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Liver Transplantation

Riccardo De Carlis, Stefano Di Sandro, Andrea Lauterio, Francesca Botta, Fabio Ferla, Enzo Andorno, Vincenzo Bagnardi, Luciano De Carlis
Donors after cardiac death in Italy constitute a relatively unique population, because of the requirement of a no-touch period of 20 min. The first aim of this study was to compare liver transplants from donors who were maintained on normothermic regional perfusion after cardiac death and suffered extended warm ischemia (DCD-group, n=20) to those from donors who were maintained on extracorporeal membrane oxygenation and succumbed to brain death (ECMO-group, n=17) and those from standard donors after brain death (DBD-group, n=52)...
July 19, 2018: Liver Transplantation
Olivier Sérée, Mario Altieri, Elodie Guillaume, Rémy De Mil, Thierry Lobbedez, Philip Robinson, Philippe Segol, Ephrem Salamé, Armand Abergel, Olivier Boillot, Filomena Conti, Olivier Chazouillères, Maryline Debette-Gratien, Dominique Debray, Géraldine Hery, Sébastien Dharancy, François Durand, Christophe Duvoux, Claire Francoz, Jean Gugenheim, Jean Hardwigsen, Pauline Houssel-Debry, Emmanuel Jacquemin, Nassim Kamar, Marianne Latournerie, Pascal Lebray, Vincent Leroy, Alessandra Mazzola, Martine Neau-Cransac, Georges-Philippe Pageaux, Sylvie Radenne, Faouzi Saliba, Didier Samuel, Claire Vanlemmens, Marie-Lorraine Woehl-Jaegle, Guy Launoy, Jérôme Dumortier
De novo malignancies are one of the major late complications and cause of death after liver transplantation (LT). Using extensive data from the French national Agence de la Biomédecine database, the present study aimed to quantify the risk of solid organ de novo malignancies (excluding non-melanoma skin cancers) after LT. The incidence of de novo malignancies among all LT patients between 1993 and 2012 was compared to that of the French population, standardized on age, gender, and calendar period (standardized incidence ratio, SIR)...
July 18, 2018: Liver Transplantation
Choon Hyuck David Kwon, Gyu-Seong Choi, Jong Man Kim, Chan Woo Cho, Jinsoo Rhu, Gaab Soo Kim, Dong Hyun Sinn, Jae-Won Joh
BACKGROUND: Even after two decades of experience in laparoscopic hepatectomy, data of purely laparoscopic approach for donor hepatectomy in adult living donor liver transplantation is limited. We report our initial experience of purely laparoscopic approach for donor hepatectomy for adult recipients to explore its potential application in the management of donors. METHOD: A retrospective data analysis of consecutive 54 cases performed between May 2013 and February 2015 was done...
July 18, 2018: Liver Transplantation
Eva-Doreen Pfister, André Karch, Wojciech G Polak, Vincent Karam, René Adam, Christophe Duvoux, Darius Mirza, John O Grady, Jürgen Klempnauer, Raymond Reding, Piotr Kalicinski, Ahmet Coker, Pavel Trunecka, Ibrahim Astarcioglu, J C Duclos-Vallée, Johann Pratschke, Andreas Paul, Irinel Popescu, Stefan Schneeberger, Oliver Boillot, Björn Nashan, Rafael T Mikolajczyk, Ulrich Baumann
Liver transplantation (LTx) is a rescue therapy for life threatening complications of Wilson disease (WD). However, data on the outcome of WD patients post LTx are scarce. The aim of our study was to analyse a large pediatric WD cohort with the aim of investigating the long-term outcome of pediatric WD patients after LTx, and to identify predictive factors for patient and transplant survival. This is a retrospective cohort study using data of all children (<18 years) liver transplanted for WD enrolled in the European Liver Transplant Registry (ELTR) from 1968 until December 2013...
July 18, 2018: Liver Transplantation
Yuki Imaoka, Masahiro Ohira, Ryosuke Nakano, Seiichi Shimizu, Shintaro Kuroda, Hiroyuki Tahara, Kentaro Ide, Tsuyoshi Kobayashi, Hideki Ohdan
Abdominal aortic calcification (AAC) is known as a risk factor of coronary artery disease, stroke, hyperphosphatemia, chronic inflammation, diabetes, and decreased estimated glomerular filtration rate. However, the clinical implications of incidental AAC findings in liver transplantation have not been evaluated in terms of post-transplantation survival and complications. Therefore, we analyzed the relationships between the AAC level and the outcomes following liver transplantation. A total of 156 consecutive patients who underwent liver transplantation between January 2007 and December 2014 were divided into two groups according to their AAC level (< or ≥ 100 mm3 ), as calculated using the Agatston method...
July 18, 2018: Liver Transplantation
Friedrich Foerster, Peter Robert Galle
In Philip K. Dick's short story The Minority Report (later made into a movie by Steven Spielberg), 3 fortune tellers called "precogs" predict crime before it happens, which allows the police to arrest criminals before any harm is done. Needless to say, treating malignancy before it occurs is any oncologist's ultimate dream. While such prognostic capabilities are not at our disposal today, hepatocellular carcinoma (HCC) is a kind of cancer, which typically occurs in a specified population which in turn can be kept under surveillance...
July 18, 2018: Liver Transplantation
Michael L Schilsky
Since the seminal experience of Starzl et al (1), liver transplant (LT) has been performed for Wilson's disease patients with failing livers and more controversially for neurologic disease. The majority of patients transplanted for Wilson's disease in a registry from the United States (2) and in a report from France (3) were adults with end-stage liver disease and its complications. These series each included pediatric patients where there was a marked increase in patients with acute liver failure due to Wilson's disease...
July 18, 2018: Liver Transplantation
Nicholas Gilbo, Laurens J Ceulemans, Geert Maleux, Frederik Nevens, Wim Laleman, Ina Jochmans, Diethard Monbaliu, Jacques Pirenne
No abstract text is available yet for this article.
June 22, 2018: Liver Transplantation
René Adam, Valérie Cailliez, Dorry Segev, Vincent Karam
No abstract text is available yet for this article.
June 19, 2018: Liver Transplantation
Avash Kalra, James R Burton, Lisa Forman
Corticosteroids have been a mainstay of immunosuppression following liver transplantation. However, evolution in the field of transplant immunology has produced steroid-free options, resulting in most transplant centers weaning steroids post-transplant within days to months - an evidence-based management decision. Patients with autoimmune hepatitis, however, receive corticosteroids prior to transplant. This raises the question of whether these patients should also be weaned from corticosteroids. In this review, we discuss the benefits of avoiding steroid use in this population of patients - an approach that not only avoids the adverse effects of corticosteroids, but does so without risking graft failure from recurrent autoimmune hepatitis or from acute cellular rejection...
June 19, 2018: Liver Transplantation
Yohei Mano, Tomoharu Yoshizumi, Kyohei Yugawa, Masafumi Ohira, Takashi Motomura, Takeo Toshima, Shinji Itoh, Noboru Harada, Toru Ikegami, Yuji Soejima, Yoshihiko Maehara
BACKGROUND: Recent studies revealed that systemic inflammation was correlated with poorer prognosis in various cancers. We investigated the prognostic value of the lymphocyte-to-monocytes ratio (LMR) in patients who underwent living donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC). METHODS: We retrospectively analyzed the records of 216 patients who underwent LDLT for HCC. Patients were divided into high- (n = 126) and low- (n = 90) LMR groups...
June 12, 2018: Liver Transplantation
Eleni Theocharidou, Michael A Heneghan
Autoimmune liver diseases (AILD) can recur following liver transplantation despite immunosuppressive therapy, with implications for graft survival. Although the evidence is not robust, disease recurrence seems to occur in the presence of less intense and/or steroid-free immunosuppression in particular in the case of autoimmune hepatitis (AIH). The main risk factor for AIH recurrence is the severity of disease activity in the explant and potentially donor/recipient HLA-DR3 mismatch. The treatment for AIH recurrence includes reintroduction or increase in the dose of steroids with or without the addition of Azathioprine...
June 12, 2018: Liver Transplantation
Mariya L Samoylova, Neil Mehta, John P Roberts, Francis Y Yao
Current guidelines recommend ultrasound (US) for hepatocellular carcinoma (HCC) surveillance in cirrhosis. We assess predictors of decreased US sensitivity for detecting HCC. At a single U.S. center, all HCC patients evaluated for liver transplant (LT) receive an abdominal US. In consecutive patients presenting 2007-2015, untreated lesions found on CT/MRI within 3 months of US were compared with US findings. Multivariable logistic regression models compared US sensitivities by patient characteristics. Of 1008 patients completing LT evaluation, 47...
May 21, 2018: Liver Transplantation
Lisa B VanWagner
No abstract text is available yet for this article.
May 21, 2018: Liver Transplantation
Kyung Chul Yoon, Sanghee Song, Eun-Kyoung Jwa, Sanghoon Lee, Jong Man Kim, Ok-Kyoung Kim, Suk Kyun Hong, Nam-Joon Yi, Kwang-Woong Lee, Myoung Soo Kim, Shin Hwang, Kyung-Suk Suh, Suk-Koo Lee
Split liver transplantation (SLT) should be cautiously considered because the right tri-sectional (RTS) graft can be a marginal graft in adult recipients. Herein, we analyzed the outcomes of RTS-SLT in Korea, where > 75% of adult liver transplantations are performed by living donor liver transplantation. Among 2,462 patients who underwent deceased donor liver transplantations (DDLT) from 2005 to 2014, we retrospectively reviewed 86 adult patients (3.4%) who received a RTS graft (RTS-SLT group). The outcomes of the RTS-SLT group were compared to those of 303 recipients of whole liver (WL-DDLT group)...
May 10, 2018: Liver Transplantation
Ahmer M Hameed, Jerome M Laurence, Vincent W T Lam, Henry C Pleass, Wayne J Hawthorne
No abstract text is available yet for this article.
May 9, 2018: Liver Transplantation
Chiara Mazzarelli, Wendy M Prentice, Michael A Heneghan, Luca S Belli, Kosh Agarwal, Mary D Cannon
Optimal involvement of palliative care services in the management of patients with decompensated cirrhosis and end-stage liver disease is limited. This may result from both ignorance and the failure to recognize the spectrum and unpredictability of the underlying liver condition. Palliative care is a branch of medicine that focuses on quality of life by optimizing symptom management and providing psychosocial, spiritual, and practical support for both patients and their caregivers. Historically, palliative care has been underutilized for patients with decompensated liver disease...
May 5, 2018: Liver Transplantation
Theodore H Welling, Kevin Eddinger, Kristen Carrier, Danting Zhu, Tyler Kleaveland, Derek E Moore, Douglas E Schaubel, Peter L Abt
Orthotopic liver transplantation (OLT) and resection are effective treatments for hepatocellular carcinoma (HCC). However, optimizing OLT and limiting HCC recurrence remains a vexing problem. New HCC MELD and allocation algorithms provide greater observation of HCC patients, many while receiving local-regional treatments. Potential benefits of local-regional treatment for limiting HCC recurrence post-OLT remain incompletely understood. Therefore we aimed to define HCC specific prognostic factors affecting recurrence in a contemporary, multi-center cohort of HCC patients undergoing OLT and specifically whether local-regional therapies limited recurrence...
May 5, 2018: Liver Transplantation
Kim H H Liss, Kyle S McCommis, Kari T Chambers, Terri A Pietka, George G Schweitzer, Sara L Park, ILKe Nalbantoglu, Carla J Weinheimer, Angela M Hall, Brian N Finck
The prevalence of obesity-associated nonalcoholic fatty liver disease has significantly increased over the past decade and end stage liver disease secondary to nonalcoholic steatohepatitis has become one of the most common indications for liver transplantation. This both increases the demand for organs and decreases the availability of donor livers deemed suitable for transplantation. While in the past many steatotic livers were discarded due to concerns over enhanced susceptibility to ischemia reperfusion injury and organ failure, the discrepancy between supply and demand has resulted in increasing use of expanded criteria donor organs including steatotic livers...
May 5, 2018: Liver Transplantation
Siyuan Yao, Toshimi Kaido, Ryuji Uozumi, Shintaro Yagi, Yosuke Miyachi, Ken Fukumitsu, Takayuki Anazawa, Naoko Kamo, Kojiro Taura, Hideaki Okajima, Shinji Uemoto
BACKGROUND: There is a consensus that portal venous pressure (PVP) modulation prevents portal hypertension (PHT) and consequent complications after adult living donor liver transplantation (ALDLT). However, PVP-modulation strategies need updating based on most recent findings. We examined our 10-year experience of PVP modulation and reevaluate whether it is necessary for all recipients or selected recipients in ALDLT. METHODS: In this retrospective study, 319 patients who underwent ALDLT from 2007 to 2016 were divided into three groups according to the necessity and results of PVP modulation: not indicated (n=189), indicated and successful (n=92), and indicated but failed (n=38)...
April 30, 2018: Liver Transplantation
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