Identification of patients best suited for combined liver–kidney transplantation: Part II

Connie L. Davis, Thomas A. Gonwa, Alan H. Wilkinson – 30 December 2003 – Liver‐kidney transplantation (LKT) should be reserved for those recipients with primary disease affecting both organs. However, increasing transplant list waiting times have increased the development and duration of acute renal failure before liver transplantation. Furthermore, the need for posttransplant calcineurin inhibitors can render healing from acute renal failure difficult.

Monitoring extracellular concentrations of lactate, glutamate, and glycerol by in vivo microdialysis in the brain during liver transplantation in acute liver failure

Flemming Tofteng, Fin Stolze Larsen – 30 December 2003 – Swelling of cerebral glial cells is a characteristic complication in patients with acute liver failure (ALF). This astrocyte edema may result in high intracranial pressure (ICP) and brain herniation before or during liver transplantation. Metabolic alterations responsible for the development of high ICP in patients with ALF are not fully understood. We describe changes in neurochemistry during liver transplantation using a cerebral microdialysis technique in a young man with severe ALF and cerebral edema.

Fate of hepatocyte and sinusoidal lining cell function and kinetics after extended cold preservation and transplantation of the rat liver

Yusuke Miyagawa, Hiroshi Imamura, Junpei Soeda, Kotaro Matsunaga, Satoshi Mochida, Kenji Fujiwara, Yutaka Matsuyama, Seiji Kawasaki – 30 December 2003 – We investigated the chronological profile of graft damage and recovery after liver cold ischemia‐reperfusion (I/R) injury, with particular attention to the role of apoptosis on hepatocyte and sinusoidal endothelial cell (SEC) damage.

Outflow reconstruction in recipients of right liver graft from living donors

Yasuhiko Sugawara, Masatoshi Makuuchi, Hiroshi Imamura, Junichi Kaneko, Takao Ohkubo, Norihiro Kokudo – 30 December 2003 – Right‐lobe transplantation is now a commonly used procedure in living donor liver transplantation (LDLT) to adult recipients. However, the risk for outflow obstruction is still an issue in LDLT. The right hepatic vein (RHV) was anastomosed end to end to the graft hepatic vein without unfavorable tension on the anastomosis. The anterior wall of the recipient hepatic vein was incised longitudinally, and a V‐shaped vein graft was patched to form a wide and long orifice.

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.

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