Improved treatment response with basiliximab immunoprophylaxis after liver transplantation: Results from a double‐blind randomized placebo‐controlled trial

Peter Neuhaus, Pierre‐Alain Clavien, Dilip Kittur, Mauro Salizzoni, Antoni Rimola, Kamal Abeywickrama, Elke Ortmann, Lawrence Chodoff, Michael Hall, Alexander Korn, Björn Nashan – 30 December 2003 – Basiliximab, a high‐affinity chimeric monoclonal antibody, is effective in reducing acute rejection episodes in renal allograft recipients. We assessed the ability of this antibody to similarly improve the outcome in liver transplant recipients. Adult recipients of a primary cadaveric liver transplant were randomized to treatment, stratified by hepatitis C virus (HCV) seropositivity.

Keratin, fas, and cryptogenic liver failure

Abraham J. Sorom, Scott L. Nyberg, Gregory J. Gores – 30 December 2003 – Background: About 10 percent of patients who undergo liver transplantation have cryptogenic liver disease. In animal models, the absence of heteropolymeric keratins 8 and 18 or the presence of mutant keratins in hepatocytes causes or promotes liver disease. We have previously described a mutation in the keratin 18 gene in a patient with cryptogenic cirrhosis, but the importance of mutations in the keratin 8 and keratin 18 genes in such patients is unclear.

Liver transplantation for cholangiocellular carcinoma: Analysis of a single‐center experience and review of the literature

Mitsugi Shimoda, Douglas G. Farmer, Steven D. Colquhoun, Michael Rosove, R. Mark Ghobrial, Hasan Yersiz, Pauline Chen, Ronald W. Busuttil – 30 December 2003 – Cholangiocellular carcinoma (CCC) is a biliary malignancy that frequently presents in advanced unresectable stages. The role of liver transplantation (LT) as a surgical modality is unclear. The goal of this study is to evaluate outcomes of patients with CCC undergoing LT. A retrospective analysis of all patients undergoing LT was undertaken. Only those patients with the pathological diagnosis of CCC were included on the study.

Risk factors for acute rejection in pediatric living related liver transplantation: The impact of HLA matching

Yasuhiko Sugawara, Koichi Mizuta, Hideo Kawarasaki, Tadatoshi Takayama, Hiroshi Imamura, Masatoshi Makuuchi – 30 December 2003 – The influence of HLA compatibility on acute rejection in cadaveric liver transplantation is not clearly defined, and that in living related liver transplantation (LRLT) has only been poorly examined. Few studies have focused solely on a pediatric population. Fifty‐eight cases of pediatric LRLT were analyzed. Patient and graft survival rates and postoperative complications were assessed.

Life‐threatening hypophosphatemia after right hepatic lobectomy for live donor adult liver transplantation

James J. Pomposelli, Elizabeth A. Pomfret, David L. Burns, Ann Lally, Andrea Sorcini, Fredric D. Gordon, W. David Lewis, Roger Jenkins – 30 December 2003 – Life‐threatening hypophosphatemia (phosphorus < 1.0 mg/dL) has been reported only once after liver resection for tumor and was associated with a significant increase in postoperative complications. Hypophosphatemia is associated with reversible cardiac dysfunction, hypoventilation, and impaired immunity.

Transplant legislation: Ethical and practical issues in liver allocation—The case of Switzerland

Zakiyah Kadry, Eberhard L. Renner, Pierre‐Alain Clavien – 30 December 2003 – Ethical and practical issues relating to liver allocation have been discussed in many countries. Several governments, including the United States, have attempted over the past few years to impose new legislation, which has resulted in virulent debates among individual centers, organ procurement agencies, states, and various groups of interest. This report discusses the current ongoing legislative process in Switzerland. In 1999, the people of Switzerland voted to develop transplant legislation.

Disease recurrence after living liver transplantation for primary biliary cirrhosis: A clinical and histological follow‐up study

Etsuko Hashimoto, Masahiko Shimada, Sanshirou Noguchi, Makiko Taniai, Katsutoshi Tokushige, Naoaki Hayashi, Ken Takasaki, Syouhei Fuchinoue, Jurgen Ludwig – 30 December 2003 – We describe the recurrence of primary biliary cirrhosis (PBC) in recipients of living liver transplants. We are not aware of similar previous reports. Because most donors for living liver transplantation (LLT) are blood relatives with close HLA matches, the recurrence of PBC in transplant recipients might offer additional insights in the pathogenesis of the condition.

Dyslipidemia during sirolimus therapy in liver transplant recipients occurs with concomitant cyclosporine but not tacrolimus

James F. Trotter, Michael E. Wachs, Thomas E. Trouillot, Thomas Bak, Marcelo Kugelmas, Igal Kam, Gregory Everson – 30 December 2003 – Since its approval as an immunosuppressive agent in renal transplantation, sirolimus (RAPA) recently has been used in the primary immunosuppression regimen at several liver transplant centers. One of the major side effects of RAPA is hypercholesterolemia, which is reported in up to 44% of patients. We describe our experience in 57 primary liver transplant recipients treated with RAPA and either cyclosporine A (CSA) or tacrolimus (TAC).

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