| Potential effect of cyclosporin A in formation of cholesterol gallstones in pediatric liver transplant recipients. | |
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MedLine Citation:
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PMID: 9246038 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Recent advancements in liver transplantation have resulted in extended survival both for grafts and recipients. Such improvement, together with the shortage of donor organs has prompted expansion of the donor pool to include less than ideal donors, especially in life-threatening situations. The use of older liver donors has been associated with lower long-term survival. However, potential morbidity such as gallstone formation has not been explored. We analyzed bile composition in a child who developed cholesterol gallstones in the proximal bile duct two years after undergoing emergency liver transplantation with a liver from a 78-year-old donor. Oral administration of ursodeoxycholic acid (ursodiol) shifted the cholesterol composition of the bile from a supersaturated, potentially crystallized state to a liquid (micellar) state. Unlike cyclosporin A, FK506 showed an increase in the proportion of chenodeoxycholic acid and a decrease in the proportion of cholic acid, and thus may exhibit minimal or no hepatotoxic effect. Thus, in donor livers with factors known to be associated with cholesterol gallstone formation (such as age, sex, or obesity), one may consider analyzing the bile composition at the time of procurement. Depending on cholesterol and bile acid composition the use of FK506 with or without addition of ursodeoxycholic acid may be warranted. |
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Authors:
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S Cao; K Cox; S S So; W Berquist; S P Lee; W G Haigh; W Concepcion; H Monge; C O Esquivel |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Digestive diseases and sciences Volume: 42 ISSN: 0163-2116 ISO Abbreviation: Dig. Dis. Sci. Publication Date: 1997 Jul |
Date Detail:
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Created Date: 1997-08-25 Completed Date: 1997-08-25 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7902782 Medline TA: Dig Dis Sci Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1409-15 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, Stanford University Medical Center, Palo Alto, California 94304, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Aged Bile / chemistry Cholagogues and Choleretics / therapeutic use Cholelithiasis / chemistry*, etiology Cholesterol / metabolism* Cyclosporine / adverse effects*, therapeutic use Female Humans Immunosuppressive Agents / adverse effects*, therapeutic use Liver Transplantation* Male Tacrolimus / therapeutic use Tissue Donors Ursodeoxycholic Acid / therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Cholagogues and Choleretics; 0/Immunosuppressive Agents; 109581-93-3/Tacrolimus; 128-13-2/Ursodeoxycholic Acid; 57-88-5/Cholesterol; 59865-13-3/Cyclosporine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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