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NewYork-Presbyterian Hospital/Columbia University Medical Center physician-scientists presented new research at the 2009 American Transplant Congress in Boston, May 30 to June 3. Topics included minimizing steroid exposure for liver transplant patients with hepatitis C; hypothermic machine perfusion vs. cold storage for preserving donor livers; and the effectiveness of neutrophil-lymphocyte ratio in predicting colorectal liver metastases in liver cancer patients undergoing transplantation.

Dr. Jean Emond, chief of transplantation at NewYork-Presbyterian Hospital/Columbia University Medical Center and the Thomas S. Zimmer Professor of Surgery at Columbia University College of Physicians and Surgeons; and Dr. Dr. Robert S. Brown Jr., director of the Center for Liver Disease and Transplantation at NewYork-Presbyterian Hospital, chief of the Division of Abdominal Organ Transplantation and the Frank Cardile Professor of Medicine and Pediatrics in Surgery at Columbia University College of Physicians and Surgeons, are both available for comment on the following studies and on other news from the conference.

Preservation/Reperfusion Injury Is Attenuated by Hypothermic Machine Perfusion in Human Liver Transplantation.

Authors: Scot D. Henry, Ben Arrington, Benjamin Samstein, Sean W. C. Chen, Michael J. Goldstein, Jean C. Emond, H. Thomas Lee, James V. Guarrera

In hypothermic machine perfusion (HMP), a solution is pumped through the donor organ at temperatures between 1°C and 10°C in order to preserve the organ for transplantation. The technique is only just beginning to be used in liver transplantation. In a study comparing donor livers preserved using cold storage without perfusion to donor livers preserved with HMP, the latter were shown to be better preserved, with significantly improved functional and molecular markers.

Negative Impact of Neutrophil-Lymphocyte Ratio on Outcome Following Liver Transplantation for Hepatocellular Carcinoma (HCC).

Authors: Karim J. Halazun, Mark A. Hardy, Abbas A. Rana, David C. Woodland, Robert S. Brown, Jean C. Emond, Department of Organ Transplantation

A retrospective analysis looked at neutrophil-lymphocyte ratio (NLR) — an indicator of inflammatory status previously established as a prognostic tool in colorectal liver metastases — and found it to be an effective tool for predicting risk for tumor recurrence and death in liver cancer patients receiving transplantation.

Low-Dose Slowly-Tapered Steroids for Immunosuppression in Hepatitis C Virus Infected Liver Transplant Recipients: A 2-Year Follow-Up.

Authors: E. Verna, E. Pichardo, J. Emond, R. Brown Jr.

A two-year study of hepatitis C-infected patients receiving a liver transplant concluded that reducing the dosage and slowing the taper of the steroid regimen did not affect outcomes. Reducing steroid exposure may lessen the side effects of high-dose steroids, including increased risk of cardiovascular disease, high cholesterol and blood pressure, weight gain, diabetes, bone weakness and cataracts.

The Effect of Socioeconomic Status on Survival and Fibrosis in Hepatitis C Virus Infected Liver Transplant Recipients: Experience at an Urban Referral Center.

Authors: Verna, E. Pichardo, E. Farrand, J. Emond, R. Brown Jr.

A retrospective study looked at the impact of socioeconomic status on the outcome of hepatitis C-infected patients receiving a liver transplant. They found that higher income is associated with improved one-year survival, but there was no association found between higher income and hepatitis C recurrence at one year.

Incisional Hernias and Liver Transplantation: Assessment of Clinical Practice and Outcomes.

Authors: B. Samstein, E. Pichardo, T. Perez, R. Brown Jr., J. Emond

Incisional hernias (IH) — protrusion of an organ through the wall that normally contains it — are a well-known complication following liver transplantation (LT). An analysis of patients receiving hernia repair found it to be safe and effective.

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