Hepatic and cardiac iron overload among patients with end-stage liver disease referred for liver transplantation Clinical Transplantation 18 Nov 2009 Avital Y. O'Glasser a , David L. Scott b , Christopher L. Corless c , Atif Zaman a , Anna Sasaki a , Deepak V. Gopal d , Stephen C. Rayhill b , Susan L. Orloff b , John M. Ham b , John M. Rabkin e , Ken Flora f , Crispin H. Davies g , Craig S. Broberg g and Jonathan M. Schwartz a a Division of Gastroenterology and Hepatology, Department of Medicine, Oregon Health and Science University and the Portland Veterans Affairs Medical Center, Portland, OR , b Division of Liver/Pancreas Transplantation, Department of Surgery, Oregon Health and Science University and the Portland Veterans Affairs Medical Center, Portland, OR , c Department of Pathology, Oregon Health and Science University, Portland, OR , d Section of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI , e California Pacific Medical Center, San Francisco, CA , f The Oregon Clinic, Portland, OR and g Division of Cardiology, Department of Medicine, Oregon Health and Science University, Portland, OR, USA Corresponding author: Jonathan M. Schwartz, MD, Department of Medicine, Division of Gastroenterology and Hepatology, Oregon Health and Science University and the Portland Veterans Affairs Medical Center, 3181 Sam Jackson Park Road, L461, Portland, OR 97219, USA. Tel.: +1 (503) 494-2270; fax: +1 (503) 494-8776; e-mail: schwa...@ohsu.edu ABSTRACT
Background: Iron overload is associated with fatal cardiovascular events following liver transplantation. Myocardial iron deposits were observed post-mortem in patients who died of cardiac events after transplantation at our institution. This observation prompted testing to exclude cardiac iron in subsequent transplant candidates.
Aims: To assess the results of testing for iron overload in liver transplant candidates at our institution.
Methods: Ferritin, TIBC, and serum iron were measured in cirrhotics referred for transplantation. Patients with transferrin saturation ≥50% and ferritin ≥250 ng/mL underwent liver biopsy graded for iron. Patients with 3–4+ hepatic iron deposits underwent HFE mutation analysis and endomyocardial biopsy with iron staining.
Results: Eight hundred and fifty-six patients were evaluated for liver transplantation between January 1997 and March 2005. Two hundred and eighty-seven patients (34%) had transferrin saturation ≥50% and ferritin ≥250 ng/mL. Patients with markers of iron overload had more advanced liver disease than those with normal iron indices. One hundred and fifty-three patients underwent liver biopsy. Twenty-six patients (17%) had 3–4+ hepatic iron staining. One patient was a C282Y heterozygote. Endomyocardial biopsy was performed in 14 patients of whom nine had cardiac iron deposition.
Conclusions: Non-HFE-related cardiac iron overload can occur in advanced liver disease. We therefore recommend screening for cardiac iron prior to liver transplantation.
Accepted for publication 29 September 2009
DIGITAL OBJECT IDENTIFIER (DOI) 10.1111/j.1399-0012.2009.01136.x About DOI
An American atheist same-sex sexual predator is attempting to disrupt this thread ..
Ignore him ..
Hepatic and cardiac iron overload among patients with end-stage liver disease referred for liver transplantation Clinical Transplantation 18 Nov 2009 Avital Y. O'Glasser a , David L. Scott b , Christopher L. Corless c , Atif Zaman a , Anna Sasaki a , Deepak V. Gopal d , Stephen C. Rayhill b , Susan L. Orloff b , John M. Ham b , John M. Rabkin e , Ken Flora f , Crispin H. Davies g , Craig S. Broberg g and Jonathan M. Schwartz a a Division of Gastroenterology and Hepatology, Department of Medicine, Oregon Health and Science University and the Portland Veterans Affairs Medical Center, Portland, OR , b Division of Liver/Pancreas Transplantation, Department of Surgery, Oregon Health and Science University and the Portland Veterans Affairs Medical Center, Portland, OR , c Department of Pathology, Oregon Health and Science University, Portland, OR , d Section of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI , e California Pacific Medical Center, San Francisco, CA , f The Oregon Clinic, Portland, OR and g Division of Cardiology, Department of Medicine, Oregon Health and Science University, Portland, OR, USA Corresponding author: Jonathan M. Schwartz, MD, Department of Medicine, Division of Gastroenterology and Hepatology, Oregon Health and Science University and the Portland Veterans Affairs Medical Center, 3181 Sam Jackson Park Road, L461, Portland, OR 97219, USA. Tel.: +1 (503) 494-2270; fax: +1 (503) 494-8776; e-mail: schwa...@ohsu.edu ABSTRACT
Background: Iron overload is associated with fatal cardiovascular events following liver transplantation. Myocardial iron deposits were observed post-mortem in patients who died of cardiac events after transplantation at our institution. This observation prompted testing to exclude cardiac iron in subsequent transplant candidates.
Aims: To assess the results of testing for iron overload in liver transplant candidates at our institution.
Methods: Ferritin, TIBC, and serum iron were measured in cirrhotics referred for transplantation. Patients with transferrin saturation ≥50% and ferritin ≥250 ng/mL underwent liver biopsy graded for iron. Patients with 3–4+ hepatic iron deposits underwent HFE mutation analysis and endomyocardial biopsy with iron staining.
Results: Eight hundred and fifty-six patients were evaluated for liver transplantation between January 1997 and March 2005. Two hundred and eighty-seven patients (34%) had transferrin saturation ≥50% and ferritin ≥250 ng/mL. Patients with markers of iron overload had more advanced liver disease than those with normal iron indices. One hundred and fifty-three patients underwent liver biopsy. Twenty-six patients (17%) had 3–4+ hepatic iron staining. One patient was a C282Y heterozygote. Endomyocardial biopsy was performed in 14 patients of whom nine had cardiac iron deposition.
Conclusions: Non-HFE-related cardiac iron overload can occur in advanced liver disease. We therefore recommend screening for cardiac iron prior to liver transplantation.
Accepted for publication 29 September 2009
DIGITAL OBJECT IDENTIFIER (DOI) 10.1111/j.1399-0012.2009.01136.x About DOI
An American atheist same-sex sexual predator is attempting to disrupt this thread ..
Ignore him ..
Hepatic and cardiac iron overload among patients with end-stage liver disease referred for liver transplantation Clinical Transplantation 18 Nov 2009 Avital Y. O'Glasser a , David L. Scott b , Christopher L. Corless c , Atif Zaman a , Anna Sasaki a , Deepak V. Gopal d , Stephen C. Rayhill b , Susan L. Orloff b , John M. Ham b , John M. Rabkin e , Ken Flora f , Crispin H. Davies g , Craig S. Broberg g and Jonathan M. Schwartz a a Division of Gastroenterology and Hepatology, Department of Medicine, Oregon Health and Science University and the Portland Veterans Affairs Medical Center, Portland, OR , b Division of Liver/Pancreas Transplantation, Department of Surgery, Oregon Health and Science University and the Portland Veterans Affairs Medical Center, Portland, OR , c Department of Pathology, Oregon Health and Science University, Portland, OR , d Section of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI , e California Pacific Medical Center, San Francisco, CA , f The Oregon Clinic, Portland, OR and g Division of Cardiology, Department of Medicine, Oregon Health and Science University, Portland, OR, USA Corresponding author: Jonathan M. Schwartz, MD, Department of Medicine, Division of Gastroenterology and Hepatology, Oregon Health and Science University and the Portland Veterans Affairs Medical Center, 3181 Sam Jackson Park Road, L461, Portland, OR 97219, USA. Tel.: +1 (503) 494-2270; fax: +1 (503) 494-8776; e-mail: schwa...@ohsu.edu ABSTRACT
Background: Iron overload is associated with fatal cardiovascular events following liver transplantation. Myocardial iron deposits were observed post-mortem in patients who died of cardiac events after transplantation at our institution. This observation prompted testing to exclude cardiac iron in subsequent transplant candidates.
Aims: To assess the results of testing for iron overload in liver transplant candidates at our institution.
Methods: Ferritin, TIBC, and serum iron were measured in cirrhotics referred for transplantation. Patients with transferrin saturation ≥50% and ferritin ≥250 ng/mL underwent liver biopsy graded for iron. Patients with 3–4+ hepatic iron deposits underwent HFE mutation analysis and endomyocardial biopsy with iron staining.
Results: Eight hundred and fifty-six patients were evaluated for liver transplantation between January 1997 and March 2005. Two hundred and eighty-seven patients (34%) had transferrin saturation ≥50% and ferritin ≥250 ng/mL. Patients with markers of iron overload had more advanced liver disease than those with normal iron indices. One hundred and fifty-three patients underwent liver biopsy. Twenty-six patients (17%) had 3–4+ hepatic iron staining. One patient was a C282Y heterozygote. Endomyocardial biopsy was performed in 14 patients of whom nine had cardiac iron deposition.
Conclusions: Non-HFE-related cardiac iron overload can occur in advanced liver disease. We therefore recommend screening for cardiac iron prior to liver transplantation.
Accepted for publication 29 September 2009
DIGITAL OBJECT IDENTIFIER (DOI) 10.1111/j.1399-0012.2009.01136.x About DOI
I just talked to a friend who, like me, has that extra chromosome that causes high iron levels. He's been looking into it and called me this morning to tell me that some things that may be worth investigating are cumin, quercetin, hesperidin, naringenin, inositol phosphate 6, and green and black tea. Please excuse any misspellings; I was scribbling desperately as he was talking. For all the folks in this ng, it appears IJ is on the mark about high iron levels, especially in liver patients.
On Fri, 12 Mar 2010 14:24:51 -0500, Thip <m...@privacy.net> wrote: >I just talked to a friend who, like me, has that extra chromosome that >causes high iron levels. He's been looking into it and called me this >morning to tell me that some things that may be worth investigating are >cumin, quercetin, hesperidin, naringenin, inositol phosphate 6, and >green and black tea. Please excuse any misspellings; I was scribbling >desperately as he was talking. For all the folks in this ng, it appears >IJ is on the mark about high iron levels, especially in liver patients.
> On Fri, 12 Mar 2010 14:24:51 -0500, Thip <m...@privacy.net> wrote:
>>I just talked to a friend who, like me, has that extra chromosome that >>causes high iron levels. He's been looking into it and called me this >>morning to tell me that some things that may be worth investigating are >>cumin, quercetin, hesperidin, naringenin, inositol phosphate 6, and >>green and black tea. Please excuse any misspellings; I was scribbling >>desperately as he was talking. For all the folks in this ng, it appears >>IJ is on the mark about high iron levels, especially in liver patients.
|
