Liver-specific deceased donor risk indices
HEPATOLOGY RESEARCH
Authors: Wang, Zifa; Hisatake, Garrett; Yang, Libin
Abstract
In order to assess the quality of the donor liver, procuring surgeons should accurately evaluate not only general donor risk indices, such as donor age, causes of brain death and cold ischemic time, but also consider the specific donor risk indices. In this review, we focus on liver-specific deceased donor risk indices, including liver steatosis, anti-hepatitis B core (HBc) positive or hepatitis C virus (HCV) positive donors, hypernatremia and anatomical variations. Liver steatosis is strongly associated with poor graft function after liver transplantation. Liver with more than 40-50% macrosteatosis should not be used. However, at present the quantity of fatty livers lack accepted standards. The computerized image analysis programs should be used to automate the determination of fat content in liver biopsy specimens. Liver grafts from anti-HBc positive donors can be safely used, preferentially in hepatitis B surface antigen (HBsAg) positive or anti-HBc/anti-HBs positive recipients. HCV positive allografts free from fibrosis or severe inflammation are a safe option for HCV positive recipients. The procurement team should consider liver biopsy to evaluate these HCV positive allografts. Donor serum sodium over 150mm may predict a higher rate of graft primary non-functions. Recently, however, some investigators reported the sodium level likely has little clinical impact on post-transplant liver function. The incidence of hepatic artery variations has been reported to be approximately 30%. To avoid injuries, it is very important to know and identify these variations with precision at the time of organ procurement.
Seroprevalence of Hepatitis B, Hepatitis C, and Human T-Cell Lymphotropic Virus Infections in HIV-Infected Patients in Sierra Leone
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE
Authors: Yendewa, George A.; Sahr, Foday; Aguilera, Antonio; Lakoh, Sulaiman; Sesay, Momodu; Deen, Gibrilla F.; Patino, Lucia; Poveda, Eva; Salata, Robert A.
Abstract
HIV coinfection with hepatitis B virus (HBV), hepatitisCvirus (HCV), andhumanT-cell lymphotropic viruses1 and 2 (H TLV-1 and HTLV-2) is common because of shared transmission routes. There is no published data on the prevalence of these infections in people living with HIV in Sierra Leone. We conducted a cross-sectional study of 211 HIV-positive patients aged >= 18 years in Freetown, Sierra Leone, in November 2017. Plasma samples were analyzed using the chemiluminescent microparticle immunoassay (Architect System, Abbott ARCHITECT Analyzer, Abbott Park, IL. The majority were female (63.5%), with median age 36 years (interquartile range [IQR]: 32-44) and median CD4 count of 396 cells/mu L (IQR: 214-534). Sixty patients (28.4%) were newly diagnosed and antiretroviral therapy (ART) naive; 151 patients (71.6%) were ART experienced. The prevalence of the hepatitis B surface antigen (HBsAg), total anti-hepatitis B core antibody, and anti-HCV was 21.7%, 82.9%, and 4.3%, respectively. Nocases of HTLV-1 orHTLV-2were detected. Male gender (P= 0.004) and CD4 < 350 cells/mu L (P = 0.017) were associated with the HBsAg positive status.