Recent advances in liver transplantation for the practicing gastroenterologist

Ranjan Mascarenhas, Ahmet Gurakar

Research output: Contribution to journalArticle

Abstract

Liver transplantation is the definitive therapy for end-stage liver disease of various etiologies as well as acute liver failure and early-stage hepatocellular carcinoma. The Model for End-Stage Liver Disease (MELD) score is essential for organ allocation in the United States. Addition of the serum sodium level to the MELD score is a recent development that helps prognosticate cirrhotic patients with hyponatremia, a commonly seen manifestation of end-stage liver disease. The currently used Milan criteria for hepatocellular carcinoma have been expanded with some success at certain transplant centers, and tumor downstaging prior to transplant is being used more frequently. The tremendous shortage of donor organs continues to be the major limitation of this life-saving therapy. This has led to the use of extended-criteria donors, donation after cardiac death, split liver grafts, and live donor liver transplants. Renal dysfunction following liver transplant requires close monitoring and dose adjustments of immunosuppressive medications. Although most liver transplants in the United States are for chronic hepatitis C infection and its sequelae, hepatitis C virus recurrence is a common problem that is challenging to treat in the post-transplant population.

Original languageEnglish (US)
Pages (from-to)443-450
Number of pages8
JournalGastroenterology and Hepatology
Volume5
Issue number6
StatePublished - Jun 2009

Fingerprint

Liver Transplantation
End Stage Liver Disease
Transplants
Tissue Donors
Hepatocellular Carcinoma
Liver
Acute Liver Failure
Hyponatremia
Chronic Hepatitis C
Immunosuppressive Agents
Gastroenterologists
Hepacivirus
Liver Diseases
Sodium
Kidney
Recurrence
Therapeutics
Infection
Serum
Population

Keywords

  • Donation after cardiac death
  • Hepatocellular carcinoma
  • Live donor liver transplant
  • Model for end-stage liver disease
  • Orthotopic liver transplant

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Recent advances in liver transplantation for the practicing gastroenterologist. / Mascarenhas, Ranjan; Gurakar, Ahmet.

In: Gastroenterology and Hepatology, Vol. 5, No. 6, 06.2009, p. 443-450.

Research output: Contribution to journalArticle

@article{fa655705ec86401386148061263503b0,
title = "Recent advances in liver transplantation for the practicing gastroenterologist",
abstract = "Liver transplantation is the definitive therapy for end-stage liver disease of various etiologies as well as acute liver failure and early-stage hepatocellular carcinoma. The Model for End-Stage Liver Disease (MELD) score is essential for organ allocation in the United States. Addition of the serum sodium level to the MELD score is a recent development that helps prognosticate cirrhotic patients with hyponatremia, a commonly seen manifestation of end-stage liver disease. The currently used Milan criteria for hepatocellular carcinoma have been expanded with some success at certain transplant centers, and tumor downstaging prior to transplant is being used more frequently. The tremendous shortage of donor organs continues to be the major limitation of this life-saving therapy. This has led to the use of extended-criteria donors, donation after cardiac death, split liver grafts, and live donor liver transplants. Renal dysfunction following liver transplant requires close monitoring and dose adjustments of immunosuppressive medications. Although most liver transplants in the United States are for chronic hepatitis C infection and its sequelae, hepatitis C virus recurrence is a common problem that is challenging to treat in the post-transplant population.",
keywords = "Donation after cardiac death, Hepatocellular carcinoma, Live donor liver transplant, Model for end-stage liver disease, Orthotopic liver transplant",
author = "Ranjan Mascarenhas and Ahmet Gurakar",
year = "2009",
month = "6",
language = "English (US)",
volume = "5",
pages = "443--450",
journal = "Gastroenterology and Hepatology",
issn = "1554-7914",
publisher = "Gastro-Hep Communications, Inc.",
number = "6",

}

TY - JOUR

T1 - Recent advances in liver transplantation for the practicing gastroenterologist

AU - Mascarenhas, Ranjan

AU - Gurakar, Ahmet

PY - 2009/6

Y1 - 2009/6

N2 - Liver transplantation is the definitive therapy for end-stage liver disease of various etiologies as well as acute liver failure and early-stage hepatocellular carcinoma. The Model for End-Stage Liver Disease (MELD) score is essential for organ allocation in the United States. Addition of the serum sodium level to the MELD score is a recent development that helps prognosticate cirrhotic patients with hyponatremia, a commonly seen manifestation of end-stage liver disease. The currently used Milan criteria for hepatocellular carcinoma have been expanded with some success at certain transplant centers, and tumor downstaging prior to transplant is being used more frequently. The tremendous shortage of donor organs continues to be the major limitation of this life-saving therapy. This has led to the use of extended-criteria donors, donation after cardiac death, split liver grafts, and live donor liver transplants. Renal dysfunction following liver transplant requires close monitoring and dose adjustments of immunosuppressive medications. Although most liver transplants in the United States are for chronic hepatitis C infection and its sequelae, hepatitis C virus recurrence is a common problem that is challenging to treat in the post-transplant population.

AB - Liver transplantation is the definitive therapy for end-stage liver disease of various etiologies as well as acute liver failure and early-stage hepatocellular carcinoma. The Model for End-Stage Liver Disease (MELD) score is essential for organ allocation in the United States. Addition of the serum sodium level to the MELD score is a recent development that helps prognosticate cirrhotic patients with hyponatremia, a commonly seen manifestation of end-stage liver disease. The currently used Milan criteria for hepatocellular carcinoma have been expanded with some success at certain transplant centers, and tumor downstaging prior to transplant is being used more frequently. The tremendous shortage of donor organs continues to be the major limitation of this life-saving therapy. This has led to the use of extended-criteria donors, donation after cardiac death, split liver grafts, and live donor liver transplants. Renal dysfunction following liver transplant requires close monitoring and dose adjustments of immunosuppressive medications. Although most liver transplants in the United States are for chronic hepatitis C infection and its sequelae, hepatitis C virus recurrence is a common problem that is challenging to treat in the post-transplant population.

KW - Donation after cardiac death

KW - Hepatocellular carcinoma

KW - Live donor liver transplant

KW - Model for end-stage liver disease

KW - Orthotopic liver transplant

UR - http://www.scopus.com/inward/record.url?scp=68349122390&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=68349122390&partnerID=8YFLogxK

M3 - Article

C2 - 20574505

AN - SCOPUS:68349122390

VL - 5

SP - 443

EP - 450

JO - Gastroenterology and Hepatology

JF - Gastroenterology and Hepatology

SN - 1554-7914

IS - 6

ER -