PubMed · 8929149
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W T Cornblath, J D Trobe. 1996. Retinal transient ischemic attack.. https://doi.org/10.1001/archneur.1996.00550040020003
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Liver transplantation is the established therapy of choice for endstages of acute and chronic liver diseases of various aetiologies. The place of liver transplantation in the treatment of malignant liver disease, in particular hepatocellular carcinoma, remains, however, debated: liver transplantation for hepatocellular carcinoma achieves 5-year survival similar to that for other indications, and 5-year disease-free survival better than that following "curative" resection, provided certain criteria are fulfilled (one node max. 5 cm in diameter or max. 3 nodes each of max. 3 cm in diameter). This must be weighed against the uncertainties of preoperative staging and the shortage of donor organs. In contrast, cholangiocarcinoma has a poor prognosis after liver transplantation with 3- and 5-year survival rates below 20%. Only small, incidental, peripheral, intrahepatic cholangiocarcinomas in patients with primary sclerosing cholangitis seem to be an exception to this rule. Liver metastases indicate generalised tumour spread, and thus are not an indication for liver transplantation. Liver transplantation may be justified for liver metastases of neuroendocrine gastrointestinal tumours, provided the primary has been curatively resected and there is no extrahepatic spread. Finally, liver-transplanted (immunosuppressed) patients are at increased risk to develop malignant tumours. This includes in particular epithelial skin tumours, (EBV-associated lymphoproliferative diseases and (HHV8-induced) Kaposi's sarcoma.
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Triptans, 5-HT1B/1D agonists used in migraine treatment, are rarely involved in serious coronary events due to vasospasm. 5 HT1 receptors mediate vasodilation and vasoconstriction of coronary arteries. Reports of serious coronary events mainly concern patients with known risk factors for coronary artery disease. It is prudent to obtain a thorough medical history before treatment with a triptan is started. If chest pain occurs, the possibility of coronary ischemia should be investigated. Stroke, a known complication to migraine, has also been reported in patients treated with triptans, but available data do not suggest that triptans, when correctly used, greatly increase the risk.