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https://www.readbyqxmd.com/read/28214240/bridging-locoregional-therapy-longitudinal-trends-and-outcomes-in-patients-with-hepatocellular-carcinoma
#1
REVIEW
Hayley C Oligane, Orrie N Close, Minzhi Xing, Hyun S Kim
The purpose of this article is to analyze longitudinal trends in locoregional therapy (LRT) use and review locoregional therapy's role in the management of hepatocellular carcinoma prior to orthotropic liver transplantation Porrett et al. (2006) . LRT has a role in both bridge to transplantation and downstaging of patients not initially meeting Milan or UCSF Criteria. Due to the lack of randomized controlled trials, no specific bridging LRT modality is recommended over another for treating patients on the waiting list, however each modality has unique and patient-specific advantages...
February 2, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28212256/hepatic-epithelioid-hemangioendothelioma-and-adult-liver-transplantation-proposal-for-a-prognostic-score-based-on-the-analysis-of-the-eltr-elita-registry
#2
Quirino Lai, Estelle Feys, Vincent Karam, Rene Adam, Jurgen Klempnauer, Martin Oliverius, Vincenzo Mazzaferro, Andreas Pascher, Piotr Remiszewski, Helena Isoniemi, Jacques Pirenne, Aksel Foss, Bo G Ericzon, Sasa Markovic, Jan P Lerut
BACKGROUND: Hepatic epithelioid hemangioendothelioma (HEHE) is a rare vascular tumor which has an intermediate aggressive behavior. Although the value of liver transplantation (LT) is well established, its place in the management of HEHE is still unclear. The aim of this study is to confirm, based on a very large patient cohort, the value of LT in the management of HEHE and to identify risk factors for post-LT recurrence. METHODS: The outcome of 149 transplant recipients with HEHE recorded in the European Liver Transplant Registry during the period November 1984 to May 2014 was analyzed...
March 2017: Transplantation
https://www.readbyqxmd.com/read/28209105/navajo-neurohepatopathy%C3%A2-a-case-report-and-literature-review-emphasizing-clinicopathologic-diagnosis
#3
REVIEW
C P Bitting, J A Hanson
Navajo Neurohepatopathy (NNH) is a rare hepatocerebral mitochondrial DNA (mtDNA) depletion syndrome (MDS) with nonspecific clinical or pathologic features aside from Navajo ancestry. Because of the rarity of NNH, diagnosis rests on close clinicopathologic correlation and appropriate tissue triage for quantitative mtDNA analysis. We present a new case of NNH in which the clinical presentation and H&E liver biopsy histology indicated the need for NNH workup. Quantitative analysis of mtDNA in liver tissue was significantly reduced, and mutational analysis of the MPV17 gene confirmed homozygosity for the NNH-associated missense mutation, R50Q...
September 2016: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/28187493/recurrence-of-hepatocellular-carcinoma-after-liver-transplantation-is-there-a-place-for-resection
#4
Elena Fernandez-Sevilla, Marc-Antoine Allard, Jasmijn Selten, Nicolas Golse, Eric Vibert, Antonio Sa Cunha, Daniel Cherqui, Castaing Denis, René Adam
INTRODUCTION: Recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) is widely considered as a terminal condition. Therefore, the role of surgery is uncertain in this case. The purpose of this study was to identify the prognostic factors of survival after post-LT HCC recurrence and evaluate the impact of surgery in this setting. PATIENTS AND METHODS: All patients transplanted for HCC between 1991 and 2013 in a single institution and who further developed a post-LT recurrence were included in this study...
February 10, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28147371/crohn-s-disease-and-intestinal-transplantation
#5
Pavel Drastich, Martin Oliverius
BACKGROUND: Most patients with Crohn's disease (CD) require one or more operations during their lifetime. Repeated resections and surgical complications may result in short gut in a subset of patients, typically those with extensive small bowel disease or a penetrating CD phenotype. The effects of short bowel syndrome (SBS) can range in seriousness from mild to life-threatening advanced intestinal failure. Worldwide, CD is the second leading indication for intestinal transplantation (ITx) in SBS, but the overall incidence of ITx is quite low...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/28144391/impact-of-transjugular-intrahepatic-porto-systemic-shunt-on-post-liver-transplantation-outcomes-study-based-on-the-united-network-for-organ-sharing-database
#6
Khalid Mumtaz, Sherif Metwally, Rohan M Modi, Nishi Patel, Dmitry Tumin, Anthony J Michaels, James Hanje, Ashraf El-Hinnawi, Don Hayes, Sylvester M Black
AIM: To determine the impact of transjugular intrahepatic porto-systemic shunt (TIPS) on post liver transplantation (LT) outcomes. METHODS: Utilizing the United Network for Organ Sharing (UNOS) database, we compared patients who underwent LT from 2002 to 2013 who had underwent TIPS to those without TIPS for the management of ascites while on the LT waitlist. The impact of TIPS on 30-d mortality, length of stay (LOS), and need for re-LT were studied. For evaluation of mean differences between baseline characteristics for patients with and without TIPS, we used unpaired t-tests for continuous measures and χ(2) tests for categorical measures...
January 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28133934/a-novel-immune-function-biomarker-identifies-patients-at-risk-of-clinical-events-early-following-liver-transplantation
#7
Siddharth Sood, Craig Haifer, Lijia Yu, Julie Pavlovic, Leonid Churilov, Paul J Gow, Robert M Jones, Peter W Angus, Kumar Visvanathan, Adam G Testro
: Balancing immunosuppression after liver transplant is difficult, with clinical events common. We investigate whether a novel immune biomarker based on a laboratory platform with widespread availability that measures interferon gamma (IFNγ) after stimulation with a lyophilized ball containing an adaptive and innate immune stimulant can predict events following transplantation. 75 adult transplant recipients were prospectively monitored in a blinded, observational study. 55/75 (73.3%) patients experienced a total 89 clinical events...
January 30, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28127943/fungal-endotipsitis-a-case-report-and-literature-review
#8
Thomas R McCarty, Jordan Sack, Bakhtiar Syed, Roger Kim, Basile Njei
Endotipsitis is a broad term used to describe sustained and clinically significant bacteremia or fungemia from a suspected vegetation or thrombus within the transjugular intrahepatic portosytemic shunt (TIPS) device. Endotipsitis is a rare infection in post-TIPS patients and given the diagnostic challenges, there is a need to establish formal diagnostic criteria. Bacterial causes of endotipsitis have been well documented in the literature, but few fungal-associated etiologies have been published to date. With this paucity of data, treatment strategies are lacking regarding the role of antifungal duration, the aggressiveness of medical therapy, and the role of liver transplantation...
January 27, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28105981/cryopreservation-of-hepatocyte-microbeads-for-clinical-transplantation
#9
Suttiruk Jitraruch, Anil Dhawan, Robin D Hughes, Celine Filippi, Sharon C Lehec, Leanne Glover, Ragai R Mitry
Intraperitoneal transplantation of hepatocyte microbeads is an attractive option for the management of acute liver failure. Encapsulation of hepatocytes in alginate microbeads supports their function and prevents immune attack of the cells. Establishment of banked cryopreserved hepatocyte microbeads is important for emergency use. The aim of this study was to develop an optimised protocol for cryopreservation of hepatocyte microbeads for clinical transplantation using modified freezing solutions. Four freezing solutions with potential for clinical application were investigated...
January 20, 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28076479/dietary-management-for-dyslipidemia-in-liver-transplant-recipients
#10
Andressa S Pinto, Marcio F Chedid, Léa T Guerra, Daiane D Cabeleira, Cleber D P Kruel
Background: Dyslipidemia occurs in approximately 70% of all liver transplant (LT) recipients, and no prior control studies have demonstrated any dietary intervention to change it. Aim: To analyze the effects of a dietary intervention on the lipid profile of dyslipidemic LT recipients. Methods: All LT recipients with dyslipidemia on clinical follow-up were enrolled. Anthropometric evaluation, food history, body composition (bioimpedance) and assessment of basal metabolism through indirect calorimetry were performed...
November 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28070117/re-transplantation-higher-creatinine-levels-in-hepatitis-c-virus-patients-and-donor-age-are-predictors-of-mortality-in-long-term-analysis-of-late-acute-rejection-in-liver-transplantation
#11
Lucas Souto Nacif, Rafael Soares Pinheiro, Rafael Antônio de Arruda Pécora, Ryan Yukimatsu Tanigawa, Vinicius Rocha-Santos, Wellington Andraus, Venancio Avancini Ferreira Alves, Luiz Carneiro D'Albuquerque
BACKGROUND Late acute rejection (LAR) differs in its clinical and histological presentation and management from early acute rejection. This clinical entity is not completely understood; thus, we aimed to identify significant prognostic factors that can influence post-transplant survival in LAR patients. The purpose of this study was to evaluate the incidence and post-transplant survival of patients from a single center with a focus on late acute rejection. MATERIAL AND METHODS From January 2002 to June 2013, all liver biopsies from patients with rejection were scored using the Banff criteria...
January 10, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28058211/organ-transplantation-and-drug-eluting-stents-perioperative-challenges
#12
REVIEW
Aparna Dalal
Patients listed for organ transplant frequently have severe coronary artery disease (CAD), which may be treated with drug eluting stents (DES). Everolimus and zotarolimus eluting stents are commonly used. Newer generation biolimus and novolimus eluting biodegradable stents are becoming increasingly popular. Patients undergoing transplant surgery soon after the placement of DES are at increased risk of stent thrombosis (ST) in the perioperative period. Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor such as clopidogrel, prasugrel and ticagrelor is instated post stenting to decrease the incident of ST...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28053303/management-of-liver-allograft-trauma-resulting-in-massive-subcapsular-hematoma-after-living-donor-liver-transplantation-can-we-salvage-the-liver-allograft
#13
Shih-Chao Hsu, Ashok Thorat, Kin-Shing Poon, Chun-Chieh Yeh, Te-Hung Chen, Horng-Ren Yang, Long-Bin Jeng
BACKGROUND Liver allograft trauma resulting in subcapsular hematoma after living donor liver transplantation (LDLT), although rare, is a life-threatening condition and requires prompt management to avoid any catastrophe. Herein we describe our successful experience in dealing with liver allograft hematoma that developed in the post-operative period after LDLT. MATERIAL AND METHODS From January 2002 to May 2015, a total of 616 recipients underwent LDLT at our institute. The intra-operative and postoperative records of these patients were analyzed to study the cases of liver allograft hematoma...
January 5, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28024124/developing-therapies-to-treat-hepatitis-c-infection-in-post-liver-transplant-recipients
#14
Thomas R McCarty, Joseph K Lim
Currently, hepatitis C virus (HCV) infection remains the most common indication for liver transplant in the United States (US) with almost universal HCV recurrence in the post-liver transplant setting. Previous interferon (IFN)-related efficacy and tolerability concerns about worsening liver function have limited treatment options for many patients with HCV-associated decompensated liver disease and post-liver transplant recipients. However, the last decade has seen a seen a radical shift in the management of HCV with multiple direct-acting antiviral (DAA) treatments that provide more effective, all-oral, IFN-free alternatives...
February 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28013117/hepatocellular-carcinoma-is-the-most-common-indication-for-liver-transplantation-and-placement-on-the-waitlist-in-the-united-states
#15
Ju Dong Yang, Joseph J Larson, Kymberly D Watt, Alina M Allen, Russell H Wiesner, Gregory J Gores, Lewis R Roberts, Julie A Heimbach, Michael D Leise
BACKGROUND & AIMS: Management strategies for patients with hepatitis C virus (HCV) infection and hepatocellular carcinoma (HCC) have changed, along with liver allocation policies based on model for end-stage liver disease (MELD) score. We investigated etiologic-specific trends in liver transplantation in the United States (US) during different time periods. METHODS: We performed a retrospective study, using the United Network for Organ Sharing/ Organ Procurement and Transplantation Network registry data to identify all adult patients registered for liver transplantation in the US from January 1, 2004 through December 31, 2015...
December 21, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27966241/clinical-analysis-of-hyperkalemic-renal-tubular-acidosis-caused-by-calcineurin-inhibitors-in-solid-organ-transplant-recipients
#16
W Lin, L Mou, H Tu, L Zhu, J Wang, J Chen, Y Hu
WHAT IS KNOWN AND OBJECTIVE: Calcineurin inhibitor (CNI)-based immunosuppressive regimen is widely used for preventing rejection in solid organ transplantation. Hyperkalemic renal tubular acidosis (RTA) caused by CNI is uncommon and potentially underappreciated. We reported four such cases to increase awareness of this risk and to provide recommendations for its management based on our experience. CASE SUMMARY: Four middle-aged males underwent solid organ transplant (two kidneys, one liver, one heart) and were treated with CNI-based immunosuppressive regimen (one cyclosporine A, three tacrolimus)...
February 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27957759/systematic-review-recurrent-autoimmune-liver-diseases-after-liver-transplantation
#17
REVIEW
A J Montano-Loza, R A Bhanji, S Wasilenko, A L Mason
BACKGROUND: Autoimmune liver diseases (AILD) constitute the third most common indication for liver transplantation (LT) worldwide. Outcomes post LT are generally good but recurrent disease is frequently observed. AIMS: To describe the frequency and risk factors associated with recurrent AILD post-LT and provide recommendations to reduce the incidence of recurrence based on levels of evidence. METHODS: A systematic review was performed for full-text papers published in English-language journals, using the keywords 'autoimmune hepatitis (AIH)', 'primary biliary cholangitis and/or cirrhosis (PBC)', 'primary sclerosing cholangitis (PSC)', 'liver transplantation' and 'recurrent disease'...
December 12, 2016: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27956374/current-review-of-iron-overload-and-related-complications-in-hematopoietic-stem-cell-transplantation
#18
Erden Atilla, Selami K Toprak, Taner Demirer
Iron overload is an adverse prognostic factor for patients undergoing hematopoietic stem cell transplantation (HSCT). In HSCT setting, pretransplant and early posttransplant ferritin and transferrin saturation were found to be highly elevated due to high transfusion requirements. In addition to that, post-HSCT iron overload had shown to be related with infections, hepatic sinusoidal obstruction syndrome (SOS), mucositis, liver dysfunction and acute GVHD. Hyperferritinemia causes decreased survival rates in both pre and post transplant setting...
December 12, 2016: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
https://www.readbyqxmd.com/read/27934806/molecular-appraisal-of-intestinal-parasitic-infection-in-transplant-recipients
#19
Pooja Yadav, Shehla Khalil, Bijay Ranjan Mirdha
BACKGROUND & OBJECTIVES: Diarrhoea is the main clinical manifestation caused by intestinal parasitic infections in patients, with special reference to transplant recipients who require careful consideration to reduce morbidity and mortality. Further, molecular characterization of some important parasites is necessary to delineate the different modes of transmission to consider appropriate management strategies. We undertook this study to investigate the intestinal parasitic infections in transplant recipients with or without diarrhoea, and the genotypes of the isolated parasites were also determined...
August 2016: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/27932176/intrahepatic-artery-pseudoaneurysm-induced-hemobilia-caused-by-a-plastic-biliary-stent-after-abo-incompatible-living-donor-liver-transplantation-a-case-report
#20
J M Chun, H T Ha, Y Y Choi, Y J Hwang, J Heo, H K Ryeom, Y S Han
Bile leakage after duct-to-duct anastomosis in living-donor liver transplantation (LDLT) can mostly be managed by therapeutic endoscopic retrograde cholangiopancreatography. Following this, various complications such as biliary infection, pancreatitis, perforation, and bleeding can occur, and endoscopic sphincterotomy is primarily associated with post- endoscopic retrograde cholangiopancreatography bleeding; other causes have been published in case reports. In the present case, a plastic biliary stent used for treating liver abscesses and leakage at the bile duct anastomosis site after ABO-incompatible LDLT resulted in an intrahepatic artery pseudoaneurysm and hemobilia, which were managed by angiography and coil embolization...
November 2016: Transplantation Proceedings
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