Venocclusive Disease of the Liver after Bone Marrow Transplantation: Diagnosis, Incidence, and Predisposing Factors

George B. Mcdonald, Pankaj Sharma, David E. Matthews, Howard M. Shulman, E. Donnall Thomas – 1 January 1984 – Venocclusive disease (VOD) of the liver, a fibrous obliteration of small hepatic venules, can be caused by chemoradiation therapy. We reviewed 255 consecutive patients undergoing bone marrow transplantation for malignancy during 1978 to 1980 in order to determine the incidence of VOD and the predisposing factors. Fifty‐three of 255 patients met our criteria for VOD, for an incidence of 21%.

Changes in Glutamate Receptors on Synaptic Membranes Associated with Hepatic Encephalopathy or Hyperammonemia in the Rabbit

Peter Ferenci, S. Chris Pappas, Peter J. Munson, E. Anthony Jones – 1 January 1984 – The status of the excitatory glutamatergic neurotransmitter system in hepatic encephalopathy has been studied. Synaptic membranes (SM) were prepared from the brains of normal rabbits, hyperammonemic normal rabbits, and rabbits with fulminant hepatic failure.

Bone Disease in Primary Biliary Cirrhosis: Increased Bone Resorption and Turnover in the Absence of Osteoporosis or Osteomalacia

Jennifer A. Cuthbert, Charles Y. C. Pak, Joseph E. Zerwekh, Kenneth D. Glass, Burton Combes – 1 January 1984 – The role of vitamin D in hepatic osteodystrophy was examined. Eleven unselected patients with primary biliary cirrhosis (PBC) were assessed for disorders of mineral and vitamin D metabolism. Six were not receiving supplementary vitamin D, and five were being treated with oral vitamin D (50,000 IU daily). Serum levels of 25‐hydroxyvitamin D were normal in all patients receiving oral therapy and in 4 of 6 untreated patients.

Epidemiology and Clinical Course of Liver Diseases: Identification of Candidates for Hepatic Transplantation

John M. Vierling – 1 January 1984 – Among a variety of liver diseases that have been treated by hepatic transplantation, several were chosen for evaluation because of their frequency or high rate of fatality. Information regarding the incidence and prevalence in the United States, the natural history with conventional therapy, and prognostic indicators of a terminal phase is reviewed. Based on this information, specific candidates for hepatic transplantation are identified.

Some Immunological Considerations in Liver Transplantation

Paul S. Russell – 1 January 1984 – Immunological considerations of special interest in liver transplantation are examined. It is concluded that liver transplants between human beings generate typical rejection reactions although they may, overall, be somewhat more mild than those encountered in transplanted kidneys and hearts. This is the case in some animals for reasons which are not yet clear. There is evidence that the transplanted liver can suffer immune attack better than other organs. Whether graft‐vs.–host activity is of clinical importance is uncertain.

Extrahepatic Biliary Atresia

Daniel Alagille – 1 January 1984 – Extrahepatic biliary atresia is defined as partial or total absence of permeable bile duct between porta hepatis and the duodenum. The incidence varies from 1:8,000 to 1:10,000. Cholestasis is total and permanent. 131I Rose Bengal test and needle liver biopsy allow correct identification of 95% of cases before surgery Before the surgical procedure described by Kasai in 1959, all patients died between 1 and 2 years of age. Through the use of different types of Kasai's procedures by experienced groups, 30 to 35% of patients are successfully operated on.

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