1,721,448 research outputs found
Randomized trial comparing three different regimens of interferon alfa 2a in chronic hepatitis C
No full textDonor liver steatosis and graft selection for liver transplantation: A short review
No full textEarly graft dysfunction develops in up to 10-50% of liver transplanted patients and is related to the number of risk factors which identify marginal livers. Marginal livers are defined by the presence of at least one of the following risk factors: (1) donor aged > 50 years; (2) donor with hemodynamic instability or with a residence time in ICU greater than 5 days; (3) donor with hypersodiemia; (4) donor with HCV or HBV infection; and (5) donor with macrovescicular steatosis present in > 25% of hepatocytes. The presence of steatosis involving less than 25% of hepatocytes is not considered sufficient to identify a marginal donor, although it may be associated with some risk of early or late graft failure. The reason is that the steatotic liver is characterized by a decreased tolerance to ischemia/reperfusion. It has been observed that the accumulation of fat in the hepatocytes and the increased cell volume cause an impairment of liver microcirculation. Steatosis is associated with decreased capability of ATP production and storage, with increased lipid peroxidation, and with increased release of tumor necrosis factor-α which is believed to be responsible of thw lung damage possibly occurring after transplant. The assessment of the type and extent of steatosis requires liver biopsy, not usually indicated in healthy individual. In the transplant setting a precise assessment of steatosis is the prominent reason for performing a liver biopsy of the donor liver
[The medical therapy of cholelithiasis. Critical reflections]
No full textGallbladder stones can be asymptomatic, symptomatic or complicated. Medical therapy can be indicated only in patients with symptomatic gallstones. Indications to medical therapy is today limited by the knowledge of the benign natural history of the disease and by the availability of new surgical techniques, such as laparoscopic cholecystectomy. The ideal patient to be treated by medical therapy is mildly symptomatic, non obese, with functioning gallbladder and with radiolucent, floating stones, not larger than 5 mm in diameter. This type of patient represents only 3% of the population of gallstone patients and has a 90% likelihood of having complete stone dissolution after one year of treatment with ursodeoxycholic acid (12 mg/kg of body weight/day). Medical treatment can be proposed also in patients with stones up to 10 mm in diameter, but the likelihood of complete dissolution after one year drops to 60%, thus, treatment is indicated only in selected or high-risk patients. Ursodeoxycholic acid therapy can be useful in patients with biliary sludge or microlithiasis, especially if recently developed
Hepatitis B-core antibody positive donors in Liver Trasplantation and their impact on graft survival:Evidence from the Liver Match cohort study
No full textBackground 82 Aims:The appropriate allocation of grafts from HBcAb positive donors in liver transplantation is crucial,yet a consensus is still lacking
Fulminant hepatic failure. Clinical features, etiology, epidemiology, and current management
No full text
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