Is minimal, [almost] steroid-free immunosuppression a safe approach in adult liver transplantation? Long-term outcome of a prospective, double blind, placebo-controlled, randomized, investigator-driven study.

Objective: To investigate the safety of minimal immunosuppression (IS) in liver transplantation (LT).

Background: The lack of long-term follow-up studies, including pathologic data, has led to a protean handling of IS in LT.

Methods: Between February 2000 and September 2004, 156 adults were enrolled in a prospective, randomized, double-blind, placebo-controlled minimization trial comparing tacrolimus placebo (TAC-PLAC) and TAC short-term steroid (TAC-STER) IS.

Liver transplantation for hepatocellular cancer: UCL experience in 137 adult cirrhotic patients. Alpha-foetoprotein level and locoregional treatment as refined selection criteria.

Liver transplantation (LT) is a validated treatment for selected cirrhotics with hepatocellular cancer (HCC). A retrospective single center study including 137 recipients having proven HCC was done to refine inclusion criteria for LT as well as to look at impact of locoregional treatment (LRT) on outcome. At pre-LT imaging, 42 (30.

Tacrolimus monotherapy in liver transplantation: one-year results of a prospective, randomized, double-blind, placebo-controlled study.

Background: Minimal immunosuppression (IS) is desirable in organ transplantation to reduce side effects and to promote the process of tolerance induction.

Material And Methods: Between February 2000 and September 2004, 156 adults (>15 years old) receiving a primary liver graft were enrolled in a prospective, randomized, double-blind, placebo-controlled, investigator-driven single-center study comparing tacrolimus (TAC)-placebo (PL) and TAC-low-dose, short-term (64 days) steroid (ST) IS. There were no exclusion criteria at moment of randomization.

Validation of a liquid chromatography-mass spectrometric assay for tacrolimus in liver biopsies after hepatic transplantation: correlation with histopathologic staging of rejection.

The aims of this work were both to validate a sensitive and specific method to quantify tacrolimus (TAC) in liver biopsies after hepatic transplantation and to evaluate the predictive value of either tissue or blood TAC concentrations for rejection in 146 adult patients under a TAC-based immunosuppression. Trough blood levels were monitored daily during the hospital stay by immunoassay. Liver biopsies were routinely performed at day 7 posttransplantation.

Use of anti-HBc positive allografts in adult liver transplantation: toward a safer way to expand the donor pool.

The use of livers from anti-hepatitis B core (HBc) positive donors can alleviate donor shortage. Nineteen of 367 (6%) adults receiving anti-HBc positive allografts [three were hepatitis B antigen (HBsAg) negative, hepatitis B antibody (HBsAb) positive; four were HBsAg positive and 12 were not exposed to hepatitis B viral (HBV) infection] were retrospectively reviewed. In HBsAg negative recipients, immunoprophylaxis (IP) was guided by viral serology and immunohistochemistry (IH) of day 0 and day 7 liver biopsies.

Anti-CD2 monoclonal antibody and tacrolimus in adult liver transplantation.

Background: Blockade of costimulation and adhesion signaling is an attractive approach to interfere with graft rejection

Methods: Between January 1997 and May 1999, forty adults having benign liver diseases were included in a prospective, randomized study comparing tacrolimus plus low-dose short-term steroids without (n=20, TAC group) or with a 10-day course of antihuman CD2 monoclonal antibody (n=20, BTI group).

Results: At day 7, histological rejection expressed by mean Banff scores (2.3+/-1.

Extension of the adult hepatic allograft pool using split liver transplantation.

Background: The ever increasing number of, especially, adults waiting for a liver transplantation necessitates to develop techniques allowing to extend the available donor liver pool.

Materials And Methods: Between November 1988 and December 2004, 37 (6.6%) of 559 adults underwent split liver transplantation at Saint-Luc Hospitals.

Long-term medical complications and quality of life in adult recipients surviving 10 years or more after liver transplantation.

Background And Study Aims: Little information is available about long-term results after adult liver transplantation. This study analyses long-term medical complications, changes of immunosuppression, recurrence of primary disease and quality of life 10 years after liver transplantation.

Material And Methods: During the period February 1984-April 1994, 324 LT were performed in 282 adults (>15 years).

Hepatic haemangioendothelioma in adults: excellent outcome following liver transplantation.

Hepatic epithelioid haemangioendotheliomas (HEHEs) are rare, low-grade vascular tumours. Five adults with HEHEs and one adult with a vascular tumour showing combined features of haemangioma and haemangioendothelioma underwent liver transplantation. Two HEHE patients had extrahepatic metastases at the time of transplantation.

Quality control of the European Liver Transplant Registry: results of audit visits to the contributing centers.

Background: The number of registries is increasing, but few of them perform reliability audits by comparing the data contained in the database with data contained in hospital charts.

Methods: The European Liver Transplant Registry (ELTR) cocoordinating committee appointed an independent team to check the reliability of data contained in ELTR. Centers were selected at random.

Cavocaval adult liver transplantation and retransplantation without venovenous bypass and without portocaval shunting: a prospective feasibility study in adult liver transplantation.

Background: The original method of liver transplantation (LT) included recipient inferior vena cava (IVC) resection and the use of extracorporeal venovenous bypass (VVB). Refinements in technique permit transplantation to be done with IVC preservation and without VVB use.

Material And Methods: Between November 1993 and November 2000, 202 consecutive grafts were performed in 188 adults (>/=16 years of age).

Re-use of a liver allograft; an exceptional opportunity to enlarge the organ donor pool.

Liver allograft re-use is an exceptional way of enlarging the donor pool. We describe here a case of a re-used liver allograft, originating from an insulin-intoxicated donor and transplanted at first into a recipient presenting with hyperacute liver failure due to paracetamol intoxication. Because the original recipient developed an irreversible cerebral oedema, the allograft was re-implanted electively 55.