A5012272573- Organ Transplantation Techniques and Outcomes
- Liver Disease and Transplantation
- Renal Transplantation Outcomes and Treatments
- Liver Disease Diagnosis and Treatment
- Organ Donation and Transplantation
- Hepatocellular Carcinoma Treatment and Prognosis
- Hepatitis C virus research
- Hepatitis B Virus Studies
- Renal and Vascular Pathologies
- Transplantation: Methods and Outcomes
- Cholangiocarcinoma and Gallbladder Cancer Studies
- Gallbladder and Bile Duct Disorders
- Pediatric Hepatobiliary Diseases and Treatments
- Liver Diseases and Immunity
- Renal Diseases and Glomerulopathies
- Neurological Complications and Syndromes
- Viral-associated cancers and disorders
- Cytomegalovirus and herpesvirus research
- Genetic and Kidney Cyst Diseases
- Pharmacological Effects and Toxicity Studies
- Polyomavirus and related diseases
- HIV/AIDS drug development and treatment
- Congenital Anomalies and Fetal Surgery
- HIV/AIDS Research and Interventions
- Healthcare Policy and Management
University of California, San Francisco
2016-2025
University of Colorado Denver
2023
Stanford University
1992-2023
Uppsala University Hospital
2023
Children's Hospital Colorado
2023
University of Colorado Anschutz Medical Campus
2023
NHS Blood and Transplant
2009-2022
University of California San Francisco Medical Center
2021
Johns Hopkins University
2017-2020
Delray Medical Center
2020
The precise staging of hepatocellular carcinoma (HCC) based on the size and number lesions that predict recurrence after orthotopic liver transplantation (OLT) has not been clearly established. We therefore analyzed outcome 70 consecutive patients with cirrhosis HCC who underwent OLT over a 12–year period at our institution. Pathologic tumor explanted was American Tumor Study Group modified Tumor–Node–Metastases (TNM) Staging Classification. occurred in 11.4% OLT. Kaplan–Meier survival rates...
We previously suggested that in patients with heptocellular carcinoma (HCC), the conventional Milan criteria (T1/T2) for orthotopic liver transplantation (OLT) could be modestly expanded based on pathology (UCSF criteria). The present study was undertaken to prospectively validate UCSF pretransplant imaging. Over a 5-year period, were used as selection guidelines OLT 168 patients, including 38 exceeding but meeting (T3A). 1- and recurrence-free probabilities 95.9% 90.9%, respective survivals...
Abstract We previously reported encouraging results of down-staging hepatocellular carcinoma (HCC) to meet conventional T2 criteria (one lesion 2–5 cm or two three lesions <3 cm) for orthotopic liver transplantation (OLT) in 30 patients as a test concept. In this ongoing prospective study, we analyzed longer-term outcome data on HCC larger cohort 61 with tumor stage exceeding who were enrolled between June 2002 and January 2007. Eligibility included: (1) one >5 up 8 cm; (2) at least...
We report on the long-term intention-to-treat (ITT) outcome of 118 patients with hepatocellular carcinoma (HCC) undergoing downstaging to within Milan/United Network for Organ Sharing T2 criteria before liver transplantation (LT) since 2002 and compare results 488 listed LT HCC meeting at listing in same period. The subgroups include 1 lesion >5 ≤8 cm (n = 43), 2 or 3 lesions least one >3 ≤5 total tumor diameter 61), 4-5 each ≤3 14). In group, 64 (54.2%) had received 5 (7.5%) developed...
One hundred patients underwent transjugular intrahepatic portosystemic shunt (TIPS) creation for variceal bleeding (n = 94), intractable ascites 3), hepatorenal syndrome 2), and preoperative portal decompression 1). Shunts were completed in 96 patients. Portal vein pressure was reduced from 34.5 mm Hg +/- 7.6 (standard deviation) to 24.5 6.2; the residual vein-hepatic gradient 10.4 0.9. Acute controlled 29 of 30 Of who successful TIPS creation, 26 have died 22 undergone liver...
Cirrhosis is characterized by muscle wasting, malnutrition, and functional decline that confer excess mortality not well quantified the Model for End‐Stage Liver Disease (MELD) Sodium (MELDNa) score. We aimed to develop a frailty index capture these extrahepatic complications of cirrhosis enhance prediction in patients with cirrhosis. Consecutive outpatients listed liver transplantation at single transplant center without MELD exceptions were assessed candidate measures. Best subset...
A national conference was held to better characterize the long-term outcomes of liver transplantation (LT) for patients with hepatocellular carcinoma (HCC) and assess whether it is justified continue policy assigning increased priority candidates early-stage HCC on transplant waiting list in United States. The objectives were address specific issues as they relate allocation, develop a standardized pathology report form assessment explanted liver, more imaging criteria designed qualify LT...
A major obstacle for orthotopic liver transplantation (OLT) as treatment hepatocellular carcinoma (HCC) is tumor growth resulting in dropout from the waiting list OLT. There a paucity of data on survival according to intention-to-treat analysis and rate OLT among patients with HCC. To further evaluate these issues, we analyzed outcome 46 consecutive HCC listed between January 1998 2001. Exclusion criteria were size greater than 5 cm one three lesions or four any size. Twenty-one underwent 11...
With the implementation of model for end-stage liver disease (MELD), refractory ascites, a known predictor mortality in cirrhosis, was removed as criterion allocation. Because ascites is associated with low serum sodium, we evaluated sodium an independent patients cirrhosis who were listed transplantation and whether addition to MELD superior alone. This single-center retrospective cohort all adult from February 27, 2002, December 26, 2003. Listing laboratories those nearest listing date ±2...
The American Society of Transplant Surgeons (ASTS) champions efforts to increase organ donation. Controlled donation after cardiac death (DCD) offers the family and patient with a hopeless prognosis option donate when brain criteria will not be met. Although DCD is increasing, this endeavor still in midst development. protocols, recovery techniques acceptance vary among procurement organizations transplant centers. Growing enthusiasm for has been tempered by decreased yield transplantable...
Although life-saving, liver transplantation burdens children with lifelong immunosuppression and substantial potential for morbidity mortality.To establish the feasibility of withdrawal in pediatric living donor transplant recipients.Prospective, multicenter, open-label, single-group pilot trial conducted 20 stable recipients (11 male; 55%) parental transplants diseases other than viral hepatitis or an autoimmune disease who underwent withdrawal. Their median age was 6.9 months...
Several factors are associated with increased hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT), but no reliable risk score has been established to determine the individual for HCC recurrence.We aimed develop and validate a Risk Estimation of Tumor Recurrence After Transplant (RETREAT) patients meeting Milan criteria by imaging.Predictors were tested in development cohort 721 who underwent LT between 2002 2012 at 3 academic transplant centers (University...
Delayed graft function, which is reported in up to 50% of kidney-transplant recipients, associated with increased costs and diminished long-term function. The effect that targeted mild hypothermia organ donors before recovery has on the rate delayed function unclear.We enrolled (after declaration death according neurologic criteria) from two large donation service areas randomly assigned them one temperature ranges: 34 35°C (hypothermia) or 36.5 37.5°C (normothermia). Temperature protocols,...
Serum alpha-fetoprotein (AFP) has been increasingly recognized as a marker for poor prognosis after liver transplantation (LT) hepatocellular carcinoma (HCC). Many published reports, however, have included large proportion of patients with HCC beyond the Milan criteria, and effects incorporating AFP an exclusion criterion LT remain unclear. We studied 211 consecutive undergoing within criteria according to imaging under Model End-Stage Liver Disease organ allocation system between June 2002...
From 5000 to 10 000 kidney patients die prematurely in the United States each year, and about 100 more suffer debilitating effects of dialysis, because a shortage transplant kidneys. To reduce this shortage, many advocate having government compensate donors. This paper presents comprehensive cost-benefit analysis such change. It considers not only substantial savings society recipients would no longer need expensive dialysis treatments—$1.45 million per recipient—but also estimates monetary...
Respiratory syncytial virus (RSV), a major cause of illness and death in infants worldwide, could be prevented by vaccination during pregnancy. The efficacy, immunogenicity, safety bivalent RSV prefusion F protein–based (RSVpreF) vaccine pregnant women their are uncertain.
<h3>Importance</h3> National guidelines on transplant selection have adopted successful downstaging to within Milan criteria (MC) as a viable option for the treatment of hepatocellular carcinoma (HCC) before liver (LT). Recurrence HCC after LT carries poor prognosis, and modalities remain challenging. <h3>Objective</h3> To establish 10-year outcomes patients with in large, multicenter US study based individual data; provide robust data long-term role downstaging; evaluate association...
A consensus meeting to develop guidelines that would improve the recovery and transplantation of organs from cadaver donor was held on 28–29 March 2001, in Crystal City, Virginia, sponsored by American Society Transplant Surgeons Transplantation. The crisis organ supply persists continuing shortage presents a compelling responsibility for transplant community maximize use procured donors.
The pharmacokinetics of cyclosporine was studied in six healthy volunteers after administration the drug orally (10 mg/kg) and intravenously (3 with without concomitant rifampin administration. Both blood plasma (separated at 37° C) samples were analyzed for concentration. For plasma, respectively, clearances calculated to be 0.30 0.55 L/hr/kg, values volume distribution steady state 1.31 1.68 L/kg, bioavailabilities 27% 33% during pre-rifampin phase. Post-rifampin phase 0.42 0.79 1.36 1.35...
Wachs, Michael E.; Amend, William J.; Ascher, Nancy L.; Bretan, Peter N.; Emond, Jean; Lake, John R.; Melzer, Juliet S.; Roberts, P.; Tomlanovich, Steve Vincenti, Flavio; Stock, Author Information
Prophylactic hepatitis B immunoglobulin (HBIg) reduces the risk of reinfection in surface antigen (HBsAg)–positive liver transplant recipients. In medical center this study, high–dose HBIg immunoprophylaxis is administered at a fixed dose 10,000 IU monthly, and long–term efficacy treatment regimen was examined. Of 52 HBsAg–positive recipients, 24 were immunoprophylaxis, 28 no specific therapy; 2–year recurrence rates (defined by reappearance HBsAg) 19% 76%, respectively. Fifty–four percent...