús Prieto – 30 December 2003 – The management of liver transplant recipients with renal function impairment remains controversial because cyclosporine withdrawal from triple immunosuppression regimens may be followed by graft rejection. A nonnephrotoxic and powerful immunosuppressant such as mycophenolate mofetil (MMF) could allow a reduction of cyclosporine dosage or its withdrawal and an improvement in renal function in these patients.

Use of older donor livers is associated with more extensive ischemic damage on intraoperative biopsies during liver transplantation

Marc Deschênes, Clark Forbes, Jean Tchervenkov, Jeffrey Barkun, Peter Metrakos, Joe Tector, Elliott Alpert – 30 December 2003 – Initial poor graft function is associated with increased morbidity and graft loss after liver transplantation. Donor age is a risk factor for the development of initial poor function. The severity of ischemic damage on intraoperative postreperfusion (0Post) allograft biopsy specimens is predictive of subsequent initial poor function.

Disseminated Bartonella infection with granulomatous hepatitis in a liver transplant recipient

Atul Humar, Irving Salit – 30 December 2003 – Disseminated infection with Bartonella spp with granulomatous hepatitis was diagnosed in a liver transplant recipient presenting with fever of unknown origin. Pathological findings on liver biopsy were atypical, with scant granulomas seen only after a second biopsy. The patient responded promptly to antibiotic therapy. Infections caused by Bartonella spp should be considered in transplant recipients with fever of unknown origin.

Hepatic steatosis: A specific sign of hepatitis C reinfection after liver transplantation

Leonardo Baiocchi, Giuseppe Tisone, Gianpiero Palmieri, Maria Rapicetta, Franco Pisani, Giuseppe Orlando, Carlo Umberto Casciani, Mario Angelico – 30 December 2003 – Hepatitis C virus (HCV) infection is one of the major causes leading to orthotopic liver transplantation (OLT) worldwide. Although viral infection persists in almost all patients, the pathology of recurrent HCV infection after OLT is not well characterized.

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