Liver transplantation: an unfinished product.

Liver transplantation has become an extraordinarily valuable and useful operation, but one that is not perfect and that has not been exploited to anything like its full potential. Better immunosuppression may become available soon as exemplified by developments with the Japanese drug, FK506. Improved preservation with the UW solution is already here.

Hepatic artery thrombosis following pediatric liver transplantation: Assessment of blood flow measurement in allografts.

The purpose of this study was to define parameters which could be predictive of hepatic artery thrombosis, which continues to be a major complicating factor in pediatric liver transplantation. The hepatic blood flow of 14 pediatric liver patients (15 grafts) who weighed less than 15 kg was measured electromagnetically during orthotopic liver transplantation. The results of blood flow determination and the clinical data in 7 patients (8 grafts) who developed hepatic artery thrombosis were compared with those of 7 control patients.

Aplastic anemia complicating orthotopic liver transplantation for non-A, non-B hepatitis.

Aplastic anemia developed in 9 of 32 patients (28 percent) undergoing orthotopic liver transplantation for acute non-A, non-B hepatitis, at one to seven weeks after the procedure. No patient previously had evidence of hematologic dysfunction or conditions known to be associated with aplastic anemia. No other cases of aplastic anemia were identified among 1463 patients undergoing liver transplantation for all other indications at the four centers participating in the study (chi-square = 415, P less than 0.

Hepatic resection for hepatocellular carcinoma in elderly patients.

Of 154 elective hepatectomies performed during the 13 year period from 1973 to 1985 for hepatocellular carcinoma, 27 (17.5 percent) were performed on patients 65 years of age or older. Among these elderly patients, 40.

Intraperitoneal septic complications after hepatectomy.

One hundred forty-nine elective hepatic resections were performed during the 12 years from 1973 to 1984. Nineteen of these patients (12.8%) developed intraperitoneal septic complications after hepatectomy (IPSCH), of whom 13 died of liver failure.

Esophageal stricture in Crohn's disease--a case report.

We treated a 46-year-old Japanese man with Crohn's disease of the esophagus and for whom medical therapy was adequate. Crohn's disease of the esophagus is a rare disease without specific clinical features and establishment of the diagnosis with guided biopsy is extremely difficult. Therefore, Crohn's disease of the esophagus should be considered in the differential diagnosis of biopsy-negative carcinoma of the esophagus in order to avoid major surgery.