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Pediatric liver transplantation for fulminant hepatic failure secondary to intentional iron overdose.

Sun, 06/18/2017 - 12:45
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Pediatric liver transplantation for fulminant hepatic failure secondary to intentional iron overdose.

Pediatr Transplant. 2017 Jun 15;:

Authors: Lai J, Chu J, Arnon R

Abstract
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.

PMID: 28621023 [PubMed - as supplied by publisher]

Asia-Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update.

Sun, 06/18/2017 - 12:45
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Asia-Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update.

Hepatol Int. 2017 Jun 15;:

Authors: Omata M, Cheng AL, Kokudo N, Kudo M, Lee JM, Jia J, Tateishi R, Han KH, Chawla YK, Shiina S, Jafri W, Payawal DA, Ohki T, Ogasawara S, Chen PJ, Lesmana CRA, Lesmana LA, Gani RA, Obi S, Dokmeci AK, Sarin SK

Abstract
There is great geographical variation in the distribution of hepatocellular carcinoma (HCC), with the majority of all cases worldwide found in the Asia-Pacific region, where HCC is one of the leading public health problems. Since the "Toward Revision of the Asian Pacific Association for the Study of the Liver (APASL) HCC Guidelines" meeting held at the 25th annual conference of the APASL in Tokyo, the newest guidelines for the treatment of HCC published by the APASL has been discussed. This latest guidelines recommend evidence-based management of HCC and are considered suitable for universal use in the Asia-Pacific region, which has a diversity of medical environments.

PMID: 28620797 [PubMed - as supplied by publisher]

Organ Dysfunction and Failure Following Brain Death Do Not Preclude Successful Donation.

Sun, 06/18/2017 - 12:45
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Organ Dysfunction and Failure Following Brain Death Do Not Preclude Successful Donation.

World J Surg. 2017 Jun 15;:

Authors: Essien EI, Parimi N, Gutwald-Miller J, Nutter T, Scalea TM, Stein DM

Abstract
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. The worst values were utilized for analysis and generation of the organ-specific Sequential Organ Failure Assessment (SOFA) scores. SOFA scores were calculated and used to quantify the degree of organ dysfunction. The NDD non-donors for a specific organ were used as a comparison control group. The control group refers to DNDD patients whose specific organs were not transplanted. Lack of use was mostly due to discard by the transplant team as a result of unsuitability of the organ caused by deterioration or possible donor-specific pathology.
RESULTS: One hundred and five organ donors were analyzed. Mean age was 35.0 (± 13.6), 78.1% male, median GCS 3, interquartile range (IQR) 3-4 and median injury severity score 32 (IQR 25-43). Of the successful donors, organ-specific severe dysfunction (SOFA 3 or 4) occurred in 96, 27.5 and 3.3% of cardiac, lung and liver donors, respectively. There was no significant difference between the levels of organ dysfunction in donors versus non-donors except lung donors, in which the median lowest partial pressure of arterial oxygen-to-fraction of inspired oxygen (P/F) ratio in the non-donor was 194 (IQR 121.8-308.3) compared to the median lowest P/F ratio in the donor which was 287 (IQR 180-383.5), p = 0.02. In the recipients, graft failure 6 months after transplantation was reported in one kidney recipient (0.74%) (peak donor creatinine = 1 mg/dL) and in five pancreas recipients (11.4%). The median peak glucose of the pancreas donors in failed recipients was 178 mg/dL (IQR 157-213), whereas in the functioning recipients, the median glucose of their donors was not different (185 mg/dL, IQR 157-216), p = 0.394.
CONCLUSION: Current measures of organ failure and dysfunction do not predict the success of organ donation. Successful donor management in the face of severe organ dysfunction and failure can result in lives saved.

PMID: 28620674 [PubMed - as supplied by publisher]

Hepatoblastoma: Transplant Versus Resection Experience in a Latin American Transplant Center.

Sun, 06/18/2017 - 12:45
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Hepatoblastoma: Transplant Versus Resection Experience in a Latin American Transplant Center.

Transplant Direct. 2017 Jun;3(6):e165

Authors: Caicedo LA, Sabogal A, Serrano O, Villegas JI, Botero V, Agudelo MT, Lotero V, Dávalos D, Manzi E, Aristizabal AM, Gomez C, Echeverri GJ

Abstract
BACKGROUND: Hepatoblastoma is the most common primary malignant liver tumor in children and is usually diagnosed during the first 3 years of life. Overall survival has increased 50% due to chemotherapeutic schemes, expertise surgery centers, and liver transplantation.
METHODS: A retrospective collection of data was performed from pediatric patients with diagnosis of hepatoblastoma. Variables included demographic, diagnostic tools and histological classification; chemotherapy and surgical treatment; and outcomes and patient survival. The PRETEXT classification was applied, which included the risk evaluation, and according to the medical criterion in an individualized way, underwent resection or transplant. The morbidity of patients was evaluated by the Clavien-Dindo classification. Statistical analysis was performed according to the distribution of data and the survival analysis was carried out using the Kaplan-Meier method.
RESULTS: The patients (n = 16) were divided in a resection group (n = 8) and a transplant group (n = 8). The median age at the time of diagnosis was 13.5 months. The motive for the initial consultation was the discovery of a mass; all patients had high levels of α-fetoprotein and an imaging study. Ten of 16 patients required chemotherapy before the surgical procedure. In the resection group, 5 of 8 patients were classified as Clavien I and 4 of 8 patients of the transplant group were classified as Clavien II. Patient survival at 30 months was 100% in the resection group and 65% in the liver transplantation group.
CONCLUSIONS: To our knowledge, this is the first case report of pediatric patients with hepatoblastoma and liver resection or transplant in Colombia and Latin America. Our results are comparable with the series worldwide, showing that resection and transplant increase the survival of the pediatric patients with hepatoblastoma. It is important to advocate for an increase of reporting in the scientific literature in Latin America.

PMID: 28620649 [PubMed - in process]

Effect of Fc-γ Receptor Polymorphism on Rituximab-Mediated B Cell Depletion in ABO-Incompatible Adult Living Donor Liver Transplantation.

Sun, 06/18/2017 - 12:45
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Effect of Fc-γ Receptor Polymorphism on Rituximab-Mediated B Cell Depletion in ABO-Incompatible Adult Living Donor Liver Transplantation.

Transplant Direct. 2017 Jun;3(6):e164

Authors: Sakai H, Tanaka Y, Tazawa H, Shimizu S, Verma S, Ohira M, Tahara H, Ide K, Ishiyama K, Kobayashi T, Onoe T, Ohdan H

Abstract
BACKGROUND: The affinity of IgG Fc receptor (FcγR) for rituximab, an anti-CD20 IgG1, differs based on single-nucleotide polymorphisms (SNPs) in FcγRs. This study aimed to explore the effect of such SNPs on clinical response to rituximab and outcomes in patients of ABO-incompatible (ABOi) living donor liver transplantation (LDLT).
METHODS: SNPs of FCGR2A[131H/R] and FCGR3A[158F/V], alleles encoding FcγR, were identified in 20 patients desensitized with rituximab before ABOi LDLT. The effect of these SNPs on B cell elimination and outcomes was analyzed in the patients.
RESULTS: The isoform encoded by FCGR2A[131H/H] had a higher affinity for IgG1, and accordingly, the effects of rituximab on B cells were more profound in individuals with FCGR2A[131H/H] than in individuals with FCGR2A[131H/R or R/R]. Specifically, the time to B-cell reappearance in the peripheral blood was significantly delayed, and total serum IgM levels were significantly lower early after LDLT in individuals with FCGR2A[131H/H], even though these SNPs did not significantly affect the reduction of antiblood group A/B antibodies. The incidence of blood stream infection was also significantly higher in individuals with FCGR2A[131H/H], and this SNP was associated with poor prognosis. Despite no significant effect of FCGR3A[158F/V] on survival after ABOi liver grafts, the incidence of infection was significantly higher in individuals with FCGR3A[158F/V or F/F] than in individuals with FCGR3A[158V/V].
CONCLUSIONS: Our findings indicate FCGR SNPs influence the effect of rituximab on B-cell depletion and are possibly predisposing factors for infectious complications after ABOi LDLT. This study will be a good foundation for further studies on larger cohorts.

PMID: 28620648 [PubMed - in process]

The Effect and Safety of Prostaglandin Administration in Pediatric Liver Transplantation.

Sun, 06/18/2017 - 12:45
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The Effect and Safety of Prostaglandin Administration in Pediatric Liver Transplantation.

Transplant Direct. 2017 Jun;3(6):e163

Authors: Lironi C, McLin VA, Wildhaber BE

Abstract
BACKGROUND: Prostaglandins are often administered after liver transplantation (LT) to diminish ischemia-reperfusion injury (IRI), to favor liver recovery and to prevent vascular thrombosis. Possible beneficial effects in adult liver recipients are controversial, but the single existing pediatric small case series shows no significant impact of prostaglandin administration after LT. The purpose of this study was to analyze the effect of the prostaglandin dinoprostone in pediatric liver recipients.
METHODS: A retrospective analysis of 41 children (<16 years) who underwent LT between March 2008 and December 2013 was performed. Dinoprostone was administered at a rate from 0.1 to a maximum of 0.6 μg/kg per hour immediately after LT and for a maximum of 5 days. Effect of dinoprostone on post-LT IRI and hepatic function up to 60 postoperative days and number of hypotensive episodes were analyzed.
RESULTS: The median cumulative dose of dinoprostone was 28 μg/kg (interquartile range, 23.2). Dinoprostone had no significant effect on post-LT liver function tests and factor V levels at any of the administered dosages. There was no significant association between the total quantity of vasopressor given and the number of hypotensive episodes observed in 8 patients. One patient showed a short-lasting hypotension, possibly related to the administration of dinoprostone.
CONCLUSIONS: This study did not show, at any dosage between 0.1 and 0.6 μg/kg per hour, any differences in beneficial or harmful effects of high- or low-dose dinoprostone administered immediately after pediatric LT on markers of IRI, hepatic function, or hypotension.

PMID: 28620647 [PubMed - in process]

Topical Application of Mesenchymal Stromal Cells Ameliorated Liver Parenchyma Damage After Ischemia-Reperfusion Injury in an Animal Model.

Sun, 06/18/2017 - 12:45
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Topical Application of Mesenchymal Stromal Cells Ameliorated Liver Parenchyma Damage After Ischemia-Reperfusion Injury in an Animal Model.

Transplant Direct. 2017 Jun;3(6):e160

Authors: Lam PK, Chong CCN, Lo AWI, Chan AWH, Tong CSW, Chin DWC, Wong KHK, Choy RKW, Fung AK, Wang YX, To KF, Lai PBS

Abstract
BACKGROUND: Ischemia-reperfusion injury (IRI) is commonly encountered after liver surgery. This study evaluated the hepatoprotective effects of topically applied adipose-derived mesenchymal stromal cells (ADMSCs) on hepatic IRI in a rat model.
METHODS: ADMSCs from transgenic green fluorescent protein Sprague-Dawley rats were topically applied to the liver surface of Sprague-Dawley rats after hepatic IRI and fixed in position by fibrin glue (group A, n = 24). An equivalent amount of ADMSCs were administered through the portal (group B, n = 24) or tail vein (group C, n = 24). In the control group (group D, n = 20), no treatment was given to the IRI liver.
RESULTS: All the rats in group A and group D survived. Within 2 days after hepatic IRI, only 50% of rats survived in group B, and ADMSCs were detected in thromboemboli within large vessels. 62.5% of the rats died in group C because most of the ADMSCs were trapped in the lungs. ADMSCs migrated across the liver capsule and homed to the injured liver parenchyma 3 days after topical application in group A. The homed ADMSCs expressed hepatocyte nuclear factor-4α and hepatocyte nuclear factor-1. Compared with group D, the rate of hepatic regeneration in group A was enhanced with less inflammation, smaller necrotic areas, and improved liver function. Proinflammatory cytokines IL-6, IL-21, and CD70 were significantly downregulated in group A by 6.3-, 2.7-, and 12.7-fold, respectively (P < 0.05). The neurogenic locus NOTCH homolog protein pathway was activated in the topical ADMSCs.
CONCLUSIONS: Topically applied adipose-derived mesenchymal stromal cells demonstrated hepatoprotective effects on hepatic IRI in an animal model.

PMID: 28620644 [PubMed - in process]

Early Intervention With Live Donor Liver Transplantation Reduces Resource Utilization in NASH: The Toronto Experience.

Sun, 06/18/2017 - 12:45
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Early Intervention With Live Donor Liver Transplantation Reduces Resource Utilization in NASH: The Toronto Experience.

Transplant Direct. 2017 Jun;3(6):e158

Authors: Barbas AS, Goldaracena N, Dib MJ, Al-Adra DP, Aravinthan AD, Lilly LB, Renner EL, Selzner N, Bhat M, Cattral MS, Ghanekar A, McGilvray ID, Sapisochin G, Selzner M, Greig PD, Grant DR

Abstract
BACKGROUND: In parallel with the obesity epidemic, liver transplantation for nonalcoholic steatohepatitis (NASH) is increasing dramatically in North America. Although survival outcomes are similar to other etiologies, liver transplantation in the NASH population has been associated with significantly increased resource utilization. We sought to compare outcomes between live donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT) at a high volume North American transplant center, with a particular focus on resource utilization.
METHODS: The study population consists of primary liver transplants performed for NASH at Toronto General Hospital from 2000 to 2014. Recipient characteristics, perioperative outcomes, graft and patient survivals, and resource utilization were compared for LDLT versus DDLT.
RESULTS: A total of 176 patients were included in the study (48 LDLT vs 128 DDLT). LDLT recipients had a lower model for end-stage liver disease score and were less frequently hospitalized prior to transplant. Estimated blood loss and early markers of graft injury were lower for LDLT. LDLT recipients had a significantly shorter hospitalization (intensive care unit, postoperative, and total hospitalization).
CONCLUSIONS: LDLT for NASH facilitates transplantation of patients at a less severe stage of disease, which appears to promote a faster postoperative recovery with less resource utilization.

PMID: 28620642 [PubMed - in process]

Mesenchymal stem cell-derived exosomes as a new therapeutic strategy for liver diseases.

Sun, 06/18/2017 - 12:45
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Mesenchymal stem cell-derived exosomes as a new therapeutic strategy for liver diseases.

Exp Mol Med. 2017 Jun 16;49(6):e346

Authors: Lou G, Chen Z, Zheng M, Liu Y

Abstract
The administration of mesenchymal stem cells (MSCs) as a therapy for liver disease holds great promise. MSCs can differentiate into hepatocytes, reduce liver inflammation, promote hepatic regeneration and secrete protective cytokines. However, the risks of iatrogenic tumor formation, cellular rejection and infusional toxicity in MSC transplantation remain unresolved. Accumulating evidence now suggests that a novel cell-free therapy, MSC-secreted exosomes, might constitute a compelling alternative because of their advantages over the corresponding MSCs. They are smaller and less complex than their parent cells and, thus, easier to produce and store, they are devoid of viable cells, and they present no risk of tumor formation. Moreover, they are less immunogenic than their parent cells because of their lower content in membrane-bound proteins. This paper reviews the biogenesis of MSC exosomes and their physiological functions, and highlights the specific biochemical potential of MSC-derived exosomes in restoring tissue homeostasis. In addition, we summarize the recent advances in the role of exosomes in MSC therapy for various liver diseases, including liver fibrosis, acute liver injury and hepatocellular carcinoma. This paper also discusses the potential challenges and strategies in the use of exosome-based therapies for liver disease in the future.

PMID: 28620221 [PubMed - in process]

[Not Available].

Sun, 06/18/2017 - 12:45
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[Not Available].

Praxis (Bern 1994). 2016 Aug;105(16):931-8

Authors: Schreiner P, Kröger A

PMID: 27524164 [PubMed - indexed for MEDLINE]

SSRP1 Contributes to the Malignancy of Hepatocellular Carcinoma and Is Negatively Regulated by miR-497.

Sun, 06/18/2017 - 12:45
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SSRP1 Contributes to the Malignancy of Hepatocellular Carcinoma and Is Negatively Regulated by miR-497.

Mol Ther. 2016 May;24(5):903-14

Authors: Ding Q, He K, Luo T, Deng Y, Wang H, Liu H, Zhang J, Chen K, Xiao J, Duan X, Huang R, Xia Z, Zhou W, He J, Yu H, Jiao X, Xiang G

Abstract
The aim of this study is to clarify the clinical implication and functional role of structure specific recognition protein 1 (SSRP1) in hepatocellular carcinoma (HCC) and explore the underlying mechanism of aberrant high expression of SSRP1 in cancers. In the present investigation, we validated that SSRP1 was upregulated in HCC samples. We also demonstrated that its upregulation was associated with several clinicopathologic features such as higher serum AFP level, larger tumor size, and higher T stage of HCC patients; and its high expression indicated shorter overall survival and faster recurrence. To investigate the role of SSRP1 in HCC progression, both loss- and gain-function models were established. We demonstrated that SSPR1 modulated both proliferation and metastasis of HCC cells in vitro and vivo. Furthermore, we demonstrated that SSRP1-modulated apoptosis process and its knockdown increased the sensitivity of HCC cells to doxorubicin, 5-Fluorouracil, and cisplatin. We also identified microRNA-497 (miR-497) as a posttranscriptional regulator of SSRP1. Ectopic expression of miR-497 inhibited 3'-untranslated-region-coupled luciferase activity and suppressed endogenous SSRP1 expression at both messenger RNA and protein levels. For the first time, we proved that SSRP1 upregulation contributed to HCC development and the tumor-suppressive miR-497 served as its negative regulator.

PMID: 26755331 [PubMed - indexed for MEDLINE]

Herpes simplex virus-2 transmission following solid organ transplantation: Donor-derived infection and transplantation from prior organ recipients.

Fri, 06/16/2017 - 12:45

Herpes simplex virus-2 transmission following solid organ transplantation: Donor-derived infection and transplantation from prior organ recipients.

Transpl Infect Dis. 2017 Jun 15;:

Authors: Macesic N, Abbott IJ, Kaye M, Druce J, Glanville AR, Gow PJ, Hughes PD, Korman TM, Mulley WR, O'Connell PJ, Opdam H, Paraskeva M, Pitman MC, Setyapranata S, Rawlinson WD, Johnson PDR

Abstract
BACKGROUND: Owing to limited availability of donor organs, previous solid organ transplant (SOT) recipients are increasingly considered as potential organ donors. We report donor-derived transmission of herpes simplex virus type-2 (HSV-2) to two clusters of SOT recipients with transmission from the original donor and an HSV-2-infected recipient who subsequently became a donor.
METHODS: We reviewed medical records of the donors and recipients in both clusters. Pre-transplant serology and virological features of HSV-2 were characterized. Genotyping of HSV-2 isolates to determine potential for donor transmission of HSV-2 through transplantation of organs from prior organ recipients was performed.
RESULTS: A kidney-pancreas recipient died day 9 post transplant. Following confirmation of brain death, the lungs and recently transplanted kidney were donated to two further recipients. The liver was not retrieved, but biopsy confirmed HSV-2 infection. Testing on the original donor showed negative HSV-2 polymerase chain reaction and HSV immunoglobulin (Ig)M, but positive HSV-2 IgG. The liver recipient from the original donor developed HSV-2 hepatitis and cutaneous infection that responded to treatment with intravenous acyclovir. In the second cluster, lung and kidney recipients both developed HSV-2 viremia that was successfully treated with antiviral therapy. Genotyping of all HSV-2-positive samples showed 100% sequence homology for three recipients.
CONCLUSIONS: Donor-derived HSV infection affected two clusters of recipients because of transplantation of organs from a prior organ recipient. HSV should be considered as a possible cause of illness in febrile SOT recipients in the immediate post-transplant period and may cause disseminated disease and re-infection in HSV-2-seropositive recipients. Testing of HSV serology and prophylaxis may be considered in SOT recipients not receiving cytomegalovirus prophylaxis. This article is protected by copyright. All rights reserved.

PMID: 28618165 [PubMed - as supplied by publisher]

Is Liver Transplant Education Patient-Centered?

Fri, 06/16/2017 - 12:45

Is Liver Transplant Education Patient-Centered?

Liver Transpl. 2017 Jun 15;:

Authors: Bababekov YJ, Fong ZV, Chang DC, Simpson MA, Yeh H, Pomposelli JJ

PMID: 28618164 [PubMed - as supplied by publisher]

Perioperative Use of Terlipressin in Adult Liver Transplant.

Fri, 06/16/2017 - 12:45

Perioperative Use of Terlipressin in Adult Liver Transplant.

Liver Transpl. 2017 Jun 15;:

Authors: Taneja S, Chawla YK

PMID: 28618096 [PubMed - as supplied by publisher]

Position paper on treatment of hepatitis C in Romania, 2017. Part one.

Fri, 06/16/2017 - 12:45

Position paper on treatment of hepatitis C in Romania, 2017. Part one.

J Gastrointestin Liver Dis. 2017 Jun;26(2):171-181

Authors: Gheorghe L, Sporea I, Iacob S, Şirli R, Trifan A, Dobru D, Diculescu M, Stanciu C, Pascu O, Acalovschi M, Brisc C, Cijevschi C, Gheorghe C, Spârchez Z, Rogoveanu I, Dumitrascu D

Abstract
BACKGROUND AND AIMS: Hepatitis C Virus (HCV) infection is a common condition with endemic prevalence in some areas of the world. In Romania the mean prevalence is about 3%. New treatments became available on the market in recent years and new drugs are in the pipeline. A re-evaluation of HCV therapy was considered mandatory. The Romanian Society of Gastroenterology and Hepatology undertook this task for the practitioners of this country.
METHODOLOGY: A group of recognized experts was created who screened the available literature and the major available guidelines. A list of items requiring attention has been created. These items were discussed and rated. Decisions were taken by consensus.
RECOMMENDATIONS: We present here the first of the two parts of our Society's recommendations for chronic HCV infection treatment. An agreement was reached regarding the diagnostic tools, the assessment of severity and the up-dated therapy schedules.
CONCLUSIONS: This Position Paper represents a guide for the assessment and the therapy of HCV infection. The recommendations are in concordance with other guidelines but are applied to the real-life conditions in this country.

PMID: 28617888 [PubMed - in process]

Granulomatous hepatitis: a rare primary manifestation of disseminated histoplasmosis in a renal transplant recipient.

Fri, 06/16/2017 - 12:45

Granulomatous hepatitis: a rare primary manifestation of disseminated histoplasmosis in a renal transplant recipient.

J Gastrointestin Liver Dis. 2017 Jun;26(2):114

Authors: Kothadia JP, Kone V, Giashuddin S

PMID: 28617878 [PubMed - in process]

Human Herpesvirus 6 Reactivation in DRESS With Acute Liver Failure: A Missing Key Factor.

Fri, 06/16/2017 - 12:45

Human Herpesvirus 6 Reactivation in DRESS With Acute Liver Failure: A Missing Key Factor.

Transplantation. 2017 Apr 07;:

Authors: Descamps V, Brunet-Possenti F

PMID: 28617304 [PubMed - as supplied by publisher]

Using Mobile Phone Technology to Support Young Liver Transplant Recipients Moving to Adult Services.

Fri, 06/16/2017 - 12:45

Using Mobile Phone Technology to Support Young Liver Transplant Recipients Moving to Adult Services.

Prog Transplant. 2017 Jun;27(2):207-218

Authors: Coad J, Toft A, Claridge L, Ferguson J, Hind J, Jones R, McClean P, McKiernan P, Samyn M, Taylor R

Abstract
BACKGROUND: The process and preparation of moving from child to adult services (transition) is a challenging period of time for young people and represents significant changes in care and support systems. The proliferation of mobile phone applications for health purposes suggests that it is an area for further investigation.
OBJECTIVE: The review explores the potential to use mobile phone technology to help support young liver transplant recipients moving to adult services. It represents the first review conducted in this specialism and considers a new model of support for young liver patients.
METHODS: A systematic rapid review of the published peer-reviewed literature.
RESULTS: Two searches were conducted: Search 1: the use of technology to support transition to adult services (6 studies) and Search 2: how best to support liver transplant recipients during transition (6 studies).
DISCUSSION: Research shows that to achieve positive transition young people need information about their condition and transition. The process needs to be guided by transition readiness, rather than the young persons' age. Although parents and support networks should be in place and are valued, transition should build upon self-management and independence. Results suggest that there appears to be scope to use mobile phone technology to support transition. This is the first time a review has explored the types of issues or concerns facing liver transplant patients and how these can be addressed through mobile phone technology.

PMID: 28617171 [PubMed - in process]

Liver Transplantation Using Graft From a Donor With Aplastic Anemia.

Fri, 06/16/2017 - 12:45

Liver Transplantation Using Graft From a Donor With Aplastic Anemia.

Prog Transplant. 2017 Jun;27(2):219-220

Authors: Milani S, Aliakbarian M, Khaleghi E

Abstract
Liver transplantation (LT) is a life-saving procedure in patients with end-stage liver disease. The number of patients in the waiting list for LT has steadily increased over time, so removing liver from deceased donors with unusual disorders could possibly be used for transplantation. We describe a case of LT from a donor with "aplastic anemia" to a patient with liver failure due to hepatitis C. Aplastic anemia is a syndrome of bone marrow failure. Aplastic anemia is one of the most common conditions linked to transfusion dependence, and long-term repeated transfusion inevitably results in iron overload. Also iron is a cofactor that influences the severity and progression of nonhemochromatic liver diseases, especially steatohepatitis and viral hepatitis. The aim of this report is to highlight the posttransplant findings of the recipient, with specific emphasis on the graft function. Our findings provide insights into the clinical implications of LT using graft with this rare disorder.

PMID: 28617164 [PubMed - in process]

Thirteen-Year Evaluation of the Management of Biliary Tract Complication After Deceased Donor Liver Transplantation.

Fri, 06/16/2017 - 12:45

Thirteen-Year Evaluation of the Management of Biliary Tract Complication After Deceased Donor Liver Transplantation.

Prog Transplant. 2017 Jun;27(2):192-195

Authors: Shamsaeefar A, Nikeghbalian S, Kazemi K, Motazedian N, Geramizadeh B, Malekhosseini SA

Abstract
INTRODUCTION: Although patient and graft survival rate has increased in recent years, biliary complications after liver transplantation are associated with significant morbidity and mortality.
METHODS AND MATERIALS: We reviewed the database of 1930 patients who underwent deceased donor liver transplantation between 2000 and 2013. The patients had abnormal results in liver tests, as well as fever and jaundice. Abdominal sonography was performed, and if complication was identified, the patient underwent an interventional procedure by endoscopic retrograde cholangiopancreatography or percutaneous transhepatic cholangiography. If the complication was not resolved by the mentioned procedures, exploration of common bile duct and Roux-en-Y choledochojejunostomy or revision of Roux-en-Y choledochojejunostomy was done.
RESULTS: Our study group comprised 105 patients including 66 (63%) men and 39 (37.1%) women with a mean age of 36.7 ± 12.5 years (range: 15-66 years). Among 1930 patients, 105 (5.4%) cases presented with biliary complication after liver transplantation, of which 97 (5%) and 8 (0.4%) cases presented with biliary stricture and bile leak/biloma, respectively.
CONCLUSION: In our study, most patients with biliary complications after liver transplantation responded to interventional procedures, with 37.1% requiring surgical exploration.

PMID: 28617155 [PubMed - in process]

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