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Orthotopic liver transplantation at Groote Schuur Hospital : a serial analysis of biliary cytokines and biochemical parameters

Orthotopic liver transplantation is the treatment of choice for many patients with end-stage liver disease. Despite advances in immunosuppression, acute rejection remains common (up to 70%) and results in significant patient morbidity. It is frequently difficult to distinguish abnormal liver functio...

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Main Author: Spearman, C W N
Format: Thesis
Language:English
Published: Department of Medicine 2017
Subjects:
Bile - immunology
Liver Transplantation
Transplantation immunology
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access_status_str Open Access
author Spearman, C W N
author_browse Spearman, C W N
author_facet Spearman, C W N
author_sort Spearman, C W N
collection Thesis
description Orthotopic liver transplantation is the treatment of choice for many patients with end-stage liver disease. Despite advances in immunosuppression, acute rejection remains common (up to 70%) and results in significant patient morbidity. It is frequently difficult to distinguish abnormal liver function due to rejection from that due to infection, biliary obstruction or ischaemic injury without performing invasive procedures such as a liver biopsy or angiography which may be Clinically, the diagnosis of rejection is usually once the immunological process is already hazardous. made late, established. In this study, we evaluated standard biochemical parameters and cytokine concentrations (IL-1, IL-6 and TNF-alpha) in serial samples of bile obtained post-operatively via the Ttubes of patients following orthotopic liver transplantation in order to determine whether there are any biochemical or immunological pointers to the early diagnosis of rejection which would enable earlier administration of appropriate antirejection therapy. Biliary cytokines did not prove to be useful and reliable markers of early rejection. Serial measurement of biliary bilirubin levels showed an early and significant decrease a few days prior to rejection, and were a more sensitive marker of graft function than serum bilirubin levels.
format Thesis
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institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:31:52.071Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2017
publishDateRange 2017
publishDateSort 2017
publisher Department of Medicine
publisherStr Department of Medicine
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source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/25952 Orthotopic liver transplantation at Groote Schuur Hospital : a serial analysis of biliary cytokines and biochemical parameters Spearman, C W N Bile - immunology Liver Transplantation Transplantation immunology Orthotopic liver transplantation is the treatment of choice for many patients with end-stage liver disease. Despite advances in immunosuppression, acute rejection remains common (up to 70%) and results in significant patient morbidity. It is frequently difficult to distinguish abnormal liver function due to rejection from that due to infection, biliary obstruction or ischaemic injury without performing invasive procedures such as a liver biopsy or angiography which may be Clinically, the diagnosis of rejection is usually once the immunological process is already hazardous. made late, established. In this study, we evaluated standard biochemical parameters and cytokine concentrations (IL-1, IL-6 and TNF-alpha) in serial samples of bile obtained post-operatively via the Ttubes of patients following orthotopic liver transplantation in order to determine whether there are any biochemical or immunological pointers to the early diagnosis of rejection which would enable earlier administration of appropriate antirejection therapy. Biliary cytokines did not prove to be useful and reliable markers of early rejection. Serial measurement of biliary bilirubin levels showed an early and significant decrease a few days prior to rejection, and were a more sensitive marker of graft function than serum bilirubin levels. 2017-10-31T13:10:06Z 2017-10-31T13:10:06Z 1991 2017-06-06T10:15:22Z Master Thesis Masters MMed http://hdl.handle.net/11427/25952 eng application/pdf Department of Medicine Faculty of Health Sciences University of Cape Town
spellingShingle Bile - immunology
Liver Transplantation
Transplantation immunology
Spearman, C W N
Orthotopic liver transplantation at Groote Schuur Hospital : a serial analysis of biliary cytokines and biochemical parameters
thesis_degree_str Master's
title Orthotopic liver transplantation at Groote Schuur Hospital : a serial analysis of biliary cytokines and biochemical parameters
title_full Orthotopic liver transplantation at Groote Schuur Hospital : a serial analysis of biliary cytokines and biochemical parameters
title_fullStr Orthotopic liver transplantation at Groote Schuur Hospital : a serial analysis of biliary cytokines and biochemical parameters
title_full_unstemmed Orthotopic liver transplantation at Groote Schuur Hospital : a serial analysis of biliary cytokines and biochemical parameters
title_short Orthotopic liver transplantation at Groote Schuur Hospital : a serial analysis of biliary cytokines and biochemical parameters
title_sort orthotopic liver transplantation at groote schuur hospital a serial analysis of biliary cytokines and biochemical parameters
topic Bile - immunology
Liver Transplantation
Transplantation immunology
url http://hdl.handle.net/11427/25952
work_keys_str_mv AT spearmancwn orthotopiclivertransplantationatgrooteschuurhospitalaserialanalysisofbiliarycytokinesandbiochemicalparameters

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