Liver transplanation

Hepatitis C virus is a common cause of chronic liver disease, that may lead to cirrhosis, hepatocellular cancer and liver transplanation. The advent of highly efficacious direct-acting antivirals and their success in the treatment of hepatitis C virus infection, generated soon an optimism. Thus, the World Health Organization has adopted a global strategy of reducing the incidence of new hepatitis B and C virus infection by 90 % by 2030. However, it turned out, that this goal is not achievable by drug treatment alone without a vaccination, because of the high number of infected persons, low rate of screening and poor access to treatment in several countries, and even the cost of the therapy...

BACKGROUND: Hepatic myelopathy (HM) is a rare neurological complication of advanced cirrhosis. Prognosis of patients with HM is generally poor without timely liver transplantation or interventional therapy. Self-resolving HM in patients with alcoholic cirrhosis has never been reported. CASE SUMMARY: A 53-year-old man with alcoholic cirrhosis and recurrent overt hepatic encephalopathy for 1 year was admitted for lower extremity weakness, slow movement, and stumbling gait...

In 2021, the United States performed 9,236 liver transplantations, an increase of 3.7% from 2020. As the specialty of transplant anesthesiologist continues to grow, so does the body of evidence-based research to improve patient care. New technology in organ preservation offers the possibility of preserving marginal organs for transplant or improving the graft for transplantation. The sequalae of end-stage liver disease have wide-ranging consequences that affect neurologic outcomes of patients both during and after transplantation that anesthesiologists should monitor...

Introduction: Oxalate overproduction in Primary Hyperoxaluria type I (PH1) leads to progressive renal failure and systemic oxalate deposition. In severe infantile forms of PH1 (IPH1), end-stage renal disease (ESRD) occurs in the first years of life. Usually, the management of these infantile forms is challenging and consists in an intensive dialysis regimen followed by a liver-kidney transplantation (combined or sequential). Methods: Medical records of all infants with IPH1 reaching ESRD within the first year of life, diagnosed and followed between 2005 and 2018 in two pediatric nephrology departments in Brussels and Paris, have been reviewed...

Liver transplantation has emerged as a highly efficient treatment for a variety of acute and chronic liver diseases. However, organ shortage is becoming an increasing problem globally, limiting the applicability of liver transplantation. In addition, potential recipients are becoming sicker, thereby increasing the risk of losing the graft during transplantation or in the initial postoperative period after liver transplantation (three months). This trend is challenging the model for end-stage liver disease allocation system, where the sickest candidates are prioritised and no delisting criteria are given...

OBJECTIVES: Presentation as autoimmune acute liver failure (AI-ALF) and seronegative autoimmune liver disease (SN-AILD) represents two uncommon variants of AILD. We compared the clinical profile and outcome of AI-ALF with autoimmune-non-acute liver failure (AI-non-ALF) and also SN-AILD with seropositive autoimmune liver disease (SP-AILD). MATERIALS AND METHODS: Children managed as AI-ALF and AI-non-ALF including SN-AILD and SP-AILD were enrolled and compared. AI-non-ALF was diagnosed by simplified diagnostic criteria and AI-ALF by Pediatric Acute Liver Failure Study Group criteria with positive autoantibody, exclusion of other etiologies, elevated immunoglobulin G and histology when available...

BACKGROUND: Hepatitis C (HCV) is a common cause of liver failure and liver cancer, and is a frequent indication for liver transplantation (LT). Until recently, a majority of transplanted patients were viraemic at the time of transplantation and they inevitably underwent recurrent infection of the graft. Prior to the availability of specific direct-acting antiviral (DAA) drugs, HCV infection was seldom successfully treated before or after transplantation. Key Messages: During the past 2 years, the use of interferon-free DAA therapy has transformed the management of patients post-LT and of patients on the transplant waiting list...

The Couinaud's liver segmentation is based on the identification of portal vein bifurcation and origin of hepatic veins. It is widely used clinically, because it is better suited for surgery and is more accurate in localizing and monitoring various intra parenchymal lesions. According to standard anatomy, the portal vein bifurcates into right and left branches; the left vein drains segment II, III and IV and the right vein divides into two secondary branches - the anterior portal vein drains segments V and VIII, and the posterior drains segments VI and VII...

Alternative islet transplantation sites have the potential to reduce the marginal number of islets required to ameliorate hyperglycemia in recipients with diabetes. Previously, we reported that T cell leukemia homeobox 1 (Tlx1)+ stem cells in the spleen effectively regenerated into insulin-producing cells in the pancreas of non-obese diabetic mice with end-stage disease. Thus, we investigated the spleen as a potential alternative islet transplantation site. Streptozotocin-induced diabetic C57BL/6 mice received syngeneic islets into the portal vein (PV), beneath the kidney capsule (KC), or into the spleen (SP)...

Acute kidney injury (AKI) is a common complication in liver transplant recipients. Affecting ~25% of patients preoperatively, and up to 60% postoperatively significantly worsens the prognosis. Etiology differs depending on the time of its onset, from mostly prerenal before the transplantation, ischemic in the early postoperative period to toxic AKI later on. Liver transplantation is a lenghty and complex procedure with a significant risk of hemodynamic instability, metabolic acidosis and electrolyte disturbances...

In 14 patients with cirrhosis and portal hypertention autologous mesenclyme multipotential stem cells (AMMSC) transplanation was performed in portal vein (I group, n=7) and common trunk of the hepatic artery (II group, n=6). Duration of pathological processes since diagnosis is 1-8 years (3,7±2,4 years). The initial severity was evaluated by a set of child-Pugh score: Class A - 6 (42,9%), Class B - 8 (57,1%). Cell cultures indentication and characteristics consistent with International Society of cell technology guidanes (ISCT) since 2006...

BACKGROUND: Postoperative cognitive dysfunction (POCD) is an adverse condition characterized by declined cognitive functions following surgeries and anesthesia. POCD has been associated with increased hospital stay and mortality. There are histological similarities to Alzheimer's disease. Most early studies were conducted in patients receiving cardiac surgery. Since there is no information about POCD in liver transplant recipients, we measured the incidence of POCD in patients after liver transplantation and examined the correlation between neurological dysfunction and biological markers of dementia-based diseases...

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In this paper we present a hybrid OD-3D modeling method to investigate the hepatic flow in a virtual right lobe hepatectomy (RLH), the surgical procedure for adult-to-adult living donor liver transplanation (LDLT). The 3D method is employed to simulate complex 3D flow in the portal vein, and the OD model is used to study the systemic hepatic circulation. In particular, we quantify the flow velocity and wall shear stress (WSS) in the left portal vein which increase dramatically post-RLH, and also simulate the essential hepatic distribution features in a healthy adult pre- and post-procedure...

BACKGROUND: ABO-incompatible organ transplantation typically induces hyperacute rejection. A2-to-O liver transplantations have been successful. This study compared overall and graft survival in O recipients of A2 and O grafts based on Organ Procurement and Transplantation Network data. METHODS: Scientific Registry of Transplant Recipients data were used. The first A2-to-O liver transplantation was entered on March 11, 1990; all previous transplantations were excluded...

OBJECTIVE: To determine whether portoenterostomy (PE) revision in patients afflicted with biliary atresia (BA) is a viable treatment option and, if so, identify which patients may benefit. BACKGROUND: BA, the most common cause of neonatal liver disease, results in biliary tract obstruction and hepatic fibrosis. Kasai PE is the initial surgical intervention performed and, if successful, restores drainage and preserves the native liver. Portoenterostomy failure warrants liver transplantation, but because of complications related to transplantation, treatment strategies to salvage the native liver may be beneficial...

Treatment of recurrent hepatitis C after liver transplantation is indicated in selected cases. During the combined treatment with pegylated interferon and ribavirin, some patients develop immune-mediated liver dysfunction similar to the previously described "de novo" autoimmune hepatitis. Herein we have presented three liver transplant patients who during or after combined antiviral treatment were diagnosed as autoimmune hepatitis related to interferon based on their clinical, biochemical, and liver histology features...

BACKGROUND: Veno-venous bypass is used to overcome the effects of clamping of the inferior vena cava and portal vein during liver transplanation. The routine use of veno-venous bypass is, however, controversial. OBJECTIVES: To compare the benefits and harms of veno-venous bypass (irrespective of open or percutaneous technique; heparin-coated or no heparin-coating) versus no veno-venous bypass during liver transplantation. To compare the benefits and harms of the different techniques of veno-venous bypass during liver transplantation...

AIM: The hepatic cirrhosis is associated with an important cardiovascular alterations. In this report, we review our transplant center experience with liver transplantation in the Model for End-Stage Liver Disease (MELD) era, in particular this study investigate the relationship between severity of liver disease assessed by MELD score and postoperative events. METHODS: Our retrospective review was performed on 242 cirrhotic patients underwent liver transplanation at the Department of Surgery and Transplantation of the University of Bologna...

OBJECTIVE: To study the inhibition effect of active fraction from maorenshen (MA, MB) on the growth of transplanted mouse tumor cells H22 and its mechanism. METHOD: The transplanted mouse tumor model in vivo was used to observe the antitumor activity of MA, MB. The cell cycle distributions were determined by flow cytometry (FCM). The apoptosis in tumor was measured by TdT-mediated biotinyated-dUTP nick end-labeling (TUNEL) method. RESULT: MA, MB showed antitumor activitiy on transplanted mouse tumor...