Allograft rejection in pediatric recipients of living related liver transplants

E M Alonso, J B Piper, G Echols, J R Thistlethwaite, P F Whitington – 1 January 1996 – The purpose of this study was to compare the incidence and severity of rejection episodes in a group of children receiving living related orthotopic liver transplants (LRLT) versus children receiving cadaveric liver transplants (CLT). Thirty‐eight patients received primary LRLT and 54 patients received CLT during a 3‐year period ending June 1993. Baseline immunosuppression consisted of cyclosporin, azathioprine, and corticosteroids.

The hematologic consequences of transjugular intrahepatic portosystemic shunt

A J Sanyal, A M Freedman, P P Purdum, M L Shiffman, V A Luketic – 1 January 1996 – Transjugular intrahepatic portosystemic shunts (TIPS) are a recent innovation in the management of portal hypertension. In 1992, we had previously described an instance of severe hemolysis associated with this procedure. This study was undertaken to define and quantify the true incidence of TIPS‐associated hemolysis and its clinical spectrum, as well as to test the hypothesis that portal decompression by TIPS would ameliorate hypersplenism in patients with portal hypertension.

Lymphoproliferative responses to hepatitis C virus core, E1, E2, and NS3 in patients with chronic hepatitis C infection treated with interferon alfa

G Leroux‐Roels, C A Esquivel, R DeLeys, L Stuyver, A Elewaut, J Philippé, I Desombere, J Paradijs, G Maertens – 1 January 1996 – The quality of the hepatitis C virus (HCV)‐specific T‐cell response may greatly determine the course of an HCV infection. An adequate T‐cell response may contribute to a successful clearance of the virus and a rapid recovery from the disease. An inadequate response may lead to viral persistence and may eventually contribute to the pathogenesis of hepatocellular damage in chronic disease.

Ganciclovir treatment of hepatitis B virus infection in liver transplant recipients

R G Gish, J Y Lau, L Brooks, J W S Fang, S L Steady, J C Imperial, R Garcia‐Kennedy, C O Esquivel, E B Keeffe – 1 January 1996 – To determine the safety and efficacy of ganciclovir treatment of hepatitis B virus (HBV) infection after liver transplantation, nine patients (seven males, two females; mean age, 38 years) with posttransplant HBV infection were treated with ganciclovir for 3 to 10 months. Ganciclovir was administered intravenously at an initial dose of 5 mg/kg/d and then increased to 10 mg/kg/d. Immunosuppressive drug therapy was maintained at low levels.

Monoclonal antibodies against eosinophils in liver allograft rejection

Ziv Ben‐Ari, Amar P. Dhillon, Redwan Moqbel, Linda Garwood, David Booth, Keith Rolles, Brian Davidson, Andrew K. Burroughs – 1 January 1996 – There has been recent interest in eosinophils as a histological diagnostic marker of liver allograft rejection. However, the reliability of counting eosinophils in sections stained with hematoxylin and eosin (H&E) has not been evaluated previously. We quantified eosinophils in 10 day‐5 protocol liver biopsy specimens in 10 patients.

Central pontine myelinolysis with stupor alone after orthotopic liver transplantation

Eelco F. M. Wijdicks, Paola R. Blue, Jeffery L. Steers, Russell H. Wiesner – 1 January 1996 – Central pontine myelinolysis (CPM) after orthotopic liver transplantation is frequently diagnosed at autopsy. Its actual prevalence is unknown. We reviewed 386 orthotopic liver transplantations performed at the Mayo Clinic, Rochester, MN, including 39 with autopsy reports. CPM developed in four patients (1%) (found using magnetic resonance imaging in two, at autopsy in two).

How valid is emergency liver transplantation for acute liver necrosis in patients with multiple‐organ failure?

Joél Pitre, Olivier Soubrane, Bertrand Dousset, Yves Ozier, François Baudin, Denis Devictor, Olivier Bernard, Didier Houssin, Yves Chapuis – 1 January 1996 – Multiple‐organ failure (MOF), defined as the failure of initially uninvolved organs, is the final step of definitive and massive liver necrosis. Emergency liver transplantation (ELT) has radically modified the outcome of acute liver failure and early primary graft failure, but the results of ELT in cases of MOF are unknown. From May 1988 to June 1993, 243 patients underwent a liver transplantation (LT).

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