The majority of acute iron toxicity cases occur in young children from accidental ingestion. In adults, iron poisoning is rare and mostly due to intentional ingestion. Physicians, particularly those who do not routinely treat pediatric patients, are often unfamiliar with the clinical manifestation of iron poisoning, its management, and its potential for multiple organ failure, especially liver damage. Severe acute hepatotoxicity treated with liver transplantation is rare in adults, with very limited published literature. We report a case of a severe iron tablet overdose with suicidal intent that progressed to fulminant hepatic failure despite medical treatment, ultimately treated with liver transplantation.
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http://dx.doi.org/10.7759/cureus.48392 | DOI Listing |
Hepatology
January 2025
Division of Gastroenterology and Hepatology, University of California, San Francisco, San Francisco, CA.
Background Aims: Patients with hepatocellular carcinoma (HCC) meeting UNOS-downstaging (DS) criteria have excellent post-liver transplantation (LT) outcomes. Studies on HCC beyond UNOS-DS criteria ("All-comers" (AC)) have been limited by small sample size and short follow-up time, prompting this analysis.
Approach Results: 326 patients meeting UNOS-DS and 190 meeting AC criteria from 9 LT centers across 5 UNOS regions were enrolled from 2015 to 2023 and prospectively followed.
Anesth Analg
September 2024
From the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona.
Background: During orthotopic liver transplantation, allograft reperfusion is a dynamic point in the operation and often requires vasoactive medications and blood transfusions. Normothermic machine perfusion (NMP) of liver allografts has emerged to increase the number of transplantable organs and may have utility during donation after circulatory death (DCD) liver transplantation in reducing transfusion burden and vasoactive medication requirements.
Methods: This is a single-center retrospective study involving 226 DCD liver transplant recipients who received an allograft transported with NMP (DCD-NMP group) or with static cold storage (DCD-SCS group).
Cochrane Database Syst Rev
January 2025
Cochrane Kidney and Transplant, Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia.
Background: Cytomegalovirus (CMV) is a significant cause of morbidity and death in solid organ transplant recipients. Pre-emptive treatment of patients with CMV viraemia using antiviral agents has been suggested as an alternative to routine prophylaxis to prevent CMV disease. This is an update of a Cochrane review first published in 2006 and updated in 2013.
View Article and Find Full Text PDFAnn Transplant
January 2025
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
BACKGROUND We previously reported that the Model for End-stage Liver Disease (MELD) score and donor age are risk factors for small-for-size syndrome in adult living donor liver transplantation (LDLT) involving small grafts. Since April 2021, we have performed splenectomy as a portal inflow modulation in LDLT using small grafts according to the presence of risk factors. In this study, we evaluated the validity of our splenectomy strategies for optimizing graft outcomes.
View Article and Find Full Text PDFBiomark Res
January 2025
Department of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan Hospital, Fudan University180 Fenglin Road, Shanghai, 200032, China.
Background: Predicting the efficacy of immune-based therapy in patients with unresectable hepatocellular carcinoma (HCC) remains a clinical challenge. This study aims to evaluate the prognostic value of the systemic immune-inflammation index (SII) in forecasting treatment response and survival outcomes for HCC patients undergoing immune-based therapy.
Methods: We analyzed a cohort of 268 HCC patients treated with immune-based therapy from January 2019 to March 2023.
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