Perspective review on solid-organ transplant: needs in point-of-care optical biomarkers.

Solid-organ transplant is one of the most complex areas of modern medicine involving surgery. There are challenging opportunities in solid-organ transplant, specifically regarding the deficiencies in pathology workflow or gaps in pathology support, which may await alleviations or even de novo solutions, by means of point-of-care, or point-of-procedure optical biomarkers. Focusing the discussions of pathology workflow on donor liver assessment, we analyze the undermet need for intraoperative, real-time, and nondestructive assessment of the donor injuries (such as fibrosis, steatosis, and necrosis) that are the most significant predictors of post-transplant viability.

Effects of capsule on surface diffuse reflectance spectroscopy of the subcapsular parenchyma of a solid organ.

We hypothesize that the capsular optical properties and thickness combined affect how accurate the diffuse reflectance on the surface of a capsular solid organ represents that on the subcapsular parenchyma. Monte Carlo simulations on two-layer geometries evaluated how a thin superficial layer with the thickness from 10 to 1000  μm affected the surface diffuse reflectance over a source-detector separation spanning 0.01 to 10 mm.

Liver histology as predictor of outcome in patients with acute liver failure.

Acute liver failure (ALF) is a clinical syndrome associated with significant morbidity and mortality with a highly unpredictable outcome. We retrospectively analyzed 71 ALF patients (53 males; mean age = 27.5 ± 15.

Liver transplantation for hepatocellular carcinoma: indications, bridge therapy and adjuvant therapy.

Hepatocellular carcinoma (HCC) is a major cause of cancer mortality worldwide, and its incidence is increasing in the United and States. Liver transplantation has the potential to improve survival for patients with HCC. Unfortunately, not enough donor livers are available to meet demand for liver transplantation.

Chronic HBV with pregnancy: reactivation flare causing fulminant hepatic failure.

Chronic HBV infection is a dynamic state of interaction between HBV, hepatocytes, and the immune system of the host. A series of reactivation flares and remissions may occur due to multiple causes. Among them, spontaneous reactivation and immunosuppressive drugs including steroids or cancer chemotherapy are well known.

The application of SpyScope® technology in evaluation of pre and post liver transplant biliary problems.

Background/aims: Peroral cholangioscopy with its limitations led to further research regarding development of SpyScope® technology. The aim of this retrospective study was to investigate the efficacy of a new device and the application of this device in our Liver Transplant Center.

Methods: Charts of patients who had undergone evaluation with SpyScope® were retrospectively reviewed.

Multiple bile duct hamartomas mimicking diffuse hepatic metastasis: GI image.

Bile duct hamartomas (von Meyenburg complex) are the rare benign neoplasm of the liver due to dysembryogenesis; constituted historically, cystic dilatations of the bile duct encompassed by fibrous stroma. Usually, they are asymptomatic and are not detected on routine radiological examinations including ultrasound or CT scan. Magnetic resonance cholangiography has been suggested as the best investigation for their imaging diagnosis.

Continuous intraarterial thrombolysis for early hepatic artery thrombosis following liver transplantation: case report.

Hepatic artery thrombosis remains one of the major causes of graft failure and mortality in liver transplant recipients. Urgent re-transplantation has been considered as mainstay therapy; however, even with re-transplantation mortality of more than 50% has been reported by many series. Early detection on Doppler ultrasonography and subsequent revascularization in asymptomatic patients can avoid graft loss.

Endovascular treatment of hepatic artery thrombosis following liver transplantation.

Hepatic artery thrombosis (HAT) is the most frequent vascular complication following orthotopic liver transplantation. Urgent retransplantation has been considered as the mainstay therapy. Surgical revascularization is an effective alternative in asymptomatic patients.

Nutritional effects of transjugular intrahepatic portosystemic shunt--an often neglected benefit? "A preliminary report".

Transjugular intrahepatic portosystemic shunt (TIPS) is a useful procedure for preventing complications of portal hypertension. Nutritional effects of TIPS have been described in cirrhotics. In this prospective study, the nutritional effects of TIPS in cirrhotics were aimed to be identified.

Ciliated hepatic foregut cyst: an increasingly diagnosed condition.

Background: Ciliated foregut cysts of the liver are rare, with only 96 cases diagnosed since the first description in 1857. They are being increasingly diagnosed recently; the majority of the cases have been reported in the last 15 years. Although they bear a close resemblance to the simple cyst of the liver which has essentially a benign course, ciliated hepatic foregut cysts (CHFCs) can progress to malignancy with devastating consequences.

Ciliated hepatic foregut cyst: an increasingly diagnosed condition.

Ciliated hepatic foregut cyst is a rare foregut cystic developmental malformation. It presents as a solitary cystic lesion in segment four of the liver. Histologically, it consists of four distinct layers; namely, the inner ciliate columnar epithelium, subepithelial connective tissue, smooth muscle layer, and an outer fibrous layer.

Assessing relative risks of infection and rejection: a meta-analysis using an immune function assay.

Background: Long-term use of immunosuppressants is associated with significant morbidity and mortality in transplant recipients. A simple whole blood assay that has U.S.

Daily consensus interferon (CIFN) monotherapy in non-responders or relapsers to a previous interferon regime: one year follow-up after 48 weeks of treatment.

Background/aims: Data suggests on the basis of thrice a week therapy, efficacy of mono consensus interferon is comparable to other alpha interferons. One-year follow-up after 12-month daily consensus interferon monotherapy for chronic hepatitis C among non-responders or relapsers to previous consensus interferon monotherapy is investigated.

Methods: Between February and August 1998, 11 non-cirrhotic patients with previous consensus interferon failure were treated.

Compatible ABO mismatch and liver transplantation: a single center's experience.

Objectives: The current shortage of suitable donor organs and clinical urgency can lead to implanting grafts from ABO-mismatched donors. One-year graft survival rates for patients in this scenario have been reported as ranging between 25% and 75% less than those for ABO-identical or ABOcompatible grafts. We review and compare our experiences with transplanting ABO-identical and ABO-compatible mismatched livers.

Unusual presentation of hepatic vascular tumors as fulminant hepatic failure.

Epithelioid hemangioendothelioma and angiosarcoma of the liver are rare neoplasms of vascular origin. They can present with nonspecific symptoms such as malaise and weight loss, as well as with liver-related symptoms such as abdominal pain, tender hepatomegaly and jaundice. Portal hypertension and rarely liver failure can occur.

Peri and postoperative pulmonary complications among cirrhotic individuals.

Surgical intervention among cirrhotic individuals carries a high risk for peri-and postoperative complications. We review the literature regarding the frequency and consequences of pulmonary complications in cases of cirrhosis. The experience with hepato-pulmonary syndrome and porto-pulmonary hypertension in liver transplant recipients is also presented.

Multiplex cytokine profiling of initial therapeutic response in patients with chronic hepatitis C virus infection.

Currently available prognostic tools are inadequate to discern the molecular basis of the heterogenic response in hepatitis C virus (HCV)-infected patients treated with the current standard of therapy. The expression and biological function of immune mediators have been shown to be critical in all phases of the immune response to HCV infection and likely therefore influence host response. Herein, a biometric multiplex serum cytokine assay was utilized to characterize the immunomodulatory effects of host response in 10 HCV patients.

Primary biliary cirrhosis in monozygotic and dizygotic twins: genetics, epigenetics, and environment.

Background & Aims: There is growing evidence that the interplay of genetic susceptibility and environmental factors leads to primary biliary cirrhosis (PBC). In particular, family members of an infected individual have up to a 100-fold higher risk of developing PBC. Although concordant rates for identical twins in other autoimmune diseases range between 25% and 50%, there are no such data on PBC.

Experience with liver dialysis in acetaminophen induced fulminant hepatic failure: a preliminary report.

Background/aims: Our aim was to assess the efficacy of the liver dialysis unit (LDU) in the treatment of patients with acetaminophen-induced fulminant hepatic failure.

Methods: Seventeen patients with acetaminophen-induced fulminant hepatic failure between January 1996 and December 2001 were retrospectively studied. A liver dialysis unit became available in our Unit in July 2000, and as of December 2001, four of these 17 patients had undergone treatment with liver dialysis.