A prospective randomized open study in liver transplant recipients: daclizumab, mycophenolate mofetil, and tacrolimus versus tacrolimus and steroids.

This open-label, randomized study compared the efficacy of a regimen of corticosteroids and tacrolimus (standard therapy group, n = 79) with a regimen of daclizumab induction therapy in combination with mycophenolate mofetil and tacrolimus (modified therapy group, n = 78) in primary liver transplant recipients. The primary endpoint was biopsy-proven acute rejection (BPAR) at 24 weeks. Secondary endpoints included time to rejection and patient and graft survival.

Model for end-stage liver disease score-based allocation of donors for liver transplantation: a spanish multicenter experience.

Background: Prioritizing the liver transplant waiting list (WL) is subject to great variability. We present the experience of four transplant centers in Andalusia (Southern Spain) with a new consensus model of WL management based on the Model for End-Stage Liver Disease (MELD) score.

Methods: The initial criteria for local prioritizing were: a) cirrhosis with MELD score > or =24, and b) all hepatocellular carcinoma (HCC) admitted to the WL.

Drug-induced liver injury: an analysis of 461 incidences submitted to the Spanish registry over a 10-year period.

Background & Aims: Progress in the understanding of susceptibility factors to drug-induced liver injury (DILI) and outcome predictability are hampered by the lack of systematic programs to detect bona fide cases.

Methods: A cooperative network was created in 1994 in Spain to identify all suspicions of DILI following a prospective structured report form. The liver damage was characterized according to hepatocellular, cholestatic, and mixed laboratory criteria and to histologic criteria when available.

Mycophenolate mofetil-induced neutropenia in liver transplantation.

Background: Mycophenolate mofetil (MMF) is a potent, safe immunosuppressive agent for rescue therapy of acute and chronic rejection in orthotopic liver transplant recipients. It helps to reduce the serious toxic side effects of calcineurin inhibitors (CNIs). The side effects of MMF, such as bone marrow toxicity, have been reported.

Serum immunological profile in patients with chronic autoimmune cholestasis.

Aim: To compare patients who had biochemical and histological features of chronic autoimmune cholestasis (CAIC) using serological autoantibody profiling.

Methods: Patients (n = 174 CAIC; 79 AMA(-) and 95 AMA(+)) were profiled for the following antibodies: antinuclear antibodies (ANAs), antimitochondrial antibodies (AMAs), antismooth muscle actin (SMA, mainly F-actin), antiperinuclear cytoplasmic neutrophil antibodies (pANCAs), anti-SP100, anti-GP210, anti-M2 (2-oxo-acid dehydrogenase complexes), and antisoluble liver antigen (SLA). Liver specimens were reviewed according to staging, biliary interface activity, lobular hepatitis, granulomas, cholestasis, and florid ductal lesion.

HLA class II genotype influences the type of liver injury in drug-induced idiosyncratic liver disease.

Drug-induced idiosyncratic liver disease (DIILD) depends largely on host susceptibility factors. Small studies support the genetic influence of human leukocyte antigen (HLA) class II molecules on the predisposition to DIILD. We sought associations between HLA-DRB and -DQB alleles and DIILD considered collectively or according to the biochemical expression of liver damage.

Flutamide-induced hepatotoxicity: report of a case series.

Objective: To evaluate the characteristics of flutamide induced hepatotoxicity.

Material And Methods: In this retrospective study we have analyzed all cases of flutamide hepatotoxicity submitted to the Andalucian Registry of drug-induced liver disease. Data were collected using a structured reporting form.

Multicenter retrospective study of response to interferon in chronic hepatitis B.

Aim: The only agent known to have a lasting beneficial effect in chronic hepatitis B is interferon alpha, which achieves long-term remission in 25-40% of the patients. The goals of treatment are to induce clearance of HBV DNA from serum, to return serum aminotransferases to normal, and to improve histological findings in the liver. The most important factors predictive of response to treatment are high serum aminotranferases levels, low serum HBV DNA concentrations, and active histologic changes on liver biopsy.

Acute liver injury associated with the use of ebrotidine, a new H2-receptor antagonist.

Background/aim: Ebrotidine is a new H2-receptor antagonist marketed in Spain in early 1997 and withdrawn in July 1998. We report 11 cases of acute liver injury related to ebrotidine and submitted to a Regional Registry of Hepatotoxicity between June 1997 and August 1998.

Methods: In all cases a structured protocol was used to ascertain the role of ebrotidine and to exclude other causes (viral, immunologic, metabolic) of liver injury.

Response of chronic hepatitis C to interferon-alpha treatment and relationship with iron metabolism.

Aim: to prospectively analyze the influence of iron metabolism of the response to interferon-alpha therapy in chronic hepatitis C.

Methods: ninety-two patients with chronic hepatitis C treated with recombinant alpha-interferon were included. Basal serum levels of iron, ferritin and transferrin saturation were compared in responding and nonresponding patients.

[Retrospective multicenter study of the efficacy of interferon alpha in chronic hepatitis C].

Background: Until very recently, interferon (INF) in Spain was authorized in chronic hepatitis C (C-HCV) at a dosis of 3 megaunits (mu) for 6 months. Nonetheless, the rate of maintained complete response is lower than that obtained with more prolonged treatments. The first aim of this study was to retrospectively know the effectiveness of alpha INF in patients treated for 6 or 12 months with a dosis of 3 or 5-6 MU.

[Intrahepatic cholestasis of pregnancy. Maternofetal implications].

Objective: To analyze a group of pregnancies complicated by intrahepatic cholestasis in order to favour an early recognition and to decrease maternal and fetal morbid-mortality.

Patients And Methods: Retrospective study of 46 pregnancies with intrahepatic gravidic cholestasis between 1990-94. We review the most relevant epidemiologic, clinical and biological features and the obstetric and perinatal results.

[Comparison of the indexes of serologic activity with endoscopy in intestinal inflammatory disease].

The correlation of the most commonly used clinical and serologic parameters in clinical practice were studied with an endoscopic model for inflammatory bowel disease (IBD). Eighty patients diagnosed with IBD with colic involvement (40 patients with ulcerous colitis [UC] and 40 with Crohn's disease [CD]) were prospectively studied. The CDAI was used as a clinical index of activity in the cases of CD and the True-love and Witts index was used in those with UC.

[Thyroid dysfunction in patients with chronic hepatitis C pre and post treatment with interferon].

Objective: The aim of this study was to evaluate the thyroid function and the dysfunction after interferon therapy in patients with chronic hepatitis C.

Material And Methods: Between 1988 and 1994, 119 patients with chronic hepatitis C treated with interferon were reviewed 92 patients received interferon alfa for six or twelve months. 27 patients were treated with interferon beta for six months.

[Laparoscopic diagnosis of hepatic angiomas after erroneous imaging techniques].

Hemangiomas are de most frequent benign liver tumours. Their clinical relevance is small but they can cause to the patient and/or the physician a great worry because can be indistinguishable from hepatic malignances. From 1991 to 1994 five patients with liver hemangiomas were diagnosed by laparoscopy after a erroneous and/or contradictory interpretation by various imaging techniques.

[Emergency laparoscopy. A 20-year experience].

We revised 7988 laparoscopies over twenty years. Three hundred and ninety three were urgent laparoscopies: 325 patients with acute spontaneous abdomen and 68 acute traumatic abdomen. Emergency laparoscopy is made in patients with, both spontaneous and traumatic acute abdomen, when diagnosis is not made in 8 hours with the usual clinical and imaging methods.

[Caroli's syndrome: a variable entity].

We present the case of a 56 year old woman with Caroli's disease associated to congenital liver fibrosis, renal nephrocalcinosis and cutaneous vasculitis of the legs. Clinical signs of portal hypertension were treated by a shunt technique. After an asymptomatic period, the patient suffers now from crisis of angiocholitis.

[The effect of environmental factors in inflammatory bowel disease].

In an attempt to elicit risk factors in inflammatory bowel disease in Spain, we have carried out a case-control study in which we conducted personal interviews asking marital status, place of residence, economic status, use of tobacco and contraceptives, and the method of lactation in infancy. IBD was more common in patients with a low economic level; UC was predominantly found in rural population. No differences were found in the remaining categories.