LYCOS RETRIEVER
Liver: Patients
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When complications cannot be controlled or when the liver becomes so damaged from scarring that it completely stops functioning, a liver transplant is necessary. In liver transplantation surgery, a diseased liver is removed and replaced with a healthy one from an organ donor. About 80 to 90 percent of patients survive liver transplantation. Survival rates have improved over the past several years because of drugs such as cyclosporine and tacrolimus, which suppress the immune system and keep it from attacking and damaging the new liver.
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At the University of California, San Francisco, four liver and 10 kidney transplants were performed in HIV-positive patients. HIV viral loads have remained undetectable in all patients on anti-retroviral therapy. The only death occurred in a 15-year-old child who underwent liver transplantation for hepatitis C who died as a result of a rapid recurrence of the hepatitis virus, said Dr. Peter Stock. Interestingly, patients on protease inhibitors required 25 percent of the dose of the anti-rejection drug cyclosporine compared to patients on non-nucleoside reverse transcriptase inhibitors. There has been no evidence of significant HIV progression or any adverse effect of the virus on organ function, the researchers reported.
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Over 4,000 liver transplants a year are performed in the U.S. About sixty to seventy percent of liver transplant patients are alive and well after five years. While there are some side effects from medications taken to suppress the immune system (so the transplanted liver will not be rejected) most patients lead full, productive lives. In fact, many even have children. The use of new anti-rejection drugs and other medications are constantly improving the results of liver transplantation.
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The first human liver transplant was performed in 1963 by a surgical team led by Dr. Thomas Starzl[1] of Denver, Colorado, United States. Dr. Starzl performed several additional transplants over the next few years before the first short-term success was achieved in 1967 with the first one-year survival posttransplantation. Despite the development of viable surgical techniques, liver transplantation remained experimental through the 1970s, with one year patient survival in the vicinity of 25%.
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"The good tolerability profile of VX-497 and its effect on liver inflammation encourage us to conduct studies to assess the antiviral activity of VX-497 in less refractory patient populations and in combination with interferon-alpha. Further studies of VX-497 in hepatitis C patients, both as monotherapy and in combination with interferon-alpha, if successful, will allow Vertex to develop a commercial and regulatory approval path for VX-497. Vertex is committed to the discovery and development of new antiviral drugs that may bring innovative therapies to patients with few treatment options," commented Dr. John Alam, Vice President of Clinical Development at Vertex.
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The patented invention is related to the observation that expression of AMT-011 in muscle causes a reduction of the liver triglyceride content by redistributing triglycerides from the liver to the peripheral muscles where it is metabolized. NAFLD and NASH are closely related to the pathogenesis of the "metabolic syndrome". This latter condition is characterized by central obesity, increase of serum triglycerides and insulin resistance, and is a major cause of diabetes and coronary vascular disease in the Western world. Recent epidemiological studies published in the journals Gastroenterology and Annals of Hepatology show that the prevalence of NAFLD in the general population is extremely high. Over 60 million adult Americans and an unknown proportion of children are believed to suffer from NAFLD. At the lowest range of the estimates, 11 percent of these patients develop NASH.
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