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Liver Transplantation

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https://www.readbyqxmd.com/read/28431203/donor-safety-in-living-donor-liver-transplantation-the-korean-organ-transplantation-registry-kotry-study
#1
Jae Geun Lee, Kwang-Woong Lee, Choon Hyuck David Kwon, Chong Woo Chu, Bong-Wan Kim, Dong Lak Choi, Young Kyoung You, Dong-Sik Kim, Yang Won Nah, Koo Jeong Kang, In Soek Choi, Hee Chul Yu, Geun Hong, Ho-Seong Han, Shin Hwang, Myoung Soo Kim
Major concerns about donor safety cause controversy and limit the use of living donor liver transplantation to overcome organ shortages. The Korean Organ Transplantation Registry established a nationwide organ transplantation registration system in 2014. We reviewed the prospectively collected data of all 832 live liver donors who underwent procedures between April 2014 and December 2015. We allocated the donors to a left lobe group (n=59) and a right lobe group (n=773) and analyzed the relations between graft types and remaining liver volumes and complications (graded using the Clavien five-tier grading system)...
April 21, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28426902/hepatic-steatosis-after-pediatric-liver-transplant
#2
Emily R Perito, Tabitha Vase, Rageshree Ramachandran, Andrew Phelps, Kuang-Yu Jen, Robert H Lustig, Vickie A Feldstein, Philip Rosenthal
RATIONALE: Hepatic steatosis develops after liver transplant in 30% of adults, and non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in non-transplanted children. However, post-transplant steatosis has been minimally studied in pediatric liver transplant recipients. We explored the prevalence, persistence, and association with chronic liver damage of hepatic steatosis in these children. RESULTS: In this single-center study of pediatric patients transplanted 1988-2015 (n=318), 31% of those with any post-transplant biopsy (n=271) had ≥1 biopsy with steatosis...
April 20, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28425187/significance-of-measured-intraoperative-portal-vein-flows-after-thrombendvenectomy-in-deceased-donor-liver-transplants-with-portal-vein-thrombosis
#3
Mark Draoua, Nicole Titze, Amar Gupta, Hoylan T Fernandez, Michael Ramsay, Giovanna Saracino, Gregory McKenna, Testa Giuliano, Goran B Klintmalm, Peter T W Kim
BACKGROUND: Adequate portal vein (PV) flow in liver transplantation is essential for a good outcome, and it may be compromised in patients with portal vein thrombosis (PVT). This study evaluated the impact of intraoperatively measured PV flow after PV thrombendvenectomy on outcomes after deceased donor liver transplantation. STUDY DESIGN: The study included 77 patients over a 16-year period who underwent PV thrombendvenectomy with complete flow data. Patients were classified into two groups: high PV flow (>1300 mL/min, N = 55) and low PV flow (≤1300 mL/min, N = 22)...
April 20, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28425147/liver-retransplantation-recurrent-psc-may-provide-better-outcomes
#4
EDITORIAL
Jennie Choe, David C Mulligan
No abstract text is available yet for this article.
April 20, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28422425/negativization-of-viremia-prior-to-liver-transplant-reduces-early-allograft-dysfunction-in-hepatitis-c-recipients
#5
Silvia Martini, Francesco Tandoi, Lodovico Terzi di Bergamo, Silvia Strona, Bruna Lavezzo, Marco Sacco, Francesca Maione, Federica Gonella, Paolo Strignano, Dominic Dell Olio, Mauro Salizzoni, Giorgio Maria Saracco, Renato Romagnoli
Although early allograft dysfunction (EAD) negatively impacts on survival from the first months following liver transplantation (LT), direct-acting antivirals (DAAs) have revolutionized HCV therapy. We investigated the EAD definition best predicting 90-day graft loss and identified EAD risk factors in HCV positive recipients. From 11-2002 to 06-2016, 603 HCV-positive patients (hepatocellular carcinoma 53.4%) underwent a first LT with HCV-negative donors. Median recipient MELD score 15, median donor age 63 years...
April 19, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28422396/a-simplified-multivisceral-transplantation-procedure-for-patients-with-combined-end-stage-liver-disease-and-type-2-diabetes-mellitus
#6
Xiao-Shun He, Shun-Jun Fu, Qiang Zhao, Xiao-Feng Zhu, Dong-Ping Wang, Ming Han, Wei-Qiang Ju, Yi Ma, Jiao Xing-Yuan, Xiao-Peng Yuan, An-Bin Hu, Zhi-Yong Guo
In liver transplant patients with type 2 diabetes mellitus (DM), the disease worsens after transplantation because of long-term use of diabetogenic immunosuppressive drugs, making management of those patients a great challenge. The objective of our study was to evaluate the safety and efficacy of a simplified multivisceral transplantation (SMT) procedure for the treatment of patients with end-stage liver disease and concurrent type 2 DM. Forty-four patients who had pretransplant type 2 DM were included. Twenty-three patients received SMT and 21 patients received orthotopic liver transplantation (OLT)...
April 19, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28422392/hepatic-artery-reconstruction-in-living-donor-liver-transplantation-using-surgical-loupes-achieving-low-rate-of-hepatic-arterial-thrombosis-in-consecutive-741-recipients-tips-and-tricks-to-overcome-the-poor-hepatic-arterial-flow
#7
Ping-Chun Li, Ashok Thorat, Long-Bin Jeng, Horng-Ren Yang, Ming-Li Li, Chun-Chieh Yeh, Te-Hung Chen, Shih-Chao Hsu, Kin-Shing Poon
BACKGROUND: The reconstruction of hepatic artery (HA) is most complex step in living donor liver transplantation (LDLT) due to smaller diameter of the artery and increased risk of HA related complications. Due to smaller diameter of the HA, many centres use microsurgical technique with interrupted sutures for arterial anastomosis. Aim of our study was to retrospectively investigate the outcomes after HA reconstruction performed under magnifying loupes using "parachute technique". MATERIALS AND METHODS: From August 2002 to 31(st) August 2016, LDLT was performed in 766 recipients...
April 19, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28407441/same-policy-different-impact-center-level-effects-of-share-35-liver-allocation
#8
Douglas R Murken, Allison W Peng, David D Aufhauser, Peter L Abt, David S Goldberg, Matthew H Levine
Early studies of national data suggest that the Share 35 allocation policy increased liver transplants without compromising post-transplant outcomes. Changes in center-specific volumes and practice patterns in response to the national policy change are not well characterized. Understanding center-level responses to Share 35 is crucial for optimizing the policy and constructing effective future policy revisions. Data from the United Network for Organ Sharing were analyzed to compare center-level volumes of allocation-MELD ≥35 transplants pre- and post-policy implementation...
April 13, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28407413/living-donor-liver-transplantation-are-we-ready-for-full-robotic-harvesting
#9
LETTER
Paolo Magistri, Giuseppe Tarantino, Roberto Ballarin, Andrea Coratti, Fabrizio Di Benedetto
No abstract text is available yet for this article.
April 13, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28407404/re-living-donor-liver-transplantation-are-we-ready-for-full-robotic-harvesting
#10
LETTER
Po-Da Chen, Yao-Ming Wu
No abstract text is available yet for this article.
April 13, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28407402/cirrhotic-cardiomyopathy-implications-for-liver-transplantation
#11
REVIEW
Hongqun Liu, Saumya Jayakumar, Mouhieddin Traboulsi, Samuel S Lee
The majority of the patients on a waiting list for liver transplantation have end-stage liver disease. Due to the marked peripheral vasodilatation of end stage cirrhosis that masks a latent myocardial dysfunction, cardiac abnormalities in the resting state are usually subclinical and escape the attention of physicians. However, when challenged, the systolic and diastolic contractile responses are attenuated. In addition to these contractile abnormalities, morphological changes such as enlargement or hypertrophy of cardiac chambers and electrophysiological repolarization changes including a prolonged QT interval can be observed...
April 13, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28407355/extracellular-vesicles-from-bone-marrow-derived-mesenchymal-stem-cells-protect-against-murine-hepatic-ischemia-reperfusion-injury
#12
Hiroaki Haga, Irene K Yan, David Borelli, Akiko Matsuda, Mansi Parasramka, Neha Shukla, David D Lee, Tushar Patel
Hepatic ischemia-reperfusion injury (IRI) and associated inflammation contributes to liver dysfunction and complications after liver surgery and transplantation. Mesenchymal stem cells (MSC) have been reported to reduce hepatic IRI because of their reparative immunomodulatory effects in injured tissues. Recent studies have highlighted beneficial effects of extracellular vesicles from MSCs (MSC-EV) on tissue injury. The effects of systemically administered mouse bone marrow derived MSC-EV were evaluated in an experimental murine model of hepatic IRI induced by cross clamping the hepatic artery and portal vein for 90 minutes followed by reperfusion for periods of upto 6 hours...
April 13, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28388830/the-release-of-microrna-122-during-liver-preservation-is-associated-with-early-allograft-dysfunction-and-graft-survival-after-transplantation
#13
Jasmijn W Selten, Cornelia J Verhoeven, Veerle Heedfeld, Henk P Roest, Jeroen de Jonge, Jacques Pirenne, Jos van Pelt, Jan N M IJzermans, Diethard Monbaliu, Luc J W van der Laan
INTRODUCTION: Early allograft dysfunction (EAD) after liver transplantation is associated with inferior graft survival. EAD is more prevalent in grafts from donation after circulatory death (DCD). However, accurate prediction of liver function remains difficult due to the lack of specific biomarkers. Recent experimental and clinical studies highlight the potential of hepatocyte-derived microRNAs (miRNAs) as sensitive, stable and specific biomarkers of liver injury. The aim of this study was to determine whether miRNAs in graft preservation fluid are predictive for EAD after clinical liver transplantation and in an experimental DCD model...
April 7, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28340509/liver-transplant-lt-recipients-with-nonalcoholic-steatohepatitis-nash-have-lower-risk-hepatocellular-carcinoma-hcc
#14
Sara M Lewin, Neil Mehta, R Kate Kelley, John P Roberts, Francis Y Yao, Danielle Brandman
BACKGROUND: Liver transplantation is a well-established treatment for HCC in carefully selected patients. Risk factors for tumors with poor prognostic features on explant have not been well described in a national cohort. METHODS: We performed a retrospective cohort study of adult LT recipients with HCC transplanted from 4/8/12 (when explant pathology in UNOS became available) until 9/30/2014. We evaluated the association between listing diagnosis and other demographic factors with tumor features on explant using logistic regression...
March 24, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28340504/improving-the-outcomes-of-hiv-hcv-coinfected-transplant-recipients-the-answer-is-blowin-in-the-wind
#15
EDITORIAL
Ghady Haidar, Nina Singh
No abstract text is available yet for this article.
March 24, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28296011/vedolizumab-is-safe-and-effective-in-moderate-to-severe-inflammatory-bowel-disease-following-liver-transplantation
#16
Andrew P Wright, Robert J Fontana, Ryan W Stidham
No abstract text is available yet for this article.
March 14, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28295992/liver-transplantation-versus-liver-resection-for-hepatocellular-carcinoma-in-intention-to-treat-attempt-to-perform-an-ideal-meta-analysis
#17
REVIEW
Benjamin Menahem, Jean Lubrano, Christophe Duvoux, Andrea Mulliri, Arnaud Alves, Charlotte Costentin, Ariane Mallat, Guy Launoy, Alexis Laurent
Objective This meta-analysis compared the effects of liver transplantation (LT) and liver resection (LR) on overall survival (OS) and disease-free survival (DFS) in patients with hepatocellular carcinoma (HCC) small transplantable HCC or within Milan criteria. Methods Articles comparing LR with LT for HCC, based on Milan criteria or small size, published until June 2015 were selected and a meta-analysis performed. Results No randomized controlled trial (RCT) has been published to date comparing survival outcomes in patients with HCC who underwent LR and LT...
March 14, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28294557/double-blind-randomized-controlled-trial-of-the-routine-peri-operative-use-of-terlipressin-in-adult-living-donor-liver-transplantation
#18
Mettu Srinivas Reddy, Ilankumaran Kaliamoorthy, Akila Rajakumar, Selvakumar Malleeshwaran, Ellango Appuswamy, Sukanya Lakshmi, Joy Varghese, Mohamed Rela
BACKGROUND: Peri-operative terlipressin (Tp) during living donor liver transplantation (LDLT) has been shown to reduce intra-operative portal pressures and improve renal function. Its role and safety profile has never been evaluated in a double-blinded RCT. AIM: To evaluate the haemodynamic effects, clinical benefits and safety of peri-operative terlipressin infusion in adult LDLT. METHODS: This was a single centre double-blind RCT. Consenting adults with chronic liver disease and low risk of post-transplant renal dysfunction (PTRD) undergoing their first LDLT were randomized...
March 14, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28294516/peri-transplant-pancreatitis-a-marker-of-high-mortality-and-graft-failure-in-liver-transplant-patients
#19
Tara A Russell, Sarah Park, Vatche G Agopian, Ali Zarrinpar, Douglas G Farmer, Sean O'Neill, Islam Korayem, Samer Ebaid, Jeffrey Gornbein, Ronald W Busuttil, Fady M Kaldas
Perioperative pancreatitis is a significant comorbid condition in surgical patients, however the degree to which pancreatitis affects graft and overall survival in liver transplant recipients has not been evaluated. This study assesses the impact of pancreatitis on graft and patient survival in adult orthotopic liver transplantation (OLT). All patients undergoing OLT at a single academic institution from 2007-2015 were reviewed. Pancreatitis was classified by method of diagnosis (intra-operative or radiographic (IO/R) versus isolated serologic (IS)) and timing (pre-operative versus post-operative)...
March 14, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28240843/venous-stent-in-liver-transplant-candidates-dodging-the-top-tip-traps
#20
A Merdrignac, H Jeddou, P Houssel-Debry, E Flecher, M Rayar, K Boudjema
No abstract text is available yet for this article.
February 27, 2017: Liver Transplantation
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20192
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