Study of liver transplant rejection in alcoholism-induced cirrhosis.

Rejection is the most usual cause of primary dysfunction of hepatic allograft transplants. Acute rejection (AR) often occurs in the early post-transplantation weeks, with an incidence of 12%-19%. Chronic rejection (CR) is less usual (2.

Results of liver transplants from donors aged 70 plus: analysis of Andalusian transplant register.

The progressive increase in the number of liver transplantation candidates has brought with it a consequent increase in waiting list mortality, making it necessary to revise donor selection criteria and to analyze the factors that optimize outcomes. This retrospective observational study of 1802 liver transplantations performed in Andalusia between 2000 and 2010 analyzes the outcomes from donors aged 70 years or older (n = 211) in terms of survival rates of the graft and the recipient, the type of transplant, donor age, and DMELD (Donor-Model for End-Stage Liver Disease) score. The most frequent reasons for transplantation were alcoholic cirrhosis (45.

Have we changed the liver retransplantation survival?

Introduction: Orthotropic liver retransplantation (RT) is the therapeutic option for the failure of an allograft. Patient and graft survival rates after RT are inferior to primary liver transplantation (OLT). Because of the limited number of donors, it is essential that we optimize their use.

Outcomes of domino liver transplantation: a single institution's experience.

Aims: Domino liver transplantation (DLT) is a strategy to increase the donor pool. Explanted liver from patients with familial amyloidotic polyneuropathy (FAP) are often used as domino grafts, because the liver is normal apart from the production of the mutated transthyretin variant. We present the outcomes for both donors and recipients of DLT.

Rescue immunosuppression with mammalian target of rapamycin inhibitor drugs in liver transplantation.

Background: Mammalian target of rapamycin (mTOR) inhibitors behave as potent immunosuppressants, which have the advantages, with respect to calcineurin inhibitors (CNI; cyclosporine or tacrolimus), of no nephrotoxicity but inhibition of cell proliferation. They are particularly suitable for patients with renal insufficiency or neoplasias.

Materials And Methods: Twenty-eight liver transplant patients were immunosuppressed with everolimus or sirolimus as rescue therapy after CNI treatment: 8 hepatocellular carcinomas; 7 de novo malignancies; 6 renal insufficiencies; 3 chronic rejections; 3 acute rejection episodes; and 1 epilepsy.

Indications for and survival after liver retransplantation.

Introduction: Orthotopic liver retransplantation (re-OLT) is the therapeutic option for hepatic graft failures. Survival after re-OLT is poorer than after primary OLT. Given that there is an organ shortage, it is essential that we optimize our use of this scarce resource.

[Obstructive jaundice secondary to hepatic artery aneurysm].

Background: Aneurysm of the hepatic artery is relatively infrequent, representing 16-20% of aneurysms of the visceral arteries. Clinical presentation is nonspecific and may include abdominal pain, upper digestive system hemorrhage, or obstructive jaundice, as in the case presented here.

Clinical Case: We present the case of a 47-year-old patient referred to our service due to obstructive jaundice, verifying that the pathology was caused by an aneurysm of >7 cm in diameter in the hepatic artery.

Surgical site infection in liver transplant recipients: impact of the type of perioperative prophylaxis.

Surgical site infection (SSI) is an important cause of morbidity after orthotopic liver transplantation (OLT). Perioperative antibiotic prophylaxis is one of the main modifiable risk factors. We prospectively investigated the epidemiology, risk factors, and prognosis of SSI in a cohort of 167 OLT.

Efficacy and safety of mycophenolate mofetil as part of induction therapy in liver transplantation.

Aims: To report our experience with mycophenolate mofetil (MMF) for induction and maintenance therapy to prevent acute liver transplant rejection.

Methods: A retrospective analysis of 66 elective, noncombined liver transplant patients treated beginning de novo MMF and follow for a minimum of 2 years. Thirty-nine of the 66 cases received MMF, calcineurin inhibitors, and steroids.