The effect of insulin-dependent diabetes mellitus on outcome of liver transplantation.

Background: It is not known whether there was a difference in outcome between insulin-dependent diabetes mellitus (type 1) and non-insulin dependent diabetes mellitus (type 2) after liver transplantation.

Methods: The outcome of liver transplantation in adult patients with type 1 (n=1,629) and type 2 (n=1,618) was compared to those without diabetes mellitus (DM) (nondiabetics, n=17,974) using the United Network for Organ Sharing database from 1994 to 2001, after excluding patients who had living donor or multiple organs or who underwent retransplantation, and those with incomplete data.

Results: Cryptogenic cirrhosis, hypertension, and coronary artery disease (CAD) were two to three times more common in types 1 and 2 compared with nondiabetics.

Role of liver transplantation in the management of hepatocellular carcinoma.

The treatment options for hepatocellular carcinoma (HCC) are liver resection, liver transplantation, or local ablation (e.g., percutaneous ethanol injection, cryosurgery, radio-frequency ablation, and chemoembolization).

Screening for hepatocellular carcinoma.

To determine the role of screening and to screen in a cost-effective manner, it is important to define the high-risk patient population that is most likely to benefit from screening and to identify a readily available diagnostic modality that is sensitive, specific, and inexpensive. Moreover, to have a major effect on the outcome of hepatocellular carcinoma, the test should be applicable in the majority of high-risk subjects. Herein, we identify the high-risk patient population, discuss various diagnostic modalities, and recommend a practical and cost-effective strategy for screening.

Outcome of patients with new-onset diabetes mellitus after liver transplantation compared with those without diabetes mellitus.

In liver transplant recipients, new onset of diabetes mellitus (posttransplant diabetes mellitus or PTDM) is estimated to occur in 9% to 21% of recipients. The limited published data on survival and posttransplant complications in liver transplant recipients who develop PTDM show conflicting results. The objective of our study was to compare the morbidity and mortality of 46 patients who developed PTDM with 92 age- and sex-matched patients without pretransplant or posttransplant diabetes mellitus (DM).

Pretransplant renal function predicts survival in patients undergoing orthotopic liver transplantation.

The objective of this study was to determine the impact of pretransplant renal function on graft and patient survival rates after orthotopic liver transplantation (OLT) using the United Network for Organ Sharing (UNOS) database for adults who underwent OLT between 1988 and 1996. Based on calculated creatinine clearance (CCr) at the time of OLT, patients were classified arbitrarily into those with normal renal function (>70 mL/min) and mild (40-69.9 mL/min), moderate (20-39.

Outcome of orthotopic liver transplantation in patients with hepatitis C.

Recurrence of chronic hepatitis C (HCV) after orthotopic liver transplantation (OLT) is universal. The published studies suggest that the short-term outcome is good in these patients, but the long-term prognosis remains unclear. The purpose of this study was to evaluate the outcome of patients with HCV undergoing OLT in a single center and to analyze the risk factors associated with poor outcome.

Effect of race on outcome of orthotopic liver transplantation: a cohort study.

Background: There is significant evidence to suggest that long-term survival after renal transplantation is significantly lower in African Americans than in other races. We aimed to establish whether there was a difference in survival in African Americans compared with other races after orthotopic liver transplantation (OLT) and whether race was an independent predictor of survival.

Methods: We collected data from the United Network of Organ Sharing transplant registry for all liver transplants done between 1988 and 1996 in the USA.

Mortality from hepatocellular and biliary cancers: changing epidemiological trends.

Objectives: The incidence of hepatocellular carcinoma may be rising in the United States. The aim of this study was to determine the epidemiological trends in mortality from hepatocellular carcinoma (HCC) and biliary cancers (BCs) in Maryland during the last 3 decades.

Methods: The number of deaths due to HCC and BCs from 1970 to 1997 were obtained from the Maryland State Department of Health & Hygiene vital statistics database.

Obesity and its effect on survival in patients undergoing orthotopic liver transplantation in the United States.

Studies assessing morbidity and mortality in obese patients undergoing orthotopic liver transplantation (OLT) have produced conflicting results, mainly because of the small sample size. The objective of our study was to determine graft and patient survival in obese adults receiving OLT in the U.S.