A simple modification in operative technique can reduce the incidence of nonanastomotic biliary strictures after orthotopic liver transplantation

Howard N. Sankary, Lawrence McChesney, Elizabeth Frye, Steven Cohn, Preston Foster, James Williams – 1 January 1995 – Nonanastomotic strictures after liver transplantations are a source of significant morbidity, often necessitating retransplantation. The purpose of this study was twofold: first to identify features associated with the development of this lesion; second, to make technical modifications that will decrease the incidence of this problem. In the first part of this study, 15 of 131 patients were diagnosed with nonanastomotic biliary stricture.

Shedding light into the black box of childhood cholestatic liver disease

Lan D. A. D'Agata, Maureen M. Jonas – 1 January 1995 – This work details the histologic findings in 84 liver biopsy specimens from 28 patients with progressive familial intrahepatic cholestasis (PFIC), who met the clinical criteria of early onset of chronic unremitting cholestasis, exclusion of any known metabolic or anatomic etiology, and low serum γ‐glutamyl transpeptidase (GGTP) values. Hepato‐canalicular cholestasis and disruption of the liver cell plate arrangement were early, uniform findings, and giant cell transformation was found in 56% of initial biopsies.

Concanavalin A—induced T‐cell—mediated hepatic injury in mice: The role of tumor necrosis factor

Florian Gantner, Marcel Leist, Ansgar Wilhelm Lohse, Paul Georg Germann, Gisa Tiegs – 1 January 1995 – Concanavalin A activates T lymphocytes in vitro and causes T‐cell‐dependent hepatic injury in mice. T lymphocytes were previously identified as effector cells of concanavalin A‐induced liver injury. Here we report that hepatic injury is characterized by apoptotic cell death. On concanavalin A challenge, the cytokines tumor necrosis factor‐α (TNF α), interleukin‐2, granulocyte macrophage‐colony stimulating factor, and interferon‐γ were detectable in the circulation of the mice.

Plasma levels of substance p in liver cirrhosis: Relationship to the activation of vasopressor systems and urinary sodium excretion

Conrado M. Fernández‐Rodriguez, Jesús Prieto, Jorge Quiroga, José Manuel Zozoya, Amalia Andrade, Marina Núñez, Bruno Sangro, José Penas – 1 January 1995 – The mediators of the hyperdynamic circulation of liver cirrhosis are not well characterized. Substance P is a potent vasodilatory peptide produced by the enteric nervous system and partly cleared by the liver. In this work we have investigated the plasma levels of substance P and their relationship to the hemodynamic, neurohormonal, and renal function changes occurring in patients with cirrhosis.

Pancreatic complications after distal splenorenal shunt

Gongliang Jin, Kenric M. Murayama, Jon S. Thompson, Layton F. Rikkers – 1 January 1995 – Pancreatic complications after the distal splenorenal shunt have not been commonly recognized. Between January 1978 and June 1993, 154 patients underwent a distal splenorenal shunt, and 11 patients (7%) developed pancreatic complications, of which 4 had pancreatitis alone, and 7 developed pancreatitis‐related complications. Etiology of cirrhosis, Child's classification and timing of surgery were not predictive of pancreatic complications.

Risk and prognostic factors of gut perforation after orthotopic liver transplantation for biliary atresia

Olivier Soubrane, Mahmoud El Meteini, Denis Devictor, Olivier Bernard, Didier Houssin – 1 January 1995 – The aim of this study was to assess the risk and prognostic factors of gut perforation after orthotopic liver transplantation in children with biliary atresia using univariate and stepwise regression analysis. Among 51 pediatric recipients who underwent transplantation because of biliary atresia after failure of portoenterostomy, 10 patients (20%) had 19 episodes of gut perforations after 14 transplantations. The median delay between transplantation and perforation was 13 days.

Evaluation of purine nucleoside phosphorylase release as a measure of hepatic endothelial cell injury

Clifford A. Brass, Milan G. Mody – 1 January 1995 – With emerging data that endothelial cell (EC) injury is the limiting factor in liver preservation and hepatic function, a simple and reliable biochemical technique for monitoring EC injury is needed. Measurement of purine nucleoside phosphorylase (PNP) release into the circulation from perfused liver has been proposed as such a method. However, our experiments with perfused rat liver did not display a clear or direct relationship between PNP release and endothelial cell injury.

Failure of hepatopulmonary syndrome to resolve after liver transplantation and successful treatment with embolotherapy

John J. Poterucha, Michael J. Krowka, E. Rolland Dickson, Denis A. Cortese, Anthony W. Stanson, Ruud A. F. Krom – 1 January 1995 – The hepatopulmonary syndrome is an uncommon accompaniment of chronic liver disease. The outcome of this disorder after orthotopic liver transplantation is varibable. We describe a patient with the hepatopulmonary syndrome who underwent orthotopic liver transplantation for autoimmune hepatitis. Her platypnea and orthodeoxia failed to improve postoperatively.

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