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https://www.readbyqxmd.com/read/27917074/medical-management-of-metabolic-complications-of-liver-transplant-recipients
#1
Abbey Barnard, Peter Konyn, Sammy Saab
Improved short- and long-term survival of liver transplant recipients has led to increased focus on complications of both the early and late posttransplant periods. A variety of metabolic complications have been observed in the post-orthotopic liver transplant population, including hypertension, hyperlipidemia, obesity, diabetes mellitus, nonalcoholic fatty liver disease, and nonalcoholic steatohepatitis. Although only a small proportion of patients experience metabolic complications prior to transplantation, the prevalence of these complications posttransplantation reaches or exceeds that of the general population...
October 2016: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27894188/challenges-of-endoscopic-management-of-pancreaticobiliary-complications-in-surgically-altered-gastrointestinal-anatomy
#2
REVIEW
Tin Moe Wai, Eun Young Kim
Pancreaticobiliary complications following various surgical procedures, including liver transplantation, are not uncommon and are important causes of morbidity and mortality. Therapeutic endoscopy plays a substantial role in these patients and can help to avoid the need for reoperation. However, the endoscopic approach in patients with surgically altered gastrointestinal (GI) anatomy is technically challenging because of the difficulty in entering the enteral limb to reach the target orifice to manage pancreaticobiliary complications...
November 2016: Clinical Endoscopy
https://www.readbyqxmd.com/read/27884502/the-role-of-arterial-conduits-for-revascularisation-in-adult-orthotopic-liver-transplantation
#3
REVIEW
Nikolaos A Chatzizacharias, Mohamed Aly, Raaj K Praseedom
The successful outcome in orthotopic liver transplantation (OLT) is critically dependent on the uncompromised hepatic graft blood inflow. Arterial conduits represent a good solution in cases where conventional revascularisation is not possible. The purpose of this systematic review is to analyse the published evidence on the use of arterial conduits in adult OLT. After review of the Pubmed and EMBASE databases, 19 relevant studies were identified and analysed. Even though patient survival was comparable, most large studies reported worse 1-, 3- and 5-year graft survival rates compared to grafts with standard arterial revascularisation...
November 4, 2016: Transplantation Reviews
https://www.readbyqxmd.com/read/27878476/management-of-post-liver-transplant-recurrence-of-hepatitis-c
#4
Justin Taylor, Paula Cox-North, Charles S Landis
Cirrhosis due to chronic hepatitis C (HCV) is the leading indication for liver transplantation in North America and Europe. HCV re-infection post-transplant is nearly universal and if left untreated negatively affects patient and graft survival. Until recently, treatment options for HCV were limited to interferon (IFN)-based therapies which had low sustained viral response (SVR) rates and were poorly tolerated in the post-transplant setting. In the last 3 years, the promise of the directly acting antivirals (DAAs) for the treatment of HCV has been fulfilled with high sustained viral response (SVR) rates and a low side effect profile demonstrated in both registration trials and real-world studies...
November 23, 2016: Drugs
https://www.readbyqxmd.com/read/27875636/evaluation-of-coronary-artery-disease-in-potential-liver-transplant-recipients
#5
REVIEW
Brian J Hogan, Enoka Gonsalkorala, Michael A Heneghan
Improvements in the management of patients undergoing Liver Transplantation (LT) have resulted in a significant increase in survival over recent years. Cardiac disease is now the leading cause of early mortality and the stress of major surgery, haemodynamic shifts, the possibility of haemorrhage or reperfusion syndrome require the recipient to have good baseline cardiac function. The prevalence of coronary artery disease (CAD) is increasing in liver transplant candidates, especially in those with Non-Alcohol related Fatty Liver Disease (NAFLD)...
November 22, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27875061/glycemic-control-reduces-infections-in-post-liver-transplant-patients-results-of-a-prospective-randomized-study
#6
Amisha Wallia, Kathleen Schmidt, Diana Johnson Oakes, Teresa Pollack, Nicholas Welsh, Susan Kling-Colson, Suruchi Gupta, Candice Fulkerson, Grazia Aleppo, Neehar Parikh, Josh Levitsky, J P Norvell, Alfred Rademaker, Mark E Molitch
CONTEXT: Prior studies have shown a relationship between glycemic control and post-transplant morbidity. OBJECTIVE: We conducted a prospective randomized controlled trial in post liver transplant patients, evaluating intensive inpatient glycemic control and effects on outcomes to 1 year. Research Design and Intervention: 164 patients (blood glucose (BG) > 180 mg/dL) were randomized to two target groups: BG 140 mg/dL (N= 82) and 180 mg/dL (N= 82). Patients were initiated on insulin drips and then converted to subcutaneous basal bolus insulin therapy by our Glucose Management Service...
November 22, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27872682/prophylactic-liver-transplantation-for-high-risk-recurrent-hepatocellular-carcinoma
#7
REVIEW
Po-Chih Yang, Cheng-Maw Ho, Rey-Heng Hu, Ming-Chih Ho, Yao-Ming Wu, Po-Huang Lee
Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related death in the world. Radical treatment of HCC in early stages results in a long disease-free period and improved overall survival. The choice of optimal management strategy for HCC mainly depends on the severity of the underlying liver disease. For patients with decompensated liver cirrhosis and HCC within Milan criteria (MC), liver transplant (LT) is the choice of treatment. However, for patients with good residual liver reserve and HCC within MC, selection of other curative treatments such as liver resection (LR) or radiofrequency ablation may be a reasonable alternative...
November 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27830409/perioperative-cardiovascular-evaluation-for-orthotopic-liver-transplantation
#8
REVIEW
Robert J Donovan, Calvin Choi, Asghar Ali, Douglas M Heuman, Michael Fuchs, Anthony A Bavry, Ion S Jovin
Patients with advanced liver disease have a high prevalence of cardiovascular risk factors, but many of them are asymptomatic. Cardiovascular risk stratification prior to liver transplant can be done by dobutamine stress echocardiography, stress myocardial perfusion imaging, cardiac computer tomography, and coronary angiography, but there are no clear recommendations regarding what method should be used and who should be screened. Because of this and because of inherent risk profile in this population, the variations in practice are significant...
November 9, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27805244/takotsubo-cardiomyopathy-post-liver-transplantation
#9
Ahmed Vachiat, Keir McCutcheon, Adam Mahomed, Gunter Schleicher, Liezl Brand, Jean Botha, Martin Sussman, Pravin Manga
A patient with end-stage liver disease developed stress-induced Takotsubo cardiomyopathy post liver transplantation, with haemodynamic instability requiring a left ventricular assist device. We discuss the diagnosis and management of this condition.
October 23, 2016: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/27781106/twin-pregnancy-in-a-liver-transplant-recipient-with-hiv-infection
#10
EDITORIAL
McI Van Schalkwyk, R H Westbrook, J O'Beirne, A Wright, A Gonzalez, M A Johnson, S Kinloch-de Loës
We are not aware of a report detailing the complex obstetrical and medical management of twin pregnancy in the context of HIV infection and early post-liver transplantation period. Here we describe the successful outcome of a twin pregnancy in a 28-year-old HIV-positive female receiving antiretroviral therapy and immunosuppressive therapy who was the recipient of a liver transplant for previous drug-induced liver failure.
October 5, 2016: Journal of Virus Eradication
https://www.readbyqxmd.com/read/27752034/follow-up-of-pediatric-liver-transplant-patients-after-reaching-adulthood
#11
Justyna Rajchert, Monika Rosa, Joanna Pawłowska, Milosz Parczewski, Marta Wawrzynowicz-Syczewska
BACKGROUND Despite excellent transplantation results, there is a vulnerable period of time in the post-transplant management of pediatric liver recipients, which is the time when a child becomes an adolescent. This period of psychological distress influences compliance and may result in premature transplant failure and graft loss. We performed a retrospective review of pediatric liver transplant recipients, transferred to our service for adults, in order to identify key issues associated with transition into the adult care...
October 18, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/27744664/endoscopic-management-of-anastomotic-strictures-after-liver-transplantation
#12
REVIEW
Dong Wook Lee, Hyeong Ho Jo, Juveria Abdullah, Michel Kahaleh
Endoscopic treatment of biliary strictures involving plastic stent placement has been used widely. The use of self-expandable metal stents (SEMSs) has been described for anastomotic strictures following liver transplantation (LT). This review aimed to assess and compare the efficacy of plastic stents with SEMS in LT patients. Information was retrieved regarding technical success, stricture resolution, the number of endoscopic retrograde cholangiography procedures, follow-up, immediate, and late complications...
September 2016: Clinical Endoscopy
https://www.readbyqxmd.com/read/27742339/prevalence-and-predictors-of-metabolic-syndrome-after-liver-transplantation
#13
L Vida Perez, J L Montero Alvarez, A Poyato Gonzalez, J Briceño Delgado, G Costan Rodero, E Fraga Rivas, P Barrera Baena, M De la Mata Garcia
BACKGROUND: The development of metabolic syndrome (MS) after liver transplantation (LT) is a major source of mortality derived from cardiovascular events. The aim of the present study was to determine the prevalence and risk factors of MS after LT. METHODS: One-hundred seventy-four consecutive LT patients from January 2004 to June 2010 surviving longer than 1 year after LT were included. Median follow-up after LT was 48 months. Independent predictors of MS were obtained by means of multivariate logistic regression...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27742337/endoscopic-management-of-post-liver-transplantation-biliary-strictures-with-the-use-of-fully-covered-metallic-stents
#14
M Jiménez-Pérez, J M Melgar Simón, A Durán Campos, R González Grande, J M Rodrigo López, R Manteca González
OBJECTIVE: The aim of this work was to evaluate the safety and efficacy of a fully covered self-expandable metal stent (FCSEMS) in the treatment of post-liver transplantation biliary strictures. METHODS: From October 2009 to October 2014, 44 patients with post-liver transplantation biliary stenosis were treated with the use of endoscopic retrograde cholangiography and placement of FCSEMS after informed consent. The FCSEMS was scheduled to remain in situ for 3-6 months...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27742010/the-management-of-hepatitis-b-in-liver-transplant-recipients
#15
Sammy Saab, Ping-Yu Chen, Clara E Saab, Myron J Tong
Liver transplant (LT) is now an established indication for patients with chronic hepatitis B, mainly because of the development and use of hepatitis B immunoglobulin (HBIG) and oral antivirals for prophylaxis. The combination of low-dose HBIG and antivirals has been considered the standard prophylaxis regimen to prevent post-LT recurrence of hepatitis B. The important remaining issues are related to the long-term cost of HBIG and the risk of escape hepatitis B virus (HBV) mutants. Strategies for prevention of HBV after LT are constantly improving...
November 2016: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27688651/epidemiology-of-hepatitis-c-in-greece
#16
REVIEW
Christos Triantos, Christos Konstantakis, Paraskeui Tselekouni, Maria Kalafateli, Ioanna Aggeletopoulou, Spilios Manolakopoulos
Hepatitis C is a global health issue and constitutes a major cause of chronic liver disease worldwide. In this article, a comprehensive literature search was conducted for the prevalence of hepatitis C virus (HCV) infection in Greece, since data on the HCV prevalence, viremia and genotypes are important for developing strategies to manage or eliminate HCV infection. In addition, the pattern of HCV infection was analyzed according to the geographic region and the risk factors. These differences reflect not only distinct epidemiological characteristics among populations, but also differences on the strategy of data acquisition and quantification...
September 28, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27685492/first-reported-finding-of-a-malignant-pleural-mesothelioma-in-a-patient-post-liver-transplant
#17
J Gleeson, A Doyle, S F Oon, M Iqbal
The case history of a liver transplant recipient is presented, who presented with acute dyspnoea after an innocuous fall. His early management was complicated and he was eventually diagnosed with malignant mesothelioma. This is the first such case report in the literature.
2016: Irish Medical Journal
https://www.readbyqxmd.com/read/27672280/clinical-management-of-acute-liver-failure-results-of-an-international-multi-center-survey
#18
Liane Rabinowich, Julia Wendon, William Bernal, Oren Shibolet
AIM: To assess the practice of caring for acute liver failure (ALF) patients in varying geographic locations and medical centers. METHODS: Members of the European Acute Liver Failure Consortium completed an 88-item questionnaire detailing management of ALF. Responses from 22 transplantation centers in 11 countries were analyzed, treating between 300 and 500 ALF cases and performing over 100 liver transplants (LT) for ALF annually. The questions pertained to details of the institution and their clinical activity, standards of care, referral and admission, ward- based care versus intensive care unit (ICU) as well as questions regarding liver transplantation - including criteria, limitations, and perceived performance...
September 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27650800/the-effect-of-renal-dysfunction-and-haemodialysis-on-circulating-liver-specific-mir-122
#19
Laura Rivoli, A D Bastiaan Vliegenthart, Carmelita M J de Potter, Job J M H van Bragt, Nikolaos Tzoumas, Peter Gallacher, Tariq E Farrah, Neeraj Dhaun, James W Dear
AIMS: microRNA-122 (miR-122) is a hepatotoxicity biomarker with utility in the management of paracetamol overdose and in drug development. Renal dysfunction and haemodialysis have been associated with a reduction in circulating microRNA. The objective of this study was to determine their effect on miR-122. METHODS: Blood samples were collected from 17 patients with end-stage renal disease (ESRD) on haemodialysis, 22 healthy controls, 30 patients with chronic kidney disease (CKD) and 15 patients post-kidney transplantation...
September 21, 2016: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27648064/adrenalectomy-for-solitary-metastasis-of-hepatocellular-carcinoma-post-liver-transplantation-case-report-and-literature-review
#20
Imran Khan Jalbani, Syed M Nazim, Muhammad Usman Tariq, Farahat Abbas
Liver transplantation (LT) is the treatment of choice for localized hepatocellular carcinoma (HCC) associated with cirrhosis. Extra hepatic metastasis is the most common cause of death in these patients. There is very little evidence regarding the natural history and treatment options for patients developing HCC recurrence after LT. Surgical resection offers a unique opportunity for solitary metastasis. We report a 61 year old male with solitary right adrenal metastasis 15 months post LT which was managed with open adrenalectomy...
July 2016: Pakistan Journal of Medical Sciences Quarterly
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