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liver, coagulation, transplantation

J Wu, L Jia, Y Y Li, J Li, H W Yu, Y K Zhu, Z J Hu, Q H Meng, F S Wang
Objective: To evaluate the incidence, and the characteristics of organ failure in relationship to prognosis in hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) patients using chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score for judgments of clinical treatment and prognosis. Methods: Clinical data of 316 patients who were diagnosed as HBV-ACLF during hospitalization from February 2015 to February 2016 were retrospectively analyzed. Intrahepatic and extrahepatic organ failures were assessed according to CLIF-SOFA score, and the relationship between clinical characteristics and prognosis was analyzed...
October 20, 2018: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Y H Wang, X Zhu, D Y Feng, B Q Wu
Objective: To evaluate the effect of plasma exchange combined with high-dose continuous venovenous hemodiafiltration method (CVVHDF) in the treatment of patients with acute-on-chronic liver failure with stage III-IV hepatic encephalopathy and the feasibility of pre-operative preparation for liver transplantation. Methods: Clinical data of 14 cases of medical intensive care unit of our hospital with acute-on- chronic liver failure accompanied with stage III-IV hepatic encephalopathy that underwent plasma exchange combined with high-dose CVVHDF from March 2015 to September 2017 were retrospectively summarized...
September 20, 2018: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Jigesh A Shah, Madhukar S Patel, Nathan Louras, David H Sachs, Parsia A Vagefi
As outcomes in clinical liver transplantation steadily improve, demand continues to exceed supply, leading to a substantial disparity in organ availability. The translation of porcine liver xenotransplantation (LXT) into a clinical reality aims to address this dilemma. Our laboratory has previously established an applicable model of α-1,3-galactosyltransferase knockout (GalT-KO) pig-to-primate LXT with continuous human coagulation factor infusion and costimulation blockade. This report aims to further investigate the post-LXT lipid and amino acid metabolism profile in our longest surviving recipients (25 and 29 days)...
November 16, 2018: Xenotransplantation
Ayten Saracoglu, Kemal T Saracoglu
In this review article, we aimed to mainly review the principles for the management of hemostasis, changes that occur in the hemostatic system, and the techniques to reduce hemorrhage during liver transplantation. Hemostasis is a defense mechanism that may ensue from vascular damage and hemorrhage and consists of multiple phases which involve cellular and humoral elements of coagulation. In the presence of a cause, such as trauma-induced liver injury or hepatic failure that may trigger coagulopathy, the process becomes more problematic, and moreover, severe coagulation disorders may arise in daily practice unless the situation is intervened correctly and on time...
July 2018: Journal of Anaesthesiology, Clinical Pharmacology
Sukanya Baruah, Meenu Bajpai
Fresh frozen plasma (FFP) is widely used in liver diseases to rectify coagulation derangements. In this study we have analysed the pattern of FFP usage in liver diseases and its effect on International normalized ratio (INR). A retrospective study of liver disease patients who received FFP transfusions from January 2016 to June 2016 was done. FFP used for liver transplant surgeries and plasma exchange procedures were excluded from the study. A total of 1935 units of FFP were transfused to 576 patients. We found a high linear correlation between pre transfusion INR and change in INR per unit of FFP...
October 2018: Indian Journal of Hematology & Blood Transfusion
Fumihiro Ishida
Aggressive NK cell leukemia (ANKL) is a rare malignant lymphoproliferative disorder of mature NK cells closely associated with Epstein-Barr virus (EBV) and more common in East Asia than in other areas. Significant variations exist in the morphology of ANKL tumor cells, from typical large granular lymphocyte morphology to highly atypical features with basophilic cytoplasm containing azurophilc granules. The main involved sites are hepatosplenic lesions, bone marrow and peripheral blood, and nasal or skin lesions are infrequent...
2018: Frontiers in Pediatrics
Yusuke Sakai, Makiko Koike, Kosho Yamanouchi, Akihiko Soyama, Masaaki Hidaka, Tamotsu Kuroki, Susumu Eguchi
Subcutaneous transplantation of engineered hepatocyte/fibroblast sheets (EHFSs) is a low invasive and safe approach to construct vascularized subcutaneous human liver tissue (VSLT). However, the liver-specific structures and functionalities in the development process of VSLTs in mice remain poorly understood. Here, we describe time-dependent characteristics of the formation of the vascular network, cell-cell adhesions, liver transporters, liver-specific protein synthesis, and metabolizing activities. The EHFSs formed multilayered thick tissues by rapid neovascularization, which allows overcoming extremely difficult problems, such as the lack of oxygen supply on the formation of three-dimensional primary hepatocyte tissue under the skin...
October 23, 2018: Journal of Tissue Engineering and Regenerative Medicine
Elzbieta Kolaczkowska, Craig N Jenne
We read with interest the article by von Meijenfeldt et al.,(1) which reported on correlation between coagulation and the presence of cell-free DNA during/post liver transplantation. We agree with the authors that increased levels of cfDNA/nucleosomes most probably resulted from necrosis/damage during surgery. However, presence of complexes of DNA and myeloperoxidase (MPO) suggests formation of neutrophil extracellular traps (NETs). This article is protected by copyright. All rights reserved.
October 17, 2018: Liver Transplantation
Fien A von Meijenfeldt, Ton Lisman
We thank Kolaczkowska and Jenne for their interest in our paper on plasma levels of cell-free DNA and the association with activation of coagulation prior to and during liver transplantation. We observed elevated levels of MPO-DNA complexes in plasma of patients prior to liver transplantation, which indeed suggests formation of neutrophil extracellular traps (NETs) in patients with liver disease. However, we would like to stress that although the role of NETs in experimental animal models of liver disease has been well established, there is only scanty evidence of formation of NETs in human liver disease...
October 16, 2018: Liver Transplantation
M H Liu, F Zhou, X B Wang, L P Chen, G Z Li, Q Zhao
Objective: To investigate the incidence rate of transjugular intrahepatic portosystemic shunt (TIPS) complications in the treatment of cirrhotic portal hypertension, and analyze the cause of complication to management methods. Methods: Data of 116 patients obtained from Zhongnan Hospital of Wuhan University were retrospectively analyzed. Portal venous pressure, routine blood test, coagulation test, liver and kidney function test, ammonia blood test, imaging and endoscopy reports were collected before and after procedure...
August 20, 2018: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Yanchi Wang, Junya Zhao, Nannan Duan, Wei Liu, Yuxuan Zhang, Miaojin Zhou, Zhiqing Hu, Mai Feng, Xionghao Liu, Lingqian Wu, Zhuo Li, Desheng Liang
Hemophilia B (HB) is an X-linked recessive bleeding disorder, caused by F9 gene deficiency. Gene therapy combined with the CRISPR/Cas9 technology offers a potential cure for hemophilia B. Now the Cas9 nickase (Cas9n) shows a great advantage in reducing off-target effect compared with wild-type Cas9. In this study, we found that in the multicopy ribosomal DNA (rDNA) locus, the homology directed recombination (HDR) efficiency induced by sgRNA-Cas9n was much higher than sgRNA-Cas9, meanwhile without off-target in six predicted sites...
October 5, 2018: International Journal of Molecular Sciences
Carsten Schumacher, Hendrik Eismann, Lion Sieg, Lars Friedrich, Dirk Scheinichen, Florian W R Vondran, Kai Johanning
OBJECTIVES: Increased transfusion requirements in liver transplantation have been reported to be associated with worsened outcomes, more frequent reinterventions, and higher expenses. Anesthesiologists might counteract this through improved coagulation management. We evaluated the effects of rotational thromboelastometry on transfusion and coagulation product requirements and on outcome measurements. MATERIALS AND METHODS: Patients who were 14 years or older and who were undergoing liver transplant at Hannover Medical School between January 2005 and December 2009 were included in this retrospective analysis...
October 5, 2018: Experimental and Clinical Transplantation
Michelle Lipton, Stephen Aniskevich
Acute compartment syndrome is the physiologic consequence of increasing pressures within an enclosed anatomic space; if left untreated, it can subsequently cause irreversible necrosis, nerve injury, and tissue damage. A number of iatrogenic causes have been reported in the literature; however, to the best of our knowledge, there are no prior reports of upper extremity compartment syndrome in orthotopic liver transplant following arterial line placement. Here, we report a 52-year-old male with a history of end-stage liver disease secondary to primary sclerosing cholangitis who presented for orthotopic liver transplant...
October 5, 2018: Experimental and Clinical Transplantation
King-Wah Chiu, Ting-Lung Lin, Chee-Chien Yong, Chih-Che Lin, Yu-Fan Cheng, Chao-Long Chen
RATIONALE: According to previously published studies, major complications arising from a percutaneous liver biopsy are rare and occur in less than 0.1% of cases. This report describes an approach to percutaneous liver biopsy that can help avoid damage to the liver in a living donor liver transplantation (LDLT) setting. PATIENT CONCERNS: Case 1: In the first case a donor percutaneous liver biopsy (PLB) of both lobes of the liver was performed for pre-LDLT evaluation...
October 2018: Medicine (Baltimore)
Omar Alharthi, Vahid Etezadi
Introduction: Transjugular liver biopsy (TJLB) is a minimally invasive procedure performed to obtain hepatic tissue in patients whom standard percutaneous liver biopsy is contraindicated due to abnormal coagulation profile and/or severe ascites. Additionally, it has the advantage of simultaneously measuring the hepatic venous pressures. Case Presentation: 61-year-old male with history of pulmonary fibrosis, cholecystectomy and Hepatitis C underwent transjugular liver biopsy (TJLB) as part of his lung transplant workup...
December 2018: Radiology Case Reports
Elisabeth Kemter, Joachim Denner, Eckhard Wolf
PURPOSE OF REVIEW: Porcine islets represent a potentially attractive beta-cell source for xenotransplantation into patients with type 1 diabetes, who are not eligible to islet allo-transplantation due to a lack of suitable human donor organs. Recent progress in genetic engineering/gene editing of donor pigs provides new opportunities to overcome rejection of xeno-islets, to improve their engraftment and insulin secretion capacity, and to reduce the risk for transmission of porcine endogenous retroviruses...
September 18, 2018: Current Diabetes Reports
Yuanyuan Bai, Yang Li, Juan Liu, Peng Ju
OBJECTIVE: To evaluate the effect of iron metabolism of preoperation on the length of intensive care unit (ICU) stay in liver transplant recipients. METHODS: A retrospective study was conducted. 120 adult liver transplant recipients admitted to Tianjin First Central Hospital from September 2015 to September 2017 were enrolled. The basic data, model of end-stage liver disease (MELD) evaluation system score at admission; iron metabolism index, routine blood test, blood biochemistry, coagulation time and C-reactive protein (CRP) level within 24 hours after admission; intraoperative clinical indicators such as operation time, operation bleeding volume, red blood cells and fresh frozen plasma input volume, hot ischemia time, cold ischemia time, urine volume; and the length of ICU stay were collected...
August 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Kryssia I Rodriguez-Castro, Alessandro Vitale, Mariangela Fadin, Sarah Shalaby, Patrizia Zerbinati, Maria Teresa Sartori, Stefano Landi, Irene Pettinari, Fabio Piscaglia, Guohong Han, Patrizia Burra, Paolo Simioni, Marco Senzolo
BACKGROUND AND OBJECTIVE: Portal vein thrombosis (PVT) is a common complication in cirrhosis, and when complete, it increases morbidity and mortality in liver transplant candidates. The aim of the study was to assess the hemostatic status, as well as clinical characteristics of thrombus and patients, as predictors of therapeutic efficacy of anticoagulation for the treatment of PVT in cirrhotics. PATIENTS AND METHODS: Patients with cirrhosis consecutively treated for PVT with enoxaparin were enrolled...
September 4, 2018: European Journal of Gastroenterology & Hepatology
Fien A von Meijenfeldt, Laura C Burlage, Sarah Bos, Jelle Adelmeijer, Robert J Porte, Ton Lisman
BACKGROUND & AIMS: Patients undergoing liver transplantation have complex changes in their hemostatic system, and the net effect of these changes appears a 'rebalanced' hemostatic profile. Recently, a process called NETosis, in which a neutrophil expels DNA and proteins that form a web-like structure, has been described as a mechanism of pathogen entrapment. Increasing evidence suggests a pivotal role for neutrophil extracellular traps (NETs), and their main component cell-free DNA in activation of coagulation...
August 31, 2018: Liver Transplantation
Patrick Northup, Bethany Reutemann
Hemostasis is a complex balance of clot formation and dissolution that is largely modulated by protein synthesis and degradation in the liver. In the state of end-stage liver disease, there is a disruption of the hemostatic system due to hepatic protein synthetic dysfunction. Because historical clinical laboratory testing often only analyzes a portion of the hemostasis system, the clinician may be misled into believing that cirrhosis patients are imbalanced with a tendency toward bleeding. The modern understanding of hemostasis in cirrhosis involves a rebalance of hemostasis with a tenuous equilibrium between clotting and bleeding, but an equilibrium nonetheless...
August 2018: Liver Transplantation
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