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liver transplantation surgical technique

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https://www.readbyqxmd.com/read/29128022/noninfectious-pulmonary-complications-of-liver-heart-and-kidney-transplantation-an-update
#1
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
#2
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: J Vis Surg
https://www.readbyqxmd.com/read/29061150/dysregulated-long-noncoding-rnas-lncrnas-in-hepatocellular-carcinoma-implications-for-tumorigenesis-disease-progression-and-liver-cancer-stem-cells
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/28980051/surgical-modifications-additions-and-alternatives-to-kasai-hepato-portoenterostomy-to-improve-the-outcome-in-biliary-atresia
#12
REVIEW
Shilpa Sharma, Devendra K Gupta
Kasai hepato-portoenterostomy (HPE) is the most widely used surgical technique to restore bile flow in biliary atresia (BA). We aimed to review literature on HPE substitutes and additions to Kasai especially in advanced BA (ABA). A PubMed search was done for surgical procedures apart from or along with Kasai HPE for BA. Additional procedures to prevent cholangitis were also reviewed. Procedures and outcome were analysed. Alternative procedures done by the authors have also been described briefly. Results have been compiled in this review article...
December 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28975835/role-and-future-directions-of-external-beam-radiotherapy-for-primary-liver-cancer
#13
Florence K Keane, Theodore S Hong
The incidence of primary liver cancers continues to increase in the United States and worldwide. The majority of patients with primary liver cancer are not candidates for curative therapies such as surgical resection or orthotopic liver transplantation due to tumor size, vascular invasion, or underlying comorbidities. Therefore, while primary liver cancer is the sixth-most common cancer diagnosis worldwide, it represents the second leading cause of cancer-related deaths. Radiotherapy traditionally played a limited role in the treatment of primary liver cancer due to concerns over hepatic tolerance and the inability to deliver a tumoricidal dose of radiotherapy while still sparing normal hepatic parenchyma...
July 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28964478/pediatric-living-donor-liver-transplantation
#14
Mureo Kasahara, Seisuke Sakamoto, Akinari Fukuda
Living-donor liver transplantation is an important component of all liver transplant programs especially in those that care for the pediatric population. Over the last 30 years, innovations in surgical technique have converted living donation from an experimental procedure to a standard of care. Many of these innovations occurred in countries where culturally, deceased donation is limited leaving no alternatives but living donation. The Organ Transplantation Center at the National Center for Child Health and Development (NCCHD) in Tokyo, Japan, was established in 2005 where we have generated some of those innovations and in so doing, have performed living-donor liver transplantation in over 400 children...
August 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28964477/pediatric-liver-transplantation
#15
Alex G Cuenca, Heung Bae Kim, Khashayar Vakili
Considerable strides have been made over the last several decades toward improving outcomes in pediatric liver transplantation. Refinements in surgical technique has allowed for the use of living donor and deceased donor split-liver grafts, thus expanding the pool of available organs and reducing waitlist mortality. The use of a multidisciplinary team continues to be paramount in the care of the transplant recipient. With improvements in overall graft and survival, indications for liver transplantation have also broadened...
August 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28926171/biliary-reconstructive-techniques-and-associated-anatomic-variants-in-adult-living-donor-liver-transplants-the-a2all-experience
#16
Talia B Baker, Michael A Zimmerman, Nathan P Goodrich, Benjamin Samstein, Elizabeth A Pomfret, James J Pomposelli, Brenda W Gillespie, Carl L Berg, Jean C Emond, Robert M Merion
INTRODUCTION: Living donor liver transplantation (LDLT) is a technically demanding endeavor, requiring command of the complex anatomy of partial liver grafts. We examined the influence of anatomic variation and reconstruction technique on surgical outcomes and graft survival in the nine-center A2ALL Study. METHODS: Data from 272 adult LDLT recipients (2011-2015) included details on anatomic characteristics and types of intraoperative biliary reconstruction. Associations were tested between reconstruction technique and complications, which included first biliary complication ([BC]; leak, stricture, or biloma) and first vascular complication (hepatic artery thrombosis [HAT] or portal vein thrombosis [PVT])...
September 19, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28924922/assessing-the-non-tumorous-liver-implications-for-patient-management-and-surgical-therapy
#17
Pallavi Pandey, Ankur Pandey, Mary Dillhoff, Carl Schmidt, Ihab R Kamel, Timothy M Pawlik
INTRODUCTION: Hepatic resection is performed for various benign and malignant liver tumors. Over the last several decades, there have been improvements in the surgical technique and postoperative care of patients undergoing liver surgery. Despite this, liver failure following an extended hepatic resection remains a critical potential postoperative complication. Patients with underlying parenchymal liver diseases are at particular risk of liver failure due to impaired liver regeneration with an associated mortality risk as high as 60 to 90%...
September 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28923641/simultaneous-kidney-pancreas-transplantation-with-an-original-transverse-pancreas-technique-initial-9-years-experience-with-56-cases
#18
J Paulino, A Martins, E Vigia, P Marcelino, A M Nobre, L Bicho, E Filipe, E Barroso
An innovative technique for pancreas transplantation is described. The main aspect consists of the horizontal positioning of the pancreas, which allows a better venous outflow, thus preventing thrombosis and graft loss. The program of pancreas transplantation in this national reference center for pancreatic and liver surgery was started in 2007; the initial results were considered poor, resulting in the loss of half of the grafts due to venous thrombosis. After analyzing the possible causes, this technique was proposed and successfully implemented, reducing the postoperative complications, particularly the problem of venous thrombosis...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28923635/living-donor-liver-transplantation-for-budd-chiari-syndrome-case%C3%A2-series
#19
C Karaca, C Yilmaz, R Ferecov, Z Iakobadze, K Kilic, L Caglayan, S Aydogdu, M Kilic
BACKGROUND: Venous reconstruction in living-donor liver transplantation for Budd-Chiari syndrome (BCS) has challenges because the grafts from living donors lack vena cava, and hepatic venous anastomosis must be performed on an already-thrombosed and/or stenosed inferior vena cava. Several techniques are described to overcome this problem, and we represent our experience with 22 patients. METHODS: Medical recordings of 22 patients were retrospectively collected, and disease-specific data as well as recordings about surgical technique were analyzed...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28923632/liver-transplantation-in-patients-with-complete-portal-vein-thrombosis-renoportal-or-varicoportal-anastomosis-using-cryopreserved-vein-grafts
#20
H Aktas, A Ozer, O S Guner, E Gurluler, R Emiroglu
BACKGROUND: Despite technical developments in transplantation surgery, complete portal vein thrombosis still remains a challenge for restoration of adequate portal vein inflow. Renoportal or varicoportal anastomosis provides an effective alternative solution for patients with complete portal vein thrombosis. This study describes our experience with renoportal and varicoportal anastomosis during liver transplantation. PATIENTS AND METHODS: Between January 2014 and May 2016, 5 patients with complete portal vein thrombosis underwent extra-anatomic portal anastomosis...
October 2017: Transplantation Proceedings
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