Outcome of living donor liver transplantation for Egyptian patients with hepatitis C (genotype 4)-related cirrhosis

BACKGROUND

Hepatitis C virus (HCV) recurrence after living donor liver transplantation (LDLT) represents a challenging issue due to universal viral recurrence and invasion into the graft, although the incidence of histological recurrence, risk factors, and survival rates are still controversial.

PATIENTS AND METHODS

Recurrence of HCV was studied in 38 of 53 adult patients who underwent LDLT.

RESULTS

Recipient and graft survivals were 86.6% at the end of the follow-up which was comparable to literature reports for deceased donor liver transplantation (DDLT). Clinical HCV recurrence was observed in 10/38 patients (26.3%). Four patients developed mild fibrosis with a mean fibrosis score of 0.6 and mean grade of histological activity index (HAI) of 7.1. None of the recipients developed allograft cirrhosis during the mean follow-up period of 16 +/- 8.18 months (range, 4-35 months). Estimated and actual graft volumes were negatively correlated with the incidence and early clinical HCV recurrence. None of the other risk factors were significantly correlated with clinical HCV recurrence: gender, donor and recipient ages, pretransplantation Child-Pugh or model for end-stage liver disease (MELD) scores, pre- and postoperative viremia, immunosuppressive drugs, pulse steroid therapy, and preoperative anti-HBc status.

CONCLUSIONS

Postoperative patient and graft survival rates for HCV (genotype 4)-related cirrhosis were more or less comparable to DDLT reported in the literature. Clinical HCV recurrence after LDLT in our study was low. Small graft volume was a significant risk factor for HCV recurrence. A longer follow-up and a larger number of patients are required to clarify these issues.

Partial dynamical symmetry versus quasi dynamical symmetry examination within a quantum chaos analyses of spectral data for even-even nuclei

Statistical analyses of the spectral distributions of rotational bands in 51 deformed prolate even–even nuclei in the 152 ≤ A ≤ 250 mass region \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$R_{{4_{1}^{ + } /2_{1}^{ + } }} \ge 3.00$$\end{document}R41+/21+≥3.00 are examined in terms of nearest neighbor spacing distributions. Specifically, the focus is on data for 0⁺, 2⁺, and 4⁺ energy levels of the ground, gamma, and beta bands. The chaotic behavior of the gamma band, especially the position of the \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$2_{\gamma }^{ + }$$\end{document}2γ+ band-head compared to other levels and bands, is clear. The levels are analyzed within the framework of two models, namely, a SU(3)-partial dynamical symmetry Hamiltonian and a SU(3) two-coupled quasi-dynamical symmetry Hamiltonian, with results that are further analyzed using random matrix theory. The partial and quasi dynamics both yield outcomes that are in reasonable agreement with the known experimental results. However, due to the degeneracy of the beta and gamma bands within the simplest SU(3) picture, the theory cannot be used to describe the fluctuation properties of excited bands. By changing relative weights of the different terms in the partial and quasi dynamical Hamiltonians, results are obtained that show more GOE-like statistics in the partial dynamical formalism as the strength of the pairing term is increased. Also, in the quasi-dynamical symmetry limit, more correlations are found because of the stronger couplings.