title: Nephrogenic systemic fibrosis among liver transplant recipients: a single institution experience and topic update.
abstract: Nephrogenic systemic fibrosis (NSF) is a recently characterized systemic fibrosing disorder developing in the setting of renal insufficiency. NSF's rapidly progressive nature resulting in disability within weeks of onset makes early diagnosis important. Two reports of NSF after liver transplantation are known of. We present three cases of NSF developing within a few months after liver transplantation and review the current literature. Loss of regulatory control of the circulating fibrocyte, its aberrant recruitment, in a milieu of renal failure and a recent vascular procedure appear important in its development. Known current therapies lack consistent efficacy. Only an improvement in renal function has the greatest likelihood of NSF's resolution. Delayed recognition may pose a significant barrier to functional recovery in the ubiquitously deconditioned liver transplant patient. Early recognition and implementation of aggressive physical therapy appear to have the greatest impact on halting its progression.
authors.affiliation: Division of Transplantation, Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: M
authors.initials: M
authors.lastname: Maloo
authors.forename: P
authors.initials: P
authors.lastname: Abt
authors.forename: R
authors.initials: R
authors.lastname: Kashyap
authors.forename: D
authors.initials: D
authors.lastname: Younan
authors.forename: M
authors.initials: M
authors.lastname: Zand
authors.forename: M
authors.initials: M
authors.lastname: Orloff
authors.forename: A
authors.initials: A
authors.lastname: Jain
authors.forename: A
authors.initials: A
authors.lastname: Pentland
authors.forename: G
authors.initials: G
authors.lastname: Scott
authors.forename: A
authors.initials: A
authors.lastname: Bozorgzadeh
mesh_terms: D000368:Aged; D005355:Fibrosis / Q000209:etiology; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D016896:Treatment Outcome