Outcomes of liver transplantation for patients with acute liver failure

Liver transplantation is a treatment for patients who have acute liver failure [ALF]. This study aims to evaluate the outcomes following liver transplantation in patients with ALF and compare them with cirrhotic patients who underwent liver transplantation. This retrospective cross-sectional study was conducted at Shiraz Organ Transplant Center between June 2004 and March 2011 to evaluate the clinical presentation and underlying etiology of patients with ALF and their outcomes following liver transplantation. Out of 750 patients who underwent liver transplants, 12 [8 males and 4 females] had a diagnosis of ALF. The cirrhotic group [control] consisted of 20 transplanted patients. ALF patients were younger with a mean age of 18.7 +/- 12.9 years compared to 37.4 +/- 13.6 years in the cirrhotic group [P = 0.001]. In the ALF group, 5 [41.66%] underwent partial living related liver transplantation compared to 1 [5%] in the cirrhotic group [P = 0.018]. There were significantly more early post-transplant complications observed among patients with ALF compared to the cirrhotic group [P = 0.002]. Liver transplantation is safe, effective and should be considered in patients diagnosed with ALF

Evaluation of quality of life in children six months after liver transplantation

Liver transplantation [LT] is now performed as a cure for numerous untreatable pediatric liver diseases. Quality of life [QoL] can be affected in pediatric patients with LT. Many factors are responsible for lower scores of QoL. This article aims to detail QoL in liver recipients six months following LT in children.We assessed QoLwith the following questionnaires: Child Health Quality-Parent Form 50 [CHQ-PF 50] for parents and Child Health Quality-Child Form 87 [CHQ-CF 87] for children >/= 10 years of age in 50 children with LT and their parents. According to the CHQ-PF 50 questionnaire, QoL was found to be significantly lower in LT children compared with healthy children. According to the CHQ-CF 87 questionnaire, QoL was similar in pediatric liver recipients and the normal population. According to parents' judgments, childhood liver recipients have impaired QoL. This may be due to multiple factors that include concern about the long term outcome of LT, comparing their child with other children, and complications of LT. On the other hand, older children and adolescents believe their QoL is similar to healthy children. It seems that by decreasing risk factors, we can reduce stress on families and improve QoL

Tacrolimus related hypertrophic cardiomyopathy in liver transplant recipients

Recently there are a number of reports on the cardiotoxicity of tacrolimus in post-transplant patients. There is no protocol for cardiovascular evaluation in these patients. This study was performed to evaluate the cardiotoxicity of tacrolimus in liver transplant recipients. We evaluated 63 post-liver transplant patients who received tacrolimus. They were evaluated for cardiovascular complications by physical examination, electrocardiographic and echocardiographic examinations within three and six months following liver transplantation. Serum tacrolimus levels were checked by ELISA. For comparison, we selected 50 post-liver transplant patients who received no tacrolimus and evaluated them for cardiovascular function identically. Among 63 patients, 42 were male [66.7%] and 21 were female [33.3%] 70% of the patients were adults, and 19 [30%] were within the pediatric age group. The cardiovascular examinations, electrocardiogram and echocardiography of all patients three months post-transplantation were normal except for two children who developed tacrolimus related cardiac complications. Both had high serum tacrolimus levels. No adults developed cardiovascular complications. In the control group, the results of the cardiovascular evaluations were normal in all cases. The cardiovascular toxicity of tacrolimus, such as hypertrophic cardiomyopathy, may be observed in pediatric patients. Therefore, we recommend routine regular cardiovascular evaluation of children after liver transplantation

Pattern of injury in Shiraz / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>Injury is a major neglected health problem in developing countries. The first step in dealing with injury problem is to identify the injury patterns and characteristics. Therefore, we aimed to demonstrate the current status of trauma admissions to hospitals in Shiraz, as a major city of Iran.</p><p><b>METHODS</b>A hospital-based study was conducted in 2002. All injured patients admitted during 6 months in emergency departments of two general hospitals of Shiraz, Nemazi and Chamran were included.</p><p><b>RESULTS</b>A total of 1,765 injured patients were registered during the study period, with mean age of 33 years. Manual workers were the most vulnerable group among occupational categories. Inner-city roads were the most common place of injury and traffic accident was the major cause of injury. Overally, falling injury was the second common cause of injury in males and the first cause in females (especially at the age of over 60).</p><p><b>CONCLUSION</b>As other studies conducted in our society, traffic accidents are the major cause of morbidity and mortality and this can emphasize on the obligation to take legislative action in the field of driving and road safety, directing resources and educating the public and raising the awareness of the community in prevention of this iceberg-like problem.</p>