Pulmonary gas exchange abnormalities in liver transplant candidates

Rosmawati Mohamed, Jonathan W. Freeman, Peter J. Guest, Michael K. Davies, James M. Neuberger – 30 December 2003 – Abnormal diffusing capacity is the commonest pulmonary dysfunction in liver transplant candidates, but severe hypoxemia secondary to hepatopulmonary syndrome and significant pulmonary hypertension are pulmonary vascular manifestations of cirrhosis that may affect the perioperative course. We prospectively assessed the extent of pulmonary dysfunction in patients referred for liver transplantation. A total of 57 consecutive patients with chronic liver disease were evaluated.

Hepatic steatosis and its relationship to transplantation

Charles J. Imber, Shawn D. St. Peter, Ashok Handa, Peter J. Friend – 30 December 2003 – Fatty infiltration of the liver is common in the brain‐dead donor population and has a strong correlation with primary nonfunction after cold preservation, a condition that is catastrophic to liver transplant recipients. This literature review examines factors associated with the development, diagnosis, quantification, and clinical management of this difficult condition.

Current practice regarding the use of fatty livers: A Trans‐Atlantic survey

Charles J. Imber, Shawn D. St. Peter, Inigo Lopez, Lynden Guiver, Peter J. Friend – 30 December 2003 – A strong association exists between the presence of steatosis in a donor liver for transplantation and the development of primary nonfunction in the recipient. Despite this, appraisal of the donor remains one of the least scientific aspects of the transplantation process, and many centers base their practice on subjective opinion, rather than objective data.

Model for end‐stage liver disease and Child‐Turcotte‐Pugh score as predictors of pretransplantation disease severity, posttransplantation outcome, and resource utilization in United Network for Organ Sharing status 2A patients

Robert S. Brown, K. Shiva Kumar, Mark W. Russo, Milan Kinkhabwala, Dianne L. Rudow, Patricia Harren, Steven Lobritto, Jean C. Emond – 30 December 2003 – The Model for End‐Stage Liver Disease (MELD) has been proposed as a replacement for the Child‐Turcotte‐Pugh (CTP) classification to stratify patients for prioritization for orthotopic liver transplantation (OLT).

Aberrations in hemostasis and coagulation in untreated discordant hepatic xenotransplantation: Studies in the dog‐to‐pig model

A. Joseph Tector, Jonathan A. Fridell, Nahel Elias, Taichi Watanabe, Julie Salazar, Doris Greinke, Peter Metrakos, Jean I. Tchervenkov – 30 December 2003 – Discordant liver xenotransplantation is a poorly explored entity. Data from the few large animal studies of hepatic xenotransplantation suggest that severe hemorrhage is encountered. The purpose of the studies described here is to characterize the nature of the hemorrhage that accompanies liver xenotransplantation. Canine livers were transplanted into porcine recipients, and lethal hemorrhage was encountered.

Timing of reinfection and mechanisms of hepatocellular damage in transplanted hepatitis C virus–reinfected liver

Giorgio Ballardini, Emilio De Raffele, Paolo Groff, Paulette Bioulac‐Sage, Alberto Grassi, Sabrina Ghetti, Micaela Susca, Mario Strazzabosco, Roberto Bellusci, Rosa Maria Iemmolo, Gianluca Grazi, Daniela Zauli, Antonino Cavallari, Francesco Bianco Bianchi – 30 December 2003 – Pathogenic mechanisms and dynamics of hepatitis C virus (HCV) reinfection in orthotopic liver transplantation (OLT) are poorly defined.

Hepatitis C quasispecies and severity of recurrence: Cause, consequence, or coincidence?

Hugo R. Rosen, Jonathan M. Schwartz – 30 December 2003 – Recurrence of hepatitis C virus (HCV) infection after liver transplantation is almost universal and usually leads to chronic hepatitis with different degrees of severity. The pathogenic mechanisms underlying the variable outcome of HCV infection recurrence are not well defined, but recent data suggest that the dynamics of HCV quasispecies may be involved.

Is D‐penicillamine useful in fulminat Wilson's disease?

Jorge Rakela, Hugo Vargas, Juan Arenas – 30 December 2003 – Background: Wilson's disease, heralded by severe hepatic insufficiency, is a rare disorder for which emergency liver transplantation is considered to be the only effective therapy. Aims: To report the features of Wilson's disease with severe hepatic insufficiency in a series of 17 patients and, during the second period of the study, to assess the efficacy of a policy consisting of early administration of D‐penicillamine. Patients: Seventeen consecutive patients with Wilson's disease were studied.

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