Are you looking for medical, legal or ethical advice? Seriously, I would
have very serious worries about harvesting a liver from someone who died as
a result of purported e use.
See, for example:
Milroy, C. M., J. C. Clark, A R W Forrest. (1996). “Pathology of deaths
associated with "ecstasy" and "eve" misuse.” Journal of Clinical Pathology
49(2): 149-53.
In virtually every case we found striking changes in the liver, which varied
from foci of individual cell necrosis to centrilobular necrosis. In one case
there was massive hepatic necrosis.
Robert Forrest
A R W Forrest LLM, FRCP, FRCPath,
Professor of Forensic Toxicology
University Dept of Forensic Pathology
Medico-legal Centre
Watery Street
SHEFFIELD
S3 7ES
UK
Voice +44 (0)114 2738721
Fax +44 (0)114 279 8942
> -----Original Message-----
> From: [log in to unmask]
> [mailto:[log in to unmask]]On Behalf Of Dr William
> Marshall
> Sent: 03 December 1999 12:06
> To: [log in to unmask]
> Subject: Perplexing transplant patient
>
>
> Dear colleagues
>
> We have a young woman who underwent liver transplantation for paracetamol
> induced acute liver failure two months ago. The donor organ came from a
> patient who had died after using ecstasy. The liver looked normal at
> surgery, donor LFTs were normal but no biopsy was done. We are
> not aware of
> any problems in the donor's past medical history.
>
> The recipient is doing well but has persistent cholestasis, with bilirubin
> 450, AST 400, alk phos 1700 GGT 1300. Liver biopsy shows no evidence of
> rejection but the liver shows extensive fatty infiltration, with lipid
> primarily in macrophages. The histological appearances are reminiscent of
> Niemann-Pick. She has a serum cholesterol concentration of 24 mmol/L with
> triglycerides 5.
>
> Immunosuppression is with tacrolimus.
>
> In our experience, such severe hypercholesterolaemia is unusual in
> cholestasis but it is the combination of the hypercholesterolaemia and the
> biopsy appearances that is the puzzle.
>
> Suggestions would be welcome.
>
> William Marshall
>
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