Affiliation: Mayo Clinic
- Evolving concepts in the diagnosis, pathogenesis, and treatment of chronic hepatic allograft rejectionR H Wiesner
Division of Liver Transplantation, Mayo Clinic, Rochester, MN 55905, USA
Liver Transpl Surg 5:388-400. 1999..Newer immunosuppressive agents, such as tacrolimus and mycophenolate, may successfully reverse chronic rejection, particularly when it is diagnosed in its early histological stages...
- Recent advances in liver transplantationRussell H Wiesner
Division of Gastroenterology and Hepatology and Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA
Mayo Clin Proc 78:197-210. 2003..However, these therapies have been fraught with metabolic complications that are now affecting quality of life and long-term survival. Tailoring immunosuppressive regimens to the individual patient is discussed...
- Model for end-stage liver disease (MELD) and allocation of donor liversRussell Wiesner
Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
Gastroenterology 124:91-6. 2003..Our aim was to assess the capability of the Model for End-Stage Liver Disease (MELD) score to correctly rank potential liver recipients according to their severity of liver disease and mortality risk on the OPTN liver waiting list...
- Liver transplantation for hepatocellular cancer: the impact of the MELD allocation policyRussell H Wiesner
William J von Liebig Transplant Center, Mayo Clinic, 200 First Street, SW, Rochester, Minnesota 55905, USA
Gastroenterology 127:S261-7. 2004..It is hoped that through continued data collection and assessment, a consensus can be reached to further optimize the use of deceased donors in HCC recipients...
- Mycophenolate mofetil use is associated with decreased risk of late acute rejection in adult liver transplant recipientsR H Wiesner
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
Am J Transplant 6:1609-16. 2006..0% vs. 87.0%, p < 0.001) and no rejection (88.1%, p < 0.001). Three-drug versus 2-drug therapy for a minimum of 6 months may offer a better treatment strategy to avoid the consequences and expense of LAR episodes...
- Mycophenolate mofetil combination therapy improves long-term outcomes after liver transplantation in patients with and without hepatitis CRussell H Wiesner
Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
Liver Transpl 11:750-9. 2005..In conclusion, the addition of MMF at discharge to tacrolimus-based immunosuppression is associated with improved long-term outcomes after liver transplantation in patients with and without HCV...
- Patient selection in an era of donor liver shortage: current US policyRussell H Wiesner
Mayo Clinic Transplant Center, Rochester, MN 55905, USA
Nat Clin Pract Gastroenterol Hepatol 2:24-30. 2005..So far, this new allocation system has been a success, but it does have its shortcomings, and even with improvements to the system, the use of the donor organ pool still needs to be optimized...
- A randomized double-blind comparative study of mycophenolate mofetil and azathioprine in combination with cyclosporine and corticosteroids in primary liver transplant recipientsR Wiesner
Mayo Clinic, Rochester, MN 55905, USA
Liver Transpl 7:442-50. 2001..MMF and AZA were equivalent in preventing graft loss at 1 year, and the safety profiles between the two immunosuppressive agents were similar...
- Noninvasive diagnosis of acute cellular rejection in liver transplant recipients: a proteomic signature validated by enzyme-linked immunosorbent assayOmar Massoud
Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, AL, USA
Liver Transpl 17:723-32. 2011..In summary, in this exploratory analysis, serum C4 and ALT levels were highly predictive of ACR in liver transplant recipients. Confirmation in a prospective, larger, and diverse population is needed...
- Predicting survival among patients listed for liver transplantation: an assessment of serial MELD measurementsKiran Bambha
Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation, Rochester, MN, USA
Am J Transplant 4:1798-804. 2004..Delta MELD is predictive of death only within 4 d of the event; however, part of this correlates with the dying process itself, thus limiting Delta MELD's utility in survival prediction models...
- Natural history and management of hepatitis C infection after liver transplantationMichael Charlton
Department of Gastroenterology and Hepatology, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA
Semin Liver Dis 24:79-88. 2004..This article describes the natural history, risk factors, and current strategies for the amelioration of posttransplant HCV infection...
- The pathogenesis of hepatitis C virus is influenced by cytomegalovirusRaymund R Razonable
Division of Infectious Diseases and Internal Medicine, Mayo Clinic and Foundation, Rochester, MN 55905, USA
Clin Infect Dis 35:974-81. 2002..05) and had a trend toward a higher hepatitis activity index (P=.10) and HCV load (P=.10) at 16 weeks after liver transplantation. The pathogenesis of HCV is influenced by its interaction with CMV but not with HHV-6...
- Impact of cytomegalovirus infection, year of transplantation, and donor age on outcomes after liver transplantation for hepatitis CKelly W Burak
Transplant Center, Mayo Clinic and Foundation, Rochester, MN 55905, USA
Liver Transpl 8:362-9. 2002..Whether CMV mediates this by inducing increased immunosuppression or directly enhancing HCV replication requires further study...
- MELD accurately predicts mortality in patients with alcoholic hepatitisWinston Dunn
Advanced Liver Disease Study Group, Mayo Clinic, Rochester, MN 55905, USA
Hepatology 41:353-8. 2005..MELD is a useful clinical tool for gauging mortality and guiding treatment decisions in patients with AH, particularly those complicated by ascites and/or encephalopathy...
- Treatment of posttransplantation recurrence of hepatitis C with interferon and ribavirin: lessons on tolerability and efficacyKozhikode V Narayanan Menon
Liver Transplant Center, Mayo Clinic and Foundation, Rochester, MN 55902, USA
Liver Transpl 8:623-9. 2002..The majority of patients require dose modifications because of side effects. Histological response is common in virological nonresponders...
- Long-term results and modeling to predict outcomes in recipients with HCV infection: results of the NIDDK liver transplantation databaseMichael Charlton
Liver Transpl 10:1120-30. 2004..Long-term death and graft loss specifically secondary to recurrence of HCV appears, however, to be determined primarily by factors other than those included in this analysis...
- Summary report of a national conference: Evolving concepts in liver allocation in the MELD and PELD era. December 8, 2003, Washington, DC, USAKim M Olthoff
Department of Surgery, Division of Transplantation, University of Pennsylvania, Philadelphia, PA, USA
Liver Transpl 10:A6-22. 2004..Recommendations for the transplant community, based on the analysis of the MELD data, were discussed and are presented in the summary document...
- MELD/PELD and the allocation of deceased donor livers for status 1 recipients with acute fulminant hepatic failure, primary nonfunction, hepatic artery thrombosis, and acute Wilson's diseaseRussell H Wiesner
Department of Medicine, Mayo Clinic, Von Liebig Transplant Center, Rochester, MN, USA
Liver Transpl 10:S17-22. 2004..4. Outcomes of adults listed as Status 1 in the United States. 5. Outcomes of pediatric candidates listed as Status 1 in the United States. 6. Proposed redefinition for Status 1 in adult and pediatric candidates...
- Preliminary results: outcome of liver transplantation for hepatitis B virus varies by hepatitis B virus genotypeHarshad C Devarbhavi
Mayo Clinic and Foundation, Rochester, MN 55905, USA
Liver Transpl 8:550-5. 2002..Patients with genotype D appear to have the highest risk for HBV recurrence and mortality. Additional larger multicenter studies are needed to confirm these findings...
- Liver allograft iron accumulation in patients with and without pretransplantation hepatic hemosiderosisMonica B Parolin
Division of Gastroenterology, Hepatology, and Liver Transplantation, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA
Liver Transpl 8:331-9. 2002..There was a suggestion that patients with severe pre-OLT hemosiderosis had a greater frequency of iron accumulation in late hepatic biopsy specimens...
- Preemptive use of oral ganciclovir to prevent cytomegalovirus infection in liver transplant patients: a randomized, placebo-controlled trialCarlos V Paya
Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota 55905, USA
J Infect Dis 185:854-60. 2002..02), compared with 11% and 0% of such patients in the ganciclovir arm (P <.01). Oral ganciclovir administered on CMV detection by PCR prevents CMV infection or disease after liver transplantation...
- Differential effects of donor age in liver transplant recipients infected with hepatitis B, hepatitis C and without viral hepatitisJohn R Lake
Gastroenterology Division, University of Minnesota, Minneapolis, Minnesota, USA
Am J Transplant 5:549-57. 2005..There are clear differences in risk factors for poor outcomes based on underlying liver disease, particularly with regard to the impact of donor age...
- Evidence-based evolution of the MELD/PELD liver allocation policyRussell H Wiesner
Liver Transpl 11:261-3. 2005
- Results of the first year of the new liver allocation planRichard B Freeman
Tufts University School of Medicine, New England Medical Center, Division of Transplantation, Boston, MA 02111, USA
Liver Transpl 10:7-15. 2004....
- Portopulmonary hypertension: Results from a 10-year screening algorithmMichael J Krowka
Divisions of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
Hepatology 44:1502-10. 2006..g., high flow and increased central volume) in liver transplantation candidates. Severity of POPH correlates poorly with MELD scores...
- Long-term survival and impact of ursodeoxycholic acid treatment for recurrent primary biliary cirrhosis after liver transplantationPhunchai Charatcharoenwitthaya
Miles and Shirley Fitterman Center for Digestive Diseases, Mayo Clinic and Foundation, Rochester, MN 55905, USA
Liver Transpl 13:1236-45. 2007..In this short period of treatment, UDCA was not associated with improved patient and graft survival compared to untreated patients...
- Celiac disease autoantibodies in severe autoimmune liver disease and the effect of liver transplantationAlberto Rubio-Tapia
Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
Liver Int 28:467-76. 2008....
- Long-term outcome of human leukocyte antigen mismatching in liver transplantation: results of the National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplantation DatabaseVijayan Balan
Department of Transplantation Medicine, Mayo Clinic, Phoenix, AZ, USA
Hepatology 48:878-88. 2008..03, HR = 2.9). CONCLUSION: Mismatching at the A locus decreases patient survival in liver transplant recipients, and mismatching at the DR and A loci affects recurrence of autoimmune liver diseases and hepatitis C, respectively...
- Hyponatremia and mortality among patients on the liver-transplant waiting listW Ray Kim
Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
N Engl J Med 359:1018-26. 2008..Under the current liver-transplantation policy, donor organs are offered to patients with the highest risk of death...
- MELD and other factors associated with survival after liver transplantationK V Narayanan Menon
The William J von Liebig Transplant Center, Mayo Clinic and Foundation, Rochester, Minnesota, USA
Am J Transplant 4:819-25. 2004..In multivariate models, age, underlying etiology of liver disease and renal failure requiring hemodialysis were independent predictors of death after OLT...
- A pilot study of the safety and tolerability of etanercept in patients with alcoholic hepatitisK V Narayanan Menon
Advanced Liver Disease Study Group, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA
Am J Gastroenterol 99:255-60. 2004..This is the first study to examine TNF inhibition with etanercept in patients with alcoholic hepatitis and the results of this study support the rationale for larger controlled studies to further assess safety and efficacy...
- The new liver allocation system: moving toward evidence-based transplantation policyRichard B Freeman
Department of Surgery, Tufts New England Medical Center Tufts University School of Medicine, Boston, MA, USA
Liver Transpl 8:851-8. 2002..Application of such risk models provides an evidenced-based approach on which to base further refinements and improve the model...
- Differential allograft gene expression in acute cellular rejection and recurrence of hepatitis C after liver transplantationRaghavakaimal Sreekumar
Transplant Center, Mayo Clinic and Foundation, Rochester, MN, USA
Liver Transpl 8:814-21. 2002..Further studies are required to determine whether gene expression profiles, either intragraft or in serum, can be used for the diagnosis and differentiation of ACR from recurrence of HCV...
- Effect of minimal listing criteria on waiting list registration for liver transplantation: a process-outcome analysisJayant A Talwalkar
Transplant Center, Mayo Clinic, Rochester, Minn 55905, USA
Mayo Clin Proc 78:431-5. 2003..To determine the level of association between minimal listing criteria (MLC) recognition and outcomes associated with waiting list registration for liver transplantation (LT)...
- Liver and intestine transplantationJohn P Roberts
University of California San Francisco, San Francisco, CA, USA
Am J Transplant 3:78-90. 2003
- Dynamics of cytomegalovirus replication during preemptive therapy with oral ganciclovirRaymund R Razonable
Division of Infectious Diseases and Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA
J Infect Dis 187:1801-8. 2003..This study identifies a relative cutoff virus load that predicts subsequent development of CMV disease and highlights the inability of oral ganciclovir to suppress CMV replication in a subset of patients...
- Improving liver allocation: MELD and PELDRichard B Freeman
Tufts New England Medical Center, Boston, MA, USA
Am J Transplant 4:114-31. 2004..Children younger than 2 years, however, still have a considerably higher rate of death on the waiting list than adults. A limited definition of ECD livers suggests that they are used more frequently for patients with lower MELD scores...
- Acquired (non-Wilsonian) hepatocerebral degeneration: complex management decisionsEelco F M Wijdicks
Department of Neurology and Medicine, Mayo Clinic, Rochester, MN 55905, USA
Liver Transpl 9:993-4. 2003..In our liver transplantation program, we were recently confronted with such a case, and present herein not only the characteristic magnetic resonance imaging findings but also some of the dilemmas of management...
- Recurrence of primary biliary cirrhosis after liver transplantation: Histologic estimate of incidence and natural historyPamela B Sylvestre
Division of Anatomic Pathology, Mayo Clinic and Foundation, Rochester, MN, USA
Liver Transpl 9:1086-93. 2003..7 years of follow-up. When criteria for histologic recurrence are expanded to include moderate lymphocytic cholangitis with lymphoplasmacytic portal infiltrate, the recurrence rate of PBC is estimated as 26%...
- Report of the first International Liver Transplantation Society expert panel consensus conference on liver transplantation and hepatitis CRussell H Wiesner
Liver Transpl 9:S1-9. 2003
- Subclinical reactivation of hepatitis B virus in liver transplant recipients with past exposureManal F Abdelmalek
Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA
Liver Transpl 9:1253-7. 2003..In our experience, infected donor livers are the most common source of de novo posttransplantation hepatitis B infection in transplant recipients...
- MELD score as a predictor of pretransplant and posttransplant survival in OPTN/UNOS status 1 patientsWalter K Kremers
The William J von Liebig Transplant Center, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA
Hepatology 39:764-9. 2004..68). In conclusion, liver allocation within the Status 1 designation may need to be further stratified by diagnosis, and MELD score may be useful for prioritizing FHF-NA candidates...
- Liver transplantation for hepatocellular carcinoma: the MELD impactPratima Sharma
Division of Transplantation Medicine, Mayo Clinic, Scottsdale, AZ, USA
Liver Transpl 10:36-41. 2004..Furthermore, the 5-month dropout rate has decreased significantly. In addition, 5-month survival while waiting has increased in the post-MELD period. Thus, the new MELD-based allocation policy has benefited HCC candidates...
- Chronic renal dysfunction late after liver transplantationAri J Cohen
Department of Surgery, Division of Transplantation, Mayo Clinic, Rochester, MN 55905, USA
Liver Transpl 8:916-21. 2002..Patients with a low GFR at 1 year (< 40 mL/min/BSA) are a high-risk group that might benefit from early therapeutic interventions aimed at preventing subsequent renal failure...
- Analysis of factors that predict alcohol relapse following liver transplantationSameer Jauhar
University of Glasgow, Scotland, UK
Liver Transpl 10:408-11. 2004..03). Further prospective studies are needed to examine this association in greater detail to provide targeted treatment for alcoholism both before and after liver transplantation...
- Prevention of post-transplant cardiovascular disease--report and recommendations of an ad hoc groupAndrew D Bostom
Department of Surgery, University of Minnesota, MMC-328 Mayo, Minneapolis 55455, USA
Am J Transplant 2:491-500. 2002
- Outcome of liver transplantation for familial amyloidotic polyneuropathyPratima Sharma
Division of Transplant Medicine, Mayo Clinic, Scottsdale, AZ, USA
Liver Transpl 9:1273-80. 2003..Outcomes for LT for patients with FAP with MET or NMET mutations were similar. Earlier LT for patients with FAP with MET30 or NMET30 mutation would improve outcomes after LT...
- Curricular guidelines for training in transplant hepatologyHugo R Rosen
Liver and Intra-Abdominal Subcommittee, American Society for Transplantation, USA
Liver Transpl 8:85-7. 2002
- Pirfenidone in the treatment of primary sclerosing cholangitisPaul Angulo
Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation, Rochester, Minnesota P 55905, USA
Dig Dis Sci 47:157-61. 2002..Pirfenidone did not benefit patients with PSC, and it was frequently associated with adverse events. The results of this pilot study discourage further trials of pirfenidone in patients with PSC...
- Natural history of hepatopulmonary syndrome: Impact of liver transplantationKaren L Swanson
Division of Pulmonary and Critical Care, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, MN 55905, USA
Hepatology 41:1122-9. 2005..In conclusion, hypoxemia of HPS is frequently progressive. As OLT outcome relates to pretransplantation PaO(2), additional MELD points should advance the priority for OLT in HPS...
- Risk factors for and clinical course of non-anastomotic biliary strictures after liver transplantationMaureen M J Guichelaar
Division of Liver Transplantation, Mayo Clinic and Mayo Foundation, Rochester, MN, USA
Am J Transplant 3:885-90. 2003..A pretransplant diagnosis of autoimmune hepatitis has been identified as a novel independent risk factor for NAS formation. Development of NAS significantly attenuates graft but not patient survival...