Microwave ablation of giant hepatic cavernous hemangiomas.

Purpose: This study was designed to explore the safety and efficacy of percutaneous microwave (MW) ablation as an alternative treatment for symptomatic giant hepatic hemangiomas.

Methods: Patients (n = 7; 6 females, 1 male; mean age = 44 years) with symptomatic, giant hemangiomas (n = 8) were treated with ultrasound-guided percutaneous MW ablation and followed for a mean of 18 months. Patient pain was recorded both before and after the procedure according to the 10-point visual analog scale.

Pretransplant donor-specific anti-HLA antibodies as predictors of early allograft rejection in ABO-compatible liver transplantation.

The significance of preexisting donor-specific HLA antibodies (HLA-DSAs) for liver allograft function is unclear. Our previous studies have shown that humoral alloreactivity frequently accompanies acute cellular rejection (ACR). In the present study, we set out to determine whether pretransplant HLA-DSAs correlate with clinically significant ACR in the first 90 days after transplantation and, if so, to determine their predictive values.

Native kidney function following liver transplantation using calcineurin inhibitors: single-center analysis with 20 years of follow-up.

Introduction: The incidence of chronic kidney disease (CKD) in liver transplant recipients has been estimated to be from 18% to 28% at 10 yr after transplantation. As outcomes from liver transplantation continue to improve, long-term native kidney function in these recipients becomes more critical to patient survival.

Methods: We analyzed 1151 adult, deceased-donor, single-organ primary liver transplantations performed at our center between 7/17/84 and 12/31/07.

Complications associated with liver transplantation in the obese recipient.

The prevalence of the metabolic syndrome with attendant morbid obesity continues to increase nationwide. A concomitant increase in non-alcoholic steatohepatitis (NASH) and associated end-stage liver disease requiring transplantation is expected to parallel this trend. Between January 1, 1997 and December 31, 2008, our center performed 813 solitary adult deceased-donor liver transplants.

Treatment with sildenafil and treprostinil allows successful liver transplantation of patients with moderate to severe portopulmonary hypertension.

Portopulmonary hypertension (PoPH) refers to pulmonary arterial hypertension associated with portal hypertension with or without evidence of an underlying liver disease. Despite the potential for curing PoPH with liver transplantation, the presence of moderate or severe PoPH is associated with increased morbidity and mortality and is, therefore, a contraindication to transplantation. Previous studies have predominantly used intravenous epoprostenol for treatment in order to qualify patients for liver transplantation.

Chronic kidney disease stage progression in liver transplant recipients.

Background And Objectives: There is little information on chronic kidney disease (CKD) stage progression rates and outcomes in liver transplant recipients. Identifying modifiable risk factors may help prevent CKD progression in liver transplant recipients.

Design, Setting, Participants, & Measurements: We performed a retrospective review of 1151 adult, deceased-donor, single-organ primary liver transplants between July 1984 and December 2007 and analyzed kidney outcomes and risk factors for CKD stage progression.

Simultaneous liver and kidney transplantation using donation after cardiac death donors: a brief report.

Although the use of donation after cardiac death (DCD) donor organs has been shown to be a viable option for liver and kidney transplant recipients, outcomes after simultaneous liver and kidney (SLK) transplantation using DCD donors are less clear. We performed a retrospective analysis of 37 adult, primary SLK transplants performed at our center between January 1, 1998 and December 31, 2008. Thirty-two patients received donation after brain death (DBD) organs, and 5 patients received DCD organs.

CT portography with gastric variceal volume measurements in the evaluation of endoscopic therapeutic efficacy of tissue adhesive injection into gastric varices: a pilot study.

Background: N-butyl-2-cyanoacrylate (NBCA) injection is used for treating gastric varices (GV). Determining the degree of obliteration of GV is not readily evident at endoscopy.

Aims: The aim of this study was to evaluate CT portography with gastric variceal volume calculations to assess endoscopic therapeutic efficacy of NBCA injection.

Liver transplantation for HELLP syndrome.

Hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome is a rare complication of pregnancy that is associated with preeclampsia and may result in rupture of the liver. Although there have been case reports of liver transplantation for HELLP syndrome, the outcomes of transplantation for this rare indication have not been reported. Furthermore, the optimal management of complicated HELLP syndrome and indications for liver transplantation are unclear.

Donation after cardiac death: the University of Wisconsin experience.

Objectives: The objective of this analysis was to compare the results of transplantation of livers, pancreases, kidneys, and lungs from donation after cardiac death (DCD) donors to organs transplanted from donation after brain death (DBD) donors.

Methods: From January 1984 through July 2000, outcomes of 382 DCD kidneys were compared to 1,089 kidneys (SPK) transplants and 36 liver transplants from DCD donors were compared to 455 SPK and 510 liver transplants from DBD donors. Likewise, 31 simultaneous pancreas-kidneys transplants from DBD donors.

The prevalence of alcohol-induced liver disease and hepatitis C and their interaction in a tertiary care setting.

Background & Aims: We examined the prevalence and clinical characteristics of alcohol-induced liver disease (ALD) in patients referred to a tertiary care center and examined the interaction between ALD and hepatitis C virus (HCV) in a longitudinal survival model.

Methods: A total of 1611 patients with chronic liver disease referred to a tertiary care center between 1994 and 2001 were analyzed. The survival of ALD, HCV, and the combination of the 2 (ALD + HCV) was compared in cirrhotic and precirrhotic patients by using Kaplan-Meier estimates.

Infected bilomas in liver transplant recipients: clinical features, optimal management, and risk factors for mortality.

Background: Infected hepatic fluid collections (bilomas) are a major infectious complication of liver transplantation. Limited data exist on management and outcome of biloma.

Methods: We report a cohort study of 57 liver transplant recipients with posttransplantation bilomas undertaken to identify the clinical features of biloma, management strategies, and outcome.

Model for end stage liver disease score predicts mortality across a broad spectrum of liver disease.

Background/aims: The utility of the model for end stage liver disease (MELD) score in non-transplant patients, particularly in those with less severe chronic liver disease remains uncertain. We studied and compared the predictive abilities of the MELD score and the Child-Turcotte-Pugh (CTP) score for intermediate (1-year) and long-term (5-year) mortality.

Methods: One thousand six hundred and eleven patients with chronic liver disease were studied.

Infected bilomas in liver transplant recipients, incidence, risk factors and implications for prevention.

Bilomas, infected hepatic fluid collections, are a frequent complication of liver transplantation. We report a case-control cohort study to determine the incidence and microbiologic profile of bilomas and risk factors for biloma formation in 492 patients undergoing liver transplantation from 1994 to 2001. Fifty-seven patients (11.

Liver transplantation at the University of Wisconsin.

Liver transplantation remains the only definitive therapy for patients with decompensated liver disease. Significant advances over the past 20 years in surgical technique, immunosuppressive agents, patient selection, and infection prophylaxis and treatment have led to improved patient and graft survival. The success of liver transplantation coupled with expanding indications has resulted in a marked shortage of donor organs.