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Book ; Thesis: Drug therapy and liver oxygenation in hemorrhagic shock

Nordin, Arno

1998

Author's details	Arno Nordin
Language	English
Size	Getr. Zählung : graph. Darst.
Publishing country	Finland
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Helsinki, Univ., Diss., 1998
HBZ-ID	HT010730884
ISBN	952-91-0369-7 ; 9529108697 ; 978-952-91-0369-0 ; 9789529108695
Database	Catalogue ZB MED Medicine, Health

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Article ; Online: High prevalence of liver fibrosis and cirrhosis in a nationwide sample of organ donors with liver histology.

Åberg, Fredrik / Savikko, Johanna / Eerola, Verner / Nordin, Arno / Isoniemi, Helena

Journal of hepatology

2023 Volume 80, Issue 5, Page(s) e205–e207

MeSH term(s)	Humans ; Prevalence ; Liver Cirrhosis/epidemiology ; Liver Cirrhosis/pathology ; Liver/pathology ; Fibrosis ; Tissue Donors
Language	English
Publishing date	2023-10-07
Publishing country	Netherlands
Document type	Letter
ZDB-ID	605953-3
ISSN	1600-0641 ; 0168-8278
ISSN (online)	1600-0641
ISSN	0168-8278
DOI	10.1016/j.jhep.2023.09.018
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Article ; Online: Value of posttransplant protocol biopsies in 2 biliary autoimmune liver diseases: A step toward personalized immunosuppressive treatment.

Vannas, Marko / Arola, Johanna / Nordin, Arno / Isoniemi, Helena

Medicine

2022 Volume 101, Issue 2, Page(s) e28509

Abstract: Abstract: The value of protocol liver graft biopsies with good liver function was evaluated in patients with primary sclerosing cholangitis (PSC) or primary biliary cholangitis (PBC).A total of 250 protocol liver biopsy reports from 182 PSC and PBC ... ...

Abstract	Abstract: The value of protocol liver graft biopsies with good liver function was evaluated in patients with primary sclerosing cholangitis (PSC) or primary biliary cholangitis (PBC).A total of 250 protocol liver biopsy reports from 182 PSC and PBC patients were compared. Overall histopathological findings and those leading to changes in immunosuppression therapy were retrospectively analyzed.The mean time to first protocol biopsy after transplantation was 5.5 (±4.5) years for PSC patients and 9.3 (±6.6) years for PBC patients. More than 1 abnormal histopathological parameter was found in 43% and 62% of PSC and PBC patients, respectively. However, the histology was interpreted as normal by the pathologist in 78% of PSC and 60% of PBC patients. Immunosuppression therapy was reduced in 10% and increased in 6% patients due to protocol biopsy findings. Biopsies leading to increased immunosuppression therapy had more portal (P = .004), endothelial (P = .008), interphase (P = .021), and lobular (P = .000) inflammation.Mild histopathological findings were frequently found in the protocol biopsies despite the normal biochemistry. PBC patients had more histological abnormalities than those transplanted due to PSC; however, PBC patients had longer follow-up times. Immunosuppression therapy could be safely increased or decreased according to protocol biopsy findings after multidisciplinary meeting discussions.
MeSH term(s)	Autoimmune Diseases ; Biopsy ; Cholangitis, Sclerosing ; Humans ; Immunosuppressive Agents/therapeutic use ; Liver Cirrhosis, Biliary ; Liver Transplantation ; Retrospective Studies
Chemical Substances	Immunosuppressive Agents
Language	English
Publishing date	2022-01-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000028509
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Article ; Online: Association Between Pre-Transplant Oral Health and Post-Liver Transplant Complications.

Olander, Annika Emilia / Helenius-Hietala, Jaana / Nordin, Arno / Savikko, Johanna / Ruokonen, Hellevi / Åberg, Fredrik

Transplant international : official journal of the European Society for Organ Transplantation

2023 Volume 36, Page(s) 11534

Abstract: Oral disease is linked with systemic inflammation and various systemic conditions, including chronic liver disease. Liver transplantation (LT) candidates often need dental infection focus eradication, and after LT, there is high risk of many inflammation- ...

Abstract	Oral disease is linked with systemic inflammation and various systemic conditions, including chronic liver disease. Liver transplantation (LT) candidates often need dental infection focus eradication, and after LT, there is high risk of many inflammation-related complications. We studied whether pre-LT dental status is associated with the occurrence of post-LT complications. This study included 225 adult LT recipients whose teeth were examined and treated before LT, and 40 adult LT recipients who did not have pre-LT dental data available. Data on post-LT complications were collected from the national liver transplant registry and followed up until the end of July 2020. Worse pre-LT dental status was associated with a higher risk of acute rejection post-LT compared to patients with good dental status. Worse dental status was also associated with higher 1-year-post-LT ALT levels and lower albumin levels. In conclusion, poor pre-LT oral health seems to associate with an increased risk of post-LT acute rejection and with elevated ALT levels and decreased albumin levels, suggesting an effect on post-LT liver health. Therefore, prevention and treatment of oral and dental diseases should be promoted early in the course of liver disease.
Language	English
Publishing date	2023-09-12
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	639435-8
ISSN	1432-2277 ; 0934-0874
ISSN (online)	1432-2277
ISSN	0934-0874
DOI	10.3389/ti.2023.11534
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Zs.A 2358: Show issues

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Article ; Online: Pasireotide Versus Octreotide in Preventing Complications After Simultaneous Pancreas-Kidney Transplantation.

Ahopelto, Kaisa / Bonsdorff, Akseli / Grasberger, Juulia / Lempinen, Marko / Nordin, Arno / Helanterä, Ilkka / Sallinen, Ville

Transplant international : official journal of the European Society for Organ Transplantation

2023 Volume 36, Page(s) 11255

Abstract: In elective pancreatic surgery, somatostatin-analogues pasireotide and octreotide are variably used to reduce postoperative complications, but knowledge on their role in pancreas transplantation is limited. This study compared pasireotide and octreotide ... ...

Abstract	In elective pancreatic surgery, somatostatin-analogues pasireotide and octreotide are variably used to reduce postoperative complications, but knowledge on their role in pancreas transplantation is limited. This study compared pasireotide and octreotide for their association with complications after simultaneous pancreas-kidney transplantation (SPK). This retrospective study included consecutive patients undergoing SPK's from July 2013 to July 2022. Between July 2013 and April 2020, octreotide was administered 0.1 mg s.c. once daily and between May 2020 and July 2022 pasireotide was administered 0.9 mg twice daily, both until third postoperative day. Complications within 90 days postoperatively were collected, and reoperation rate and Comprehensive Complication index (CCI) ≥ 33.7 (morbidity equal to one reoperation) were used as primary outcomes. Of the 213 patients undergoing SPK, 150 patients received octreotide and 63 pasireotide. Baseline characteristics were comparable. Reoperation rate was 25.3% (
MeSH term(s)	Humans ; Octreotide/therapeutic use ; Kidney Transplantation/adverse effects ; Retrospective Studies ; Somatostatin/therapeutic use ; Pancreas
Chemical Substances	Octreotide (RWM8CCW8GP) ; pasireotide (98H1T17066) ; Somatostatin (51110-01-1)
Language	English
Publishing date	2023-06-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	639435-8
ISSN	1432-2277 ; 0934-0874
ISSN (online)	1432-2277
ISSN	0934-0874
DOI	10.3389/ti.2023.11255
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Article ; Online: Comprehensive Complication Index to Monitor Morbidity and Mortality After Liver Transplantation in Primary Sclerosing Cholangitis.

Vannas, Marko J / Åberg, Fredrik / Nordin, Arno / Tukiainen, Eija / Savikko, Johanna / Isoniemi, Helena

Annals of surgery

2023 Volume 278, Issue 4, Page(s) e773–e779

Abstract: Objective: The objective of this study was to investigate the short-term and long-term morbidity after liver transplantation (LTx) in patients with primary sclerosing cholangitis (PSC).: Background: PSC is a common indication for LTx in Scandinavia. ... ...

Abstract	Objective: The objective of this study was to investigate the short-term and long-term morbidity after liver transplantation (LTx) in patients with primary sclerosing cholangitis (PSC). Background: PSC is a common indication for LTx in Scandinavia. Recently, research has focused on long-term survival and morbidity. The Comprehensive Complication Index (CCI) precisely describes postsurgical complications, by considering both number and severity. Patients and methods: Two patient groups were compared: those with classical PSC symptoms (n=148) and those with increased risk of cholangiocarcinoma (n=51, premalignant group). Two CCI scores were calculated, at 1-year post-LTx and a cumulative overall score at the latest follow-up. In addition, we investigated factors potentially related to high CCI. Results: The 1-year median CCI were 29.6 and 26.2 in the classical and premalignant groups, respectively ( P =0.308). The median overall CCI were 43.2 and 46.8 ( P =0.765), respectively. Patient survival was significantly lower in patients with 1-year CCI>42. The most common complications associated with low survival were cholangitis, infections, and hypertension. One-year and overall CCI were similar between sexes and different types of biliary anastomosis. Patients with pre-LTx Model for End-stage Liver Disease scores >20 had higher 1-year and overall CCI (36.2 and 52.6, respectively) than those with lower Model for End-stage Liver Disease scores. Both low (<22) and high (>25 kg/m 2 ) body mass indices were associated with high overall 1-year and overall CCI (50.9 and 41.8, respectively), but median body mass indices were associated with significantly lower 1-year and overall CCI (38.4, P =0.023). Conclusions: The previously determined 1-year CCI cutoff of 42 could significantly predict survival post-LTx. Mortality and morbidity were not significantly different between the PSC groups analyzed.
MeSH term(s)	Humans ; End Stage Liver Disease/surgery ; Cholangitis, Sclerosing/complications ; Cholangitis, Sclerosing/surgery ; Liver Transplantation/adverse effects ; Severity of Illness Index ; Bile Ducts, Intrahepatic ; Bile Duct Neoplasms ; Morbidity ; Retrospective Studies
Language	English
Publishing date	2023-02-24
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000005831
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Article ; Online: Risk and prediction of kidney failure early after liver transplantation.

Innanen, Tuija / Sallinen, Ville / Helanterä, Ilkka / Eerola, Verner / Nordin, Arno / Åberg, Fredrik

Scandinavian journal of gastroenterology

2023 Volume 59, Issue 4, Page(s) 461–468

Abstract: Background: Kidney disease is common after liver transplantation (LT), but postoperative kidney failure is difficult to predict. Current guidelines recommend simultaneous liver-kidney transplantation (SLKT) in patients with pre-LT estimated glomerular ... ...

Abstract	Background: Kidney disease is common after liver transplantation (LT), but postoperative kidney failure is difficult to predict. Current guidelines recommend simultaneous liver-kidney transplantation (SLKT) in patients with pre-LT estimated glomerular filtration rate (eGFR) below 30-40 mL/min, which might be too liberal. The aim of this study was to evaluate the risk of kidney failure after LT. We also assessed the predictive ability of pretransplantation eGFR using various equations. Methods: This single-center study included patients undergoing primary LT 2006-2020. Patients undergoing simultaneous liver-kidney transplantations or on dialysis before LT were analysed separately. We calculated 5 different eGFR equations measured just before LT and assessed their predictive ability using Kaplan-Meier cumulative incidence estimates. Results: Among 556 LT patients with a median follow-up of 5.0 years (IQR 2.0-8.5), 20 developed kidney failure during follow-up, 7 of them within 1-year post LT. Six of these 7 suffered from major perioperative complications. Depending on the eGFR equation used, the incidence of kidney failure within 1-year was 3.9-6.7% at pre-LT eGFR-values <30 mL/min, 1.2-3.1% at eGFR 30-60 mL/min, and 0.6-0.9% at eGFR >60 mL/min. Conclusions: Kidney failure within 1-year post-LT could not be reliably predicted by pre-LT eGFR. However, kidney failure was uncommon even in patients with severely reduced pre-LT glomerular filtration rate (eGFR <30 mL/min), and extremely rare in patients unaffected by major perioperative complications. Our data prompts further consideration regarding the guidelines for SLKT in patients with a reduced preoperative eGFR.
MeSH term(s)	Humans ; Liver Transplantation/adverse effects ; Kidney ; Renal Insufficiency/etiology ; Kidney Transplantation/adverse effects ; Glomerular Filtration Rate ; Risk Factors ; Retrospective Studies
Language	English
Publishing date	2023-12-09
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	82042-8
ISSN	1502-7708 ; 0036-5521
ISSN (online)	1502-7708
ISSN	0036-5521
DOI	10.1080/00365521.2023.2291992
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Article ; Online: Histopathological Helsinki score of colorectal liver metastases predicts survival after liver resection.

Reijonen, Pauliina / Nordin, Arno / Savikko, Johanna / Poussa, Tuija / Arola, Johanna / Isoniemi, Helena

APMIS : acta pathologica, microbiologica, et immunologica Scandinavica

2023 Volume 131, Issue 6, Page(s) 249–261

Abstract: Several perioperative scoring systems have been created to predict outcomes in metastatic colorectal cancer; however, these rarely include histological parameters. We evaluated histological factors used for patients with liver metastases operated between ...

Abstract	Several perioperative scoring systems have been created to predict outcomes in metastatic colorectal cancer; however, these rarely include histological parameters. We evaluated histological factors used for patients with liver metastases operated between 2000 and 2019 and compared the results with the Fong score. Many scoring models for overall disease-free survival (DFS) were established and compared using multivariate Cox proportional hazard models. Statistically significant predictors at a 5% level in the univariate analysis were included in the multivariate models using the backward and forward selection methods. Per these models, we established a score of eight histological factors. We defined low-, intermediate-, and high-risk groups and compared them using the Kaplan-Meier survival and receiver operating characteristics (ROC) analyses. The histological score's accuracy was compared with the modified Fong clinical risk score. The following factors constituted the Helsinki score: advanced pT stage, node-positive primary, ≥2 metastases, size >50 mm, vitality >30%, margin <5 mm, vascular invasion and biliary invasion. The high-risk group had significantly worse DFS and overall survival. In ROC analyses, the Helsinki score was slightly better than the modified Fong clinical risk score. Helsinki score challenges physicians to acknowledge histological factors as important outcome measures.
MeSH term(s)	Humans ; Prognosis ; Colorectal Neoplasms/pathology ; Retrospective Studies ; Liver Neoplasms/surgery ; Disease-Free Survival
Language	English
Publishing date	2023-04-11
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	93340-5
ISSN	1600-0463 ; 0903-4641
ISSN (online)	1600-0463
ISSN	0903-4641
DOI	10.1111/apm.13305
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Article ; Online: A Retrospective Study of Long-Term Outcomes in 16 ABO-Incompatible Deceased Donor Pediatric Liver Transplants from a National Transplant Center at Helsinki University Hospital, Finland, 1987-2022.

Jahnukainen, Timo / Sareneva, Inna / Lauronen, Jouni / Ylinen, Elisa / Tainio, Juuso / Nordin, Arno / Hukkinen, Maria / Pakarinen, Mikko P / Jalanko, Hannu

Annals of transplantation

2024 Volume 29, Page(s) e941929

Abstract: BACKGROUND The use of ABO-incompatible liver transplants (ABO-ILTs) from deceased donors has become more common due to the shortage of available donor livers and increased transplant waiting times. This retrospective study from a national transplant ... ...

Abstract	BACKGROUND The use of ABO-incompatible liver transplants (ABO-ILTs) from deceased donors has become more common due to the shortage of available donor livers and increased transplant waiting times. This retrospective study from a national transplant center at Helsinki University Hospital, Finland, aimed to assess the long-term outcomes of ABO-incompatible deceased donor pediatric liver transplants between 1987 and 2022. MATERIAL AND METHODS Sixteen (9.5%) of the 169 pediatric liver transplantations were ABO-ILTs. The median age at transplantation was 5.0 (0.5-15.4) years. Reasons for ABO-ILTs were acute liver failure (18.75%), malignancy (12.5%), small body size and long waiting time (25%), and other reasons (43.75%). The median post-transplant follow-up time was 147 (0.72-353) months. Patient and graft survival and occurrence of surgical complications were compared to ABO-identical transplants, and anti-ABO antibody titers were analyzed. RESULTS The 1-, 3-, and 5-year patient survivals were comparable between the ABO-I and ABO-compatible groups, being 81.3%, 73.9%, and 73.9% (ABO-I) and 87.5%, 82.5%, 77.9% (ABO-compatible), respectively. Three patients with ABO-ILTs died of sepsis and multiorgan failure during the first 3 months after transplantation. The occurrence of biliary complications and early vascular thrombosis (<30 days after transplantation) did not differ significantly between recipients with an ABO-ILT vs ABO-compatible liver graft. CONCLUSIONS The findings from this study support findings from previous studies that outcomes after ABO-incompatible liver transplants in children were comparable to outcomes from ABO-identical liver transplants.
MeSH term(s)	Child ; Humans ; Child, Preschool ; Adolescent ; Liver Transplantation/methods ; Retrospective Studies ; Finland ; Blood Group Incompatibility ; ABO Blood-Group System ; Hospitals ; Graft Survival ; Graft Rejection ; Living Donors
Chemical Substances	ABO Blood-Group System
Language	English
Publishing date	2024-02-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	1484710-3
ISSN	2329-0358 ; 1425-9524
ISSN (online)	2329-0358
ISSN	1425-9524
DOI	10.12659/AOT.941929
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Article ; Online: Protocol liver biopsy predicts graft survival after liver transplantation.

Liukkonen, Ville H / Nordin, Arno J / Färkkilä, Martti A / Mirtti, Tuomas K / Arola, Johanna T / Åberg, Fredrik O

Clinical transplantation

2024 Volume 38, Issue 3, Page(s) e15286

Abstract: Background: The use of protocol liver biopsy to monitor liver allograft status remains controversial. There is limited data from modern transplantation populations that includes protocol biopsies to evaluate its value in predicting clinical outcomes.: ...

Abstract	Background: The use of protocol liver biopsy to monitor liver allograft status remains controversial. There is limited data from modern transplantation populations that includes protocol biopsies to evaluate its value in predicting clinical outcomes. Methods: All protocol liver biopsies were identified from 875 patients who underwent liver transplantation at Helsinki University Hospital between 2000 and 2019. Each histologic component was analyzed for its ability to predict long-term outcomes, especially graft survival. We determined the frequency of significant biopsy findings based on the Banff working group definition. Liver function tests (LFTs) and clinical markers were evaluated for their ability to predict significant biopsy findings. Results: In total, 867 protocol liver biopsies were analyzed. Significant findings were identified in 20.1% of the biopsies. In the first protocol biopsy, steatohepatitis (hazard ratio [HR] 3.504, p = .03) and moderate or severe congestion (HR 3.338, p = .04) predicted graft loss. The presence of cholangitis (HR 2.563, p = .04), necrosis (HR 7.635, p < .001), mild congestion (HR 4.291, p = .009), and significant biopsy finding (HR 2.540, p = .02) predicted inferior death-censored graft survival. While the degree of elevation of LFTs was positively associated with significant biopsy findings, the discrimination was poor (AUC .572-.622). Combined LFTs and clinical risk factors remained suboptimal for discriminating significant biopsy findings (AUC .696). Conclusions: Our findings support the use of protocol liver biopsies after liver transplantation since they frequently revealed changes associated with long-term outcomes, even when LFTs were normal.
MeSH term(s)	Humans ; Liver Transplantation/adverse effects ; Graft Survival ; Transplantation, Homologous ; Liver/pathology ; Biopsy ; Graft Rejection/diagnosis ; Graft Rejection/etiology ; Graft Rejection/pathology
Language	English
Publishing date	2024-03-19
Publishing country	Denmark
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639001-8
ISSN	1399-0012 ; 0902-0063
ISSN (online)	1399-0012
ISSN	0902-0063
DOI	10.1111/ctr.15286
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