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liver transplantation surgical technique

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https://www.readbyqxmd.com/read/28053342/liver-transplantation-for-hepatocellular-carcinoma-outcomes-and-novel-surgical-approaches
#1
REVIEW
Gonzalo Sapisochin, Jordi Bruix
Liver transplantation for hepatocellular carcinoma (HCC) is the best treatment option for patients with early-stage tumours and accounts for ∼20-40% of all liver transplantations performed at most centres worldwide. The Milan criteria are the most common criteria to select patients with HCC for transplantation but they can be seen as too restrictive. Several proposals have been made for a moderate expansion of the criteria, which result in good outcomes but with an increase in the risk of tumour recurrence...
January 5, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28052307/ultrashort-bowel-syndrome-outcome-in-children-treated-in-a-multidisciplinary-intestinal-rehabilitation-unit
#2
Mariela Dore, Paloma Triana Junco, Ane Andres Moreno, Vanesa Nuñez Cerezo, Martha Romo Muñoz, Alba Sánchez Galán, Alejandra Vilanova Sánchez, Gerardo Prieto, Esther Ramos, Francisco Hernandez, Leopoldo Martínez Martínez, Manuel Lopez Santamaria
Aim Short bowel syndrome (SBS) is the leading cause of intestinal failure (IF) in the pediatric population. Our aim was to review long-term outcome of ultrashort bowel syndrome (USBS) in an Intestinal Rehabilitation Unit (IRU). Patients and Methods Retrospective study of patients with USBS (defined as < 10 cm of remnant small bowel) treated between 2000 and 2015. Demographic data, clinical, and treatment variables including parenteral nutrition (PN), surgical techniques, and intestinal transplantation (IT) were analyzed...
January 4, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28042248/comprehensive-guide-to-laparoscope-assisted-graft-harvesting-in-live-donors-for-living-donor-liver-transplantation-perspective-of-laparoscopic-vision
#3
Tomohide Hori, Toshimi Kaido, Taku Iida, Shintaro Yagi, Shinji Uemoto
BACKGROUND: A living donor (LD) for liver transplantation (LT) is the best target for minimally invasive surgery. Laparoscope-assisted surgery (LAS) for LDs has gradually evolved. A donor safety rate of 100% should be guaranteed. METHODS: We began performing LAS for LDs in June 2012. The aim of this report is to describe the surgical procedures of LAS in detail, discuss various tips and pitfalls, and address the potential for a smooth transition to more advanced LAS...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28039700/extended-hepatectomy-using-the-bipolar-tissue-sealer-an-experimental-model-of-small-for-size-syndrome-in-pigs
#4
Antonios Athanasiou, Michael Kontos, Emmanouil Pikoulis, John Griniatsos, Apostolos Papalois, Eleftherios Spartalis, Demetrios Moris, Evangelos Felekouras, Theodoros Liakakos
PURPOSE: After liver transplantation with a small-for-size liver graft or after extensive hepatectomy for liver malignancies or other non malignant conditions with an insufficient liver volume, the survival of patients depends on liver regeneration. This study was carried out in order to create a new porcine model for the study of small-for-size syndrome (SFSS) after extensive hepatectomy. METHODS: In the present study we used 23 domestic Landrace pigs weighing 28...
November 2016: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28009756/regeneration-and-cell-recruitment-in-an-improved-heterotopic-auxiliary-partial-liver-transplantation-model-in-the-rat
#5
Yoshihiro Ono, Angelica Pérez-Gutiérrez, Mladen I Yovchev, Kentaro Matsubara, Shinichiro Yokota, Jorge Guzman-Lepe, Kan Handa, Alexandra Collin de l'Hortet, Angus W Thomson, David A Geller, Hiroshi Yagi, Michael Oertel, Alejandro Soto-Gutierrez
BACKGROUND: Auxiliary partial liver transplantation (APLT) in humans is a therapeutic modality used especially to treat liver failure in children or congenital metabolic disease. Animal models of APLT have helped to explore therapeutic options. Though many groups have suggested improvements, standardizing the surgical procedure has been challenging. Additionally, the question of whether graft livers are reconstituted by recipient-derived cells after transplantation has been controversial...
January 2017: Transplantation
https://www.readbyqxmd.com/read/27995088/current-technical-issues-for-surgery-of-primary-liver-cancer
#6
REVIEW
Yoshikuni Kawaguchi, Goro Honda, Itaru Endo, Daniel Cherqui, Norihiro Kokudo
Primary liver cancer is the fifth most common cancer worldwide. Apart from liver transplantation, surgical resection has been accepted as the effective local treatment for hepatocellular carcinoma (HCC), one of the most common primary liver cancers. Recent technological innovations including navigation technology and intraoperative real-time fluorescence guidance have been utilized for liver resections in clinical practice. With respect to liver resection techniques, the laparoscopic approach has been increasingly gaining popularity as one of the minimally-invasive treatments of HCC...
November 2016: Liver Cancer
https://www.readbyqxmd.com/read/27992805/selective-ex%C3%A2-vivo-photothermal-nano-therapy-of-solid-liver-tumors-mediated-by-albumin-conjugated-gold-nanoparticles
#7
Lucian Mocan, Cristian Matea, Flaviu A Tabaran, Ofelia Mosteanu, Teodora Pop, Cosmin Puia, Lucia Agoston-Coldea, Gabriela Zaharie, Teodora Mocan, Anca Dana Buzoianu, Cornel Iancu
We have used albumin (BSA) bound to gold nanoparticles (GNPs) as active vectors to target liver cells. Our incentive to develop an original model of living liver cancer sprang from the ethical drawbacks that hindered the assessment of the selective character and the therapeutic capacity of these nano-biosystems in cancer patients. Ex vivo-perfused liver specimens were obtained from hepatocellular carcinoma patients similarly to the surgical technique of transplantation. Albumin bound to GNPs was inoculated intra-arterially onto the resulting specimen and determined the specific delivery of the nano-bioconjugate into the malignant tissue by means of the capillary bed...
March 2017: Biomaterials
https://www.readbyqxmd.com/read/27982336/splenic-artery-aneurysm
#8
Rui Antônio Ferreira Tcbc-Rj, Myriam Christina Lopes Ferreira, Daniel Antônio Lopes Ferreira, André Gustavo Lopes Ferreira, Flávia Oliveira Ramos
Splenic artery aneurysms - the most common visceral artery aneurysms - are found most often in multiparous women and in patients with portal hypertension. Indications for treatment of splenic artery aneurysm or pseudoaneurysm include specific symptoms, female gender and childbearing age, presence of portal hypertension, planned liver transplantation, a pseudoaneurysm of any size, and an aneurysm with a diameter of more than 2.5cm. Historically, the treatment of splenic artery aneurysm has been surgical ligation of the splenic artery, ligation of the aneurysm, or aneurysmectomy with or without splenectomy, depending on the aneurysm location...
September 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/27975113/pediatric-liver-transplantation-an-update-for-the-pediatrician
#9
Kristin Capone, Karine Amirikian, Ruba K Azzam
Pediatric liver transplantation is a state-of-the-art treatment for children with end-stage liver disease. Over the past few decades, the advent of new surgical techniques using split liver grafts and living donors has drastically increased the organ availability for pediatric patients, while advances in immunosuppression have improved overall outcomes. The pediatrician is a key player in the multidisciplinary team that cares for these children starting with the timely referral of children who require liver transplantation to the active participation in optimizing the child's overall health before and after transplantation...
December 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27932178/extra-anatomical-meso-portal-venous-jump-graft-repair-for-early-portal-vein-thrombosis-after-liver-transplant-in-an-infant-with-a-hypoplastic-portal-vein-a-case-report
#10
R Matsumoto, K Uchida, S Nishida, E R Island, D M Levi, J Fan, A Tekin, G Selvaggi, A G Tzakis
BACKGROUND AND PURPOSE: Small infants with biliary atresia and hypoplastic portal veins (PV) are at risk for portal vein thrombosis (PVT) after liver transplantation (LT), which can lead to graft loss and mortality. Extra-anatomical PV reconstruction techniques have been established for adult cases of PVT; however, they have not been widely accepted for infants. METHODS: Here, we report the successful use of an extra-anatomical meso-portal venous jump graft to treat early PVT after LT in a 6-month-old infant with biliary atresia and PV hypoplasia...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932128/liver-transplantation-results-by-donor-age
#11
A V Rabelo, M D Bastante, A M Raya, C S M Méndez, A R G Ramirez, Y F Suarez
OBJECTIVE: The objective of this study was to compare liver transplantation outcomes as a function of donor age. MATERIAL AND METHODS: We performed 212 liver transplantations between 2008 and 2014. We described a prospective cohort study and grouped the patients by liver donor age. We compared quantitative and categorical variables using statistical analysis. RESULTS: No statistically significant differences were found among any graft age groups in gender (always more males), time on waiting list, age, height, Child Pugh Turcotte (CHILD) score, Model for End-stage Liver Disease (MELD) score, need for intraoperative blood products, or intensive care unit stay...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932122/analysis-of-the-first-1000-liver-transplants-in-virgen-del-roc%C3%A3-o-hospital
#12
J Tinoco-González, G Suárez-Artacho, C Bernal-Bellido, C Cepeda-Franco, I Ramallo-Solis, L Marín-Gómez, J M Álamo-Martínez, J Serrano-Díez-Canedo, J Padillo-Ruíz, M A Gómez-Bravo
The goal of this work has been to analyze the first 1000 liver transplantations (LTs) performed in the Virgen del Rocío Hospital of Seville and to evaluate the changes in that time. We included 916 patients who had 1000 LTs. We distinguish 2 stages in the follow-up: the first stage, between 1990 and 2002, and the second, from 2003 to 2013 (Model for End-stage Liver Disease [MELD] stage). We analyzed recipient features, LT indications, donation criteria, surgical technique, complications, and survival both for patients and grafts...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931582/liver-transplantation-for-hepatitis-b-in-early-adulthood-analysis-of-the-united-network-for-organ-sharing-database
#13
G Rifai, A Anani, I A Hanouneh, B Mohamad, A Matloob, R Lopez, N N Zein, N Alkhouri
BACKGROUND: Chronic hepatitis B virus (HBV) infection has a mild course in most children that may delay initiation of treatment even when indicated. Unfortunately, a small number of cases can progress rapidly to cirrhosis, which may require liver transplantation (LT) in early adulthood. The aim of this study was to assess the characteristics of HBV-positive young adults who received LT and to evaluate post-transplant outcomes including patient and graft survival and differences between pre- and post-implementation of Model for End-stage Liver Disease (MELD) prioritization...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27909288/reconstruction-of-isolated-inferior-right-hepatic-vein-s-in-right-lobe-living-donor-liver-transplantation-using-polytetrafluoroethylene-grafts-a-new-feasible-concept-technique-of-bridging-conduit-venoplasty-and-outcomes
#14
Ashok Thorat, Shih-Chao Hsu, Horng-Ren Yang, Ping-Chun Li, Ming-Li Li, Chun-Chieh Yeh, Te-Hung Chen, Kin-Shing Poon, Long-Bin Jeng
BACKGROUND Right lobe living donor liver transplantation (LDLT) remains the most common form of liver transplantation in Asia. However, reconstruction of the venous outflow in a right liver allograft may pose technical difficulties if hepatic venous variations are present. Recently, much emphasis has been given to the reconstruction of large and multiple inferior right hepatic veins (IRHVs). The method of reconstructive technique, type of vascular grafts, and the outcome after the procedure have been a point of debate...
December 2, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/27904861/a-recent-advance-in-image-guided-locoregional-therapy-for-hepatocellular-carcinoma
#15
REVIEW
Yaoping Shi, Bo Zhai
BACKGROUND: Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the third most common cause of cancer-related deaths. Hepatic resection and liver transplantation are considered to be the preferred treatment for HCC. However, as novel therapeutic options such as image-guided locoregional therapies have emerged and been refined, the manner in which HCC is treated has changed dramatically compared with what it was considered just 2 decades earlier. SUMMARY: This study reviews the current results of various image-guided locoregional therapies for treating HCC, especially focusing on thermal ablative and transarterial techniques...
October 2016: Gastrointestinal Tumors
https://www.readbyqxmd.com/read/27888549/microscope-assisted-hepatic-artery-reconstruction-in-adult-living-donor-liver-transplantation-a-review-of-325-consecutive-cases-in-a-single-center
#16
Chen-Fang Lee, Johnny Chuieng-Yi Lu, Ahmed Zidan, Ching-Song Lee, Tsung-Han Wu, Kun-Ming Chan, Wei-Chen Lee
BACKGROUND: Despite the technical and medical improvements in the recent years, hepatic artery thrombosis (HAT) remains a devastating complication after living donor liver transplantation (LDLT). We described our surgical techniques and monitoring protocols for hepatic artery reconstruction. We reported one of the lowest incidence rates of HAT in the literature. METHODS: Between 2008 and 2015, a total of 325 LDLTs performed at our institute were retrospectively analyzed...
November 26, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27833378/cardiovascular-risk-after-orthotopic-liver-transplantation-a-review-of-the-literature-and-preliminary-results-of-a-prospective-study
#17
REVIEW
Giuseppina Pisano, Anna L Fracanzani, Lucio Caccamo, Maria F Donato, Silvia Fargion
Improved surgical techniques and greater efficacy of new anti-rejection drugs have significantly improved the survival of patients undergoing orthotopic liver transplantation (OLT). This has led to an increased incidence of metabolic disorders as well as cardiovascular and cerebrovascular diseases as causes of morbidity and mortality in OLT patients. In the last decade, several studies have examined which predisposing factors lead to increased cardiovascular risk (i.e., age, ethnicity, diabetes, NASH, atrial fibrillation, and some echocardiographic parameters) as well as which factors after OLT (i...
October 28, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27788810/reconstruction-of-the-outflow-tract-in-cross-auxiliary-double-domino-donor-liver-transplantation
#18
W Qu, Z-J Zhu, L Wei, L-Y Sun, Y Liu, Z-G Zeng
BACKGROUND: Auxiliary liver transplantation is accepted as an effective manner to expand the liver donor pool. A difficult surgical technical challenge of the procedure is hepatic vein reconstruction of the graft. METHODS: To resolve this problem, complex techniques are used to perform an innovative outflow tract reconstruction in the world's first cross-auxiliary double-domino donor liver transplantation with two whole liver grafts. The inferior vena cava-sparing hepatectomy technique was applied at harvest in the two domino liver donors...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27788809/hepatic-venous-and-inferior-vena-cava-morphology-no-longer-a-barrier-to-living-donor-liver-transplantation-for-budd-chiari-syndrome-surgical-techniques-and-outcomes
#19
H Pahari, R J Chaudhary, S Thiagarajan, V Raut, R Babu, P Bhangui, S Goja, A Rastogi, V Vohra, A S Soin
BACKGROUND: Living donor liver transplantation (LDLT) for Budd-Chiari syndrome (BCS) has been reported with <10 inferior vena cava (IVC) replacements with vascular/synthetic graft. The goal of this study was to review outcomes of LDLT for BCS at our center, with an emphasis on surgical techniques and postoperative anticoagulation therapy. METHODS: Between October 2011 and December 2015, a total of 1027 LDLTs were performed. Nine of these patients had BCS. We analyzed their etiologies, operative details, postoperative complications, and outcomes...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27787368/living-donor-liver-transplantation-for-budd-chiari-syndrome-overcoming-a-troublesome-situation
#20
Cengiz Ara, Sami Akbulut, Volkan Ince, Serdar Karakas, Adil Baskiran, Sezai Yilmaz
BACKGROUND: The aim of the study was to report the detailed surgical techniques of living donor liver transplantation (LDLT) in patients with Budd-Chiari syndrome (BCS). METHODS: Demographic and surgical techniques characteristics of 39 patients with BCS who underwent LDLT were retrospectively reviewed. Thirty-two of them had native vena cava inferior (VCI) preservation and 6 had retrohepatic VCI resection with venous continuity established by cryopreserved VCI (n = 4) or aortic graft (n = 2)...
October 2016: Medicine (Baltimore)
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