Abstract:
:Advances in liver transplantation continue to evolve but are hampered by continued increasing shortages in donor organs. This has resulted in a high incidence of patients dying while on the United Network for Organ Sharing waiting list. Indeed, we continue to assess ways of expanding the donor pool by using marginal donors, living donor liver transplantation, split liver transplantation, domino transplantation, and hepatic support systems to prolong survival long enough for the patient to undergo liver transplantation. Changes in the liver allocation policy to reduce the number of people dying while waiting for an organ are discussed. Implementation of the model for end-stage liver disease allocation system should help alleviate the problem of increasing deaths of patients while on the waiting list. Recurrent disease, particularly recurrent hepatitis C, continues to be a major problem, and effective therapy is needed to prevent both progression of hepatitis C and recurrence in the graft and avoid retransplantation. The use of pegylated interferon in combination with ribavirin holds promise for improving the success in overcoming recurrent hepatitis C. Finally, advances in immunosuppression have reduced the incidence of acute cellular rejection and chronic rejection. However, these therapies have been fraught with metabolic complications that are now affecting quality of life and long-term survival. Tailoring immunosuppressive regimens to the individual patient is discussed.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Wiesner RH,Rakela J,Ishitani MB,Mulligan DC,Spivey JR,Steers JL,Krom RAdoi
10.4065/78.2.197keywords:
subject
Has Abstractpub_date
2003-02-01 00:00:00pages
197-210issue
2eissn
0025-6196issn
1942-5546pii
S0025-6196(11)62551-2journal_volume
78pub_type
杂志文章,评审abstract:OBJECTIVE:To report the long-term follow-up of a matched comparison of radical nephrectomy (RN) and nephron-sparing surgery (NSS) in patients with single unilateral renal cell carcinoma (RCC) and a normal contralateral kidney. PATIENTS AND METHODS:Between August 1966 and March 1999, 1492 and 189 patients with unilater...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/75.12.1236
更新日期:2000-12-01 00:00:00
abstract::Multilocular cysts of the peritoneum diagnosed at the Mayo Clinic from 1907 through 1981 were examined and divided, on the basis of their light microscopic features, into two groups--cystic mesotheliomas and cystic lymphangiomas. There are apparent clinical differences between the two groups. Cystic mesotheliomas tend...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1982-10-01 00:00:00
abstract:OBJECTIVE:The current study was undertaken to assess the frequency of excessive enteric protein loss and protein-losing enteropathy in the relatively early period after the Fontan operation. DESIGN:Protein excretion was determined in 26 of 27 consecutive patients who underwent the Fontan procedure between January and ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61035-0
更新日期:1994-02-01 00:00:00
abstract::During the 11-year period 1975 through 1985, 1,063 surgical procedures were performed on 795 Mayo Clinic patients 90 years of age or older. Preoperative conditions, surgical setting, and perioperative morbidity and mortality were analyzed in a comparison of the local residents of Olmsted County, Minnesota (N = 224), w...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)62742-6
更新日期:1990-09-01 00:00:00
abstract:OBJECTIVE:To assess whether amiodarone, as part of a strategy to achieve sinus rhythm, is safe and effective compared with a placebo or rate control drug in patients with persistent atrial fibrillation (AF) of more than 30 days' duration. METHODS:Randomized controlled trials comparing amiodarone with a placebo or rate...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,meta分析
doi:10.1016/S0025-6196(11)61140-3
更新日期:2009-03-01 00:00:00
abstract::Use of amiodarone, an investigational antidysrhythmic agent, has been associated with cases of pulmonary toxicity. The mechanism of amiodarone pulmonary toxicity is unknown, and recommendations for the assessment and treatment of patients with this condition continue to evolve. In two patients with clinically diagnose...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)60983-5
更新日期:1985-09-01 00:00:00
abstract::A retrospective review of Mayo Clinic records through 1983 revealed 84 patients (24 male and 10 female; mean age, 41 years) with the diagnosis of pulmonary alveolar phospholipoproteinosis. The major clinical features were dyspnea, cough, fever, and chest pain. Chest roentgenograms usually showed bilateral symmetric al...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)65477-9
更新日期:1987-06-01 00:00:00
abstract::Type I anti-neuronal nuclear autoantibodies (ANNA-I, also known as "Hu") are a distinctive serologic marker of small cell lung carcinoma (SCLC) in patients who have peripheral neuropathies or encephalomyeloradiculopathies. A tumor antigen reactive with these antibodies has been identified by other investigators by Wes...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)62471-9
更新日期:1991-12-01 00:00:00
abstract:OBJECTIVE:To examine whether the outcome of patients with primary systemic amyloidosis (AL) has improved over time and to identify predictors of early mortality in patients with AL. PATIENTS AND METHODS:We studied 2 separate cohorts of patients. The first cohort, consisting of 1998 patients with AL seen at Mayo Clinic...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/mcp.2010.0480
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:To describe clinical and laboratory findings from the 2012 southeastern Minnesota pertussis outbreak. PATIENTS AND METHODS:Patients were selected for 2 parts of the study. In the first part, nasopharyngeal swabs from a convenience sample of 265 unique patients were used for both the clinician-requested polym...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2014.08.004
更新日期:2014-10-01 00:00:00
abstract::Hypoxic liver injury is defined as a massive, but transient, increase in serum transaminase levels due to an imbalance between hepatic oxygen supply and demand in the absence of other acute causes of liver damage. It typically occurs in elderly individuals with right-sided congestive heart failure and low cardiac outp...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/81.9.1232
更新日期:2006-09-01 00:00:00
abstract::To identify the wishes of patients with amyotrophic lateral sclerosis (ALS) for information, participation in decision making, and life-sustaining therapy and to determine whether these wishes are stable over time, we conducted a prospective survey (baseline and 6-month follow-up interviews) of 38 consecutive patients...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61577-8
更新日期:1991-09-01 00:00:00
abstract::Mature women often present with symptomatic vulvovaginal atrophy and vulvar dermatoses, causing noncoital pain, dyspareunia, and sexual changes. Diagnosis of these conditions can be challenging, and long-term management is required to decrease morbidity and enhance quality of life. Vaginal estrogen therapies remain sa...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2016.10.031
更新日期:2017-03-01 00:00:00
abstract::A decrease in blood androgen levels is well documented in women who experience natural or surgical menopause. This change may be associated with various negative effects on bone metabolism in addition to psychosocial and sexuality aspects of life. A review of published information on androgen replacement therapy shows...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/72.11.1051
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVES:To determine the long-term outcome of patients presenting with synchronous lymphoma and severe liver dysfunction and to describe the outcome of patients treated with initial mechlorethamine-based therapy used as a bridge to more conventional chemotherapy. PATIENTS AND METHODS:We reviewed the clinical course...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/79.2.169
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:To investigate the impact of obesity and underweight on adverse in-hospital outcomes in pulmonary embolism (PE). PATIENTS AND METHODS:Patients diagnosed as having PE based on International Statistical Classification of Diseases and Related Health Problems, 10th Revision, German Modification code I26 in the G...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2019.04.035
更新日期:2019-10-01 00:00:00
abstract::A case is reported in which a herpes zoster infection caused recurrence of phantom limb pain in a man whose left arm had been amputated 7 years previously. It is, to our knowledge, the first such case reported, and it shows the importance of peripheral mechanisms in the generation of phantom limb pain. ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1978-05-01 00:00:00
abstract:OBJECTIVE:To assess the efficacy and safety of hyperbaric oxygenation (HBO) therapy as adjunctive treatment for diabetic foot ulcers with a systematic review and meta-analysis of the literature. METHODS:MEDLINE, EMBASE, and the Cochrane Library were searched to find relevant articles published up to April 20, 2012, wi...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.mayocp.2012.10.021
更新日期:2013-02-01 00:00:00
abstract::Understanding the sequence of events responsible for pressure-related natriuresis and their pathophysiologic alterations may be useful in distinguishing various types of essential hypertension of renal origin. The perturbation of a distal step in the sequence is likely to be reflected in a simple physiologic defect. F...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)65384-1
更新日期:1989-11-01 00:00:00
abstract::We have observed the effects of concussion on nonanesthetized rats and humans. We believe the phenomenon in both to be identical. There are four obvious stages to concussion and the recovery therefrom: fourth stage--visceral (respiratory) and somatic immobility; third stage--return of irregular visceral (respiratory) ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1977-08-01 00:00:00
abstract:OBJECTIVE:To estimate cancer risks for patients with myotonic dystrophy, given that increased risks for neoplasms in association with myotonic dystrophy type 1 and type 2 have been suggested in several studies but the risks of cancers have not been quantified. PATIENTS AND METHODS:A cohort of 307 patients with myotoni...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2011.09.005
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:To compare all-cause mortality rates across the severity range of white matter hyperintensities (WMH). PATIENTS AND METHODS:Between October 26, 2010, and October 5, 2017, the ongoing Mayo Clinic Florida Familial Cerebrovascular Diseases Registry prospectively enrolled 1011 diverse participants with and witho...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2018.10.024
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:To estimate the age- and sex-adjusted incidence of melanoma in adults 61 years or older in Olmsted County, Minnesota, from 1970 through 2009. PATIENTS AND METHODS:Using Rochester Epidemiology Project resources, 397 patients were identified who were 61 years or older and who received a first lifetime diagnosi...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2016.06.028
更新日期:2016-11-01 00:00:00
abstract::B-cell chronic lymphocytic leukemia (B-CLL) is a relatively indolent hematologic malignant disease that, despite a good response to nonaggressive orally administered chemotherapy, currently remains incurable. The overall median duration of survival is more than 5 years, and the presence of anemia or thrombocytopenia a...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)61551-1
更新日期:1992-04-01 00:00:00
abstract::Hypothyroidism and hyperthyroidism are common medical disorders that are often accompanied by diverse types of neurologic and neuromuscular dysfunction. Although some of these associated disorders are well known to physicians, others are not. All of these neurologic manifestations are important because they can severe...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1981-08-01 00:00:00
abstract::Considerable advances in the diagnosis and treatment of migraine headache have occurred during the past decade, but treatment options for acute migraine attacks have expanded at a faster rate than those for prophylaxis. We describe a patient whose migraine headaches responded dramatically to sustained-release niacin a...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/78.6.770
更新日期:2003-06-01 00:00:00
abstract::Despite the emergence of clinical ethics consultation as a clinical service in recent years, little is known about how clinical ethics consultation differs from, or is the same as, other medical consultations. A critical assessment of the similarities and differences between these 2 types of consultations is important...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2011.10.010
更新日期:2012-04-01 00:00:00
abstract:UNLABELLED:Cirrhosis and liver cancer, the main causes of liver-related morbidity and mortality, result from defective repair of liver injury. This article summarizes rapidly evolving knowledge about liver myofibroblasts and progenitors, the 2 key cell types that interact to orchestrate effective repair, because deregu...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2013.10.009
更新日期:2014-01-01 00:00:00
abstract::To assess the advantages and complications of a new universal (DDD) pacemaker, we studied retrospectively the initial 38 patients who received such a pacing device. This group consisted of 27 men and 11 women whose ages ranged from 23 to 89 years. The pacemaker was the initial one for 32 patients and was the replaceme...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1983-05-01 00:00:00
abstract::Forty cases of focal sclerosing glomerulonephropathy with nephrotic syndrome or proteinuria were studied retrospectively in regard to clinical presentation, response to steroid therapy and clinical course, and histopathology of the lesion. Morphologically there was a focal segmental and global sclerosis with subendot...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1975-03-01 00:00:00