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.

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.

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.

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%.

Wilson's Disease: Indications for Liver Transplants

Irmin Sternlieb – 1 January 1984 – The clinical course of certain patients with Wilson's disease resembles that of patients with viral or drug‐induced fulminant hepatitis lasting only few weeks from recognition of symptoms to severe hepatic insufficiency and death. The disease is complicated by hemolysis and is characterized by hypercupremia. Routine laboratory findings may underestimate the severity of the disease. These patients, as well as patients with decompensated Wilsonian cirrhosis who are not responding to therapy, should be considered as candidates for liver transplants.

A [14C]Phenacetin Breath Test to Measure Hepatic Function in Man

Kerry J. Breen, Ross W. Bury, Ian V. Calder, Paul V. Desmond, Marion Peters, M. Laurie Mashford – 1 January 1984 – Phenacetin, a high‐clearance drug, was labeled as [14C‐ethyl]phenacetin and used in a breath test of hepatic function. 14CO2 appeared rapidly in breath such that more than 30% of the administered radioactivity was expired in 2 hr. For all means of expression used to describe the appearance of 14CO2 in breath, normal controls and hospitalized patients without liver disease were clearly separated from cirrhotic subjects with moderate and severe liver damage.

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