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Liver Transplantation

Antonella Putignano, Thierry Gustot
Acute-on-Chronic Liver Failure (ACLF) is a recently defined syndrome that occurs frequently in patients with cirrhosis and is associated with a poor short-term prognosis. Currently, management of patients with ACLF is mainly supportive. Despite medical progress, this syndrome frequently leads to multi-organ failure, sepsis, and, ultimately, death. The results of attempts to use liver transplantation (LT) to manage this critical condition have been poorly reported but are promising. Currently, selection criteria of ACLF patients for LT, instructions for prioritization on the waiting list, and objective indicators for removal of ACLF patients from the waiting list in cases of clinical deterioration are poorly defined...
October 17, 2016: Liver Transplantation
Amanda Lynn, Michael Leise
No abstract text is available yet for this article.
October 12, 2016: Liver Transplantation
Shaleen Agarwal, Neerav Goyal, Mohammed Nayeem, Shishir Pareek, Subash Gupta
BACKGROUND: Living donor liver transplant (LDLT) in obese patients raises concerns with regards to obtaining grafts of "adequate" graft recipient weight ratio (GRWR) and the impact of obesity on the outcomes of LDLT. METHODS: LDLT outcomes in patients weighing more than 100 kg were compared with those weighing less than 100 kg. Patients weighing more than 100 kg were divided into 3 categories based on GRWR of the grafts they received. Groups 1, 2 and 3 included patients with GRWR equal to or greater than 0...
October 12, 2016: Liver Transplantation
Andrea Lauterio, Stefano Di Sandro, Salvatore Gruttadauria, Marco Spada, Fabrizio Di Benedetto, Umberto Baccarani, Enrico Regalia, Ernesto Melada, Alessandro Giacomoni, Matteo Cescon, Davide Cintorino, Giorgio Ercolani, Matteo Rota, Giorgio Rossi, Vincenzo Mazzaferro, Andrea Risaliti, Antonio Daniele Pinna, Bruno Gridelli, Luciano De Carlis
BACKGROUND: Major concerns about donor morbidity and mortality still limit the use of living donor liver transplantation (LDLT) to overcome the organ shortage. METHODS: The present study assessed donor safety in LDTL in Italy reporting donor postoperative outcomes in 246 living donation procedures performed by seven transplant centers. Outcomes were evaluated over two time periods using the validated Clavien 5-tier grading system, and several clinical variables were analyzed to determine the risk factors for donor morbidity...
October 6, 2016: Liver Transplantation
Luis Ibáñez-Samaniego, Magdalena Salcedo, Javier Vaquero, Rafael Bañares
De novo autoimmune hepatitis (DAIH) is a rare clinical condition with features that resemble those of autoimmune hepatitis in patients undergoing liver transplantation (LT) for non-autoimmune liver disease. The diagnosis of this entity has been based on the presence of biochemical and histological patterns similar to those observed in the primary autoimmune hepatitis, although several considerations must be taken into account. The impact of DAIH on graft survival is relevant, and early diagnosis and treatment is associated with a good long-term outcome...
October 6, 2016: Liver Transplantation
Wuttiporn Manatsathit, Hrishikesh Samant
No abstract text is available yet for this article.
October 5, 2016: Liver Transplantation
Takeshi Kurihara, Tomoharu Yoshizumi, Toru Ikegami, Yuji Soejima, Yoshihiko Maehara
No abstract text is available yet for this article.
October 5, 2016: Liver Transplantation
M Rayar, G B Levi Sandri, C Cusumano, C Locher, P Houssel-Debry, C Camus, N Lombard, V Desfourneaux, M Lakehal, B Meunier, L Sulpice, K Boudjema
During orthotopic liver transplantation (OLT), clamping of the portal vein induces splanchnic venous congestion and accumulation of noxious compounds. These adverse effects could increase ischemia-reperfusion injury and subsequently the risk of graft dysfunction, especially for grafts harvested from extended criteria donors (ECD). Temporary portocaval shunt (TPCS) could prevent these complications. Between 2002 and 2013, all OLT performed in our center were retrospectively analyzed and a propensity score matching analysis was used to compare the effect of TPCS in 686 patients (343 in each group)...
October 5, 2016: Liver Transplantation
Evelyn Hsu, George V Mazariegos
Current literature and policy in pediatric liver allocation and organ procurement are reviewed here in narrative fashion, highlighting historical context, ethical framework, technical/procurement considerations and support for a logical way forward to an equitable pediatric liver allocation system that will improve pediatric wait-list and post-transplant outcomes without adversely affecting adults. Where available, varying examples of successful international pediatric liver allocation and split liver policy will be compared to current US policy to highlight potential strategies that can be considered globally...
October 5, 2016: Liver Transplantation
Kris P Croome, C Burcin Taner
No abstract text is available yet for this article.
September 29, 2016: Liver Transplantation
Giuseppe Iuppa, Federico Aucejo, Charles Miller
No abstract text is available yet for this article.
September 22, 2016: Liver Transplantation
Clara T Nicolas, Scott L Nyberg, Julie K Heimbach, Kymberly Watt, Harvey S Chen, Matthew A Hathcock, Walter K Kremers
Share 35 was implemented in 2013 to direct livers to the most urgent candidates by prioritizing MELD (Model for End-stage Liver Disease) ≥ 35 patients. We aim to evaluate this policy's impact on costs and mortality. Our study includes 834 waitlisted patients and 338 patients who received deceased-donor, solitary liver transplants at Mayo Clinic between January 2010-December 2014. 101 (30%) of these patients were transplanted after Share 35. After Share 35, 29 (29%) MELD ≥ 35 patients received transplants, as opposed to 46 (19%) in the pre-Share 35 era (p=0...
September 22, 2016: Liver Transplantation
Hideaki Uchiyama, Tomoharu Yoshizumi, Toru Ikegami, Norifumi Harimoto, Shinji Itoh, Hirohisa Okabe, Yuji Soejima, Yoshihiko Maehara
Most right hepatic grafts without the middle hepatic vein (MHV) trunk in living donor liver transplantation (LDLT) have multiple venous orifices which should be reconstructed in order to avoid detrimental congestion. The aim of the current study was to retrospectively investigate the efficacy of using internal jugular vein (IJV) grafts for reconstructing multiple venous orifices on right grafts in LDLT. Medical records of 174 recipients who underwent LDLT using a right graft without the MHV trunk between January 2004 and May 2015 were retrospectively reviewed...
September 22, 2016: Liver Transplantation
Justin Parekh, Vlad M Matei, Alejandro Canas-Coto, Daniel Friedman, William M Lee
BACKGROUND: Budd-Chiari syndrome (BCS) is a rare disease resulting from obstruction of the hepatic venous outflow tract that typically presents with abdominal pain, jaundice and ascites without frank liver failure. However, BCS may also evolve more rapidly to acute liver failure (ALF-BCS). AIMS: To describe the clinical features, treatment and outcomes of ALF due to BCS and compare our results with those in the published literature. METHODS: Twenty of the 2,300 patients enrolled in the Acute Liver Failure Study Group (ALFSG) registry since 1998, presented with a clinical diagnosis of BCS...
September 22, 2016: Liver Transplantation
Shikha S Sundaram, Cara L Mack, Amy G Feldman, Ronald J Sokol
Biliary Atresia is a progressive, fibro-obliterative disorder of the intra and extrahepatic bile ducts in infancy. The majority of affected children will eventually develop end-stage liver disease and require liver transplantation. Indications for liver transplant in biliary atresia include failed Kasai portoenterostomy, significant and recalcitrant malnutrition, recurrent cholangitis, and the progressive manifestations of portal hypertension. Extra-hepatic complications of this disease, such as hepatopulmonary syndrome and portopulmonary hypertension, are also indications for liver transplantation...
September 21, 2016: Liver Transplantation
Elizabeth C Verna
No abstract text is available yet for this article.
September 21, 2016: Liver Transplantation
John Bucuvalas, Sandy Feng
No abstract text is available yet for this article.
September 17, 2016: Liver Transplantation
Graziano Oldani, Stéphanie Lacotte, Lorenzo A Orci, Vaihere Delaune, Florence Slits, Quentin Gex, Philippe Morel, Laura Rubbia-Brandt, Christian Toso
BACKGROUND: Due to the wide availability of genetically modified animals, mouse orthotopic liver transplantation is often preferred over rat liver transplantation. We present a simplified mouse liver transplantation technique, and compare transplantation outcomes with versus without hepatic artery anastomosis. METHODS: Instruments for liver implantation were designed and 3D-printed. The suprahepatic vena cava anastomosis was performed with 10-0 running suture. The vena porta and infrahepatic vena cava were joined on extraluminal cuffs, using the 3D-printed device for spatial alignment and stabilisation...
September 12, 2016: Liver Transplantation
Amir Kashani, H G Lipshutz, Andrew S Klein, Irene Kim, Marc L Friedman, Juvelyn Palomique, Vinay Sundaram
No abstract text is available yet for this article.
September 12, 2016: Liver Transplantation
Jason A Wertheim
No abstract text is available yet for this article.
September 9, 2016: Liver Transplantation
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