Liver transplantation

Article Abstract:

Liver transplants are now considered to be successful treatment options for patients with liver disease. In some cases the patient's liver is removed first, in other cases the donor liver is transplanted without removing the patient's liver. Thousands of patients every year are considered as candidates for liver transplants, and as with any transplant procedure, organ supply tightens decisions criteria regarding transplantation. Approximately 1,600 liver transplants are currently performed in the United States each year, with the need estimated at between 4,000 and 50,000. Healthier patients often suffer severe consequences and death when they are passed over and a donor liver is given to a more critically ill patient. Patients with a better health status experience a more favorable outcome after liver transplant than critically ill transplant recipients. Liver transplantation should be performed earlier in the course of illness; however, this would also increase the demand for donor organs. Currently, many potential liver donors are rejected for unjustifiable reasons such as age, which generally has little effect on liver function, and other disease states which are unlikely to affect the quality of the donor organ, such as diabetes mellitus. The criteria for liver transplant candidacy is relatively clear for patients with nonmalignant end-stage liver disease that is not likely to recur, and less clear for many other disease states, including AIDS and hepatitis B, which are likely to reinfect the patient. More than 60 different diseases have been treated with liver transplantation, most commonly chronic active hepatitis, various forms of cirrhosis, and inborn errors of metabolism that involve the liver. Today patients with alcoholic cirrhosis are more commonly considered for liver transplant than they were 5 to 10 years ago, because treatment for substance abuse is more sophisticated and optimistic. Transplantation as a treatment for liver cancer is controversial because preventing recurrence of the cancer is not possible. Damaged veins, which previously made transplantation dangerous, can now be identified through sophisticated imaging techniques; liver transplantation can now be performed with newer procedures in vascular surgery. The authors assert that the possibility of recurrence of liver disease should not exclude patients from consideration for liver transplant, since the benefits can outweigh the risks. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Statistics, Social policy, Liver diseases, Donation of organs, tissues, etc., Tissue donation

---

Liver transplantation

Article Abstract:

This is the second part of a two-part review article that deals with the biologic and medical aspects of liver transplantation. Aspects of tissue compatibility and the use of immunosuppressive agents such as cyclosporine to prevent graft-versus-host disease (GVHD) are discussed. GVHD is the immunologic attack on the transplanted organ, in this case the liver, by the immunologic system of the recipient when it identifies the liver as foreign. Cyclosporine decreases or depresses the native immunologic reaction in the recipient (host); this comes, however, at the expense of immunologic protection from other conditions, including infection by viruses, bacteria and pathogenic fungi. The drugs also make it difficult for the body to deal successfully with a return of an original tumor or new tumors which develop during the period of immunosuppression. The liver has great regenerative ability and capacity for recovery, which is important because transplanted livers must recover from traumas which may result from inadequate oxygenation (ischemic injury) or rejection. Furthermore, some drugs given to patients who undergo transplantation are toxic to the liver, but are necessary to destroy remaining tumor cells. Small incidental tumors of the liver do not usually recur, but larger cancers, particularly those that have invaded from another site (metastasized), can kill in as little as three months following transplantation. Recent trends have included simultaneous or staged replacement of multiple organs, and in some cases the transplantation of auxiliary livers which can be placed in the gutter on either side of the vertebral system. The financial aspects of liver transplantation have a strong influence on who can become candidates for the procedure. Currently liver transplantation costs an average of $238,000 in the first year, and because the procedure still remains classified as experimental, most government and private insurers will not pay for the operation. More information on the comprehensive costs of liver transplantation is urgently required.

Research, Evaluation, Prevention, Complications and side effects, Cyclosporine, Cyclosporins, Graft versus host reaction, Transplantation immunology, Graft vs. host disease

---

Chimerism after liver transplantation for type IV glycogen storage disease and type I Gaucher's disease

Article Abstract:

The migration of cells from a transplanted liver into the recipient's tissues could correct several metabolic disorders caused by enzyme deficiencies. The migration of cells between a donor organ and the recipient's tissues has been called chimerism. In two patients with type IV glycogen storage disease, amylopectin deposits in the heart - a characteristic of the disease - had almost completely vanished three to five years after they received a liver transplant. DNA hybridization showed that both patients had cells from the donated liver in their hearts. A patient with type I Gaucher's disease also received a liver transplant. This disease is characterized by deposits of glucocerebroside in various organs. A lymph-node biopsy two years after transplantation revealed that cerebroside deposits had decreased. The biopsy also showed that his lymph nodes contained cells from the donated liver. Cells from donated organs could supply enzymes to correct metabolic deficiencies.

Physiological aspects, Gaucher's disease, Glycogenosis, Glycogen storage diseases

Similar abstracts:

• Abstracts: Bone marrow transplantation for sickle cell disease: a study of parents' decisions. The rise and fall of the futility movement
• Abstracts: Fetal fibronectin detection in preterm labor: evaluation of a prototype bedside dipstick technique and cervical assessment
• Abstracts: Secondary cancers after bone marrow transplantation for leukemia or aplastic anemia. Bone marrow transplantation for sickle cell disease
• Abstracts: Cyclosporine treatment for inflammatory bowel disease. A comparison of budesonide and mesalamine for active Crohn's disease
• Abstracts: Disparities in incidence of diabetic end-stage renal disease according to race and type of diabetes. Chronic renal failure after transplantation of a nonrenal organ

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.