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liver transplantation surgical technique

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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)
https://www.readbyqxmd.com/read/27785450/minimally-invasive-image-guided-therapies-for-hepatocellular-carcinoma
#8
REVIEW
Mohamed E Abdelsalam, Ravi Murthy, Rony Avritscher, Armeen Mahvash, Michael J Wallace, Ahmed O Kaseb, Bruno C Odisio
Hepatocellular carcinoma (HCC) is the fifth most frequently occurring cancer globally and predominantly develops in the setting of various grades of underlying chronic liver disease, which affects management decisions. Image-guided percutaneous ablative or transarterial therapies have acquired wide acceptance in HCC management as a single treatment modality or combined with other treatment options in patients who are not amenable for surgery. Recently, such treatment modalities have also been used for bridging or downsizing before definitive treatment (ie, surgical resection or liver transplantation)...
2016: Journal of Hepatocellular Carcinoma
https://www.readbyqxmd.com/read/27785449/hepatocellular-carcinoma-a-review
#9
REVIEW
Julius Balogh, David Victor, Emad H Asham, Sherilyn Gordon Burroughs, Maha Boktour, Ashish Saharia, Xian Li, R Mark Ghobrial, Howard P Monsour
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and is a leading cause of cancer-related death worldwide. In the United States, HCC is the ninth leading cause of cancer deaths. Despite advances in prevention techniques, screening, and new technologies in both diagnosis and treatment, incidence and mortality continue to rise. Cirrhosis remains the most important risk factor for the development of HCC regardless of etiology. Hepatitis B and C are independent risk factors for the development of cirrhosis...
2016: Journal of Hepatocellular Carcinoma
https://www.readbyqxmd.com/read/27781375/multidisciplinary-management-of-hepatoblastoma-in-children-experience-from-a-developing-country
#10
Naresh Shanmugam, Julius Xavier Scott, Vimal Kumar, Mukul Vij, Priya Ramachandran, Gomathy Narasimhan, Mettu Srinivas Reddy, Venugopal Kota, Deenadayalan Munirathnam, Chayarani Kelgeri, Karthick Sundaram, Mohamed Rela
BACKGROUND: Advances in chemotherapy, liver resection techniques, and pediatric liver transplantation have vastly improved survival in children with hepatoblastoma (HB). These are best managed by a multidisciplinary team (MDT) in a setting where all treatment options are available. Until recently, this was difficult to achieve in India. METHODS: All children (<16 years) with HB treated in a pediatric liver surgery and transplantation unit between January 2011 and July 2016 were reviewed...
October 26, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27672272/split-liver-transplantation-in-adults
#11
REVIEW
Koji Hashimoto, Masato Fujiki, Cristiano Quintini, Federico N Aucejo, Teresa Diago Uso, Dympna M Kelly, Bijan Eghtesad, John J Fung, Charles M Miller
Split liver transplantation (SLT), while widely accepted in pediatrics, remains underutilized in adults. Advancements in surgical techniques and donor-recipient matching, however, have allowed expansion of SLT from utilization of the right trisegment graft to now include use of the hemiliver graft as well. Despite less favorable outcomes in the early experience, better outcomes have been reported by experienced centers and have further validated the feasibility of SLT. Importantly, more than two decades of experience have identified key requirements for successful SLT in adults...
September 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27625785/liver-transplantation-in-a-patient-with-complete-portal-vein-thrombosis-is-there-a-surgical-way-out-a-case-report
#12
Tommaso Maria Manzia, Laura Fazzolari, Matteo Manuelli, Marco Pellicciaro, Leonardo Baiocchi, Giuseppe Tisone
INTRODUCTION: Due to the complexity of the surgical procedure portal vein thrombosis (PVT) has long been considered an absolute contraindication to liver transplantation (LT). The presence of a large splenorenal shunt (SRS) could make portal anastomosis a valid option. PRESENTATION OF CASE: We report the case of a 37-year-old female patient with Grade III PVT and a large SRS, who underwent orthotopic LT. Liver was implanted using a 1992-Belghiti piggyback technique and portal anastomosis was performed using the large spleno-renal shunt...
November 2016: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/27621745/standardized-surgical-techniques-for-adult-living-donor-liver-transplantation-using-a-modified-right-lobe-graft-a-video-presentation-from-bench-to-reperfusion
#13
REVIEW
Shin Hwang, Tae-Yong Ha, Chul-Soo Ahn, Deok-Bog Moon, Ki-Hun Kim, Gi-Won Song, Dong-Hwan Jung, Gil-Chun Park, Sung-Gyu Lee
After having experienced more than 2,000 cases of adult living donor liver transplantation (LDLT), we established the concepts of right liver graft standardization. Right liver graft standardization intends to provide hemodynamics-based and regeneration-compliant reconstruction of vascular inflow and outflow. Right liver graft standardization consists of the following components: Right hepatic vein reconstruction includes a combination of caudal-side deep incision and patch venoplasty of the graft right hepatic vein to remove the acute angle between the graft right hepatic vein and the inferior vena cava; middle hepatic vein reconstruction includes interposition of a uniform-shaped conduit with large-sized homologous or prosthetic grafts; if the inferior right hepatic vein is present, its reconstruction includes funneling and unification venoplasty for multiple short hepatic veins; if donor portal vein anomaly is present, its reconstruction includes conjoined unification venoplasty for two or more portal vein orifices...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
https://www.readbyqxmd.com/read/27607532/revisiting-apolt-for-metabolic-liver-disease-a-new-look-at-an-old-idea
#14
Mettu Srinivas Reddy, Rajesh Rajalingam, Mohamed Rela
Even though Auxiliary Partial Orthotopic Liver Transplantation (APOLT) as a technique was popularized in the late eighties, its role in metabolic liver disease remains controversial. The slow progress in gene therapy research, high incidence of technical complications and the problem of long term graft atrophy have been roadblocks to its wider application. Better understanding of reciprocal dynamics of portal flow and regeneration between the graft and native liver along with multiple refinements in surgical technique have improved outcomes of this operation making it a safe alternative to OLT for patients with a wide range of noncirrhotic metabolic liver diseases (NCMLD)...
September 8, 2016: Transplantation
https://www.readbyqxmd.com/read/27599952/-hepatocellular-carcinoma-in-navarre-study-of-characteristics-and-evolution-in-clinical-practice
#15
I R Elizalde Apestegui, C Saldaña Dueñas, S Goñi Esarte, C Prieto Martínez, B Sangro Gómez-Acebo, J M Zozaya Urmeneta
BACKGROUND: Hepatocellular carcinoma generally arises in a cirrhotic liver. The aim of screening is to improve survival. The aims of our study are to determine the characteristics and evolution of hepatocellular carcinoma and the effect of screening on survival, in clinical practice in Navarre. METHODS: Prospective and retrospective study of 111 patients diagnosed with hepatocellular carcinoma in public hospitals in Navarre between January 2009 and January 2015...
2016: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/27581998/recanalized-umbilico-caval-anastomosis-as-a-temporary-portosystemic-shunt-in-pediatric-living-donor-liver-transplantation-the-crossed-fingers-method
#16
Taizen Urahashi, Yoshiyuki Ihara, Yukihiro Sanada, Noriki Okada, Naoya Yamada, Yuta Hirata, Takumi Katano, Koichi Mizuta
A temporary portocaval shunt (TPCS) associated with retrohepatic vena cava preservation prevents the edema caused by splanchnic congestion during liver transplantation (LT), especially for non-cirrhotic cases. We herein report a modified TPCS technique using the recanalized umbilical vein and an end-to-side recanalized umbilico-caval anastomosis for use during pediatric living donor liver transplantation (LDLT). This work evaluated a group of pediatric patients who underwent LDLT between 2001 and 2014 with the conventional TPCS (n=16) versus the recanalized umbilico-caval shunt (crossed fingers method, n=10)...
September 1, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27559001/generation-of-multilayered-3d-structures-of-hepg2-cells-using-a-bio-printing-technique
#17
Hyeryeon Jeon, Kyojin Kang, Su A Park, Wan Doo Kim, Seung Sam Paik, Sang-Hoon Lee, Jaemin Jeong, Dongho Choi
Background/Aims: Chronic liver disease is a major widespread cause of death, and whole liver transplantation is the only definitive treatment for patients with end-stage liver diseases. However, many problems, including donor shortage, surgical complications and cost, hinder their usage. Recently, tissue-engineering technology provided a potential breakthrough for solving these problems. Three-dimensional (3D) printing technology has been used to mimic tissues and organs suitable for transplantation, but applications for the liver have been rare...
August 25, 2016: Gut and Liver
https://www.readbyqxmd.com/read/27550409/exchange-of-partial-liver-transplantation-between-children-with-different-non-cirrhotic-metabolic-liver-diseases-how-do-we-arrive-there
#18
Cheng-Yen Chen, Chinsu Liu, Niang-Cheng Lin, Hsin-Lin Tsai, Che-Chuan Loong, Cheng-Yuan Hsia
Hepatic-based metabolic disorders are characterized by an enzyme deficiency expressed solely or mainly in the liver. They are divided into cirrhotic or non-cirrhotic metabolic liver diseases (NCMLDs), and most of them can be treated by liver transplantation. Because the livers with NCMLDs are usually structurally and functionally normal, the primary aim of the liver graft is to support the deficient enzymes rather than maintaining liver functions. Hence, we hypothesize that the exchange of partial liver grafts by the technique of auxiliary partial orthotopic liver transplantation (APOLT) between patients with 2 different NCMLDs may be feasible to replace the deficient enzymes in each patient...
2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/27468208/advances-in-endoscopic-management-of-biliary-complications-after-living-donor-liver-transplantation-comprehensive-review-of-the-literature
#19
REVIEW
Milljae Shin, Jae-Won Joh
Apart from noticeable improvements in surgical techniques and immunosuppressive agents, biliary complications remain the major causes of morbidity and mortality after living donor liver transplantation (LDLT). Bile leakage and stricture are the predominant complications. The reported incidence of biliary complications is 15%-40%, and these are known to occur more frequently in living donors than in deceased donors. Despite the absence of a confirmed therapeutic algorithm, many approaches have been used for treatment, including surgical, endoscopic, and percutaneous transhepatic techniques...
July 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27468188/predictive-factors-of-short-term-outcome-after-liver-transplantation-a-review
#20
REVIEW
Giuliano Bolondi, Federico Mocchegiani, Roberto Montalti, Daniele Nicolini, Marco Vivarelli, Lesley De Pietri
Liver transplantation represents a fundamental therapeutic solution to end-stage liver disease. The need for liver allografts has extended the set of criteria for organ acceptability, increasing the risk of adverse outcomes. Little is known about the early postoperative parameters that can be used as valid predictive indices for early graft function, retransplantation or surgical reintervention, secondary complications, long intensive care unit stay or death. In this review, we present state-of-the-art knowledge regarding the early post-transplantation tests and scores that can be applied during the first postoperative week to predict liver allograft function and patient outcome, thereby guiding the therapeutic and surgical decisions of the medical staff...
July 14, 2016: World Journal of Gastroenterology: WJG
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