Health‐related quality of life in long‐term survivors of pediatric liver transplantation

Deborah E. Midgley, Tatum A. Bradlee, Christopher Donohoe, Kevin P. Kent, Estella M. Alonso – 30 December 2003 – The purpose of this study is to measure the health‐related quality of life (HRQOL) in children who are long‐term survivors of liver transplantation and to pilot the Liver Transplant Disability Scale (LTDS), a newly developed 12‐point scale that quantifies chronic medical disability related to liver transplantation. This study is a cross‐sectional survey of 51 children surviving liver transplantation by at least 2 years, with a median age of 4.94 years.

Intracerebral hemorrhage after liver transplantation

Wei‐Lin Wang, Zhen‐Fan Yang, Chung‐Mau Lo, Chi‐Leung Liu, Sheung‐Tat Fan – 30 December 2003 – We report 5 patients with intracerebral hemorrhage after orthotopic liver transplantation (OLT) and identify the possible risk factors. Between November 1991 and April 1999, 75 adult patients received 77 orthotopic liver transplants at Queen Mary Hospital, Hong Kong. Five patients (6.5%) developed intracerebral hemorrhage postoperatively. Clinical and laboratory data were reviewed, and potential risk factors were analyzed.

Controversies in the management of hepatitis C virus infection after liver transplantation

Mitchell L. Shiffman, Hugo E. Vargas, Gregory T. Everson – 30 December 2003 – Recurrence of hepatitis C virus infection after liver transplantation is universal. A significant percentage of these patients develop progressive graft injury and cirrhosis. Those factors that modulate disease progression in liver transplant recipients with recurrent hepatitis C virus infection remain controversial and are poorly understood. Treatment of recurrent hepatitis C virus after liver transplantation with either interferon or interferon and ribavirin has yielded only limited success.

Oxygen availability during orthotopic liver transplantation

Georgia Kostopanagiotou, Vassilios Smyrniotis, Kassiani Theodoraki, Yannis Skalkidis, Nigel Heaton, Dennis Potter – 30 December 2003 – Studies have stressed the role of adequate tissue oxygenation in the light of an optimal patient outcome and allograft viability in liver transplantation. The practice of monitoring conventional hemodynamic parameters during liver transplantation could be complemented by parameters assessing real oxygen availability. In the present prospective study, real arterial available oxygen content (CavlO2) and its extraction ratio (O2ERavl) were calculated.

Delayed onset of severe hepatitis C‐related liver damage following liver transplantation: A matter of concern?

Marina Berenguer, Victoria Aguilera, Martin Prieto, Domingo Carrasco, Miguel Rayón, Fernando San Juan, Carmen Landaverde, José Mir, Joaquín Berenguer – 30 December 2003 – Although histological hepatitis occurs in the majority of hepatitis C virus (HCV)‐infected liver transplant recipients, the natural history is highly variable. Whereas progression to cirrhosis occurs in up to 30% after 3 to 7 years, the disease remains stable in another third of patients, in whom protocol liver biopsies might be avoided.

Are preformed antibodies to biliary epithelial cells of clinical importance in liver transplantation?

Xupeng Ge, Bo‐Göran Ericzon, Grzegorz Nowak, Henrik Öhrström, Ulrika Broomé, Suchitra Sumitran‐Holgersson – 30 December 2003 – During acute liver allograft rejection, most of the tissue damage to bile duct epithelium is thought to occur as a consequence of direct immunologic injury by T‐cell‐mediated immune effector mechanisms. However, the role of antibodies to biliary epithelial cells (BECs) in liver transplant rejection is not known.

Bile secretory function after warm hepatic ischemia‐reperfusion injury in the rat

Luigi Accatino, Margarita Pizarro, Nancy Solís, Marco Arrese, Cecilia S. Koenig – 30 December 2003 – Hepatic ischemia‐reperfusion (I‐R) injury frequently is associated with cholestasis. However, the underlying mechanisms are not fully understood. The aim of the study is to assess bile secretory function in vivo in rats subjected to warm lobar hepatic ischemia at different times during reperfusion. A model of lobar 70% warm hepatic ischemia for 30 minutes was used with studies conducted at 1 and 6 hours and 1, 3, and 7 days after reperfusion.

Late onset of tacrolimus‐related posterior leukoencephalopathy after living donor liver transplantation

Nils R. Frühauf, Susanne Koeppen, Fuat H. Saner, Thomas Egelhof, Gregor Stavrou, Silvio Nadalin, Christoph E. Broelsch – 30 December 2003 – Neurotoxicity is a well‐known side effect of tacrolimus‐based immunosuppression after liver transplantation. Until now, only 31 cases of immunosuppression‐associated leukoencephalopathy in liver transplant recipients reported in the literature are related to tacrolimus therapy. We report a patient who developed a posterior leukoencephalopathy syndrome, secondary to tacrolimus‐based immunosuppression, after living donor liver transplantation.

Setting organ allocation priorities: Should we care what the public cares about?

Mira Johri, Peter A. Ubel – 30 December 2003 – Objective: To investigate the nature of public preferences in the allocation of donor liver grafts for transplantation. Design: A qualitative study based upon the transcripts of four focus groups. Setting: Derby, Derbyshire, UK. Participants: Twenty‐two members of the public in the Derby locality, recruited to one of four focus groups through local community groups.

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