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Colectomy is rightly viewed as a last resort in selected patients with slow-transit constipation. A new study presents US national data that raises new concerns regarding the outcome of this procedure and perhaps questions whether it should be offered at all.
Whereas the status of the liver as privileged and exempt from humoral rejection has fallen, attempts at breaching the blood group barrier during transplantation have continued. Previously restricted to paediatric patients and emergencies, advances in immunosuppression protocols have improved outcomes to the point that ABO-incompatible liver transplantation might be more widely used in adults.
What is in a name; and why does the nomenclature of one disease, primary biliary cirrhosis, cause such contention that a proposed name change by those deeply committed to the advancement of its understanding and management stimulate huge debate?
Pre-operative diagnosis of biliary strictures often presents as a challenge to clinicians. Strictures have a range of benign causes, but can also be a result of cancer and so an ability to diagnose them accurately is very important. In this Review the authors discuss the existing modalities of assessing strictures and argue that a multimodal and multidisciplinary approach is likely to be best. New biomarkers and emerging techniques are hoped to improve diagnostic capabilities in future.
Treatment failure associated with HCV resistance to newly developed direct-acting antiviral agents is not an uncommon occurrence and poses a substantial problem to clinicians trying to re-treat patients who have failed available interferon-free treatments. A new study suggests that host-targeted agents are the way forward, but is this approach really feasible?
Rationing of livers for transplantation is a difficult problem especially when creation of national policies is needed. Italy recently convened a national consensus conference to decide who should be first in line.