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Hyperbilirubinemia after liver transplantation

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https://www.readbyqxmd.com/read/28834072/a-severely-cholestatic-liver-graft-can-be-successfully-used-in-deceased-donor-liver-transplantation
#1
Seisuke Sakamoto, Kengo Sasaki, Hajime Uchida, Soichi Narumoto, Toshihiro Kitajima, Rie Irie, Akinari Fukuda, Takako Yoshioka, Mureo Kasahara
The shortage of deceased organs is still a serious issue in Japan. A proactive approach to using liver grafts from extended criteria donors (ECDs) may be one way of expanding the donor pool; however, if it is recklessly attempted, a recipient receiving such a marginal graft can be at risk of mortality due to the primary non-function or a delayed graft function. We herein report the successful outcome of a recipient receiving a severely cholestatic graft that was considered transplantable because it lacked features characteristic of a long duration of "cholestasis" according to the precise interpretation of a donor biopsy...
August 18, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28748879/early-clinical-manifestations-and-laboratory-findings-before-and-after-treatment-of-cytomegalovirus-infection-in-kidney-transplant-patients
#2
Wasim Ahmed Siddiqui, Issa Al Salmi, Amitabh Jha, Abbas Pakkyara, Mohammad Yasir, Faissal A M Shaheen
Cytomegalovirus (CMV) is one of the most frequently encountered opportunistic viral pathogens in kidney transplant recipients. In this study, we retrospectively reviewed all living related and unrelated kidney transplant recipients on regular follow-up from January 2006 to June 2015, who were suspected to have CMV clinically and confirmed by DNA polymerase chain reaction (PCR). CMV PCR was detected in 102 kidney transplant recipients. The median time of detection after kidney transplant was 21 months, ranging from 15 days to 84 months...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28437326/favorable-outcomes-of-preterm-infants-with-parenteral-nutrition-associated-liver-disease-treated-with-intravenous-fish-oil-based-lipid-emulsion
#3
Michael Sorrell, Alvaro Moreira, Kay Green, Rachel Jacob, Robin Tragus, Laura Keller, Amy Quinn, Donald McCurnin, Alice Gong, Abeer El Sakka, Naveen Mittal, Cynthia Blanco
OBJECTIVES: The aim of the study was to determine the acute and long-term outcomes of preterm infants treated with an intravenous fish oil-based lipid emulsion (FishLE) for parenteral nutrition-associated liver disease (PNALD). METHODS: Preterm infants 14 days to 24 months of age with anatomic short gut or severe intestinal dysmotility, serum direct bilirubin ≥4 mg/dL, and requiring >60% calories from parenteral nutrition were eligible. Enrolled infants received 1 g · kg · day of FishLE until resolution of direct hyperbilirubinemia or return of enteral nutrition...
May 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28403210/molecular-adsorbent-recirculating-system-mars-in-acute-liver-injury-and-graft-dysfunction-results-from-a-case-control-study
#4
Hans U Gerth, Michele Pohlen, Gerold Thölking, Hermann Pavenstädt, Marcus Brand, Christian Wilms, Anna Hüsing-Kabar, Dennis Görlich, Iyad Kabar, Hartmut H J Schmidt
BACKGROUND: The primary therapeutic goals in the treatment of liver injury are to support liver regeneration or bridge the gap to liver transplantation (LT). Molecular adsorbent recirculating system (MARS) therapy has shown beneficial effects for specific symptoms of liver failure; however, general survival advantages have not yet been demonstrated. AIM: We studied the effects of MARS therapy compared to standard medical treatment (SMT) in two patient cohorts: in patients with an acute liver injury and in those with graft dysfunction (GD)...
2017: PloS One
https://www.readbyqxmd.com/read/28340835/can-patients-who-develop-cerebral-death-in-fulminant-liver-failure-despite-liver-transplantation-be-previously-forseen
#5
K B Sarici, S Karakas, E Otan, V Ince, C Koc, S Koc, H Bayraktar, C Aydin, C Kayaalp, S Gungor, Y Kablan, S Yilmaz
BACKGROUND: The outcome of medical treatment is worse in fulminant liver failure (FLF) developing on acute or chronic ground. Recently, liver transplantations with the use of living and cadaveric donors have been performed in these diseases and good results obtained. In this study, we aimed to present the factors affecting the recovery of cerebral functions after liver transplantation in hepatic encephalopathy (HE) developing in FLF, to identify irreversible patient groups and to prevent unnecessary liver transplantation...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28138249/propylthiouracil-induced-liver-failure-and-artificial-liver-support-systems-a-case-report-and-review-of-the-literature
#6
Dong-Bo Wu, En-Qiang Chen, Lang Bai, Hong Tang
BACKGROUND: Antithyroid drugs carry a potential risk of hepatotoxicity. Propylthiouracil (PTU) is commonly prescribed for patients with hyperthyroidism. PTU, however, can induce liver injury, ranging from mild asymptomatic elevation of aminotransferases to acute liver failure (ALF). CASE PRESENTATION: This case reports on a 16-year-old Chinese girl with hyperthyroidism, who was admitted to our hospital for jaundice, nausea, and fatigue associated with severe hyperbilirubinemia and coagulopathy...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28032131/endovascular-mechanical-thromboaspiration-of-right-hepatic-arterial-thrombosis-after-liver-transplantation
#7
Roberto Gandini, Daniel Konda, Luca Toti, Sergio Abrignani, Stefano Merolla, Giuseppe Tisone, Roberto Floris
A 56-year-old male Patient presented 27 days after a liver transplantation (LT) with fever and hyperbilirubinemia. He underwent CT examination resulting in a diagnosis of right hepatic artery (HA) occlusion with hepatic bilomas. Once placed a long right femoral 6F introducer at the origin of the HA, a 0.014" guidewire was advanced over the thrombus, in a segmental branch. A 4MAX (Penumbra, Alameda, USA) catheter was advanced and withdrawn under constant aspiration until complete clot removal was achieved. Follow-up CT and D-US assessments at 12 months demonstrated regular HA patency and bilomas reduction...
April 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27932174/salvage-splenic-artery-embolization-for-saving-falling-living-donor-graft-due-to-portal-overflow-a-case-report
#8
H Okabe, T Yoshizumi, T Ikegami, H Uchiyama, N Harimoto, S Itoh, K Kimura, H Baba, Y Maehara
Portal decompression is an approach for reducing portal overflow caused by small-for-size syndrome. We report the case of a patient who recovered from rapidly progressing hyperbilirubinemia caused by a small graft by decompressing portal overflow with splenic artery embolization following a living donor liver transplantation (LDLT). The patient was a 54-year-old man with end-stage liver disease secondary to alcoholic liver cirrhosis; the donor was his 54-year-old wife. The graft volume of the left lobe was 444 mL, which was 34...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27863862/extracorporeal-membrane-oxygenation-with-multiple-organ-failure-can-molecular-adsorbent-recirculating-system-therapy-improve-survival
#9
Bailey E Sparks, Nicholas C Cavarocchi, Hitoshi Hirose
BACKGROUND: Liver dialysis, molecular adsorbent recirculating system (MARS) particularly, has been used in liver failure to bridge to transplantation. We expanded the indication for MARS to patients with acute shock liver failure and cardiopulmonary failure on extracorporeal membrane oxygenation (ECMO), aiming to improve survival to wean from ECMO. METHODS: Retrospective chart analysis of patients on ECMO between 2010 and 2015 found 28 patients who met the criteria for acute liver failure, diagnosed by hyperbilirubinemia (total bilirubin ≥10 mg/dl) or by elevated transaminase (alanine transaminase >1,000 IU/liter)...
January 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27804185/early-post-transplant-hyperbilirubinemia-is-a-possible-predictive-factor-for-developing-neurological-complications-in-pediatric-living-donor-liver-transplant-patients-receiving-tacrolimus
#10
Kazushige Sato, Yoshinobu Kobayashi, Atsushi Nakamura, Daizo Fukushima, Susumu Satomi
The cause of post-transplant CNI-NCs is multifactorial and not ascribed solely to CNI toxicity. A total of 90 children (aged <20 years) who underwent LDLT were evaluated to investigate the predictive factors associated with CNI-NCs. Twelve patients (13.3%) developed CNI-NCs after LDLT (age range, 2-15 years). The symptoms of CNI-NCs were seizures, VD, and stupor. The median onset of CNI-NCs was 10 days (range, 5-30 days) post-transplant. In the univariate analysis, higher recipient age at LDLT, donor age and recipient's BW, lower actual GV/SLV and TAC dosage/BW, and higher mean T-Bil and sodium level for 7 days after transplantation were independently significantly associated with TAC-NCs...
March 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/27796825/complete-response-to-post-transplant-lymphoproliferative-disorder-by-surgical-resection-and-rituximab-after-living-donor-liver-re-transplantation-for-recurrent-primary-sclerosing-cholangitis
#11
Koichiro Haruki, Hiroaki Shiba, Junichi Shimada, Norimitsu Okui, Tomonori Iida, Katsuhiko Yanaga
Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication of solid organ transplantation. We herein report a case of PTLD after living-donor liver re-transplantation (reLDLT) for recurrent primary sclerosing cholangitis (PSC), for which complete response was achieved by surgical resection and rituximab. A 47-year-old man, who had undergone living-donor liver transplantation (LDLT) twice at age of 43 and 45 years for end-stage liver disease firstly for PSC and secondary for recurrent PSC, suffered liver dysfunction due to an acute cellular rejection (ACR) 17 months after reLDLT...
February 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27574883/favorable-outcomes-of-preterm-infants-with-pnald-treated-with-iv-fish-oil-based-lipid-emulsion
#12
Michael Sorrell, Alvaro Moreira, Kay Green, Rachel Jacobs, Robin Tragus, Laura Keller, Amy Quinn, Donald McCurnin, Alice Gong, Abeer El Sakka, Naveen Mittal, Cynthia Blanco
OBJECTIVES: To study the acute and long-term outcomes of preterm infants treated with an intravenous (IV) fish oil-based lipid emulsion (FishLE) for parenteral nutrition-associated liver disease (PNALD). METHODS: Preterm infants 14 days to 24 months of age with anatomic short gut or severe intestinal dysmotility, serum direct bilirubin ≥4 mg/dL, and requiring >60% calories from PN were eligible. Enrolled infants received 1 g/kg/day of FishLE until resolution of direct hyperbilirubinemia or return of enteral nutrition...
August 27, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27563464/accuracy-of-hepatobiliary-scintigraphy-after-liver-transplantation-and-liver-resection
#13
Manuel Eckenschwiller, Hanns Ackermann, Wolf O Bechstein, Frank Grünwald
Background and Aims. Biliary complications are the most frequent complications after common liver surgeries. In this study, accuracy of hepatobiliary scintigraphy (HBS) and impact of hyperbilirubinemia were evaluated. Methods. Between November 2007 and February 2016, 131 patients underwent hepatobiliary scintigraphy after having liver surgery. 39 patients with 42 scans after LTX (n = 13) or hepatic resection (n = 26) were evaluated in the study; 27 were male, with mean age 60 years. The subjects underwent hepatobiliary scintigraphy with Tc-99m labeled Mebrofenin...
2016: International Journal of Molecular Imaging
https://www.readbyqxmd.com/read/27437193/living-related-liver-transplantation-in-an-infant-with-neonatal-hemochromatosis
#14
Shin Jie Choi, Jong Sub Choi, Peter Chun, Jung Kyung Yoo, Jin Soo Moon, Jae Sung Ko, Woo Sun Kim, Gyeong Hoon Kang, Nam-Joon Yi
Neonatal hemochromatosis (NH) is a severe neonatal liver injury that is confirmed by extra-hepatic iron accumulation. Although a recent study described treating NH with exchange transfusions and intravenous immunoglobulin, liver transplantation should be considered for patients with severe liver failure that does not respond to other medical treatment. Herein, we report the case of a two-month-old female infant who presented with persistent ascites and hyperbilirubinemia. Her laboratory findings demonstrated severe coagulopathy, high indirect and direct bilirubin levels, and high ferritin levels...
June 2016: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/27326811/patterns-of-early-allograft-dysfunction-in-adult-live-donor-liver-transplantation-the-a2all-experience
#15
James J Pomposelli, Nathan P Goodrich, Jean C Emond, Abhinav Humar, Talia B Baker, David R Grant, Robert A Fisher, John P Roberts, Kim M Olthoff, Brenda W Gillespie, Robert M Merion
BACKGROUND: Early allograft dysfunction (EAD) after living donor liver transplantation (LDLT) has often been attributed to inadequate graft size, and termed small-for-size syndrome. Early allograft dysfunction definitions include a variable constellation of findings, including hyperbilirubinemia, coagulopathy, encephalopathy, and ascites formation. Among putative causes of EAD after LDLT are excessive portal pressure and/or flow. Our objective was to evaluate patterns of EAD after LDLT...
July 2016: Transplantation
https://www.readbyqxmd.com/read/27313607/recipient-hyperbilirubinemia-may-reduce-ischemia-reperfusion-injury-but-fails-to-improve-outcome-in-clinical-liver-transplantation
#16
Mihai Oltean, Christian Barrenäs, Paulo Ney Martins, Gustaf Herlenius, Bengt Gustafsson, Styrbjörn Friman, William Bennet
Background. Exogenous bilirubin may reduce experimental ischemia-reperfusion injury (IRI) due to its antioxidant properties. We studied if early graft exposure to high bilirubin levels in the recipient affects the early IRI and outcomes after liver transplantation (LTx). Methods. In 427 LTx patients, the AUROC curve based on bilirubin and AST at day 1 identified a cutoff of 2.04 mg/dL for the recipient pretransplant bilirubin. Recipients were grouped as having low (group L, n = 152) or high (group H, n = 275) bilirubin...
2016: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/27306278/effects-of-therapeutic-plasma-exchange-on-early-allograft-dysfunction-after-liver-transplantation
#17
Wonho Choe, Seog-Woon Kwon, Sung-Soo Kim, Shin Hwang, Gi-Won Song, Sung-Gyu Lee
BACKGROUND: Early allograft dysfunction (EAD) is a serious complication of liver transplantation (LT) and is associated with graft failure, which can result in patient mortality. Due to the shortage of organs for retransplantation, only a small proportion of EAD patients undergo retransplantation. Thus, liver support is needed for most patients with EAD. METHODS: We evaluated the effects of therapeutic plasma exchange (TPE) in EAD patients. EAD was defined as a sustained hyperbilirubinemia (≥10 mg/dL) within 30 days of LT without concurrent biliary complications...
June 16, 2016: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/26838802/potential-pitfalls-on-the-99m-tc-mebrofenin-hepatobiliary-scintigraphy-in-a-patient-with-biliary-atresia-splenic-malformation-syndrome
#18
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
https://www.readbyqxmd.com/read/26711920/brain-abscess-in-hepatopulmonary-syndrome-associated-with-biliary-atresia
#19
Keiichi Morita, Hiroaki Fukuzawa, Kosaku Maeda
The first-choice therapy for biliary atresia (BA) is Kasai hepatoportoenterostomy, which has been shown to greatly improve outcome. Various long-term complications, however, such as portal hypertension and hepatopulmonary syndrome (HPS), can occur in patients with native liver. A rare case of brain abscess in an 11-year-old girl with HPS associated with BA is reported. The patient underwent hepatoportoenterostomy for BA at 53 days of age, with resolution of hyperbilirubinemia. At 10 years of age, she was diagnosed with severe HPS with right-to-left shunting, and preparations for liver transplantation proceeded...
December 2015: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/26707296/donor-safety-and-recipient-liver-function-after-right-lobe-liver-transplantation-from-living-donors-with-gilbert-syndrome
#20
W H Kang, S Hwang, G W Song, D H Jung, K H Kim, G C Park, T Y Ha, C S Ahn, D B Moon, Y I Yoon, M H Shin, W J Kim, S H Kim, S G Lee
BACKGROUND: Donor safety is the most important aspect in living-donor liver transplantation (LDLT). Gilbert syndrome is an autosomal recessive condition that is a common cause of isolated unconjugated hyperbilirubinemia, and its prevalence is not negligibly low in the general population. This study intended to assess donor safety and recipient liver function after LDLT with the use of right liver grafts from living donors with Gilbert syndrome. METHODS: Among 2,140 right liver transplantations performed from January 2002 to December 20113 at our institution, we identified 12 living donors (0...
December 2015: Transplantation Proceedings
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