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liver transplantation surgical technique

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https://www.readbyqxmd.com/read/29328523/improved-portal-vein-venoplasty-with-autogenous-patch-in-pediatric-living-donor-liver-transplantation
#1
Mingxuan Feng, Ping Wan, Bijun Qiu, Tao Zhou, Yi Luo, Lihong Gu, Jiachang Chi, Chengpeng Zhong, Yefeng Lu, Jianjun Zhang, Qiang Xia
BACKGROUND: An atretic or hypoplastic portal vein (PV) represents a challenge for PV reconstruction in pediatric living donor liver transplantation (LDLT). Several PV venoplastic techniques have been developed. However, we still seek improved venoplastic techniques with better efficacy and compatibility. METHOD: From June 2016 to July 2017, 271 LDLT procedures were performed at the Department of Liver Surgery, Ren Ji Hospital. A total of 16 consecutive children with atretic and sclerotic PVs underwent a novel technique - the autogenous PV patch plastic technique...
January 12, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29318365/-innovations-in-surgical-treatment-of-pediatric-solid-tumors
#2
REVIEW
A Schmidt, S W Warmann, C Urla, J Fuchs
The overall survival of children with solid tumors has shown a substantial increase in the past decades due to progress in all of the disciplines involved in the treatment. The poor prognosis for advanced stages of disease and the morbidity related to therapeutic procedures are still a challenge. Innovations in the surgical treatment of solid tumors can contribute to increase the survival rate of affected children and to decrease the treatment-related morbidity. Considering these aspects, the successful implementation of innovations is described based on four examples...
January 9, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29312973/critical-appraisal-of-chinese-2017-guideline-on-the-management-of-hepatocellular-carcinoma
#3
REVIEW
Di-Yang Xie, Zheng-Gang Ren, Jian Zhou, Jia Fan, Qiang Gao
Hepatocellular carcinoma (HCC) is the fourth most common and the third most lethal cancer in China. An updated version of consensus-based recommendations on the management of HCC has been recently published by a multidisciplinary group of Chinese experts including liver surgeons, hepatic oncologists, radiologists and pathologists. Major changes have been made to the diagnostic criteria. In addition to dynamic multi-detector computed tomography (CT) and magnetic resonance imaging (MRI), gadoxetic acid-enhanced MRI and contrast-enhanced ultrasound (CEUS) are added to the diagnostic imaging tests...
December 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/29281863/impact-of-abdominal-shape-on-living-liver-donor-outcomes-in-mini-incision-right-hepatic-lobectomy-comparison-among-three-techniques
#4
Mohamed Safwan, Shunji Nagai, Kelly Collins, Michael Rizzari, Atsushi Yoshida, Marwan Abouljoud
While minimally invasive techniques for living donor hepatectomy have been developed, the surgical feasibility and limitations remain to be elucidated. The risks and outcomes involved need to be better understood prior to their widespread application. The aim of this study was to assess feasibility of minimally invasive donor hepatectomy by reviewing our experience. A total of 99 living donor liver transplantation (LDLTs) performed between 2000 and 2016 were retrospectively reviewed. All 99 living liver donors underwent right hepatectomy...
December 27, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29280704/reversible-pneumatosis-cystoides-intestinalis-after-liver-transplantation
#5
M Telegrafo, A A Stabile Ianora, G Angelelli, M Moschetta
Pneumatosis cystoides intestinalis (PCI) is a rare disease characterized by the presence of multiple gas-filled cysts within the submucosa or subserosa of the intestinal wall. We report a case of PCI in a 54-yearold man 4 weeks after liver transplantation due to hepatitis B virus (HBV)-associated liver cirrhosis presenting with illness, diarrhea and abdominal pain. CT scans revealed normal shape of the abdominal parenchymal organs and no intra-hepatic complication due to liver transplantation. Main abdominal venous and arterial vessels resulted patent...
September 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29273893/intraoperative-doppler-sonogram-in-pediatric-liver-transplants-a-pictorial-review-of-intraoperative-and-early-postoperative-complications
#6
A Luana Stanescu, Shawn E Kamps, André A S Dick, Marguerite T Parisi, Grace S Phillips
A spectrum of vascular complications can be seen in pediatric liver transplant patients, including occlusion and hemodynamically significant narrowing of the vessels that provide inflow to or outflow from the graft. Intraoperative Doppler ultrasound (US) has the potential benefit of identifying vascular complications in pediatric liver transplant patients prior to abdominal closure. Importantly, intraoperative Doppler US can be used as a problem-solving tool in situations such as position-dependent kinking of the portal or hepatic veins, or in suspected vasospasm of the hepatic artery...
December 22, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29237362/de-novo-malignancies-after-liver-transplantation-a-single-institution-experience
#7
Tufan Egeli, Tarkan Unek, Mucahit Ozbilgin, Cihan Agalar, Serhan Derici, Mesut Akarsu, Ilkay Tugba Unek, Murat Aysin, Aylin Bacakoglu, Ibrahim Astarcıoglu
OBJECTIVES: Our objective was to analyze characteristics, risk factors, and incidence of de novo malignancies after liver transplant. MATERIALS AND METHODS: The hospital records of 557 patients who underwent liver transplant were analyzed from the point of de novo malignancy development. We evaluated the demographic features and survival of these patients retrospectively. RESULTS: The research covered 429 patients, 9 (2%) of whom developed de novo malignancy...
December 14, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29199380/liver-resection-for-hcc-outside-the-bclc-criteria
#8
Manish S Bhandare, Shraddha Patkar, Nitin Shetty, Ashwin Polnaya, Suyash Kulkarni, Rohit R Dusane, Shailesh V Shrikhande, Mahesh Goel
PURPOSE: Surgical resection still remains the mainstay of management of hepatocellular carcinoma (HCC). At present, Barcelona clinic liver cancer (BCLC) staging is the most widely used tool to guide treatment; however, criteria for offering surgery as curative treatment are restrictive. We aimed to evaluate short-term and long-term outcomes of HCC after resection, even for patients outside BCLC criteria for resection. METHODS: Data was collected from a prospective database from GI and HPB Department, Tata Memorial Hospital, Mumbai...
December 4, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29166466/neurological-complications-of-solid-organ-transplantation
#9
REVIEW
José Luiz Pedroso, Lívia Almeida Dutra, Pedro Braga-Neto, Agessandro Abrahao, João Brainer Clares de Andrade, Gabriel Lopes da Silva, Laila Almeida Viana, José Osmar Medina Pestana, Orlando G Barsottini
Solid organ transplantation is a significant development in the treatment of chronic kidney, liver, heart and lung diseases. This therapeutic approach has increased patient survival and improved quality of life. New surgical techniques and immunosuppressive drugs have been developed to achieve better outcomes. However, the variety of neurological complications following solid organ transplantation is broad and carries prognostic significance. Patients may have involvement of the central or peripheral nervous system due to multiple causes that can vary depending on time of onset after the surgical procedure, the transplanted organ, and the intensity and type of immunosuppressive therapy...
October 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/29128022/noninfectious-pulmonary-complications-of-liver-heart-and-kidney-transplantation-an-update
#10
REVIEW
Shruti Gadre, Robert M Kotloff
Despite significant advances in surgical techniques, perioperative care, and immunosuppressive therapy, solid organ transplantation still carries considerable risk of complications. Pulmonary complications, in particular, are a major cause of morbidity and mortality. Although infectious complications prevail, the lungs are also vulnerable to a variety of noninfectious complications related to the transplant surgery and adverse effects of the immunosuppressive regimen. This article focuses on noninfectious pulmonary complications associated with the 3 most commonly performed solid organ transplant procedures: liver, kidney, and heart...
December 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29078606/depicting-surgical-anatomy-of-the-porta-hepatis-in-living-donor-liver-transplantation
#11
Paul Kelly, Albert Fung, Joy Qu, Paul Greig, Gordon Tait, Jodie Jenkinson, Ian McGilvray, Anne Agur
Visualizing the complex anatomy of vascular and biliary structures of the liver on a case-by-case basis has been challenging. A living donor liver transplant (LDLT) right hepatectomy case, with focus on the porta hepatis, was used to demonstrate an innovative method to visualize anatomy with the purpose of refining preoperative planning and teaching of complex surgical procedures. The production of an animation-enhanced video consisted of many stages including the integration of pre-surgical planning; case-specific footage and 3D models of the liver and associated vasculature, reconstructed from contrast-enhanced CTs...
2017: Journal of visualized surgery
https://www.readbyqxmd.com/read/29061150/dysregulated-long-noncoding-rnas-lncrnas-in-hepatocellular-carcinoma-implications-for-tumorigenesis-disease-progression-and-liver-cancer-stem-cells
#12
REVIEW
Xiaoqi Huo, Shuanglin Han, Guang Wu, Olivier Latchoumanin, Gang Zhou, Lionel Hebbard, Jacob George, Liang Qiao
Hepatocellular carcinoma (HCC) is one of the most common malignant tumours with a poor prognosis worldwide. While early stage tumours can be treated with curative approaches such as liver transplantation or surgical resection, these are only suitable for a minority of patients. Those with advanced stage disease are only suitable for supportive approaches and most are resistant to the conventional chemotherapy or radiotherapy. Liver cancer stem cells (LCSCs) are a small subset of cancer cells with unlimited differentiation ability and tumour forming potential...
October 23, 2017: Molecular Cancer
https://www.readbyqxmd.com/read/29055880/component-separation-of-abdominal-wall-with-intraoperative-botulinum-a-presents-satisfactory-outcomes-in-large-incisional-hernias-a-case-report
#13
Lucas Torres Oliveira, Felipe Futema Essu, Gustavo Heluani Antunes de Mesquita, Yuri Justi Jardim, Leandro Ryuchi Iuamoto, Fábio Yuji Suguita, Diego Ramos Martines, Fernanda Nii, Daniel Reis Waisberg, Alberto Meyer, Wellington Andraus, Luiz Augusto Carneiro D'Albuquerque
PURPOSE: Transplantation patients have a series of associated risk factors that make appearance of incisional hernia (IH) more likely. A number of aspects of the closure of large defects remain controversial. In this manuscript, we present the repair of a large IH following liver transplantation through the technique of posterior components separation combined with the anterior, together with the intraoperative use of botulinum toxin A and the placement of mesh. As a secondary objective, we analyze the incidence of IH following liver transplantation in our service...
October 12, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29038827/is-routine-intraoperative-contrast-enhanced-ultrasonography-useful-during-whole-liver-transplantation
#14
Nicolas Golse, Simone Santoni, Vincent Karam, Oriana Ciacio, Gabriella Pittau, Marc-Antoine Allard, Daniel Cherqui, Antonio Sa Cunha, René Adam, Denis Castaing, Eric Vibert
BACKGROUND: Vascular complications following liver transplantation (LT) may result from technical deficiencies. Intraoperative diagnosis remains challenging but can prevent serious delayed complications. Intraoperative Doppler ultrasonography (IOUS) represents the gold standard for imaging, although it requires radiological skills. Contrast-enhanced ultrasonography has been reported during postoperative assessments, but never intraoperatively (CE-IOUS). The aim of this study was to assess the feasibility of routine CE-IOUS, to evaluate its impact on surgical strategy and its usefulness...
October 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29032378/survey-results-of-the-expert-meeting-on-laparoscopic-living-donor-hepatectomy-and-literature-review
#15
Jai Young Cho, Ho-Seong Han, Hironori Kaneko, Go Wakabayashi, Hideaki Okajima, Shinji Uemoto, Olivier Soubrane, Chee-Chien Yong, Chao-Long Chen, Tan To Cheung, Giulio Belli, Shoji Kubo, Yao-Ming Wu, Kuo-Hsin Chen, Roberto I Troisi, Choon Hyuck David Kwon, Kyung-Suk Suh, Arvinder S Soin, Ki-Hun Kim, Daniel Cherqui
BACKGROUND: Because laparoscopic donor surgery has been successful in pediatric living donor liver transplantation, its application is expanding to right hepatectomy. However, there is no consensus on the indications for laparoscopic donor hepatectomy or on the details of the surgical technique. OBJECTIVE: To evaluate the current status of laparoscopic donor hepatectomy and to summarize the expert opinion on it. METHODS: Before the expert meeting on September 8, 2016, in Seoul, Korea, a survey was undertaken from expert liver surgeons from around the world...
October 14, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/29031662/percutaneous-treatment-of-hepatocellular-carcinoma-state-of-the-art-and-innovations
#16
REVIEW
Jean-Charles Nault, Olivier Sutter, Pierre Nahon, Nathalie Ganne-Carrié, Olivier Séror
Percutaneous treatment of hepatocellular carcinoma (HCC) encompasses a vast range of techniques, including monopolar radiofrequency ablation (RFA), multibipolar RFA, microwave ablation, cryoablation and irreversible electroporation. RFA is considered to be one of the main curative treatments for HCC of less than 5 cm developing on cirrhosis, together with surgical resection and liver transplantation. However, controversies exist concerning the respective roles of ablation and liver resection for HCC of less than 3 to 5 cm on cirrhosis...
October 12, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29030698/biliary-atresia-and-liver-transplantation-results-and-thoughts-for-primary-liver-transplantation-in-select-patients
#17
REVIEW
Riccardo Superina
Biliary atresia (BA) is one of the most common indications for liver transplantation in children. Despite advances in biliary atresia surgical techniques, most children will ultimately require liver transplantation. Possible pre-operative predictors of outcome after the Kasai operation are: 1. Age at operation 2. Presence of the biliary atresia splenic malformation syndrome (BASM) 3. Center specific factors 4. Liver histology and 5. Anatomic pattern of bile ducts found at surgery.Age at surgery is considered a strong predictor of success after portoenterostomy...
December 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/29025385/the-impact-of-preoperative-variables-on-intraoperative-blood-loss-and-transfusion-requirements-during-orthotopic-liver-transplant
#18
Mohammad Hossein Eghbal, Kazem Samadi, Mohammad Bagher Khosravi, Mohammad Ali Sahmeddini, Sina Ghaffaripoor, Mohammad Ghorbani, Sakineh Shokrizadeh
OBJECTIVES: Liver transplant traditionally and potentially is associated with the risk of massive blood loss and transfusion, which can adversely affect transplant outcomes. Many variables influence the amount of bleeding, and these can be categorized as patient related, surgery related, and graft related. We aimed to assess the effects of these variables on the amount of bleeding and transfusion during liver transplant; predicting the risk of massive blood loss can help transplant teams to select and manage patients more effectively...
October 12, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29025297/liver-transplantation-in-patients-with-cardiac-disease
#19
Christopher L Wray
Liver transplantation (LT) is a unique surgical procedure that has major hemodynamic and cardiovascular implications. Recently, there has been significant interest focused on cardiovascular issues that affect LT patients in all phases of the perioperative period. The preoperative cardiac evaluation is a major step in the selection of LT candidates. LT candidates are aging in concordance with the general population; cardiovascular disease and their risk factors are highly associated with older age. Underlying cardiovascular disease has the potential to affect outcomes in LT patients and has a major impact on candidate selection...
October 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29019744/pediatric-liver-transplant-techniques-and-complications
#20
Natally Horvat, Antonio Sergio Zafred Marcelino, Joao Vicente Horvat, Tássia Regina Yamanari, Jose de Arimateia Batista Araújo-Filho, Pedro Panizza, Joao Seda-Neto, Eduardo Antunes da Fonseca, Francisco Cesar Carnevale, Luciana Mendes de Oliveira Cerri, Paulo Chapchap, Giovanni Guido Cerri
Liver transplant is considered to be the last-resort treatment approach for pediatric patients with end-stage liver disease. Despite the remarkable advance in survival rates, liver transplant remains an intricate surgery with significant morbidity and mortality. Early diagnosis of complications is crucial for patient survival but is challenging given the lack of specificity in clinical presentation. Knowledge of the liver and vascular anatomy of the donor and the recipient or recipients before surgery is also important to avoid complications...
October 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
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