For conditions that the Model for End-Stage Liver Disease (MELD) score does not accurately predict waitlist mortality, transplant centers may apply to regional review boards for exception points. For patients with primary sclerosing cholangitis (PSC) suffering from bacterial cholangitis, consensus recommendations published in December 2006 are to grant exception points for recurrent cholangitis with ≥2 episodes of bacteremia or ≥1 episode septic complications. Using data provided by the United Network for Organ Sharing, we evaluated PSC patients who applied for exception points due to bacterial cholangitis from February 27, 2002 to March 14, 201Before publication of the recommendations, 66.0% of applications were accepted, compared with 80.1% after (p < 0.001). Focusing on applications after publication of the recommendations, 311 (74.6%) did not meet the recommended criteria, and 250 (80.4%) of these were approved. Of patients with approved applications, those not meeting consensus criteria were more likely to be transplanted, (77.4% vs. 62.8%, p = 0.043), whereas those with denied applications for approved indications were more liked to die/be removed (44.4% vs. 9.5%, p = 0.49). Although data are needed to properly identify those patients at highest risk for waitlist mortality, standardized criteria or a centralized review board should be adopted to ensure consistency in the granting of exception points.
Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease histologically characterized by the presence of intrahepatic and/or extrahepatic biliary duct concentric, obliterative fibrosis, eventually leading to cirrhosis. Approximately 75% of patients with PSC have inflammatory bo...
Confocal endomicroscopy is an emergent technique and allows real optical biopsies in the gastrointestinal (GI) tract. The aim of this study was to evaluate a new intraductal confocal miniprobe in patients with a normal common bile duct (CBD) or with a suspicion of a malignant stenosis (cholangioc...
Primary sclerosing cholangitis (PSC) is a rare chronic cholestatic disease of unknown aetiology affecting the biliary tree. It is characterised by bile duct inflammation and fibrosis, and in many patients it progresses to biliary cirrhosis and hepatic failure necessitating liver transplantation. ...
Inflammatory pseudotumor (IPT) of the liver is a benign condition with a good prognosis. However, it is difficult to distinguish clinical and radiological findings of IPT from those of malignancies. The aims of this study are to determine the clinical, radiological, and pathological characteristi...
To evaluate drug and indication specific off-label use in paediatrics, applied to ciprofloxacin (CPFX) in cholangitis.MethodsWe collected four different sets of data for an off-label drug use evaluation. (1) Literature review from medical journals, the use and safety profile from the whole Swedis...
Colorectal cancer is the second most common cause of cancer-related death in the Western world. Its development is typically through colorectal adenomas. Colorectal cancer prevalence may be reduced substantially by primary prevention including colonoscopy and polypectomy. Secondary prevention app...
Aborted myocardial infarction (MI) is defined by major (≥50%) ST-segment resolution and a lack of subsequent cardiac enzyme rise ≥2 the upper normal limit. This ultimate myocardial salvage has been observed in approximately 15% of ST-elevation MI (STEMI) patients after fibrinolysis. S...
Thiamine is an essential component of cellular metabolism, and lack of this vitamin results in a potentially life-threatening biochemical lesion. The stress of surgery and critical disease depletes electrolytes, minerals, and essential biochemical substrates. We hypothesized that critical illness...
SWe investigated whether transcutaneous ultrasound (TUS) augments coronary thrombolysis and achieves higher rates of Thrombolysis In Myocardial Infarction (TIMI) flow grade 3 and ST-segment resolution in patients with ST-segment elevation myocardial infarction (STEMI).In animal coronary and perip...
Enteric pathogens can cause relapsing infections in a proportion of treated patients, but greater understanding of this phenomenon is hindered by the lack of appropriate animal models. We report here a robust animal model of relapsing primary typhoid that initiates after apparently successful ant...
