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Bilirubin-Associated Acute Tubular Necrosis in a Kidney Transplant Recipient.

Fri, 03/08/2013 - 12:21

Bilirubin-Associated Acute Tubular Necrosis in a Kidney Transplant Recipient.

Am J Kidney Dis. 2013 Feb 25;

Authors: Rafat C, Burbach M, Brochériou I, Zafrani L, Callard P, Rondeau E, Hertig A

Abstract
Unlike hemoglobin or myoglobin, bilirubin, a breakdown product of the catabolism of heme molecules, usually is not seen as a nephrotoxic protein. We report the case of an adult kidney recipient who developed jaundice 4 years after transplantation because of a malignant cholangiocarcinoma. He progressively lost transplant function, accompanied by a continuous increase in bilirubinemia. Kidney biopsy showed bile granules in the cytoplasm of tubular epithelial cells and bile thrombi in dilated tubules, but no interstitial inflammation. The tumor was unresectable and the patient died 2 months later. Because the patient had no jaundice-associated confounding factor that could explain his kidney failure, such as sepsis, heart failure, or liver failure with hepatorenal syndrome, this exceptional case suggests that bilirubin per se should be seen as a potential cause of acute tubular necrosis.

PMID: 23465956 [PubMed - as supplied by publisher]

Lung transplant of extrahospitalary donor after cardiac death.

Fri, 03/08/2013 - 12:21

Lung transplant of extrahospitalary donor after cardiac death.

Am J Emerg Med. 2013 Mar 2;

Authors: Mateos Rodríguez AA, Navalpotro Pascual JM, Del Río Gallegos F

Abstract
Non-heart-beating donors (NHBDs) have to meet the predefined criteria for organ donation including death from irreversible cessation of the beating heart. The Maastricht conference defined 4 NHBD categories to differentiate their viability and ethical-legal support. In Spain, NHBDs who originate from an out-of-hospital setting correspond to type II donors. These are patients who have had a cardiac arrest outside hospital and, after failed CPR attempts, are transferred with hemodynamic support measures to the hospital for organ donation. The Hospital Clínico San Carlos also has a lung donation program in collaboration with the Hospital Puerta de Hierro in Madrid and the Hospital Marques de Valdecilla in Santander. The objective of this study is to describe the results of lung transplantation of after cardiac death program, specifically the section regarding lung extraction donation. Twenty potential lung donors were obtained during the study. Most patients were male (19 cases), with a mean age of 42 years (36.5-49.5 years). A total of 33 lungs were donated (18 right and 15 left lungs). Most extractions were multiorganic (19 cases). One liver, 19 kidneys, 2 pancreas, and 19 corneas were obtained from these donors; bone tissue was obtained from all donors. The transplantation was bipulmonary in 13 cases and unipulmonary in 7. Thirty days after transplantation, 2 recipients died, 1 died of stroke associated with bilateral pneumonia and 1 died of hypovolemic shock resulting from hemothorax. The remaining 18 patients were progressing well at 30 days. Our data suggest that lung transplantation from patients after extrahospitalary cardiac death is feasible.

PMID: 23465877 [PubMed - as supplied by publisher]

The collaborative transplant study registry.

Fri, 03/08/2013 - 12:21

The collaborative transplant study registry.

Transplant Rev (Orlando). 2013 Mar 2;

Authors: Opelz G, Döhler B, Ruhenstroth A, Cinca S, Unterrainer C, Stricker L, Scherer S, Gombos P, Süsal C, Daniel V, Tran H

Abstract
The Collaborative Transplant Study (CTS) was initiated in 1982. Over the last 30 years, it has collected information on over half a million kidney, liver, heart, lung, and pancreas transplant procedures. Participation is voluntary and the study has strictly scientific objectives. Analyses of the CTS database serve as an international reference source in the field of solid organ transplantation.

PMID: 23465693 [PubMed - as supplied by publisher]

Maintaining functional islets through encapsulation in an injectable saccharide-peptide hydrogel.

Fri, 03/08/2013 - 12:21

Maintaining functional islets through encapsulation in an injectable saccharide-peptide hydrogel.

Biomaterials. 2013 Feb 25;

Authors: Liao SW, Rawson J, Omori K, Ishiyama K, Mozhdehi D, Oancea AR, Ito T, Guan Z, Mullen Y

Abstract
Islet transplantation offers a promising treatment for type 1 diabetes (T1D). However, a major hurdle in this treatment is the rapid loss of functional islets during culture and after transplantation. The liver site, currently utilized for transplantation, is suboptimal for achieving long-term insulin independence due to a rapid islet loss followed by a chronic decline in islet function after transplantation. Herein, we report a synthetic saccharide-peptide (SP) hydrogel that allows suspending islets in liquid and injecting for in situ polymerization without forming islet clumps, indicating its potential in extrahepatic islet transplantation. In vitro, rat islets in SP hydrogel maintained a 3D structure and high glucose-stimulated insulin release similar to that observed in freshly isolated islets for 4 weeks, while control islets cultured in suspension lost their 3D structure and insulin release responses by 2 weeks. Biocompatibility of SP hydrogel was shown by the absence of cytokine mRNA activation in peripheral blood mononuclear cells (PBMCs) exposed to hydrogel in vitro and by the absence of cellular infiltrates in and around the hydrogel implanted subcutaneously. Syngeneic Lewis rat islets transplanted in SP hydrogel in various extrahepatic sites stained strongly for insulin, and more effectively reversed diabetes than unencapsulated islets when transplanted in an omental pocket. In conclusion, the SP hydrogel is non-cytotoxic and supports normal islet structure and function both in vitro and in vivo. Specifically, the ability of the hydrogel to separate individual islets after transplantation is important for maintaining their function in vivo. This important property, combined with the versatility and biocompatibility, makes our SP hydrogel a promising synthetic scaffold that can facilitate transplantation of organized heterogeneous cells to preserve their micro-structure and function.

PMID: 23465491 [PubMed - as supplied by publisher]

Functional characterization of Fospeg, and its impact on cell cycle upon PDT of Huh7 hepatocellular carcinoma cell model.

Fri, 03/08/2013 - 12:21

Functional characterization of Fospeg, and its impact on cell cycle upon PDT of Huh7 hepatocellular carcinoma cell model.

Photodiagnosis Photodyn Ther. 2013 Feb;10(1):87-94

Authors: Sherifa G, Saad Zaghloul MA, Elsayed OF, Rueck A, Steiner R, Abdelaziz AI, Abdel-Kader MH

Abstract
BACKGROUND: Although several treatment options are available for hepatocellular carcinoma (HCC), their application is mostly restricted to early diagnosed cases or includes liver transplantation, which is rarely available due to donor scarcity. The attractiveness of PDT as a cancer treatment does not only come from its minimal invasiveness, but also from the high selectivity due to tumor localization that can be applied. Precise focusing of light on tumor lesions will result in tumor-specific PDT activation. Novel photosensitizers can be applied in such low concentrations that cells not subjected to irradiation remain healthy. The lethal effect and mechanism of death induction of the photosensitizer Fospeg has never been studied on hepatocellular carcinoma. The aim of the present study is to functionally analyze the impact of PDT on Huh-7 HCC cell line, as well as to analyze its impact on cell cycle protein expression.
METHODS: Cellular viability, and proliferation assays were conducted via MTT and BrdU assay, respectively. Transfected cell models of Huh7 with different constructs harboring cell cycle genes and downstream reporter luciferase gene were generated.
RESULTS: Our results show a statistically significant decrease in both viability and proliferation of Huh-7 cells following PDT, while maintaining Fospeg and laser concentrations far below toxic levels. Proliferative cell cycle genes show a tendency of inhibition, while p53 levels show a significant increase following PDT.
CONCLUSION: Fospeg-mediated PDT is a promising strategy for treatment of hepatocellular carcinoma and needs to be further explored in vivo.

PMID: 23465377 [PubMed - in process]

Revealing Impaired Blood Supply to the Bile Ducts on Contrast-Enhanced Ultrasound: A Novel Diagnosis Method to Ischemic-Type Biliary Lesions After Orthotropic Liver Transplantation.

Fri, 03/08/2013 - 12:21

Revealing Impaired Blood Supply to the Bile Ducts on Contrast-Enhanced Ultrasound: A Novel Diagnosis Method to Ischemic-Type Biliary Lesions After Orthotropic Liver Transplantation.

Ultrasound Med Biol. 2013 Feb 25;

Authors: Ren J, Zheng BW, Wang P, Liao M, Zheng RQ, Lu MD, Lu Y, Zeng J, Zhang YL

Abstract
Ischemic-type biliary lesions (ITBLs) are a major source of morbidity and mortality after orthotropic liver transplantation (OLT). The study determines diagnostic accuracy of contrast-enhanced ultrasound (CEUS) in diagnosing ITBLs. Nine healthy volunteers, six OLT recipients without complications, 36 OLT patients with complications (12 without ITBLs and 24 with ITBLs) underwent CEUS. Two radiologists reviewed the sonograms of the hilar bile duct wall and established specific criteria used to detect ITBLs. Next, the sonograms of six OLT recipients without complications and 36 patients with complications (12 without ITBLs and 24 with ITBLs) were retrospectively reviewed by two other independent, blinded radiologists. The sensitivity, specificity and accuracy of CEUS were evaluated. The main feature differentiating ITBLs from three other groups was non- or hypo-enhancement of the hilar bile duct wall in arterial phase (all p < 0.05), which was selected as the primary criterion for subsequent study. The sensitivity, specificity and accuracy were 66.7%, 88.9% and 76.2% for reader 1 and 62.5%, 88.9% and 73.8% for reader 2, respectively. A good interobserver agreement (κ = 0.85) was achieved. In this study, CEUS shows promise of detection of ITBLs by revealing impaired blood supply to the bile ducts, but more studies will be needed to establish its usefulness.

PMID: 23465141 [PubMed - as supplied by publisher]

Human Liver Regeneration Is Characterized by the Coordinated Expression of Distinct MicroRNA Governing Cell Cycle Fate.

Fri, 03/08/2013 - 12:21

Human Liver Regeneration Is Characterized by the Coordinated Expression of Distinct MicroRNA Governing Cell Cycle Fate.

Am J Transplant. 2013 Mar 6;

Authors: Salehi S, Brereton HC, Arno MJ, Darling D, Quaglia A, O'Grady J, Heaton N, Aluvihare VR

Abstract
In the absence of adequate compensatory regeneration, overwhelming liver damage can cause acute liver failure (ALF) and death without emergent liver transplantation (LT). Auxiliary LT produces satisfactory outcomes in this setting, with the prospect of native liver regeneration sustaining long-term survival. Since animal models only partially recapitulate human liver regeneration, we investigated the molecular mechanisms controlling it in this unique LT setting, as an exemplar of human liver regeneration. We demonstrate coordinated changes in expression of microRNA (miRNA) during regeneration that drive proliferation, innate immunity and angiogenesis. In contrast, failed regeneration in a similar cohort is associated with distinct miRNA enforcing cell cycle inhibition and DNA methylation. The miRNA expression associated with successful or failed regeneration when recapitulated in vitro, triggered expression of cardinal regeneration-linked genes promoting cell cycle entry or inhibition, respectively. Furthermore, inhibition of miRNA 150, 663 and 503, whose downregulation is associated with successful regeneration, induced cell proliferation which a key determinant of successful regeneration. Our data indicate that human liver regeneration may be orchestrated by distinct miRNA controlling key regeneration-linked processes including hepatocyte proliferation. To our knowledge this is the first characterization of molecular processes associated with human liver regeneration.

PMID: 23465054 [PubMed - as supplied by publisher]

Regulatory T cells in pediatric living donor liver transplantation.

Fri, 03/08/2013 - 12:21

Regulatory T cells in pediatric living donor liver transplantation.

Pediatr Transplant. 2013 Mar 7;

Authors: Ji H, Liu Y, Kupiec-Weglinski JW

PMID: 23464984 [PubMed - as supplied by publisher]

De novo Cancer-Related Death in Australian Liver and Cardiothoracic Transplant Recipients.

Fri, 03/08/2013 - 12:21

De novo Cancer-Related Death in Australian Liver and Cardiothoracic Transplant Recipients.

Am J Transplant. 2013 Mar 6;

Authors: Na R, Grulich AE, Meagher NS, McCaughan GW, Keogh AM, Vajdic CM

Abstract
Evidence is sparse on the relative mortality risk posed by de novo cancers in liver and cardiothoracic transplant recipients. A retrospective cohort study was conducted in Australia using population-based liver (n = 1926) and cardiothoracic (n = 2718) registries (1984-2006). Standardized mortality ratios (SMRs) were computed by cancer type, transplanted organ, recipient age and sex. During a median 5-year follow-up, de novo cancer-related mortality risk in liver and cardiothoracic recipients was significantly elevated compared to the matched general population (n = 171; SMR = 2.83; 95% confidence interval [95%CI], 2.43-3.27). Excess risk was observed regardless of transplanted organ, recipient age group or sex. Non-Hodgkin lymphoma was the most common cancer-related death (n = 38; SMR = 16.6; 95%CI, 11.87-22.8). The highest relative risk was for nonmelanocytic skin cancer (n = 23; SMR = 49.6, 95%CI, 31.5-74.5), predominantly in males and in recipients of heart and lung transplants. Risk of death from de novo cancer was high in pediatric recipients (n = 5; SMR = 41.3; 95%CI, 13.4-96.5), four of the five deaths were non-Hodgkin lymphoma. De novo cancer was a leading cause of late death, particularly in heart and liver transplantation. These findings support tailored cancer prevention strategies, surveillance to promote early detection, and guidelines for managing immunosuppression once cancer occurs.

PMID: 23464511 [PubMed - as supplied by publisher]

Incidence and risk factors for new-onset diabetes in living-donor liver transplant recipients.

Fri, 03/08/2013 - 12:21

Incidence and risk factors for new-onset diabetes in living-donor liver transplant recipients.

Clin Transplant. 2013 Mar 7;

Authors: Honda M, Asonuma K, Hayashida S, Suda H, Ohya Y, Lee KJ, Yamamoto H, Takeichi T, Inomata Y

Abstract
With the increased number of long-term survivors after liver transplantation, new-onset diabetes after transplantation (NODAT) is becoming more significant in patient follow-up. However, the incidence of new-onset diabetes after living-donor liver transplantation (LDLT) has not been well elucidated. The aim of this study was to evaluate the incidence and risk factors for NODAT in adult LDLT recipients at a single center in Japan. A retrospective study was performed on 161 adult patients without diabetes who had been followed up for ≥three months after LDLT. NODAT was defined according to the 2003 American Diabetes Association/World Health Organization guidelines. The recipient-, donor-, operation-, and immunosuppression-associated risk factors for NODAT were assessed. Overall, the incidence of NODAT was 13.7% (22/161) with a mean follow-up of 49.8 months. In a multivariate analysis, the identified risk factors for NODAT were donor liver-to-spleen (L-S) ratio (hazard ratio [HR] = 0.022, 95% confidence interval [CI] = 0.001-0.500, p = 0.017), and steroid pulse therapy for acute rejection (HR = 3.320, 95% CI = 1.365-8.075, p = 0.008). In conclusion, donor L-S ratio and steroid pulse therapy for acute rejection were independent predictors for NODAT in LDLT recipients. These findings can help in screening for NODAT and applying early interventions.

PMID: 23464510 [PubMed - as supplied by publisher]

Ex vivo Normothermic Machine Perfusion and Viability Testing of Discarded Human Donor Livers.

Fri, 03/08/2013 - 12:21

Ex vivo Normothermic Machine Perfusion and Viability Testing of Discarded Human Donor Livers.

Am J Transplant. 2013 Mar 6;

Authors: Op den Dries S, Karimian N, Sutton ME, Westerkamp AC, Nijsten MW, Gouw AS, Wiersema-Buist J, Lisman T, Leuvenink HG, Porte RJ

Abstract
In contrast to traditional static cold preservation of donor livers, normothermic machine perfusion may reduce preservation injury, improve graft viability and potentially allows ex vivo assessment of graft viability before transplantation. We have studied the feasibility of normothermic machine perfusion in four discarded human donor livers. Normothermic machine perfusion consisted of pressure and temperature controlled pulsatile perfusion of the hepatic artery and continuous portal perfusion for 6 h. Two hollow fiber membrane oxygenators provided oxygenation of the perfusion fluid. Biochemical markers in the perfusion fluid reflected minimal hepatic injury and improving function. Lactate levels decreased to normal values, reflecting active metabolism by the liver (mean lactate 10.0 ± 2.3 mmol/L at 30 min to 2.3 ± 1.2 mmol/L at 6 h). Bile production was observed throughout the 6 h perfusion period (mean rate 8.16 ± 0.65 g/h after the first hour). Histological examination before and after 6 h of perfusion showed well-preserved liver morphology without signs of additional hepatocellular ischemia, biliary injury or sinusoidal damage. In conclusion, this study shows that normothermic machine perfusion of human donor livers is technically feasible. It allows assessment of graft viability before transplantation, which opens new avenues for organ selection, therapeutic interventions and preconditioning.

PMID: 23463950 [PubMed - as supplied by publisher]

Image of the month. Abscess due to a "lost" stone during the previous cholecystectomy.

Fri, 03/08/2013 - 12:21
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Image of the month. Abscess due to a "lost" stone during the previous cholecystectomy.

JAMA Surg. 2013 Jan;148(1):99-100

Authors: Thomopoulos T, Mentha G, Toso C

PMID: 23324846 [PubMed - indexed for MEDLINE]

Fucosyltransferase 8 as a functional regulator of nonsmall cell lung cancer.

Fri, 03/08/2013 - 12:21
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Fucosyltransferase 8 as a functional regulator of nonsmall cell lung cancer.

Proc Natl Acad Sci U S A. 2013 Jan 8;110(2):630-5

Authors: Chen CY, Jan YH, Juan YH, Yang CJ, Huang MS, Yu CJ, Yang PC, Hsiao M, Hsu TL, Wong CH

Abstract
The up-regulation of fucosyltransferase 8 (FUT8), the only enzyme catalyzing α1,6-fucosylation in mammals, has been observed in several malignant cancers including liver, ovarian, thyroid, and colorectal cancers. However, the pathological role and the regulatory mechanism of FUT8 in cancers remain largely unknown. In the current study, we report that the expression of FUT8 is up-regulated in nonsmall cell lung cancer (NSCLC) and correlates with tumor metastasis, disease recurrence, and poor survival in patients with NSCLC. Knocking down FUT8 in aggressive lung cancer cell lines significantly inhibits their malignant behaviors including in vitro invasion and cell proliferation, as well as in vivo metastasis and tumor growth. The results of glycoproteomic and microarray analyses show that FUT8 globally modifies surface antigens, receptors, and adhesion molecules and is involved in the regulation of dozens of genes associated with malignancy, suggesting that FUT8 contributes to tumor progression through multiple mechanisms. Moreover, we show that FUT8 is up-regulated during epithelial-mesenchymal transition (EMT), a critical process for malignant transformation of tumor, via the transactivation of β-catenin/lymphoid enhancer-binding factor-1 (LEF-1). These results provide a model to illustrate the relation between FUT8 expression and lung cancer progression and point to a promising direction for the prognosis and therapy of lung cancer.

PMID: 23267084 [PubMed - indexed for MEDLINE]

Place of surgical resection in the treatment strategy of gastrointestinal neuroendocrine tumors.

Fri, 03/08/2013 - 12:21
Related Articles

Place of surgical resection in the treatment strategy of gastrointestinal neuroendocrine tumors.

Target Oncol. 2012 Sep;7(3):153-9

Authors: Gaujoux S, Sauvanet A, Belghiti J

Abstract
Neuroendocrine tumors (NET) are usually slow-growing neoplasms carrying an overall favorable prognosis. Surgery, from resection to transplantation, remains the only potential curative option for these patients, and should always be considered. Nevertheless, because of very few randomized controlled trials available, the optimal treatment for these patients remains controversial, especially regarding the place of surgery. We herein discuss the place of surgical resection in the treatment strategy in neuroendocrine tumors of the digestive tract.

PMID: 22923166 [PubMed - indexed for MEDLINE]

Dual liver transplantation.

Thu, 03/07/2013 - 12:10

Dual liver transplantation.

J Zhejiang Univ Sci B. 2013 Mar;14(3):178-184

Authors: Chen H, Zhang Y, Han YM, Huguet E, Huang DS, Dong JH

Abstract
Reperfusion is the key strategy in acute ST-segment elevation myocardial infarction (STEMI) care, and it is time-dependent. Shortening the time from symptom to reperfusion and choosing the optimal reperfusion strategy for STEMI patients are great challenges in practice. We need to improve upon the problems of low reperfusion rate, non-standardized treatment, and economic burden in STEMI care. This article briefly reviews the current status of reperfusion strategy in STEMI care, and also introduces what we will do to bridge the gap between the guidelines and implementation in the clinical setting through the upcoming China STEMI early reperfusion program.

PMID: 23463760 [PubMed - as supplied by publisher]

Use of perfluorocarbons to enhance the performance of perfused three-dimensional hepatic cultures.

Thu, 03/07/2013 - 12:10

Use of perfluorocarbons to enhance the performance of perfused three-dimensional hepatic cultures.

Biotechnol Prog. 2013 Mar 6;

Authors: Shi G, Coger RN

Abstract
Bioartificial liver devices (BALs) are extracorporeal systems designed to temporarily bridge patients until a suitable donated liver is available for transplantation and also have value for pharmaceutical testing applications. Yet critical issues exist that limit the functional performance of their current designs. One of these concerns scale up issues connected to oxygen (O2 ) delivery to the cells housed within their three-dimensional (3D) configurations, and its consequences to device performance. As primary blood substitute candidates with extraordinarily high O2 capacity, perfluorocarbons (PFCs) offer hope as one strategy for addressing the O2 delivery issue encountered when scaling up the tissue space of current BAL designs. This study utilizes a PFC-based second-generation O2 carrier OXYCYTE® , as an additive to regular nutrient medium, for augmenting O2 delivery in a customized 3D tissue assembly system. The results demonstrate that the addition of PFCs significantly increases the O2 capacity of regular medium and that net cytochrome P450 activity levels are considerably increased under flow in PFC-treated systems, as compared to controls. This work thus clarifies the benefits of using PFCs to enhance the functional performance of 3D liver systems. © 2013 American Institute of Chemical Engineers Biotechnol. Prog.,, 2013.

PMID: 23463714 [PubMed - as supplied by publisher]

Preparing for the inevitable: The death of a living liver donor.

Thu, 03/07/2013 - 12:10

Preparing for the inevitable: The death of a living liver donor.

Liver Transpl. 2013 Mar 6;

Authors: Miller C, Smith ML, Fujiki M, Uso TD, Quintini C

Abstract
Living donor liver transplantation (LDLT) is associated with a low but finite and well documented risk of donor morbidity and mortality, therefore organizations and individuals involved in this activity must accept the fact that donor death is as a question of "when, not if". Studies in the field of crisis management show that "preparing for the inevitable" not only is critical in preparing Institutions to better respond to catastrophic events, but more importantly play a crucial role in preventing them. This manuscript describes the background of crisis management with specific reference to the death of a living liver donor and propose a general framework that can be adopted by living donor liver transplant programs around the world. © 2013 American Association for the Study of Liver Diseases.

PMID: 23463650 [PubMed - as supplied by publisher]

Should minors be considered as potential living liver donors?

Thu, 03/07/2013 - 12:10

Should minors be considered as potential living liver donors?

Liver Transpl. 2013 Mar 5;

Authors: Capitaine L, Thys K, Assche KV, Sterckx S, Pennings G

Abstract
For many patients, living donor liver transplantation represents their only hope of receiving a life-saving graft. In certain (albeit rare) cases, a minor will be the only suitable donor. Living liver donation by minors has been reported in several countries. In the academic literature and professional guidelines, little attention is paid to the development of an ethical framework for this practice. The focus is frequently limited to donation of regenerative tissues and kidneys. However, liver donation differs in important respects due to the increased medical risks and the lack of substitute therapies. Therefore, in this paper, we assess whether living liver donation by minors is ethically appropriate. © 2013 American Association for the Study of Liver Diseases.

PMID: 23463629 [PubMed - as supplied by publisher]

Post-transplantation sequential entecavir monotherapy following 1-year combination therapy with hepatitis B immunoglobulin.

Thu, 03/07/2013 - 12:10

Post-transplantation sequential entecavir monotherapy following 1-year combination therapy with hepatitis B immunoglobulin.

J Gastroenterol. 2013 Mar 6;

Authors: Yi NJ, Choi JY, Suh KS, Cho JY, Baik M, Hong G, Lee KW, Kim W, Kim YJ, Yoon JH, Lee HS, Kim DG

Abstract
BACKGROUND: Combination therapy of intravenous hepatitis B immunoglobulin (ivHBIG) and nucleos(t)ide (NA) analogues is the best post-liver transplantation (LT) prophylactic measure for hepatitis B virus (HBV). However, to reduce the long-term drawbacks of ivHBIG, we evaluated the efficacy of sequential entecavir (ETV) monotherapy. METHODS: Twenty-nine candidates with HBV-related liver disease were prospectively enrolled. The patients were selected if the patient was suitable for one of the following inclusion criteria: (1) NA-naïve patients except for ETV, and (2) negative HB e antigen (HBeAg) and undetectable HBV DNA at the time of LT. Post-LT HBV prophylaxis consisted of 1-year combination therapy with ETV (0.5 mg daily) plus ivHBIG per 5 weeks, followed by ETV monotherapy. The primary endpoint was the 2-year recurrence rate of HB. The median follow-up period was 31 months. RESULTS: At the time of transplantation, HBeAg was positive in 21 % and HBV DNA was detectable in 52 % of the study participants. No HBV recurrence was reported during the first year. During the second year, HBV recurrence was noted in one who suffered from HCC recurrence without viral mutation. Recurrence free survival rates were 96.6 and 96.4 % at 1- and 2-year post-transplant by intention-to-treat analysis. One patient died of fungal infection. CONCLUSION: Sequential ETV monotherapy after 1-year combination therapy might be safe in NA-naïve replicators as well as non-replicators.

PMID: 23463400 [PubMed - as supplied by publisher]

Fenestration treatment for polycystic liver disease improved quality of life.

Thu, 03/07/2013 - 12:10

Fenestration treatment for polycystic liver disease improved quality of life.

Am Surg. 2013 Mar;79(3):116-8

Authors: Yilmaz TU, Sözen H, Kiliç K, Erbaş G, Dalgiç A

PMID: 23461935 [PubMed - in process]

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