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JOURNAL ARTICLE
US Liver Transplant Outcomes After Normothermic Regional Perfusion vs Standard Super Rapid Recovery.
Aleah L Brubaker, Marty T Sellers, Peter L Abt, Kristopher P Croome, Shaheed Merani, Anji Wall, Phillipe Abreu, Musab Alebrahim, Roy Baskin, Humberto Bohorquez, Robert M Cannon, Kelly Cederquist, John Edwards, Benjamin G Huerter, Mark J Hobeika, Lori Kautzman, Alan N Langnas, David D Lee, Joao Manzi, Ahmed Nassar, Nikole Neidlinger, Trevor L Nydam, Gabriel T Schnickel, Farjad Siddiqui, Ashley Suah, Raeda Taj, C Burcin Taner, Giuliano Testa, Rodrigo Vianna, Frederick Vyas, Martin I Montenovo
IMPORTANCE: Normothermic regional perfusion (NRP) is an emerging recovery modality for transplantable allografts from controlled donation after circulatory death (cDCD) donors. In the US, only 11.4% of liver recipients who are transplanted from a deceased donor receive a cDCD liver. NRP has the potential to safely expand the US donor pool with improved transplant outcomes as compared with standard super rapid recovery (SRR). OBJECTIVE: To assess outcomes of US liver transplants using controlled donation after circulatory death livers recovered with normothermic regional perfusion vs standard super rapid recovery...
April 3, 2024: JAMA Surgery
#2
JOURNAL ARTICLE
Xingru Wang, Fei Chen, Qian Zhang, Jianwei Li
TECHNIQUE: Choledochojejunostomy is an important procedure in hepatobiliary pancreatic surgery. It is used in pancreaticoduodenectomy, biliary strictures, liver transplantation, and other surgical reconstructions involving bile duct resection. Safe and reliable anastomosis under laparoscopic guidance is important for good postoperative recoveries. There are some difficulties owing to the limited angle of laparoscopic instruments. Standardized anastomosis methods are currently lacking, especially for cases with thin bile duct walls and small diameters...
March 25, 2024: Asian Journal of Surgery
#3
Usman Iqbal Aujla, Imran Ali Syed, Ahmad Karim Malik, Muhammad Ramzan, Abdullah Saeed
Post-liver transplantation biliary complications remain a serious concern and are associated with reduced patient and graft survival. Among various biliary complications, anastomotic stricture (AS) is the most frequent and challenging one. The frequency of AS after living donor liver transplantation (LDLT) is higher as compared to deceased donor liver transplantation. The management involves endoscopic retrograde cholangiopancreatography and/or percutaneous transhepatic biliary drainage, but refractory cases necessitate surgical revision...
March 2024: ACG Case Reports Journal
#4
JOURNAL ARTICLE
Joonho Hur, Woosun Choi, Sang Lim Choi, Suk-Won Suh
To investigate the outcomes following percutaneous placement of a retrievable fully covered self-expanding metal stent (fcSEMS) with anchoring flaps at proximal and distal ends for the treatment of biliary anastomotic strictures following living-donor liver transplantation (LDLT). We retrospectively reviewed the medical records of nine patients who underwent this procedure at our centre between April 2020 and March 2021. Percutaneous stent placement was technically successful in 100% patients, and all stents were successfully retrieved...
March 2024: Journal of International Medical Research
#5
JOURNAL ARTICLE
Ana M Calinescu, Sébastien Monluc, Stephanie Franchi-Abella, Dalila Habes, Gabrielle Weber, Marion F Almes, Jerome Waguet, Emmanuel Jacquemin, Virginie Fouquet, Jordi Miatello, Geraldine Hery, Catherine Baujard, Emmanuel Gonzales, Sophie Branchereau, Florent Guérin
OBJECTIVES: We aimed to analyze the risk factors for management failure of BC after pediatric liver transplantation (pLT) by retrospectively analyzing primary pLT performed between 1997 and 2018 (n = 620 patients). RESULTS: In all, 117/620 patients (19%) developed BC. The median (range) follow-up was 9 (1.4-21) years. Patient survival at 1, 5 and 10 years was 88.9%, 85.7%, 84.4% and liver graft survival was 82.4%, 77.4%, and 74.3% respectively...
March 20, 2024: BMC Research Notes
#6
JOURNAL ARTICLE
Zhaoyi Wu, Danqing Liu, Yanjiao Ou, Zeliang Xu, Gang Heng, Wei Liu, Nengsheng Fu, Jingyi Wang, Di Jiang, Lang Gan, Jiahong Dong, Xiaojun Wang, Zhiyu Chen, Leida Zhang, Chengcheng Zhang
BACKGROUND: Biliary complications, especially non-anastomotic stricture (NAS), are the main complications after liver transplantation. Insufficient sampling and no recognized animal models obstruct the investigation. Thus, the mechanisms and alterations that occur during endoscopic treatment (ET) of NAS remain unclear. METHODS: Samples were obtained with endoscopic forceps from the hilar bile ducts of NAS patients receiving continuous biliary stent implantation after diagnosis...
March 2024: Clinical and Translational Medicine
#7
JOURNAL ARTICLE
Zhihao Li, Ashwin Rammohan, Vasanthakumar Gunasekaran, Suyoung Hong, Itsuko Chih-Yi Chen, Jongman Kim, Kris Ann Hervera Marquez, Shih Chao Hsu, Elvan Onur Kirimker, Nobuhisa Akamatsu, Oren Shaked, Michele Finotti, Marcus Yeow, Lara Genedy, Philipp Dutkowski, Silv O Nadalin, Markus U Boehnert, Wojciech G Polak, Glenn K Bonney, Abhishek Mathur, Benjamin Samstein, Jean C Emond, Giuliano Testa, Kim M Olthoff, Charles B Rosen, Julie K Heimbach, Timucin Taner, Tiffany Cl Wong, Chung-Mau Lo, Kiyoshi Hasegawa, Deniz Balci, Mark Cattral, Gonzalo Sapisochin, Nazia Selzner, Long Bin Jeng, Dieter Broering, Jae-Won Joh, Chao-Long Chen, Kyung-Suk Suh, Mohamed Rela, Pierre-Alain Clavien
In living-donor liver transplantation, biliary complications including bile leaks and biliary anastomotic strictures remain significant challenges, with incidences varying across different centers. This multicentric retrospective study (2016-2020) included 3633 adult patients from 18 centers and aimed to identify risk factors for these biliary complications and their impact on patient survival. Incidences of bile leaks and biliary strictures were 11.4% and 20.6%, respectively. Key risk factors for bile leaks included multiple bile duct anastomoses (Odds Ratio [OR] 1...
February 28, 2024: American Journal of Transplantation
#8
JOURNAL ARTICLE
Pierre Mayer, Pierre-Yves Christmann, Lucile Héroin, François Habersetzer
No abstract text is available yet for this article.
December 2024: Endoscopy
#9
Khalid Al Shamousi, Said A Al-Busafi, Ahmed Alwassief, Mohammed Al Nassar, Jawahir Lal
This report presents an innovative water-wire cannulation technique for managing challenging anastomotic strictures in post-orthotopic liver transplant patients, highlighting its successful application in two distinct cases. Anastomotic strictures pose a significant hurdle in hepatobiliary medicine, often complicating the course post-liver transplantation. Standard endoscopic retrograde cholangiopancreatography (ERCP) methods frequently encounter limitations in severe stricture cases, necessitating alternative approaches...
January 2024: Curēus
#10
REVIEW
Alejandra Utrilla Fornals, Cristian Costas-Batlle, Sophie Medlin, Elisa Menjón-Lajusticia, Julia Cisneros-González, Patricia Saura-Carmona, Miguel A Montoro-Huguet
Many patients undergo small bowel and colon surgery for reasons related to malignancy, inflammatory bowel disease (IBD), mesenteric ischemia, and other benign conditions, including post-operative adhesions, hernias, trauma, volvulus, or diverticula. Some patients arrive in the operating theatre severely malnourished due to an underlying disease, while others develop complications (e.g., anastomotic leaks, abscesses, or strictures) that induce a systemic inflammatory response that can increase their energy and protein requirements...
January 12, 2024: Nutrients
#11
André Mascarenhas, Hugo Pinto Marques, João Coutinho, Américo Martins, Fernando Nolasco
Biliary injury secondary to trauma is frequently associated with long-term complications. Liver transplantation is rarely indicated but might be the best therapeutic option in severe or intractable cases. We report the case of a 19-year-old male referred for liver transplantation due to biliary injury after abdominal trauma. A Roux-en-Y hepaticojejunostomy was initially performed without immediate complications. Anastomotic stricture developed requiring several trials of biliary dilatation and stenting through a percutaneous approach...
March 2024: Radiology Case Reports
#12
JOURNAL ARTICLE
Ghada M Mohamed, Andrew J Gilman, Todd H Baron
Video 1A 51-year-old woman underwent orthotopic liver transplant with duct-to-duct anastomosis for primary biliary cholangitis 8 months prior to presentation. Two months postoperatively, she presented with clinical biliary pancreatitis. An MRCP performed on admission demonstrates dilated donor biliary tree and a severe stricture at the anastomosis. An index ERCP shows an indwelling surgical biliary "stent" exiting the duodenal papillae and anastomotic stricture. The surgical stent was removed, a sphincterotomy was performed, and there was an inability to traverse the anastomotic stricture...
December 2023: VideoGIE
#13
JOURNAL ARTICLE
Guergana G Panayotova, Keri E Lunsford, R Cutler Quillin, Abbas Rana, Vatche G Agopian, Grace S Lee-Riddle, Daniela Markovic, Flavio Paterno, Adam D Griesemer, Arpit Amin, Diane Alonso, Juan P Rocca, Daniel Borja-Cacho, Roberto Hernandez-Alejandro, John J Fung, Shawn J Pelletier, Shimul A Shah, James V Guarrera
BACKGROUND AIMS: In liver transplantation, cold preservation induces ischemia, resulting in significant reperfusion injury. Hypothermic Oxygenated Machine Perfusion (HMP-O2) has shown benefit compared to static cold storage (SCS) by limiting ischemia-reperfusion injury. This study reports outcomes using a novel portable HMP-O2 device in the first US randomized control trial. APPROACH RESULTS: The PILOT™ trial (NCT03484455) was a multicenter, randomized, open-label, non-inferiority trial, with participants randomized to HMP-O2 or SCS...
December 13, 2023: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
#14
JOURNAL ARTICLE
Björn Grobe, Freya Wellhöner, Friederike Klein, Patrick Chhatwal, Marius Vital, Dietmar H Pieper, Torsten Voigtländer, Henrike Lenzen, Heiner Wedemeyer, Philipp Solbach, Benjamin Heidrich
BACKGROUND AND AIMS: Bacterial cholangitis is a common complication in patients with ischemic type biliary lesions and/or anastomotic strictures after liver transplantation (LTX). Patients frequently need antibiotics and endoscopic retrograde cholangiography (ERC) to improve the bile flow. Antibiotic treatment is based on findings in standard microbiological cultivation (SMC) of bile. However, the cultivation techniques are limited to a subset of bacteria easy-to-cultivate. Therefore, the aim of our study was to evaluate the value of next generation sequencing as an additional diagnostic tool to SMC in ischemic type biliary lesions and/or anastomotic strictures...
2024: Journal of Clinical and Experimental Hepatology
#15
EDITORIAL
A practical approach to the endoscopic management of biliary strictures after liver transplantation.
Alex Bofill, Andrés Cárdenas
Biliary tract complications are an important cause of morbidity and mortality after liver transplantation (LT) occurring in 5% to 25% of patients. The most common biliary complication in LT recipients are strictures representing approximately half of these biliary adverse events. Bile duct strictures can be divided into anastomotic biliary strictures (ABS) and non-anastomotic biliary strictures (NABS) depending on their location in the biliary tree, being ABS the most encountered type. Several risk factors identified in previous studies can predispose to the development of ABS and NABS, especially those related to surgical techniques and donor characteristics...
November 28, 2023: Annals of Hepatology
#16
JOURNAL ARTICLE
Mark Ly, Ngee-Soon Lau, Catriona McKenzie, James G Kench, Doruk Seyfi, Avik Majumdar, Ken Liu, Geoffrey McCaughan, Michael Crawford, Carlo Pulitano
INTRODUCTION: Histological injury to the biliary tree during organ preservation leads to biliary strictures after liver transplantation. The Bile Duct Injury (BDI) score was developed to assess histological injury and identify the grafts most likely to develop biliary strictures. The BDI score evaluates the bile duct mural stroma, peribiliary vascular plexus (PVP) and deep peribiliary glands (DPGs), which were correlated with post-transplant biliary strictures. However, the BDI score has not been externally validated...
October 27, 2023: Journal of Clinical Medicine
#17
JOURNAL ARTICLE
Naotaka Kugiyama, Shunpei Hashigo, Katsuya Nagaoka, Takehisa Watanabe, Shinya Ushijima, Yukiko Uramoto, Motohiro Yoshinari, Jun Morinaga, Ryosuke Gushima, Masakuni Tateyama, Motohiko Tanaka, Hideaki Naoe, Yasuhiko Sugawara, Taizo Hibi, Yasuhito Tanaka
BACKGROUND: Endoscopic biliary stenting is a standard treatment for biliary strictures after liver transplantation. Plastic stents are often replaced before stent dysfunction to prevent the development of cholangitis and jaundice. Therefore, the precise duration of stent patency is unclear. METHODS: We compared retrospectively the stent patency period and stent dysfunction rate between inside stents (IS) and conventional plastic stents (PS) in 48 patients with post-transplant strictures, distinguishing endoscopic biliary stenting with and without stent dysfunction at stent replacement...
April 2024: DEN Open
#18
Vipul Gautam, Vikram Kumar, Shaleen Agarwal, Subhash Gupta
Bronchobiliary fistula (BBF) is a very rare condition in children. Only a few pediatric BBF cases have been reported, in the context of a ruptured hydatid cyst or liver abscess. BBF after living donor liver transplantation (LDLT) has not been reported in the pediatric literature. We report a 7-year-old female child with Wilson disease, who developed BBF post-LDLT. She had a clinically uneventful course in the immediate post-transplant period. She was readmitted on postoperative day (POD) 75 with a productive cough and respiratory difficulty, which was diagnosed as bilioptysis secondary to BBF...
October 27, 2023: Korean journal of transplantation
#19
JOURNAL ARTICLE
Katlin Mallette, Jeffrey Hawel, Ahmad Elnahas, Nawar A Alkhamesi, Christopher M Schlachta, Ephraim S Tang
BACKGROUND: Benign biliary strictures can have a significant negative impact on patient quality of life. There are several modalities which can be utilized with the goal of stricture resolution. These techniques include balloon dilatation, placement of multiple plastic stents and more recently, the use of metal stents. The aim of this study was to evaluate the local success of self-expanding metal stents in successfully resolving benign biliary strictures. METHODS: This was a single institution, retrospective case series...
October 21, 2023: BMC Gastroenterology
#20
JOURNAL ARTICLE
Gang Tang, Linyu Zhang, Lingying Xia, Jie Zhang, Zhengqiang Wei, Rongxing Zhou
BACKGROUND: Hypothermic Oxygenated Machine Perfusion (HOPE) is a novel organ-preservation technology designed to optimize organ quality. However, the effects of HOPE on morbidity and mortality after liver transplantation remain unclear. This meta-analysis evaluated the potential benefits of HOPE in liver transplantation. MATERIALS AND METHODS: The Embase, Web of Science, PubMed, Cochrane Library, and Scopus databases were searched for articles published up to June 15, 2023 (updated on August 12, 2023)...
September 22, 2023: International Journal of Surgery
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