Monthly Archives: August 2012

Journal club: vascular complications of orthotopic liver transplantation

This recent article, published in the J Amer Coll Surg (see link below) analyzed the experience of over 4,000 liver transplants, and specifically at the outcomes of portal vein thrombosis (PVT) and hepatic artery thrombosis (HAT).  Rates of graft loss … Continue reading

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Terrorism, liver; Y. pestis

Yersinia pestis, cause of the plague, may cause hepatitis and hepatomegaly.

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Administration

Two scenarios that call for the administration of IV N-acetylcysteine (NAC): 1) acute acetaminophen hepatotoxicity, and 2) acute liver failure NOS with moderate to advanced hepatic encephalopathy.

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Radiology: Intraductal papillary mucinous neoplasm (IPMN)

Intraductal papillary mucinous neoplasms (IPMN) are frequently discovered during routine abdominal imaging.  Though most are benign, like colonic polyps they have the potential to grow and become dysplastic/malignant.  The presence of IPMN is not itself a contraindication for liver transplantation, … Continue reading

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Clinical Pearl

The treatment of mild acute cellular rejection (ACR) can be accomplished by increasing the doses of home immunosuppressive medications; it is the moderate and severe cases of ACR that require steroid pulse therapy.

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The Sunday Chronicles

Amy’s fears of physician incompetence were realized when her doctor began the physical exam from the wrong side of her body.

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Sulfation

When the bile duct is obstructed there is retention of bile acids in the hepatocyte, leading to necrosis and apoptosis.  A portion of the bile acids are modified by sulfation, and both sulfated and unsulfated bile acids are regurgitated into … Continue reading

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