Clinical Liver Disease

Latest Episodes:

Hepatitis C Virus: Antiviral Therapy in Wait-Listed Patients - Asmeen Bhatt and Gregory T. Everson – Article Reading Nov 03, 2013

Show notes

HCV infection universally recurs in patients who are viremic at the time of transplantation, leading to reduced graft survival and increased patient mortality. Review the current interferon-based therapies and learn about emerging drugs and interferon-free treatment from experts Dr. Asmeen Bhatt and Dr. Gregory Everson.

Common Problems in Liver Allograft Biopsy Interpretation: Resolving Clinical Dilemmas - Oyedele A. Adeyi – Article Reading Nov 03, 2013

Show notes

Liver allograft biopsy is crucial to the posttransplant management of patients treated for end-stage chronic liver disease, ALF, or HCC. Markers of graft injury such as parenchymal and biliary injury can be useful, but aren't specific, and enzyme changes may lack sensitivity in the context of transplantation.

MELD Score, Allocation, and Distribution in the United States - Joel P. Wedd, Ann M. Harper, and Scott W. Biggins – Article Reading Nov 03, 2013

Show notes

The Model for End-Stage Liver Disease (MELD) score uses the international normalized ratio, creatinine, and total bilirubin to predict 3-month mortality risk, making it a relatively easy and objective measurement for organ allocation, however concerns about equitable distribution remain.

Hepatitis B Virus: Prevention of Recurrent Infection - Federico G. Villamil and Fernando M. Cairo – Article Reading Nov 03, 2013

Show notes

HBV was once regarded as a contraindication for liver transplantation. In the last 20 years advances such as HBIG and LAM have made HBV infection one of the best indications for LT, although cost and availability of prophylactic therapies can be challenges. .

Hepatitis C Virus: Management of Recurrent Disease - Elizabeth C. Verna – Article Reading Nov 03, 2013

Show notes

Successful treatment of HCV improves survival after liver transplantation, but antiviral therapy for patients awaiting transplantation or on immunosuppression after LT continues to be clinically challenging. In this era of rapidly changing HCV therapy, Dr. Elizabeth Verna explains strategies for eliminating hepatitis C in pre- and post-LT settings.

Current State of Living Donor Liver Transplantation - Paige M. Porret and Kim M. Olthoff - Article Reading Nov 03, 2013

Show notes

Pioneered in pediatric patients in the late 1980s due to insufficient appropriately sized liver donors and high mortality among children on the organ waiting list, living donor liver transplantation is now also employed in the adult patient population.

Donor and Recipient Effects on Graft and Patient Survival - JP Norvell and Josh Levitsky – Article Reading Nov 03, 2013

Show notes

The rising use of expanded criteria donors in an aging patient population makes careful selection of donors and recipients increasingly important. Understand the complex interplay between factors such as donor age, risk index, sex, race, and genetics, as well as the etiology of the liver disease in the recipient, to improve patient outcomes.

The Liver Transplant Operation - Charles Miller and Teresa Diago Uso – Article Reading Nov 03, 2013

Show notes

ince the first liver transplant operation in 1963, the field has experienced huge medical and surgical advances. Drs. Miller and Diago Uso review the complex interplay of donor and recipient factors which now contribute to 5-year survival rates approaching 75 per cent.

Immunosuppression: Conventions and Controversies - Neil Mehta and Ryutaro Hirose – Article Reading Nov 03, 2013

Show notes

Liver transplant recipients generally need lifelong immunosuppression - approximately 7 to 17 per cent of patients experience an episode of acute cellular rejection with 3 to 12 months of LT, respectively.

Acute Liver Failure: Peritransplant Management and Outcomes - Oren K. Fix – Article Reading Nov 03, 2013

Show notes

Acute liver failure (ALF) manifests in patients without preexisting liver disease or cirrhosis, and the results can be devastating. Most patients quickly become critically ill, and approximately one third of ALF patients won't survive without liver transplantation. Read expert commentary from Dr. Oren Fix on the etiology, risks, and prognosis, to better manage patients with ALF.

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