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  • 1
    Electronic Resource
    Electronic Resource
    Liver transplantation in patients over 60 years of age (2000)
    Springer
    Transplant international 13 (2000), S. S165 
    Details
    ISSN: 1432-2277
    Keywords: Key words Liver transplantation ; Older patient
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Liver transplantation was previously only offered to patients under 60 years of age. We have analyzed the outcome after acceptance on the waiting list and after liver transplantation of patients over 60 years old. A total of 150 patients over 60 years old were listed for a first liver transplantation during 1990–1998. The annual number increased throughout the period. Primary biliary cirrhosis, primary sclerosing cholangitis, and acute hepatic failure were the most frequent diagnoses. A total of 119 patients received a first liver allograft. The patient 1-year survival was 75 % and 3-year survival 62 %, which was not significantly lower (P = 0.21) than that of the younger patients. When correcting for year of transplantation, the survival was, however, moderately but significantly lower than among the younger patients. Survival among those 〉 65 years (n = 38) did not differ from that of patients 60–65 years of age (n = 81). We conclude that an increasing number of patients over 60 years old can be listed for liver transplantation and receive a liver allograft with highly satisfying results.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050315
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  • 2
    Electronic Resource
    Electronic Resource
    Ursodeoxycholic acid increased bile flow and affects bile composition in the early postoperative phase following liver transplantation (1998)
    Springer
    Transplant international 11 (1998), S. S231 
    Details
    ISSN: 1432-2277
    Keywords: Key words Bile flow ; Bile acids ; Ursodeoxycholic acid ; Liver transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Orally given ursodeoxycholic acid (UDCA) has beneficial effects on laboratory parameters in different cholestatic conditions. In order to investigate the effect on early graft function after liver transplantation, 33 patients were randomized to receive either UDCA 15 mg/kg per day or placebo from the 1st postoperative day until 3 months after transplantation. All liver grafts produced bile within 24 h after revascularization. In both groups there was an increasing bile flow each day until day 5 after transplantation. This increase was more pronounced in the UDCA group where the flow on day 2 reached a mean value of 183 ± 28 ml/day compared to 106 ± 17 ml/day in the placebo group (P 〈 0.05). The average daily volume of bile produced during the first 10 days was also found to be higher in the UDCA group compared to the placebo group (242 ± 20 ml vs 176 ± 18 ml, P 〈 0.02). In the UDCA group a significant decrease in total bile acid output between the 5th and 10th postoperative days was found, while in the placebo group the amount of bile acids excreted remained stable over time. The composition of bile differed between the two groups with an increase in the portion of UDCA in the UDCA group from the 2nd postoperative day (25 % vs 4.6 %, P 〈 0.0003). The fraction of UDCA then remained high during the whole study period with a peak at day 3 when 38.1 ± 6.6 % of the bile acids consisted of UDCA. In the placebo group, the fraction of UDCA was low from the beginning and diminished further over time. Prophylactic UDCA treatment was found to have a significant positive impact on the ALT level during the 4th and 5th postoperative days, but had no effect on bilirubin or GGT in the early postoperative phase (days 1–10). No differences in cyclosporine requirement were found between the two groups.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050467
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Stool cultures obtained before liver transplantation are useful for choice of perioperative antibiotic prophylaxis (1997)
    Springer
    Transplant international 10 (1997), S. 432-438 
    Details
    ISSN: 1432-2277
    Keywords: Key words Stool cultures ; liver transplantation ; antibiotic prophylaxis ; Liver transplantation ; stool cultures ; antibiotic prophylaxis ; Antibiotic prophylaxis ; liver transplantation ; stool cultures
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Bacterial infections, especially cholangitis, are still common complications after liver transplantation (LTx). During recent years, multiresistant enterococci have become a nosocomial problem in transplant units. The present prospective study on 26 patients, including 24 patients with chronic liver disease, demonstrated that enterococci were the predominant micro-organism involved in post-LTx bacterial infections. They were cultured in the feces and in other sites of 10 out of 13 (77 %) patients who underwent extensive examinations. Ampicillin-resistant Enterococcus faecium strains were isolated in urine or feces of 2 of the 13 patients prior to LTx. Similarly, resistance to ampicillin and gentamicin, the empirically used antibiotics for patients with fever of unknown origin, was found in E. faecium strains in 3 and 2 patients, respectively. Moreover, multiresistant E. faecium and E. faecalis strains were demonstrated in 46 % of the patients in the postoperative period (3 months). However, no vancomycin-resistant enterococci were isolated. The use of antibiotics within 4 months prior to LTx significantly increased the risk of developing ampicillin-resistant bacteria at the time of LTx and of infections with bacteria of enteric origin after LTx (P = 0.03 and 0.01, respectively). We conclude that stool and urine cultures performed prior to LTX may be useful for selecting prophylactic antibiotic regimens.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050082
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    Paper (German National Licenses)
    Fulltext
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