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326 records – page 1 of 33.

ABO-incompatible liver transplantation for critically ill adult patients.

https://arctichealth.org/en/permalink/ahliterature163388
Source
Transpl Int. 2007 Aug;20(8):675-81
Publication Type
Article
Date
Aug-2007
Author
Christian Toso
Mohammed Al-Qahtani
Faisal A Alsaif
David L Bigam
Glenda A Meeberg
A M James Shapiro
Vincent G Bain
Norman M Kneteman
Author Affiliation
Department of Surgery, Section of Hepatobiliary, Pancreatic and Transplant Surgery, University of Alberta, Edmonton, Canada.
Source
Transpl Int. 2007 Aug;20(8):675-81
Date
Aug-2007
Language
English
Publication Type
Article
Keywords
ABO Blood-Group System - immunology
Adolescent
Adult
Aged
Alberta - epidemiology
Critical Illness
Female
Follow-Up Studies
Graft Rejection - blood - epidemiology - prevention & control
Graft Survival
Humans
Immunosuppressive Agents - therapeutic use
Incidence
Liver Failure - blood - surgery
Liver Transplantation - adverse effects
Male
Middle Aged
Prognosis
Retrospective Studies
Survival Rate
Abstract
ABO incompatible (ABO-In) liver transplant remains a controversial solution to acute liver failure in adults. Adult liver recipients with acute liver failure or severely decompensated end-stage disease, intubated and/or in the intensive care unit, were grouped as ABO-In (n = 14), ABO-compatible (n = 29, ABO-C) and ABO-identical (n = 65, ABO-Id). ABO-In received quadruple immunosuppression with antibody-depleting induction agents (except two), calcineurin inhibitors, antimetabolites and steroids. No significant difference of patient and graft survivals was observed among ABO-In, ABO-C and ABO-Id: graft survivals were 64%, 62% and 67%, respectively, in 1 year and 56%, 54% and 60%, respectively, in 5 years; patient survivals 86%, 69% and 67%, respectively, in 1 year and 77%, 61% and 62%, respectively, in 5 years. Three ABO-In grafts were lost (one hyper-acute rejection and two hepatic artery thrombosis). Surgical and infectious complications were similarly distributed between groups, except the hepatic artery thrombosis, more frequent in ABO-In (2, 14%) than ABO-I (1, 1.5%, P
PubMed ID
17521384 View in PubMed
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Access to adult liver transplantation in Canada: a survey and ethical analysis.

https://arctichealth.org/en/permalink/ahliterature212821
Source
CMAJ. 1996 Feb 1;154(3):337-42
Publication Type
Article
Date
Feb-1-1996
Author
M A Mullen
N. Kohut
M. Sam
L. Blendis
P A Singer
Author Affiliation
University of Toronto Joint Centre for Bioethics, Ont.
Source
CMAJ. 1996 Feb 1;154(3):337-42
Date
Feb-1-1996
Language
English
Publication Type
Article
Keywords
Adult
Canada
Data Collection
Health Care Rationing - organization & administration
Health Services Accessibility - organization & administration
Humans
Liver Transplantation
Organizational Policy
Patient Selection
Resource Allocation
Waiting Lists
Abstract
To describe the substantive and procedural criteria used for placing patients on the waiting list for liver transplantation and for allocating available livers to patients on the waiting list; to identify principal decision-makers and the main factors limiting liver transplantation in Canada; and to examine how closely cadaveric liver allocation resembles theoretic models of source allocation.
Mailed survey.
Medical directors of all seven Canadian adult liver transplantation centres, or their designates. Six of the questionnaires were completed.
Relative importance of substantive and procedural criteria used to place patients in the waiting list for liver transplantation and to allocate available livers. Identification of principal decision-makers and main limiting factors to adult liver transplantation.
Alcoholism, drug addiction, HIV positivity, primary liver cancer, noncompliance and hepatitis B were the most important criteria that had a negative influence on decisions to place patients on the waiting list for liver transplantation. Severity of disease and urgency were the most important criteria used for selecting patients on the waiting list for transplantation. Criteria that were inconsistent across the centres included social support (for deciding who is placed on the waiting list) and length of time on the waiting list (for deciding who is selected from the list). Although a variety of people were reported as being involved in these decisions, virtually all were reported to be health to be health care professionals. Thirty-seven patients died while waiting for liver transplantation in 1991; the scarcity of cadaveric livers was the main limiting factor.
Criteria for resource allocation decisions regarding liver transplantation are generally consistent among the centres across Canada, although some important inconsistencies remain. Because patients die while on the waiting list and because the primary limiting factor is organ supply, increased organ acquisition efforts are needed.
Notes
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PubMed ID
8564903 View in PubMed
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[Acute fulminant liver failure. Importance of early contact with a specialist].

https://arctichealth.org/en/permalink/ahliterature221877
Source
Lakartidningen. 1993 Jan 6;90(1-2):37-40
Publication Type
Article
Date
Jan-6-1993
Author
L S Eriksson
L. Eleborg
A. Nemeth
B G Ericzon
Author Affiliation
Medicinska kliniken, Huddinge sjukhus.
Source
Lakartidningen. 1993 Jan 6;90(1-2):37-40
Date
Jan-6-1993
Language
Swedish
Publication Type
Article
Keywords
Acute Disease
Hepatic Encephalopathy - diagnosis - mortality - therapy
Hospital Units
Humans
Liver Transplantation
Prognosis
Sweden
PubMed ID
8421401 View in PubMed
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Acute liver failure in children: the first 348 patients in the pediatric acute liver failure study group.

https://arctichealth.org/en/permalink/ahliterature169060
Source
J Pediatr. 2006 May;148(5):652-658
Publication Type
Article
Date
May-2006
Author
Robert H Squires
Benjamin L Shneider
John Bucuvalas
Estella Alonso
Ronald J Sokol
Michael R Narkewicz
Anil Dhawan
Philip Rosenthal
Norberto Rodriguez-Baez
Karen F Murray
Simon Horslen
Martin G Martin
M James Lopez
Humberto Soriano
Brendan M McGuire
Maureen M Jonas
Nada Yazigi
Ross W Shepherd
Kathleen Schwarz
Steven Lobritto
Daniel W Thomas
Joel E Lavine
Saul Karpen
Vicky Ng
Deirdre Kelly
Nancy Simonds
Linda S Hynan
Author Affiliation
University of Pittsburgh, Children's Hospital of Pittsburgh, PA 15213, USA. Robert.squires@chp.edu
Source
J Pediatr. 2006 May;148(5):652-658
Date
May-2006
Language
English
Publication Type
Article
Keywords
Adolescent
Canada - epidemiology
Child, Preschool
Cohort Studies
Databases, Factual
Female
Great Britain
Health status
Humans
Infant
Infant, Newborn
Liver Failure, Acute - diagnosis - epidemiology - therapy
Liver Transplantation
Male
Needs Assessment
Predictive value of tests
Prognosis
United States - epidemiology
Abstract
To determine short-term outcome for children with acute liver failure (ALF) as it relates to cause, clinical status, and patient demographics and to determine prognostic factors.
A prospective, multicenter case study collecting demographic, clinical, laboratory, and short-term outcome data on children from birth to 18 years with ALF. Patients without encephalopathy were included if the prothrombin time and international normalized ratio remained > or = 20 seconds and/or >2, respectively, despite vitamin K. Primary outcome measures 3 weeks after study entry were death, death after transplantation, alive with native liver, and alive with transplanted organ.
The cause of ALF in 348 children included acute acetaminophen toxicity (14%), metabolic disease (10%), autoimmune liver disease (6%), non-acetaminophen drug-related hepatotoxicity (5%), infections (6%), other diagnosed conditions (10%); 49% were indeterminate. Outcome varied between patient sub-groups; 20% with non-acetaminophen ALF died or underwent liver transplantation and never had clinical encephalopathy.
Causes of ALF in children differ from in adults. Clinical encephalopathy may not be present in children. The high percentage of indeterminate cases provides an opportunity for investigation.
Notes
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PubMed ID
16737880 View in PubMed
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Acute liver failure in Sweden: etiology and outcome.

https://arctichealth.org/en/permalink/ahliterature161905
Source
J Intern Med. 2007 Sep;262(3):393-401
Publication Type
Article
Date
Sep-2007
Author
G. Wei
A. Bergquist
U. Broomé
S. Lindgren
S. Wallerstedt
S. Almer
P. Sangfelt
A. Danielsson
H. Sandberg-Gertzén
L. Lööf
H. Prytz
E. Björnsson
Author Affiliation
Section of Gastroenterology and Hepatology, Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Source
J Intern Med. 2007 Sep;262(3):393-401
Date
Sep-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Female
Humans
Liver Failure, Acute - etiology - surgery
Liver Transplantation
Male
Middle Aged
Retrospective Studies
Sweden - epidemiology
Abstract
To determine the causes and outcome of all patients with acute liver failure (ALF) in Sweden 1994-2003 and study the diagnostic accuracy of King's College Hospital (KCH) criteria and the model for end-stage liver disease (MELD) score with transplant-free deaths as a positive outcome.
Adult patients in Sweden with international normalized ratio (INR) of >or=1.5 due to severe liver injury with and without encephalopathy at admission between 1994-2003 were included.
A total of 279 patients were identified. The most common cause of ALF were acetaminophen toxicity in 42% and other drugs in 15%. In 31 cases (11%) no definite etiology could be established. The KCH criteria had a positive-predictive value (PPV) of 67%, negative-predictive value (NPV) of 84% in the acetaminophen group. Positive-predictive value and negative-predictive value of KCH criteria in the nonacetaminophen group were 54% and 63% respectively. MELD score>30 had a positive-predictive value of 21%, negative-predictive value of 94% in the acetaminophen group. The corresponding figures for the nonacetaminophen group were 64% and 76% respectively.
Acetaminophen toxicity was the most common cause in unselected patients with ALF in Sweden. KCH criteria had a high NPV in the acetaminophen group, and in combination with MELD score
PubMed ID
17697161 View in PubMed
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Adult liver transplant survey: policies towards eligibility criteria in Canada and the United States 2007.

https://arctichealth.org/en/permalink/ahliterature154959
Source
Liver Int. 2008 Nov;28(9):1250-5
Publication Type
Article
Date
Nov-2008
Author
Karen I Kroeker
Vincent G Bain
Thomas Shaw-Stiffel
Tse-Ling Fong
Eric M Yoshida
Author Affiliation
Department of Medicine, University of Alberta, Edmonton, AB, Cananda.
Source
Liver Int. 2008 Nov;28(9):1250-5
Date
Nov-2008
Language
English
Publication Type
Article
Keywords
Canada
Eligibility Determination
Humans
Liver Transplantation - contraindications
Questionnaires
United States
Abstract
To assess the current practice patterns of liver transplant centres in Canada and the USA regarding transplant eligibility.
Liver transplantation is an evolving field and today remains the only life-sustaining treatment for end-stage liver disease. Issues of allocation and transplant eligibility are important factors in the ethical practice of medicine.
Questionnaires were mailed to liver transplant programme directors in Canada and the USA inquiring about current practices regarding recipient eligibility.
This study demonstrates that there is consensus in the use of other eligibility criteria, including non-compliance, social status, abstinence from alcohol and methadone and cocaine use. Interestingly, literature is lacking to support the use of these parameters as eligibility criteria with the exception of alcohol. There is a lack in consensus regarding marijuana use, human immunodeficiency virus status, ability to accept blood transfusions and prisoner status. The literature suggests that liver transplantation in select patients who refuse blood transfusions results in good outcomes.
Important decisions regarding transplant eligibility still have to be made empirically in the absence of scientific literature about various social issues. While consensus among transplant programmes is useful, it is important that we continue to use the evidence in the literature to revise these eligibility criteria, keeping in mind ethical principles applied to the access and allocation of a scarce resource.
Notes
Comment In: Liver Int. 2008 Nov;28(9):1186-918822075
PubMed ID
18822078 View in PubMed
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Advanced glycation end product in familial amyloidotic polyneuropathy (FAP).

https://arctichealth.org/en/permalink/ahliterature198719
Source
J Intern Med. 2000 Apr;247(4):485-92
Publication Type
Article
Date
Apr-2000
Author
N. Nyhlin
Y. Ando
R. Nagai
O. Suhr
M. El Sahly
H. Terazaki
T. Yamashita
M. Ando
S. Horiuchi
Author Affiliation
Gastroenterology and Hepatology Section, Department of Medicine, Umeå University Hospital, S-901 85 Umeå, Sweden.
Source
J Intern Med. 2000 Apr;247(4):485-92
Date
Apr-2000
Language
English
Publication Type
Article
Keywords
Adult
Aged
Amyloid Neuropathies - genetics - pathology - surgery
Biopsy
Connective Tissue - pathology
Female
Glycosylation End Products, Advanced - analysis
Humans
Immunoenzyme Techniques
Intestinal Mucosa - pathology
Liver Transplantation
Male
Middle Aged
Muscle, Smooth, Vascular - pathology
Vitrectomy
Vitreous Body - pathology
Abstract
Advanced glycation end products (AGE) are present in amyloid deposits in beta2-microglobulin amyloidosis, and it has been postulated that glycation of beta2-microglobulin may be involved in fibril formation. The aim of this paper was to ascertain whether AGE occur in amyloid deposits in familial amyloidotic polyneuropathy (FAP).
Department of Medicine, Umeå University Hospital and First Department of Internal Medicine, Kumamoto University School of Medicine.
The presence of AGE was sought immunohistochemically and biochemically in amyloid-rich tissues from patients with FAP.
Biopsy specimens from nine patients and 10 controls were used for the immunohistochemical analysis. For amyloid preparation, vitreous samples from three FAP patients were used.
Immunohistochemical studies using a polyclonal anti-AGE antibody revealed positive immunoreactivity in intestinal materials, but the pattern of reactivity was unevenly distributed; it was often present in the border of amyloid deposits, or surrounding them. Non-amyloid associated immunoreactivity was also observed in a few regions of the specimens, although the AGE-positive structures were situated in areas containing amyloid deposits. Western blotting of purified amyloid from the vitreous body of FAP patients revealed a significant association of AGE with amyloid fibrils.
The immunoreactivity for the AGE antibody suggests that AGE may be involved in fibril formation in FAP.
PubMed ID
10792563 View in PubMed
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[Advisability of biliary drainage in liver fragments reconstruction].

https://arctichealth.org/en/permalink/ahliterature279323
Source
Khirurgiia (Mosk). 2016;(9):4-12
Publication Type
Article
Author
A V Semenkov
E F Kim
A V Filin
D S Burmistrov
A V Metelin
Yu R Kamalov
T N Galyan
A V Goncharova
Source
Khirurgiia (Mosk). 2016;(9):4-12
Language
Russian
Publication Type
Article
Keywords
Anastomosis, Surgical - adverse effects - instrumentation - methods
Anastomotic Leak - epidemiology - prevention & control
Biliary Tract Diseases - epidemiology - etiology - prevention & control
Biliary Tract Surgical Procedures - adverse effects - methods
Decompression, Surgical - methods
Drainage - methods
Female
Humans
Incidence
Liver Transplantation - adverse effects - methods
Male
Middle Aged
Moscow - epidemiology
Outcome and Process Assessment (Health Care)
Retrospective Studies
Stents
Abstract
to estimate the effect of decompressive stented drainage of biliary anastomosis on incidence of biliary complications.
294 patients aged from 5 months to 61 years (mean 13.8±0.81) were enrolled. They underwent liver fragments transplantation in the Department of Liver Transplantation of Petrovsky Russian Research Center of Surgery for the period from March 1997 to January 2016. Decompressive stented drainage tubes were used in 28 (9.5%) patients. Reconstruction without drainage was applied in 266 (90.5%) cases. In the group of biliobiliary reconstruction drainage was used in 18 out of 89 cases (20.2%), in the group of biliodigestive reconstruction - in 10 out of 202 cases (4.9%). Incidence of specific biliary complications was assessed.
There was significant direct correlation of stented drainage of biliodigestive anastomosis with various biliary complications including bile leakage (r= -0,1253; p=0.06), obturation of anastomosis (r=0.045; p=0.501), stricture of anastomosis (r= -0.0665; p=0.320), other strictures of intrahepatic bile ducts (r= -0.0291; p=0.664), hepatolithiasis (r=0.0857; p=0.199). However significant direct correation was observed between stented drainage and incidence of intrahepatic bile ducts strictures (r=0.2117; p=0.046) and anastomosis obturation (r=0.2330; p=0.028) in case of biliobiliary reconstruction. Significant correation with other biliary complications was absent (p>0.05).
Unconstrained stented drainage during primary biliary reconstruction is associated with increased incidence of biliary complications and should not be indicated routinely. Clear need for drainage should be determined in further investigations.
PubMed ID
27723689 View in PubMed
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326 records – page 1 of 33.