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https://www.readbyqxmd.com/read/28343205/-biliary-atresia-signs-and-symptoms-diagnosis-clinical-management
#1
Ewa Orłowska, Piotr Czubkowski, Piotr Socha
Biliary atresia is a chronic cholangiopathy leading to progressive fibrosis of both intra- and extrahepatic bile ducts. The cause of the condition is unknown. Fundamental management of biliary atresia is surgical intervention and the outcomes of the treatment depend on the child's age with best results when performed within the first 2 months of life. Thus, the main role of pediatric healthcare is an urgent differential diagnosis and prompt qualification for the surgery, optimal postoperative management and early qualification for the liver transplantation in patients with persistent cholestasis...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28340509/liver-transplant-lt-recipients-with-nonalcoholic-steatohepatitis-nash-have-lower-risk-hepatocellular-carcinoma-hcc
#2
Sara M Lewin, Neil Mehta, R Kate Kelley, John P Roberts, Francis Y Yao, Danielle Brandman
BACKGROUND: Liver transplantation is a well-established treatment for HCC in carefully selected patients. Risk factors for tumors with poor prognostic features on explant have not been well described in a national cohort. METHODS: We performed a retrospective cohort study of adult LT recipients with HCC transplanted from 4/8/12 (when explant pathology in UNOS became available) until 9/30/2014. We evaluated the association between listing diagnosis and other demographic factors with tumor features on explant using logistic regression...
March 24, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28339922/therapeutic-plasma-exchange-for-potential-human-leukocyte-antigen-antibody-mediated-rejection-in-liver-transplant-patients
#3
Eric Salazar, David Cohen, Tina Ipe, Christopher Leveque
No abstract text is available yet for this article.
March 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28338118/unusual-discovery-after-an-examination-for-abdominal-pain-abernethy-1b-malformation-and-liver-adenomatosis-a-case-report
#4
Romeo Ioan Chira, Adriana Calauz, Simona Manole, Simona Valean, Petru Adrian Mircea
Congenital extrahepatic portosystemic shunt (Abernethy malformation) is a rare condition characterized by developmental abnormalities of the portal venous system resulting in the diversion of the portal blood from the liver to the systemic venous system through a complete or partial shunt of the portomesenteric blood. We report the case of an 18 year-old female examined for abdominal pain, presenting cholestasis syndrome and an elevated serum aspartate aminotransferase level. Liver ultrasound examination revealed the absence of the portal vein with a complete extrahepatic shunt of the portal blood, multiple focal liver lesions, and multiple associated vascular anomalies...
March 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28337446/lack-of-clinical-relevance-of-ana-and-asma-positivity-in-patients-with-liver-transplantation-without-a-history-of-autoimmune-diseases
#5
Lucienne Pellegrini, Gianpaolo Parrilli, Antonella Santonicola, Luigi Cinquanta, Cesare Caputo, Carolina Ciacci, Fabiana Zingone
The relevance of isolated autoimmunity elevation in orthotopic liver transplantation (OLT) patients is unknown. Our aim was to analyse how serum autoantibodies change in time and to evaluate their clinical relevance in OLT patients. Patients were invited to provide samples to evaluate ANA, AMA, ASMA, and LKM at the time of enrolment (T0), after 6 months (T6), and after 12 months (T12). We included 114 patients in the study (76% males, median age 62.5 years), finding isolated elevation of at least one serum antibody in up to 80% of them...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28336908/early-chimerism-after-liver-transplantation-reflects-the-clinical-course-of-recurrent-hepatitis-c
#6
Masashi Utsumi, Akinobu Takaki, Yuzo Umeda, Kazuko Koike, Stephanie C Napier, Nobukazu Watanabe, Susumu Shinoura, Ryuichi Yoshida, Daisuke Nobuoka, Tetsuya Yasunaka, Takahiro Oto, Motoo Araki, Kazuhide Yamamoto, Toshiyoshi Fujiwara, Takahito Yagi
BACKGROUND Human leukocyte antigen (HLA) mismatch is a characteristic feature of post-orthotopic liver transplantation (OLT) hepatitis C. To investigate the importance of donor HLA-restricted immune cells in post-OLT hepatitis C recurrence, we analyzed the frequency of donor chimerism and the clinical course of post-OLT hepatitis C. MATERIAL AND METHODS We analyzed peripheral blood chimerism in 11 HCV-reinfected patients with post-HLA mismatched OLT. Patients were divided into 2 groups: the OLT chronic hepatitis C (CHC) group (n=8), exhibiting active hepatitis C recurrence; and the OLT-persistently normal ALT (PNALT) group (n=3), without active hepatitis...
March 24, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28334710/prevention-of-tlr9-pathway-in-warm-ischemia-in-porcine-donor-liver-after-cardiac-death
#7
Zigong Shao, Baoping Jiao, Dehui Yi, Tingting Liu, Qi Pan, Ying Cheng, Hao Liu
OBJECTIVE: To investigate effect of warm ischemia after cardiac death on activation of TLR9 pathway in porcine liver. METHODS: Donor of cardiac death (DCD) model was established with Duroc, Landrace, Large White crossbred pigs. Liver tissues from the animals were harvested at 0, 5, 10, 15, 25 and 30 minutes after warm ischemia for analysis of expression of TLR9, IRF7, IFN-β, and TNF-α at mRNA and protein levels by real-time PCR and western blot, respectively, and for assessment of NF-κB/DNA binding activity by western blot detection of p65 protein...
March 27, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28333889/normothermic-ex-situ-liver-preservation-the-new-gold-standard
#8
Richard W Laing, Hynek Mergental, Darius F Mirza
PURPOSE OF REVIEW: Normothermic machine perfusion of the liver (NMP-L) is a novel technology recently introduced into the practice of liver transplantation. This review recapitulates benefits of normothermic perfusion over conventional static cold storage and summarizes recent publications in this area. RECENT FINDINGS: The first clinical trials have demonstrated both safety and feasibility of NMP-L. They have shown that machine perfusion can entirely replace cold storage or be commenced following a period of cold ischaemia...
March 22, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28333852/re-intervention-in-de-novo-vitreous-opacities-after-pars-plana-vitrectomy-in-familial-amyloidotic-polyneuropathy-ttr-val30metportuguese-patients
#9
Natália Novais Ferreira, David Afonso Cunha Dias, Rui Pedro Afonso Carvalho, Maria Teresa Pardal Monteiro Coelho
PURPOSE: To report management of de novo vitreous amyloid opacities after previous pars plana vitrectomy in familial amyloidotic polyneuropathy transthyretin Val30Met. METHODS: This work is a retrospective observational consecutive case series of five eyes of four patients. Demographic data, transthyretin mutation involved, age at the beginning of disease, duration of disease, treatment (liver transplant or tafamidis), time between vitrectomy and re-intervention, and ophthalmologic changes were evaluated...
March 22, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28333015/role-of-stereotactic-body-radiation-therapy-before-orthotopic-liver-transplantation-retrospective-evaluation-of-pathologic-response-and-outcomes
#10
Edward Michael Mannina, Higinia Rosa Cardenes, Foster D Lasley, Benjamin Goodman, Jennifer Zook, Sandra Althouse, John Alvin Cox, Romil Saxena, Joseph Tector, Mary Maluccio
PURPOSE: To analyze the results of stereotactic body radiation therapy (SBRT) in patients with early-stage, localized hepatocellular carcinoma who underwent definitive orthotopic liver transplantation (OLT). METHODS AND MATERIALS: The subjects of this retrospective report are 38 patients diagnosed with hepatocellular carcinoma who underwent SBRT per institutional phase 1 to 2 eligibility criteria, before definitive OLT. Pre-OLT radiographs were compared with pathologic gold standard...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28332273/reducing-the-incidence-of-hepatic-artery-thrombosis-in-pediatric-liver-transplantation-effect-of-microvascular-techniques-and-a-customized-anticoagulation-protocol
#11
William A Ziaziaris, Alexandre Darani, Andrew J A Holland, Angus Alexander, Jonathan Karpelowsky, Pasquale Barbaro, Michael Stormon, Edward O'Loughlin, Albert Shun, Gordon Thomas
We aimed to assess the incidence of HAT over three eras following implementation of microvascular techniques and a customized anticoagulation protocol in a predominantly cadaveric split liver transplant program. We retrospectively reviewed pediatric liver transplants performed between April 1986 and 2016 and analyzed the incidence HAT over three eras. In E1, 1986-2008, each patient received a standard dose of 5 U/kg/h of heparin and coagulation profiles normalized passively. In E2, 2008-2012, microvascular techniques were introduced...
March 22, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28332100/expression-of-programmed-death-1-and-its-ligands-in-the-liver-of-biliary-atresia
#12
Pan-Liang Wang, Jun Wang, Ying Zhou, Xiao-Song Chen, Ke-Jun Zhou, Jie Wen, Jian-Jun Zhang, Wei Cai
BACKGROUND: An aberrant immune response is the predominant pathogenetic factor in biliary atresia (BA). Programmed death-1 (PD-1) and its two ligands, programmed death ligand-1 and programmed death ligand-2 (PD-L1 and PD-L2, respectively) play an important inhibitory role in immune reactions. We aimed to illustrate the expression of these molecules in BA. METHODS: Liver specimens were obtained from infants with BA during the Kasai procedure (early BA) and liver transplantation (late BA)...
March 22, 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/28331807/transmission-of-hepatitis-d-virus-between-spouses-a-longitudinal-study-of-the-first-reported-canadian-case
#13
Carla Osiowy, Anton Andonov, Kevin Fonseca, Ken Swidinsky, Elizabeth Giles, Andrew Mason, Carla S Coffin
In chronic hepatitis B (CHB), hepatitis D virus (HDV) superinfection can lead to acute liver failure. The incidence of HDV superinfection is unknown, but is often detected in immigrants from HDV endemic countries. In this report, we characterize long-term clinical and virological outcomes in a hepatitis B virus (HBV) infected carrier before and after HDV superinfection, acquired from their spouse having HBV/HDV co-infection. A 38 year-old Mongolian male with CHB on anti-HBV therapy developed acute liver failure following HDV superinfection...
2017: IDCases
https://www.readbyqxmd.com/read/28331452/balloon-occlusion-technique-for-managing-portal-vein-hemorrhage-in-liver-transplantation
#14
John B Seal, Humberto Bohorquez, Naren Battula, Lucia DeGregorio, Emily Bugeaud, David S Bruce, Ian C Carmody, Ari J Cohen, George E Loss
BACKGROUND: Portal vein thrombosis (PVT) is relatively common among candidates for liver transplantation and can present significant intraoperative challenges. Depending on the extent of PVT, thromboendovenectomy (TEV), portal bypass, or systemic inflow may be required to restore portal inflow. While TEV is the most commonly used approach to restore anatomic portal inflow, portal vein injury and life-threatening hemorrhage are risks with this technique. CASE REPORT: We present a salvage technique for managing portal vein injury during TEV using intraluminal balloon occlusion of the portal vein during portal vein repair and reconstruction...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28331449/cyclin-d1-in-the-liver-role-of-noncanonical-signaling-in-liver-steatosis-and-hormone-regulation
#15
Kelley G Núñez, Janet Gonzalez-Rosario, Paul T Thevenot, Ari J Cohen
BACKGROUND: Cyclin D1 is an important protein for cell cycle progression; however, functions independent of the cell cycle have been described in the liver. Cyclin D1 is also involved in DNA repair, is overexpressed in many cancers, and functions as a proto-oncogene. The lesser-known roles of Cyclin D1, specifically in hepatocytes, impact liver steatosis and hormone regulation in the liver. METHODS: A comprehensive search of PubMed was conducted using the keywords Cyclin D1, steatosis, lipogenesis, and liver transplantation...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28331447/novel-biliary-reconstruction-techniques-during-liver-transplantation
#16
Ian C Carmody, John Romano, Humberto Bohorquez, Emily Bugeaud, David S Bruce, Ari J Cohen, John Seal, Trevor W Reichman, George E Loss
BACKGROUND: Biliary complications remain a significant problem following liver transplantation. Several surgical options can be used to deal with a significant size mismatch between the donor and recipient bile ducts during the biliary anastomosis. We compared biliary transposition to recipient biliary ductoplasty in cadaveric liver transplant. METHODS: A total of 33 reconstructions were performed from January 1, 2005 to December 31, 2013. In the biliary transposition group (n=23), 5 reconstructions were performed using an internal stent (5 or 8 French pediatric feeding tube), and 18 were performed without...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28331444/post-liver-transplant-delirium-increases-mortality-and-length-of-stay
#17
Nathan Oliver, Humberto Bohorquez, Stephanie Anders, Andrew Freeman, Kerry Fine, Emily Ahmed, David S Bruce, Ian C Carmody, Ari J Cohen, John Seal, Trevor W Reichman, George E Loss
BACKGROUND: Incidence of delirium after liver transplantation (LT) has been reported to occur in 10%-47% of patients and is associated with increased hospital and intensive care unit lengths of stay and poor outcomes. METHODS: Our primary objective was to evaluate the incidence and predisposing risk factors for developing delirium after LT. Our secondary objectives were to describe how delirium is managed in patients after LT, to examine the utilization of resources associated with delirium after LT, and to analyze the outcomes of patients who were treated for delirium after LT...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28330599/impact-of-graft-preservation-solutions-for-liver-transplantation-on-early-cytokine-release-and-postoperative-organ-dysfunctions-a-pilot-study
#18
H Brisson, C Arbelot, A Monsel, C Parisot, M Girard, E Savier, C Vezinet, Q Lu, J-C Vaillant, J-L Golmard, G Gorochov, O Langeron, J-J Rouby
INTRODUCTION: During liver transplantation, graft ischemia-reperfusion injury leads to a systemic inflammatory response producing postoperative organ dysfunctions. The aim of this observational and prospective study was to compare the impact of Solution de conservation des organes et tissus (SCOT) 15 and University of Wisconsin (UW) preservation solutions on early cytokine release, postreperfusion syndrome and postoperative organ dysfunctions. METHODS: Thirty-seven liver transplantations were included: 21 in UW Group and 16 in SCOT 15 group...
March 15, 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28329027/prevalence-and-predictors-for-compensated-advanced-chronic-liver-disease-c-acld-in-patients-with-chronic-hepatitis-delta-virus-hdv-infection
#19
Ingrid Couto, Marilu Victoria, Valdiléa G Veloso, Lorena Rodrigues, Beatriz Grinsztejn, Marcus Lacerda, Flamir Victoria, Hugo Perazzo
OBJECTIVE: The study aimed to evaluate the prevalence and predictor factors for compensated advanced chronic liver disease (c-ACLD) in patients with hepatitis Delta virus (HDV) infection. METHODS: This cross-sectional study included consecutive HDV-infected patients defined by positive anti-HDV. Patients with hepatitis C coinfection, liver transplantation or presence of conditions that limit liver (LSM) or spleen stiffness measurement (SSM) were excluded. Blood tests, abdominal ultrasound, SSM and LSM by transient elastography (FibroScan®) were performed at the same day...
2017: PloS One
https://www.readbyqxmd.com/read/28328734/practical-recommendations-for-long-term-management-of-modifiable-risks-in-kidney-and-liver-transplant-recipients-a-guidance-report-and-clinical-checklist-by-the-consensus-on-managing-modifiable-risk-in-transplantation-commit-group
#20
James M Neuberger, Wolf O Bechstein, Dirk R J Kuypers, Patrizia Burra, Franco Citterio, Sabina De Geest, Christophe Duvoux, Alan G Jardine, Nassim Kamar, Bernhard K Krämer, Herold J Metselaar, Frederik Nevens, Jacques Pirenne, Manuel L Rodríguez-Perálvarez, Didier Samuel, Stefan Schneeberger, Daniel Serón, Pavel Trunečka, Giuseppe Tisone, Teun van Gelder
Short-term patient and graft outcomes continue to improve after kidney and liver transplantation, with 1-year survival rates over 80%; however, improving longer-term outcomes remains a challenge. Improving the function of grafts and health of recipients would not only enhance quality and length of life, but would also reduce the need for retransplantation, and thus increase the number of organs available for transplant. The clinical transplant community needs to identify and manage those patient modifiable factors, to decrease the risk of graft failure, and improve longer-term outcomes...
April 2017: Transplantation
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