Liver & GIT
Following liver transplantation, recurrence of primary disease in the liver most likely occuresin : (AIIMS Nov. 08)
|C||Alpha - I antitrypsin deficiency|
|D||Primary biliary cirrhosis|
End Stage Liver Disease
i. The Model for End-Stage Liver Disease (MELD) score.
ii. The MELD score is based upon a mathematical model that includes
a. Bilirubin b. Creatinine c. Prothrombin time expressed as international normalized ratio (INR).
PELD score (Pediatric End-Stage Liver Disease) (Younger than 12)
a. Age b. Serum Bilirubin c. Albumin d. INR
Rapamycin, an inhibitor of later events in T cell activation, is approved for use in kidney transplantation but is not used for use in liver transplant recipients because of the association with an increased frequency of hepatic artery thrombosis in the first month posttransplantation.
1. Focal nodular hyperplasia
i. Occurs at all ages and is not caused by oral contraceptives.
ii. It is often asymptomatic and appears as a hypervascular mass, often with a central hypodense “stellate” scar on CT scan or MRI.
iii. It is not a true neoplasm but a nonspecific reaction to altered blood flow is associated with an elevated angiopoietin 1/angiopoietin 2 mRNA ratio and may also occur in patients with cirrhosis, with exposure to certain drugs such as azathioprine, and in antiphospholipid syndrome.
2. Hepatic adenoma occurs most commonly in the third and fourth decades of life and is usually caused by oral contraceptives.