Geographic disparities in deceased donor liver transplantation within a single UNOS region

Neal R. Barshes, Natasha S. Becker, W. Kenneth Washburn, Glenn A. Halff, Thomas A. Aloia, John A. Goss – 24 April 2007 – Although the Model for End‐Stage Liver Disease (MELD) scoring system has improved the ability to measure medical urgency for transplantation, geographic disparities in the probability of being delisted as a result of complications of end‐stage liver disease or death and in the probability of orthotopic liver transplantation (OLT) remain.

Conversion to sirolimus‐based immunosuppression in maintenance liver transplantation patients

Isabelle Morard, Jérôme Dumortier, Laurent Spahr, Antoine Hadengue, Pietro Majno, Philippe Morel, Gilles Mentha, Emiliano Giostra – 24 April 2007 – Sirolimus (SRL) has been proposed to replace calcineurin inhibitors (CNI) in case of CNI‐induced toxicity. The aim of this study was to evaluate the efficacy and safety of conversion from CNI to SRL in maintenance liver transplantation (LT) patients. Between 2002 and 2006, conversion was performed in 48 patients (17 female, 31 male; mean age 57 ± 10 yr) after a median delay of 19.4 months (range 0.2–173 months) after LT.

Combined liver‐kidney transplantation in glycogen storage disease Ia: A case beyond the guidelines

Mirco Belingheri, Luciana Ghio, Ambra Sala, Francesca Menni, Laura Trespidi, Mariano Ferraresso, Luisa Berardinelli, Giorgio Rossi, Alberto Edefonti, Rossella Parini – 24 April 2007 – Glycogen storage disease type Ia (GSD Ia) is a rare metabolic disorder due to hepatic glucose‐6‐phosphatase deficiency. Although great progress has been made in managing affected patients, severe hypoglycemia, lactic acidosis, hyperlipidemia, hepatic cytolysis, and impaired kidney function are frequent.

Pediatric hepatopulmonary syndrome is seen with polysplenia/interrupted inferior vena cava and without cirrhosis

Nitika Arora Gupta, Carlos Abramowsky, Todd Pillen, Douglas Redd, Carlos Fasola, Thomas Heffron, Rene Romero – 24 April 2007 – Hepatopulmonary syndrome (HPS) is a triad of liver dysfunction, hypoxemia, and intrapulmonary vascular dilatation. We describe the prevalence and clinical features of HPS at a pediatric liver transplant center. Patients referred to Children's Healthcare of Atlanta/Emory University transplant program from February 1999 to May 2005 were reviewed. Oxygen saturation in room air was screened by percutaneous pulse oximetry.

Nonanastomotic biliary strictures after liver transplantation, part 1: Radiological features and risk factors for early vs. Late presentation

Carlijn I. Buis, Robert C. Verdonk, Eric J. Van der Jagt, Christian S. van der Hilst, Maarten J. H. Slooff, Elizabeth B. Haagsma, Robert J. Porte – 24 April 2007 – Nonanastomotic biliary strictures (NAS) are a serious complication after orthotopic liver transplantation (OLT). The exact pathogenesis is unclear. Purpose of this study was to identify risk factors for the development of NAS after OLT. A total of 487 adult liver transplants with a median follow‐up of 7.9 years were studied. All imaging studies of the biliary tree were reviewed.

Nonanastomotic biliary strictures after liver transplantation, part 2: Management, outcome, and risk factors for disease progression

Robert C. Verdonk, Carlijn I. Buis, Eric J. van der Jagt, Annette S. H. Gouw, Abraham J. Limburg, Maarten J. H. Slooff, Jan H. Kleibeuker, Robert J. Porte, Elizabeth B. Haagsma – 24 April 2007 – Nonanastomotic biliary strictures (NAS) after orthotopic liver transplantation (OLT) are associated with high retransplant rates. The aim of the present study was to describe the treatment of and identify risk factors for radiological progression of bile duct abnormalities, recurrent cholangitis, biliary cirrhosis, and retransplantation in patients with NAS.

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