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Jaundice after liver transplantation

Dellys M Soler, Antonio I Del Valle, David Fernandez-Lube, Benjamin L Shneider
OBJECTIVE: Specific inherited disorders may be more common in island communities. Prior case reports suggest that cholestatic liver diseases may constitute a group of these inherited disorders in Puerto Rico. A cross-sectional survey of liver diseases in children was conducted to assess this hypothesis. METHODS: A cross-sectional analysis was performed in patients with chronic cholestasis at "Hospital Pediátrico Universitario" in San Juan, Puerto Rico. Ten potential participants with high gamma-glutamyl transpeptidase (GGTP) cholestasis were identified...
December 2016: Puerto Rico Health Sciences Journal
Tomohide Hori, Yasuharu Onishi, Hideya Kamei, Nobuhiko Kurata, Masatoshi Ishigami, Yoji Ishizu, Yasuhiro Ogura
Hepatitis C recurrence continues to present a major challenge in liver transplantation (LT). Approximately 10% of hepatitis C virus (HCV)-positive recipients will develop fibrosing cholestatic hepatitis (FCH) after LT. FCH is clinically characterized as marked jaundice with cholestatic hepatic dysfunction and high titers of viremia. Pathologically, FCH manifests as marked hepatocyte swelling, cholestasis, periportal peritrabecular fibrosis and only mild inflammation. This progressive form usually involves acute liver failure, and rapidly results in graft loss...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Yukihiro Sanada, Yasunaru Sakuma, Hideki Sasanuma, Atsushi Miki, Takumi Katano, Yuta Hirata, Noriki Okada, Naoya Yamada, Yoshiyuki Ihara, Taizen Urahashi, Naohiro Sata, Yoshikazu Yasuda, Koichi Mizuta
Utilizing the opened round ligament as venous grafts during liver transplantation is useful but controversial, and there are no pathological analyses of this procedure. Herein, we describe the first reported case of a pathological analysis of an opened round ligament used as a venous patch graft in a living donor liver transplantation (LDLT). A 13-year-old female patient with biliary atresia underwent LDLT using a posterior segment graft from her mother. The graft had two hepatic veins (HVs), which included the right HV (RHV; 15 mm) and the inferior RHV (IRHV; 20 mm)...
September 14, 2016: World Journal of Gastroenterology: WJG
Chiyoe Shirota, Hiroo Uchida, Yasuyuki Ono, Naruhiko Murase, Takahisa Tainaka, Kazuki Yokota, Kazuo Oshima, Ryo Shirotsuki, Akinari Hinoki, Hisami Ando
BACKGROUND: The indications for and efficacy of revision of portoenterostomy (PE) for biliary atresia (BA) needs to be reassessed in an era of liver transplantation. We therefore reviewed the long-term outcomes following revision of PE. METHODS: This was a retrospective study of the medical records of patients with BA who underwent PE and revision of PE. We investigated the role of revision on outcomes of jaundice-free native liver survival (approval number: 2015-0094)...
September 3, 2016: Journal of Hepato-biliary-pancreatic Sciences
Tomohide Hori, Yasuharu Onishi, Hideya Kamei, Nobuhiko Kurata, Masatoshi Ishigami, Yoji Ishizu, Yasuhiro Ogura
BACKGROUND Hepatitis C recurrence is a serious matter after liver transplantation (LT). Approximately 10% of hepatitis C virus (HCV) positive recipients develop fibrosing cholestatic hepatitis (FCH). FCH rapidly results in graft loss. Currently, direct-acting antivirals (DAAs) are effective and safe for hepatitis C, even after LT. However, only a few cases of successfully treated FCH after LT have been reported. We present FCH in a complicated case with sepsis and portal flow obstruction after LT. CASE REPORT A 66-year-old man underwent cadaveric LT...
2016: American Journal of Case Reports
Samuel Raimundo Fernandes, Antonio T Alves, Margarida Barreto Cortes, Helena Cortez-Pinto
We report the case of a 37-year-old man with a previous bone marrow transplantation presenting with abdominal pain, diarrhoea and jaundice. Laboratory evaluation showed marked elevated liver enzymes, amylase and lipase with ultrasonographic evidence of acute alithiasic pancreatitis. Liver biopsy was compatible with graft-versus-host disease and toxic hepatitis. The patient rapidly improved after increasing immunosuppression. Although gastrointestinal manifestations are common in graft-versus-host disease, clinical acute pancreatitis is rarely seen...
2016: BMJ Case Reports
Hideyuki Sasaki, Hiromu Tanaka, Motoshi Wada, Takuro Kazama, Megumi Nakamura, Hironori Kudo, Ryoji Okubo, Tsuyoshi Sakurai, Masaki Nio
PURPOSE: Long-term survivors of biliary atresia (BA) sometimes experience liver dysfunction. We evaluated the prognostic factors for long-term native liver survival (NLS) in BA patients after the Kasai procedure. METHODS: This study included 67 patients with jaundice disappearance after the Kasai procedure performed between 1972 and 1995, and NLS for over 10 years. We retrospectively evaluated the clinical parameters, including the type of BA, age at the Kasai procedure, medical conditions, and treatments...
September 2016: Pediatric Surgery International
Qusay A Abdoh, Asma M Alnajjar, Faisal A Abaalkhail, Mohammed Al Sebayel, Hussa F Al-Hussaini, Waleed K Al-Hamoudi, Hazem Helmy, Mohamad Almansour, Hussien A Elsiesy
HEHE is a rare neoplasm of vascular origin that occurs in the liver; UNOS reported a favorable outcome after liver transplantation in 110 patients with 1-year and 5-year survival of 80% and 64%. Case Report. A 40-year-old lady presented with a three-month history of right upper abdominal pain with nausea, vomiting, and significant loss of weight associated with scleral icterus and progressive abdominal distension. Examination revealed jaundice, hepatomegaly, and ascites. Serum bilirubin was 26.5 mg/dL and ALP was 552 CT...
2016: Canadian Journal of Gastroenterology & Hepatology
Kevin Chatham-Stephens, Ethel Taylor, Art Chang, Amy Peterson, Johnni Daniel, Colleen Martin, Patricia Deuster, Rebecca Noe, Stephanie Kieszak, Josh Schier, Karl Klontz, Lauren Lewis
In September 2013, the Hawaii Department of Health (HDOH) was notified of seven adults who developed acute hepatitis after taking OxyELITE Pro™, a weight loss and sports dietary supplement. CDC assisted HDOH with their investigation, then conducted case-finding outside of Hawaii with FDA and the Department of Defense (DoD). We defined cases as acute hepatitis of unknown etiology that occurred from April 1, 2013, through December 5, 2013, following exposure to a weight loss or muscle-building dietary supplement, such as OxyELITE Pro™...
July 1, 2016: Drug Testing and Analysis
Victoria Shakhin, Kishore Iyer, Jaime Chu, Archana Ramaswami, Neil Lester, Ronen Arnon
Small bowel obstruction in a pediatric patient following liver transplant often results from adhesions, hernias, or post-transplant lymphoproliferative disease. Here, we present an unusual and previously unreported entity - Roux-en-Y intussusception in an eight-yr-old female several years after liver transplantation. Although a rare complication, Roux-en-Y intussusception should be considered as a potential etiology in the patient presenting with bowel obstruction, with specific attention to acute presentation accompanying jaundice...
September 2016: Pediatric Transplantation
Palittiya Sintusek, Voranush Chongsrisawat, Yong Poovorawan
OBJECTIVE: Wilson's disease (WD) is a rare autosomal recessive disorder characterized by copper accumulation. Clinical presentations are extraordinarily diverse, and currently no single diagnostic test can confirm WD with high accuracy. A complete understanding of the presentations and improved diagnostic methods are important for disease management. The authors' aimed to examine disease characteristics, management, and treatment outcome of WD in children, especially when genetic analysis and liver copper measurements were limited...
February 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Anil Arora, Naresh Bansal, Praveen Sharma, Vikas Singla, Varun Gupta, Pankaj Tyagi, Manish Malik, Ashish Kumar
BACKGROUND: Hepatitis C Virus (HCV) infection is common in patients with end stage renal disease (ESRD) and is an important cause of liver disease. We describe the demographic, clinical and biochemical profile of these patients from a tertiary care center of north India. METHODS: Records of consecutive patients of HCV infection with ESRD on maintenance hemodialysis or with renal transplantation who presented to our unit from January 2009 to June 2013 were analyzed...
March 2016: Journal of Clinical and Experimental Hepatology
Yosra Kerkeni, Amine Ksiaa, Mohsen Belghith, Lassad Sahnoun, Kais Maazoun, I Krichene, Mongi Mekki, Nouri Abdellatif
BACKGROUND: Biliary atresia (BA) is a progressive inflammatory destructive process of the bile ducts occurring in about one of every 20.000 live births. If left untreated, biliary atresia can lead to liver failure. AIM: This is the first study on biliary atresia from Africa. The Aim of our study is to describe the clinical and prognostic aspects of biliary atresia in a Tunisian medical centre, where integrated medico-surgical management of children with liver diseases is lacking and liver transplant is not available...
November 2015: La Tunisie Médicale
Piyush Ranjan, Rinkesh Kumar Bansal, N Mehta, S Lalwani, V Kumaran, M K Sachdeva, M Kumar, S Nundy
BACKGROUND: Liver transplantation has become common in India over the last decade and biliary strictures after the procedure cause a significant morbidity. Endoscopic retrograde cholangiopancreatography (ERCP) is a safe and effective treatment modality for post-transplant biliary strictures so we decided to evaluate prospectively the outcomes of endoscopic treatment in post-living donor liver transplantation (LDLT) biliary strictures. METHODS: We studied ten consecutive patients who had developed biliary strictures (out of 312 who had undergone liver transplantation between June 2009 and June 2013) and had been referred to the Department of Gastroenterology for management...
January 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Jane Maestri Brittain, Lise Borgwardt
Biliary atresia (BA) is an obliterative cholangiopathy affecting 1:10.000-14.000 of newborns. Infants with Biliary Atresia Splenic Malformation syndrome (BASM) are a subgroup of BA patients with additional congenital anomalies. Untreated the disease will result in fatal liver failure within the first years of life. Kasai portoenterostomy restores bile flow and delay the progressive liver damage thereby postponing liver transplantation. An early diagnosis is of most importance to ensure the effectiveness of the operation...
2016: Diagnostics
Manuel Mendizabal, Marcelo Oscar Silva
Acute liver failure is a critical medical condition defined as rapid development of hepatic dysfunction associated with encephalopathy. The prognosis in these patients is highly variable and depends on the etiology, interval between jaundice and encephalopathy, age, and the degree of coagulopathy. Determining the prognosis for this population is vital. Unfortunately, prognostic models with both high sensitivity and specificity for prediction of death have not been developed. Liver transplantation has dramatically improved survival in patients with acute liver failure...
January 28, 2016: World Journal of Gastroenterology: WJG
Laure Nizery, Christophe Chardot, Samira Sissaoui, Carmen Capito, Alexandra Henrion-Caude, Dominique Debray, Muriel Girard
Biliary atresia (BA) is a rare and severe inflammatory and obliterative cholangiopathy that affects both extra- and intrahepatic bile ducts. BA symptoms occur shortly after birth with jaundice, pale stools and dark urines. The prognosis of BA has dramatically changed in the last decades: before the Kasai operation most BA patients died, while nowadays with the sequential treatment with Kasai operation±liver transplantation BA patient survival is close to 90%. Early diagnosis is very important since the chances of success of the Kasai procedure decrease with time...
June 2016: Clinics and Research in Hepatology and Gastroenterology
Daisuke Ito, Tomohiro Tanaka, Nobuhisa Akamatsu, Kyoji Ito, Kiyoshi Hasegawa, Yoshihiro Sakamoto, Hayato Nakagawa, Hidetaka Fujinaga, Norihiro Kokudo
The authors present a case of recurrent acute liver failure because of occupational exposure to organic solvents. A 35-year-old man with a 3-week history of worsening jaundice and flu-like symptoms was admitted to our hospital. Viral hepatitis serology and autoimmune factors were negative. The authors considered liver transplantation, but the patient's liver function spontaneously recovered. Liver biopsy revealed massive infiltration of neutrophils, but the cause of the acute hepatitis was not identified. Four months after discharge, the patient's liver function worsened again...
January 2016: Medicine (Baltimore)
Mark Thursz, Ewan Forrest, Paul Roderick, Christopher Day, Andrew Austin, John O'Grady, Stephen Ryder, Michael Allison, Dermot Gleeson, Anne McCune, David Patch, Mark Wright, Steven Masson, Paul Richardson, Luke Vale, Jane Mellor, Louise Stanton, Megan Bowers, Ian Ratcliffe, Nichola Downs, Scott Kirkman, Tara Homer, Laura Ternent
BACKGROUND: Alcoholic hepatitis (AH) is a distinct presentation of alcoholic liver disease arising in patients who have been drinking to excess for prolonged periods, which is characterised by jaundice and liver failure. Severe disease is associated with high short-term mortality. Prednisolone and pentoxifylline (PTX) are recommended in guidelines for treatment of severe AH, but trials supporting their use have given heterogeneous results and controversy persists about their benefit. OBJECTIVES: The aim of the clinical effectiveness and cost-effectiveness of STeroids Or Pentoxifylline for Alcoholic Hepatitis trial was to resolve the clinical dilemma on the use of prednisolone or PTX...
December 2015: Health Technology Assessment: HTA
H Imai, H Kamei, Y Onishi, K Yamada, Y Ishizu, M Ishigami, H Goto, Y Ogura
A 39-year-old man was diagnosed with allopurinol-induced hepatic injury. He did not show any sign of hepatic encephalopathy, but his serum total bilirubin level was >40 mg/dL when he visited the local hospital. The therapeutic effects of initial medical treatments were transient, and both renal function and coagulation ability were gradually deteriorated. Four months after the onset of hepatic injury, he was referred to our hospital for the purpose of liver transplantation (LT). Although he was wasting and severely jaundiced, his consciousness level was not disturbed at all, with normal serum ammonia blood concentration before LT...
November 2015: Transplantation Proceedings
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