Fried Liver Catches Cardiac Killer

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ironjustice - 24 Apr 2009 16:52 GMT

They found those that have elevated iron in their livers died
of cardiac failure.

Marked iron in liver explants in the absence of major hereditary
hemochromatosis gene defects: a risk factor for cardiac failure.
Fenton H, Torbenson M, Vivekanandan P, Yeh MM, Hart J, Ferrell L
Transplantation 2009 Apr 27; 87(8):1256-60.

BACKGROUND:
Patients with hereditary hemochromatosis are known to have an
increased risk for morbidity and mortality after orthotopic liver
transplantation.
METHODS:
The clinical, histological, and genetic findings were examined in
a series of seven adult patients with marked iron accumulation
in their liver explants and cardiac failure despite the absence of
HFE mutations.
RESULTS:
Causes for cirrhosis were alcohol and hepatitis C virus (HCV) (n=2),
HCV (n=1), alcohol (n=1), and cryptogenic cirrhosis (n=3).
Ages at transplantation ranged from 46 to 62 years.
Genetic studies confirmed all seven cases were negative for HFE
mutations C282Y and H63D.
The liver explants showed marked iron accumulation that
predominately involved hepatocytes, with more than 90% of the
iron in hepatocytes.
Two patients required cardiac transplantation and four died of
cardiac failure.
Cardiac tissues obtained from autopsies (n=3), endomyocardial
biopsy (n=1), or cardiac transplants (n=2) showed marked
myocyte hypertrophy and iron deposits with or without interstitial
fibrosis.
CONCLUSIONS:
This study highlights a unique set of liver transplant patients with
marked iron deposition in their cirrhotic liver who developed severe
cardiac failure and have iron deposits in the heart, despite the
absence of major HFE gene mutations.
The cause of the systemic iron overload remains to be discovered.

Transplantation [Transplantation]

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ironjustice - 26 Apr 2009 19:35 GMT

those that have elevated iron in their livers died of cardiac failure.
<<

"Venesection reduces the risk of cardiac complications"

Outcome of liver transplantation in hereditary hemochromatosis
Faisal S Dar, Walid Faraj, Muhammad B Zaman, Adam Bartlett,
Adrian Bomford, Adrian O'Sullivan, John O'Grady, Michael Heneghan,
Mohamed Rela and Nigel D Heaton
Kings College London School of Medicine, Institute of Liver Studies,
Kings College Hospital, London, UK
Correspondence to Prof. Nigel Heaton,
Consultant Surgeon and Professor of Transplantation,
Institute of Liver Studies, Kings College Hospital, Denmark Hill,
London, SE5 9RS, UK. Tel.: +203 299 3762; fax: +203 299 3575;
e-mail: nigel.heaton@kch.nhs.uk

ABSTRACT
Hereditary hemochromatosis (HH) is a genetic disorder of iron
metabolism.
It is an uncommon indication for liver transplantation (LT).
It has been suggested that patients who undergo LT for cirrhosis
related to HH have higher morbidity and mortality from cardiac,
infectious and malignant complications.
The purpose of this retrospective review was to determine whether
these observations hold true in the current era.
We analysed the data of 22 patients who had LT for HH from 1996
to 2007 at our center.
Thirteen patients had LT for complications of end-stage liver
disease,
seven for hepatocellular carcinoma (HCC) and two for subacute liver
failure.
Cofactors promoting liver disease were identified in 15 patients.
Ten patients had iron reduction with venesection before
transplantation.
Patient and graft survival at 1 and 5 years were 80.7%, and 74%
respectively.
There were seven deaths after a median follow up of 46 months either
because of multiorgan failure, or caused by HCC recurrence.
Bacterial infections were the commonest cause of morbidity.
Patients with HH remain at a higher risk of developing HCC.
Infectious complications are common.
Iron reduction with preoperative venesection reduces the risk of
cardiac and infection complications postoperatively.
Improved survival post-LT reflects changes in selection, disease
modification through venesection, and improvement in
immunosuppression.

KEYWORDS
acute liver failure • C282Y • Cirrhosis • HCC • hemochromatosis •
HFE • Iron overload • liver transplantation

Received: 25 July 2008 Revision requested:
5 September 2008 Accepted: 18 February 2009

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1432-2277.2009.00863.x About DOI
Copyright Journal compilation © 2009 ESOT

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http://tinyurl.com/4rq595

DEAD PEOPLE WALKING
http://tinyurl.com/zk9fk

> Marked iron in liver explants in the absence of major hereditary
> hemochromatosis gene defects: a risk factor forcardiacfailure.
[quoted text clipped - 41 lines]
>
> DEAD PEOPLE WALKINGhttp://tinyurl.com/zk9fk

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ironjustice - 27 Apr 2009 01:11 GMT

Spamming Fuckwit

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ironjustice - 27 Apr 2009 02:51 GMT

On Apr 26, 5:11 pm, ironjustice <flakey...@aol.com> wrote: snip <<

You really are stupid aren't ya .. shteater ..

All of you shteaters were TOLD to stay off my posts ..

All of you shteaters were TOLD .. no congregating ..

All of you shteaters .. remember .. when you cut my posts .. it is
evidence OF .. the dysfunctional predatorial nature of you ..
disease ridden mutated .. shteating .. **freaks** ..

"Venesection reduces the risk of cardiac complications"

Outcome of liver transplantation in hereditary hemochromatosis
Faisal S Dar, Walid Faraj, Muhammad B Zaman, Adam Bartlett,
Adrian Bomford, Adrian O'Sullivan, John O'Grady, Michael Heneghan,
Mohamed Rela and Nigel D Heaton
Kings College London School of Medicine, Institute of Liver Studies,
Kings College Hospital, London, UK
Correspondence to Prof. Nigel Heaton,
Consultant Surgeon and Professor of Transplantation,
Institute of Liver Studies, Kings College Hospital, Denmark Hill,
London, SE5 9RS, UK. Tel.: +203 299 3762; fax: +203 299 3575;
e-mail: nigel.hea...@kch.nhs.uk

ABSTRACT
Hereditary hemochromatosis (HH) is a genetic disorder of iron
metabolism.
It is an uncommon indication for liver transplantation (LT).
It has been suggested that patients who undergo LT for cirrhosis
related to HH have higher morbidity and mortality from cardiac,
infectious and malignant complications.
The purpose of this retrospective review was to determine whether
these observations hold true in the current era.
We analysed the data of 22 patients who had LT for HH from 1996
to 2007 at our center.
Thirteen patients had LT for complications of end-stage liver
disease,
seven for hepatocellular carcinoma (HCC) and two for subacute liver
failure.
Cofactors promoting liver disease were identified in 15 patients.
Ten patients had iron reduction with venesection before
transplantation.
Patient and graft survival at 1 and 5 years were 80.7%, and 74%
respectively.
There were seven deaths after a median follow up of 46 months either
because of multiorgan failure, or caused by HCC recurrence.
Bacterial infections were the commonest cause of morbidity.
Patients with HH remain at a higher risk of developing HCC.
Infectious complications are common.
Iron reduction with preoperative venesection reduces the risk of
cardiac and infection complications postoperatively.
Improved survival post-LT reflects changes in selection, disease
modification through venesection, and improvement in
immunosuppression.

KEYWORDS
acute liver failure • C282Y • Cirrhosis • HCC • hemochromatosis •
HFE • Iron overload • liver transplantation

Received: 25 July 2008 Revision requested:
5 September 2008 Accepted: 18 February 2009

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1432-2277.2009.00863.x About DOI
Copyright Journal compilation © 2009 ESOT

------------

Who loves ya.
Tom

Jesus Was A Vegetarian!
http://tinyurl.com/2r2nkh

Man Is A Herbivore!
http://tinyurl.com/4rq595

DEAD PEOPLE WALKING
http://tinyurl.com/zk9fk

Reply to this Message