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hepatitis, Liver transplant

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https://www.readbyqxmd.com/read/28634131/cost-effectiveness-of-pre-versus-post-liver-transplant-hepatitis-c-treatment-with-direct-acting-antivirals
#1
Sumeyye Samur, Brian Kues, Turgay Ayer, Mark S Roberts, Fasiha Kanwal, Chin Hur, Drew Michael S Donnell, Raymond T Chung, Jagpreet Chhatwal
BACKGROUND & AIMS: Oral direct-acting antivirals (DAAs) for hepatitis C virus (HCV) treatment offer new hope to both pre- and post-liver transplant (LT) patients. However, whether to treat HCV patients pre- versus post-LT is not clear, as treatment can improve liver function but could reduce the chance of receiving a LT while on the waiting list. Our objective was to evaluate the cost-effectiveness of pre-LT versus post-LT HCV treatment with oral DAAs in decompensated cirrhotic patients on the LT waiting list...
June 17, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28631103/transesophageal-echocardiography-in-orthotopic-liver-transplantation-a-comprehensive-intraoperative-monitoring-tool
#2
REVIEW
Luigi Vetrugno, Federico Barbariol, Umberto Baccarani, Francesco Forfori, Giovanni Volpicelli, Giorgio Della Rocca
Intraoperative transesophageal echocardiography is a minimally invasive monitoring tool that can provide real-time visual information on ventricular function and hemodynamic volume status in patients undergoing liver transplantation. The American Association for the Study of Liver Diseases states that transesophageal echocardiography should be used in all liver transplant candidates in order to assess chamber sizes, hypertrophy, systolic and diastolic function, valvular function, and left ventricle outflow tract obstruction...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28630341/pig-model-mimicking-chronic-hepatitis-e-virus-infection-in-immunocompromised-patients-to-assess-immune-correlates-during-chronicity
#3
Dianjun Cao, Qian M Cao, Sakthivel Subramaniam, Danielle M Yugo, C Lynn Heffron, Adam J Rogers, Scott P Kenney, Debin Tian, Shannon R Matzinger, Christopher Overend, Nicholas Catanzaro, Tanya LeRoith, Heng Wang, Pablo Piñeyro, Nicole Lindstrom, Sherrie Clark-Deener, Lijuan Yuan, Xiang-Jin Meng
Chronic hepatitis E virus (HEV) infection is a significant clinical problem in immunocompromised individuals such as organ transplant recipients, although the mechanism remains unknown because of the lack of an animal model. We successfully developed a pig model of chronic HEV infection and examined immune correlates leading to chronicity. The conditions of immunocompromised patients were mimicked by treating pigs with an immunosuppressive regimen including cyclosporine, azathioprine, and prednisolone. Immunocompromised pigs infected with HEV progressed to chronicity, because 8/10 drug-treated HEV-infected pigs continued fecal virus shedding beyond the acute phase of infection, whereas the majority (7/10) of mock-treated HEV-infected pigs cleared fecal viral shedding at 8 wk postinfection...
June 19, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28629563/positron-emission-tomography-computed-tomography-in-patients-with-hepatocellular-carcinoma-undergoing-liver-transplantation-useful-necessary-or-irrelevant
#4
REVIEW
Pedro Antonio Cascales-Campos, Pablo Ramírez Romero, Marcel André Schneider, Victor Lopez-Lopez, José Luis Navarro, Laura Frutos, Jose Antonio Pons Miñano, Pascual Parrilla Paricio
Hepatocellular Carcinoma (HCC) is an aggressive tumor entity, with the only curative options being surgical resection or orthotopic liver transplantation (OLT). The presence of one single tumor nodule of less than 5 centimeters diameter or a maximum of 3 nodules, with the largest of these not exceeding 3 centimeters (Milan criteria) constitute the clinical situation in which the best results for OLT in patients with HCC have been achieved. The survival of patients fulfilling the Milan criteria after transplantation is comparable to patients with similar tumor stages without cirrhosis, undergoing hepatic resection...
June 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28628564/risk-of-post-transplant-hepatocellular-carcinoma-recurrence-is-higher-in-recipients-of-livers-from-male-than-female-living-donors
#5
Sangbin Han, Ju Dong Yang, Dong Hyun Sinn, Jong Man Kim, Gyu Sung Choi, Gangha Jung, Joong Hyun Ahn, Seonwoo Kim, Justin S Ko, Mi Sook Gwak, Choon Hyuck D Kwon, Michael D Leise, Geum-Youn Gwak, Julie K Heimbach, Gaab Soo Kim
OBJECTIVE: To evaluate the relationship between donor sex and hepatocellular carcinoma (HCC) recurrence after living donor liver transplantation. BACKGROUND: HCC shows a male predominance in incidence and recurrence after tumor resection due to sex differences in hepatic sex hormone receptors. There have been no studies evaluating the importance of donor sex on post-transplant HCC recurrence. METHODS: Of 384 recipients of livers, from living donors, for HCC: 104/120 who received grafts from female donors were matched with 246/264 who received grafts from male donors using propensity score matching, with an unfixed matching ratio based on factors like tumor biology...
June 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28627746/hepatic-perivascular-mesenchymal-stem-cells-with-myogenic-properties
#6
Sudheer Shenoy P, Bipasha Bose
Pericytes are multipotent mesenchymal stem cells (MSCs) located on the walls of blood vessels in various organs and are characterized as CD146(+) cells.. In this study, we have first immunohistochemically detected such pericytes in the perivascular regions of liver from two mouse genotypes namely wild-type (WT) and myostatin null (Mstn(-/-) ). We further isolated such pericytes using sorting as CD146(+) CD34(-) CD56(-) CD45(-) cells. The main finding of this study involve the contrasting -fibrogenic versus myogenic behavior of liver pericytes from WTMstn(-/-) ) mouse respectively...
June 19, 2017: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/28627403/accepting-hearts-from-hepatitis-c-positive-donor-can-we-expand-the-donor-pool
#7
Jonathan Grinstein, Laura M Lourenco, Helen S Te, John F Renz, Valluvan Jeevanandam, Nir Uriel
BACKGROUND: Until recently, transplantation from hepatitis C positive donors was relatively contraindicated as eradication of active hepatitis C previously required an interferon-based regimen which has been associated with rejection in solid organ transplantation. New interferon-free treatment regimens for hepatitis C have fewer adverse events and higher cure rates than interferon-based regimens. Interferon-free regimens have been shown to be safe in the liver transplantation literature but little is known about the safety and efficacy of treatment in heart transplantation...
June 13, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28626929/successful-liver-transplantation-for-non-resectable-desmoplastic-nested-spindle-cell-tumor-complicated-by-cushing-s-syndrome
#8
Sarah Tehseen, Louis Rapkin, Erwin Schemankewitz, Joseph F Magliocca, Rene Romero
Desmoplastic spindle cell tumors of liver are rare tumors of low malignant potential characterized by well-demarcated nests of spindle and epithelioid cells in a dense desmoplastic stroma. While surgery remains the definitive treatment, there have been reports of tumor recurrence locally and metastasis which respond poorly to chemotherapy. Hepatic transplant has been attempted in cases of recurrence or large size of primary tumor. Long-term follow-up and imaging surveillance are required as these tumors have shown a tendency for recurrence many years after initial therapy...
June 18, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28625011/liver-epithelioid-progenitor-cells-derived-from-fetal-luxi-bovine-alleviate-liver-fibrosis
#9
Kunfu Wang, Hao Liu, Jinjuan Yang, Caiyun Ma, Zebiao Zhang, Dong Zheng, Weijun Guan
Liver epithelioid progenitor cells (LEPCs) have important roles in liver therapy because of their hepatic differentiation potency in vitro and in vivo. Despite many researches on humans, mice, and rats, equivalent progenitor cells derived from bovine are relatively rare. The purpose of our current study is to characterize bovine LEPCs, and research on the cure potency of this heteroplastic progenitor cells on mice liver fibrosis. We have used collagenase IV digesting and differential adhesion method to isolate slabstone shape, EpCAM, LGR5, NCAM1 and SOX9 positive progenitor cells from fetal Luxi bovine liver...
June 17, 2017: Cytotechnology
https://www.readbyqxmd.com/read/28624110/interferon-free-antiviral-therapy-for-chronic-hepatitis-c-among-patients-in-the-liver-transplant-setting
#10
REVIEW
Marjolein van Tilborg, Raoel Maan, Adriaan J van der Meer, Robert J de Knegt
Chronic hepatitis C (HCV) infection remains a major public health problem with many infected individuals worldwide. The revolutionary discovery of highly effective direct-acting antivirals (DAAs) makes chronic HCV infection a curable disease, even in patients with advanced liver disease. Liver function may improve shortly after initiation of antiviral therapy in patients on the waiting list and could even obviate the need for transplantation. However, whether these short term benefits also result in a favorable prognosis on the long-term remains to be seen and this fuels the discussion whether DAAs should be used prior to liver transplantation in all patients...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28624107/recurrence-of-primary-sclerosing-cholangitis-primary-biliary-cholangitis-and-auto-immune-hepatitis-after-liver-transplantation
#11
REVIEW
T Visseren, S Darwish Murad
Liver transplantation is a well-accepted treatment for decompensated chronic liver disease due to primary sclerosing cholangitis (PSC), primary biliary cholangitis (PBC) and auto-immune hepatitis (AIH). Survival after liver transplantation is generally good with 1 and 5-year survival rates around 90% and 70-85%. After transplantation, however, these diseases recur in 8.6-27% (rPSC), 10.9-42.3% (rPBC) and 7-42% (rAIH), and this poses significant challenges in terms of management and graft outcome in these patients...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28624106/alcohol-use-and-smoking-after-liver-transplantation-complications-and-prevention
#12
REVIEW
José Ursic-Bedoya, Hélène Donnadieu-Rigole, Stéphanie Faure, Georges-Philippe Pageaux
The last thirty years have been very prosperous in the field of liver transplantation (LT), with great advances in organ conservation, surgical techniques, peri-operative management and long-term immunosuppression, resulting in improved patient and graft survival rates as well as quality of life. However, substance addiction after LT, namely alcohol and tobacco, results in short term morbidity together with medium and long-term mortality. The main consequences can be vascular (increased risk of hepatic artery thrombosis in smokers), hepatic (recurrent alcoholic cirrhosis in alcohol relapsers) and oncological (increased risk of malignancy in patients consuming tobacco and/or alcohol after LT)...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28624104/acute-kidney-injury-after-liver-transplantation-recent-insights-and-future-perspectives
#13
REVIEW
Jubi E de Haan, Ewout J Hoorn, Hilde R H de Geus
Acute kidney injury (AKI) is a common postoperative complication after liver transplantation (LT). The occurrence of postoperative AKI after LT (Post-LT AKI) is associated with inferior patient and graft outcomes. Post-LT AKI is multifactorial in origin and has been related to the severity of liver disease, pre-LT renal dysfunction, graft quality, perioperative events and toxicity of immunosuppressive therapy. Furthermore it is thought that hepatic ischaemia reperfusion injury might be a driving force in the aetiology of post-LT AKI...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28624103/from-organoids-to-organs-bioengineering-liver-grafts-from%C3%A2-hepatic-stem-cells-and-matrix
#14
REVIEW
Jorke Willemse, Ruby Lieshout, Luc J W van der Laan, Monique M A Verstegen
Due to the complex function and structure of the liver, resourceful solutions for treating end-stage liver disease are required. Currently, liver transplantation is the only curative therapeutic option. However, due to a worldwide donor shortage, researchers have been looking in other fields for alternative sources of transplantable liver tissue. Recent advances in our understanding of liver physiology, stem cell and matrix biology, have accelerated tissue engineering research. Most notable is the discovery of a culture system to grow liver-like organoids from human hepatic stem cells...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28624102/hepatitis-e-virus-a-potential-threat-for-patients-with-liver-disease-and-liver-transplantation
#15
REVIEW
Annemiek A van der Eijk, Suzan D Pas, Robert A de Man
Immunocompromised patients are at risk of acquiring acute hepatitis E virus infection (HEV), leading to chronicity. Chronic HEV infection is associated with persistent viraemia, raised transaminase activity, histological features associated with chronic hepatitis and evidence of rapid development of cirrhosis. Extrahepatic manifestations have been associated with HEV. Most frequently reported are neurological disorders with predominantly involvement of the peripheral nervous system. In patients using immunosuppressive drugs antibody production is often delayed and HEV RNA detection is superior to serology to detect infection...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28623253/c-c-chemokine-ligand-5-is-critical-for-facilitating-macrophage-infiltration-in-the-early-phase-of-liver-ischemia-reperfusion-injury
#16
Chiou-Mei Lee, Hsin-Hsin Peng, Polung Yang, Jiin-Tarng Liou, Chia-Chih Liao, Yuan-Ji Day
CCL5/RANTES, a chemoattractant for myeloid cells, is induced by hepatic ischemia/reperfusion injury (IRI). The roles of CCL5 in hepatic IRI were carried out by means of CCL5 immunodepletion, antagonistic competition by Met-CCL5, and treatment with recombinant murine CCL5 (rmCCL5). Depletion or inhibition of CCL5 reduced severity of hepatic IRI, whereas rmCCL5 treatment aggravated liver IRI as manifested in elevated serum alanine aminotransferase (ALT) and tissue myeloperoxidase (MPO) levels. Moreover, IRI severity was reduced in CCL5-knockout (CCL5-KO) mice versus wildtype (WT) mice, with drops in serum ALT level, intrahepatic MPO activity, and histological pathology...
June 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28622247/effects-of-portal-hypertension-on-gadoxetic-acid-enhanced-liver-magnetic-resonance-diagnostic-and-prognostic-implications
#17
Ulrika Asenbaum, Ahmed Ba-Ssalamah, Mattias Mandorfer, Richard Nolz, Julia Furtner, Thomas Reiberger, Arnulf Ferlitsch, Klaus Kaczirek, Michael Trauner, Markus Peck-Radosavljevic, Andreas G Wibmer
OBJECTIVE: The aim of this study was to investigate the impact of portal hypertension (PH) on gadoxetic acid-enhanced liver magnetic resonance imaging (MRI) and assess diagnostic and prognostic implications in comparison to established imaging features of PH. MATERIALS AND METHODS: Institutional review board-approved retrospective study of 178 patients (142 men; median age, 59.4 years) with chronic liver disease undergoing MRI and hepatic venous pressure gradient (HVPG) measurement between January 2008 and April 2015...
June 16, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28621875/retransplantation-after-a-failed-donation-after-circulatory-determination-of-death-liver-transplant-meld-exception-priority-and-second-chances
#18
EDITORIAL
Peter L Abt, David S Goldberg
Increased utilization of higher-risk liver allografts is hampered by concerns about an increased risk of post-transplant graft failure and subsequent death if the patient is not retransplanted. This dilemma faces clinicians considering broader use of livers from donation after circulatory determination of death (DCDD) donors. In the setting of primary non-function or early hepatic artery thrombosis (HAT), there is a mechanism for standardized awarding of Model for End-Stage Liver Disease (MELD) exception points...
June 16, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28621023/pediatric-liver-transplantation-for-fulminant-hepatic-failure-secondary-to-intentional-iron-overdose
#19
Joanne Lai, Jaime Chu, Ronen Arnon
Acute iron poisoning may lead to life-threatening hepatotoxicity. We present the cases of two pediatric patients with hepatotoxicity following intentional iron ingestion that progressed rapidly to fulminant hepatic failure despite treatment with deferoxamine. Liver transplantation was lifesaving in both patients. These cases emphasize the need for a high index of suspicion for iron ingestion, close monitoring for liver toxicity, and timely consideration for liver transplantation.
June 15, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28620674/organ-dysfunction-and-failure-following-brain-death-do-not-preclude-successful-donation
#20
Eno-Obong I Essien, Nehu Parimi, Jennifer Gutwald-Miller, Tyree Nutter, Thomas M Scalea, Deborah M Stein
BACKGROUND: Organ dysfunction is common after neurologic determination of death (NDD) but before organ collection. Reliable markers for graft success following transplant of these organs would be useful. We sought to determine the relationship between the donor after neurologic determination of death (DNDD) pathophysiology and successful organ donation. METHODS: Donor information was obtained through the local organ procurement organization. Donor demographics and clinical data points for cardiovascular, renal, respiratory, hepatic, hematological and neuroendocrine systems were reviewed 12 h before and 12 h after neurologic determination of death was declared...
June 15, 2017: World Journal of Surgery
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