Hyperglobulinæmia in Liver Disease

Triger, D. R.; Wright, Ralph

doi:10.1016/s0140-6736(73)91827-8

Cited by 154 publications

(53 citation statements)

References 39 publications

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“…5 . 6 However, other factors such as splenic stimulation from gut-derived antigens due to spontaneous portasystemic shunting l3 , 14 have been implicated as a cause, which may explain the inconsistent effect of shunt procedures on hypersplenism. In general, more collaterals are encountered during OLTx for postnecrotic cirrhosis, as compared to other diseases, such as primary biliary cirrhosis or sclerosing cholangitis.…”

Section: Discussionmentioning

confidence: 99%

Reversal of Hypersplenism Following Orthotopic Liver Transplantation

Yanaga¹,

Tzakis²,

Shimada³

et al. 1989

Annals of Surgery

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The purpose of this study was to clarify the effect of orthotopic liver transplantation on hypersplenism. In a I-year period from July 1, 1986 to June 30,1987 adult patients underwent 233 orthotopic liver transplantations. Of the 58 patients with hypersplenism who were analyzed in this study, hypersplenism was more commonly associated with postuecrotic cirrhosis than other kinds of liver disease (55.3% (47/85) "S. 14.5% (11/76); p < 0.0(1». Postoperative platelet counts were statistically higher than preoperative values (p < 0.05). The latest platelet counts were more than lOO,OOO/mm 3 in 53 patients (91.4%). Of the eight patients whose preoperative and postoperative spleen volumes could be compared, all showed the reduction in the spleen size (p < 0.02). We conclude that orthotopic liver transplantation, wbich is a radical surgical procedure for portal hypertension, reverses hypersplenism.with liver cirrhosis, which· commonly pre~ents itself as splenomegaly with hematologic disorders, i.e., leukopenia, thrombocytopenia, and anemia. 1 The incidence of hypersplenism among cirrhotics varies from 15% to 70%,1 and splenectomy is known to relieve the hematologic disorders associated with this clinical entity.2-4 Passive congestion of the spleen due to portal hypertension is thought to cause the splenomegaly, which results in the sequestration and the destruction of the blood elements. 5 ,6 Although portacaval and distal splenorenal shunts are known to reduce the splenic vein pressure, the effect of these shunts on hypersplenism remains

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Section: Discussionmentioning

confidence: 99%

Reversal of Hypersplenism Following Orthotopic Liver Transplantation

Yanaga¹,

Tzakis²,

Shimada³

et al. 1989

Annals of Surgery

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“…[150][151][152] Complement activation and circulating immune complexes also could influence inflammation-based renal injury in patients with ESLD. [153][154][155][156] Cirrhosis is associated with decreased complement levels (C3, C4, and total complement) caused by impaired hepatic production, as well as enhanced consumption. [157][158][159][160] Consumption is mediated through both the alternative and classical complement pathways.…”

Section: Other Mechanisms Of Renal Injury In the Setting Of Cirrhosismentioning

confidence: 99%

Pathophysiology of renal disease associated with liver disorders: Implications for liver transplantation. Part I

Davis

Gonwa

Wilkinson

2002

Liver Transplantation

117

131

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“…Hypergammaglobulinemia (1)(2)(3)(4), together with a depression of cell-mediated immunity (5)(6)(7), have been consistently observed in acute or chronic hepatitis and hepatic cirrhosis of varying etiology including that due to alcohol. The explanation for elevations in serum immunoglobulins has not been clarified but has been attributed by some (1), to bypass of reticuloendothelial antigen trapping or processing functions in the damaged liver.…”

Section: Introductionmentioning

confidence: 99%