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Living Donor Liver

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https://www.readbyqxmd.com/read/28239914/-d-10-meld-as-a-novel-predictor-of-patient-and-graft-survival-after-adult-to-adult-living-donor-liver-transplantation
#1
Arvinder Singh Soin, Sanjay Goja, Sanjay Kumar Yadav, Tseten Yonjen Tamang, Amit Rastogi, Prashant Bhangui, S Thiagrajan, Vikram Raut, Raghvendra Y Babu, Neeraj Saraf, Narendra Singh Chaudhary, Vijay Vohara
We modified the previously described DMELD score in deceased donor liver transplant, to (D+10)MELD to account for living donors being about 10 years younger than deceased donors, and tested it on living donor liver transplantation (LDLT) recipients. 500 consecutive LDLT, between July 2010 and December 2012 were retrospectively analyzed to see the effect of (D+10)MELD on patient and graft survival. Donor age alone did not influence survival. Recipients were divided into 6 classes on based on the (D+10)MELD score: Class 1 (0-399), Class 2 (400-799), Class 3 (800-1199), class 4 (1200-1599), Class 5 (1600-1999) and Class 6 (>2000)...
February 26, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28238015/syndrome-of-inappropriate-antidiuretic-hormone-secretion-following-liver-transplantation
#2
Kosei Takagi, Takahito Yagi, Susumu Shinoura, Yuzo Umeda, Ryuichi Yoshida, Daisuke Nobuoka, Nobuyuki Watanabe, Takashi Kuise, Tomokazu Fuji, Hiroyuki Araki, Toshiyoshi Fujiwara
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is an extremely rare cause of hyponatremia post-liver transplantation. A 15-year-old Japanese girl with recurrent cholangitis after Kasai surgery for biliary atresia underwent successful living donor liver transplantation. Peritonitis due to gastrointestinal perforation occurred. Hyponatremia gradually developed but improved after hypertonic sodium treatment. One month later, severe hyponatremia rapidly recurred. We considered the hyponatremia's cause as SIADH...
February 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/28235493/ultrasound-guided-transversus-abdominis-plane-block-for-postoperative-analgesia-in-living-liver-donors-a-prospective-randomized-double-blinded-clinical-trial
#3
Arzu Kıtlık, Mehmet Ali Erdogan, Ulku Ozgul, Mustafa Said Aydogan, Muharrem Ucar, Huseyin Ilksen Toprak, Cemil Colak, Mahmut Durmus
BACKGROUND: Transversus abdominis plane (TAP) block is a peripheral nerve block that reduces postoperative pain, nausea, vomiting and the need for postoperative opioids following various types of abdominal surgery. The primary aim of the present study was to evaluate the effects of TAP block on postoperative analgesia and opioid consumption in living liver donors in whom a right "J" abdominal incision was used. METHODS: This prospective, double-blinded, randomized controlled study was conducted with 50 living liver donors, aged 18-65years, who were scheduled to undergo right hepatectomy...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28224470/three-patients-treated-with-sofosbuvir-plus-ledipasvir-for-recurrent-hepatitis-c-after-liver-transplantation
#4
Tomokazu Kawaoka, Michio Imamura, Kei Morio, Yuki Nakamura, Masataka Tsuge, Clair Nelson Hayes, Yoshiiku Kawakami, Hiroshi Aikata, Hidenori Ochi, Kouhei Ishiyama, Hideki Ohdan, Kazuaki Chayama
We previously reported results of interferon (IFN)-free daclatasvir and asunaprevir for the treatment of recurrent hepatitis C virus (HCV) genotype 1 infection after liver transplantation (LT). Here we report three patients who achieved viral response with no effect on the blood concentrations of immunosuppressive agents following sofosbuvir plus ledipasvir treatment. The first patient was a 68-year-old female with HCV-related liver cirrhosis who failed to respond to pegylated-IFN and ribavirin (PEG-IFN/RBV) after living donor LT...
February 21, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28220684/living-donor-liver-transplantation-during-the-first-three-months-of-life
#5
Mureo Kasahara, Seisuke Sakamoto, Kengo Sasaki, Hajime Uchida, Toshihiro Kitajima, Takanobu Shigeta, Soichi Narumoto, Yoshihiro Hirata, Akinari Fukuda
BACKGROUND: Living donor liver transplantation is now an established technique for treating children with end-stage liver disease. Few data exist about liver transplantation for exclusively young infants, especially infants of <3 months of age. We report our single-center experience with 12 cases in which living donor liver transplantation (LT) was performed during the first 3 months of life and compare the results with those of older infants who underwent LT. All of the patients were treated at the National Center of Child Health and Development, Tokyo, Japan...
February 21, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28220036/proposal-for-a-new-predictive-model-of-short-term-mortality-after-living-donor-liver-transplantation-due-to-acute-liver-failure
#6
COMPARATIVE STUDY
Hyun Sik Chung, Yu Jung Lee, Yun Sung Jo
BACKGROUND Acute liver failure (ALF) is known to be a rapidly progressive and fatal disease. Various models which could help to estimate the post-transplant outcome for ALF have been developed; however, none of them have been proved to be the definitive predictive model of accuracy. We suggest a new predictive model, and investigated which model has the highest predictive accuracy for the short-term outcome in patients who underwent living donor liver transplantation (LDLT) due to ALF. MATERIAL AND METHODS Data from a total 88 patients were collected retrospectively...
February 21, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28219590/continuous-paravertebral-infusions-as-an-effective-adjunct-for-postoperative-pain-management-in-living-liver-donors-a-retrospective-observational-study
#7
K Mistry, J Hutchins, J Leiting, K Mangalick, T Pruett, S Chinnakotla
We analyzed the effectiveness of paravertebral-block for immediate postoperative pain control in living liver donors. Specifically, we sought to determine whether or not the addition of paravertebral catheters with continuous ropivacaine infusion would decrease postoperative opioid use and reduce the incidence of adverse effects and complications. We reviewed the records of 26 patients who underwent right-lobe living donor hepatectomy (RLDH): 16 with and 10 without such catheters. The primary outcome was opioid use on postoperative day (POD) 1 through 3...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28219589/estimation-of-right-lobe-graft-weight-from-computed-tomographic-volumetry-for-living-donor-liver-transplantation
#8
X Yang, C W Chu, J D Yang, K H Yang, H C Yu, B H Cho, H You
BACKGROUND: The objective of the study was to establish a right-lobe graft weight (GW) estimation formula for living donor liver transplantation (LDLT) from right-lobe graft volume without veins (GVw/o_veins), including portal vein and hepatic vein measured by computed tomographic (CT) volumetry, and to compare its estimation accuracy with those of existing formulas. Right-lobe GW estimation formulas established with the use of graft volume with veins (GVw_veins) sacrifice accuracy because GW measured intra-operatively excludes the weight of blood in the veins...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28218989/liver-transplantation-from-donors-with-positive-blood-cultures-increased-risk-of-graft-failure-or-opportunity-to-expand-the-donor-pool
#9
Paolo Antonio Grossi
Organ transplantation is considered the therapy of choice for end-stage organ failure. However, the growing gap between the number of patients waiting for transplantation and available organs continue to be the number one issue facing the transplant community. As a consequence the major focus in liver transplantation has been developing strategies to increase available donors, including the use of live donor liver segments, splitting deceased donor grafts for two patients and the use of organs procured from donors after circulatory death (DCD)...
February 20, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28216198/relationship-between-intraoperative-hypotension-and-acute-kidney-injury-after-living-donor-liver-transplantation-a-retrospective-analysis
#10
Toshiyuki Mizota, Miho Hamada, Shino Matsukawa, Hideya Seo, Tomoharu Tanaka, Hajime Segawa
OBJECTIVE: Acute kidney injury (AKI) is common after liver transplantation (LT) and has a significant impact on outcomes. Although several risk factors for post-LT AKI have been identified, the effect of intraoperative hemodynamic status on post-LT AKI remains unknown. Therefore, the authors aimed to investigate the relationship between hemodynamic parameters during LT and postoperative AKI. DESIGN: A retrospective observational study. SETTING: University hospital...
December 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28213931/successful-resumption-of-peritoneal-dialysis-following-living-donor-liver-transplantation-in-children-with-end-stage-renal-disease
#11
Hiroyuki Kanazawa, Akinari Fukuda, Mai Sato, Shingo Ishimori, Kengo Sasaki, Hajime Uchida, Takanobu Shigeta, Vidyadhar Padmakar Mali, Seisuke Sakamoto, Kenji Ishikura, Mureo Kasahara
Children with ESRD in need of RRT are commonly managed by PD due to difficulty with vascular access for HD and the relatively large extracorporeal blood volume required. Major abdominal surgery may result in injury to the peritoneum and consequent adhesion, thereby resulting in a reduction in the anatomical capacity and transport capability across the peritoneal membrane. Here, we report successful resumption of PD after LDLT in two pediatric patients. The causes of ESRD were PH1 and juvenile nephronophthisis, respectively...
February 18, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28207759/investigations-on-therapeutic-glucocerebrosidases-through-paired-detection-with-fluorescent-activity-based-probes
#12
Wouter W Kallemeijn, Saskia Scheij, Sascha Hoogendoorn, Martin D Witte, Daniela Herrera Moro Chao, Cindy P A A van Roomen, Roelof Ottenhoff, Herman S Overkleeft, Rolf G Boot, Johannes M F G Aerts
Deficiency of glucocerebrosidase (GBA) causes Gaucher disease (GD). In the common non-neuronopathic GD type I variant, glucosylceramide accumulates primarily in the lysosomes of visceral macrophages. Supplementing storage cells with lacking enzyme is accomplished via chronic intravenous administration of recombinant GBA containing mannose-terminated N-linked glycans, mediating the selective uptake by macrophages expressing mannose-binding lectin(s). Two recombinant GBA preparations with distinct N-linked glycans are registered in Europe for treatment of type I GD: imiglucerase (Genzyme), contains predominantly Man(3) glycans, and velaglucerase (Shire PLC) Man(9) glycans...
2017: PloS One
https://www.readbyqxmd.com/read/28207553/laparoscopic-living-donor-right-hemihepatectomy-with-venous-outflow-reconstruction-using-cadaveric-common-iliac-artery-allograft-case-report-and-literature-review
#13
Jiaxin Li, Jiwei Huang, Hong Wu, Yong Zeng
RATIONALE: With the development of laparoscopic technique, the total laparoscopic living donor right hemihepatectomy (LLDRH) procurement surgery has been successfully performed in many liver transplant centers all over the world, and the number of cases is continuing to increase. We report our case of laparoscopic right graft resection with venous outflow reconstruction using cadaveric common iliac artery allograft in our center and review literatures about total LLDRH surgery. PATIENT CONCERNS AND DIAGNOSES: A 40-year-old male living donor for right hepatectomy was selected after pretransplant evaluation including laboratory tests, liver volume, anatomy of hepatic vein, artery, portal vein, and bile duct...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28205018/the-donor-advocacy-team-a-risk-management-program-for-living-organ-tissue-and-cell-transplant-donors
#14
Susumu Eguchi, Akihiko Soyama, Kazuhiro Nagai, Yasushi Miyazaki, Shintaro Kurihara, Masaaki Hidaka, Shinichiro Ono, Tomohiko Adachi, Koji Natsuda, Takanobu Hara, Fumihiko Fujita, Kengo Kanetaka, Mistuhisa Takatsuki
BACKGROUND AND PURPOSE: Although the incidence of living donor death is low in Japan, statistics show one living liver donor death in more than 7000 living liver transplants. Thus, medical transplant personnel must recognize that the death of a living organ or tissue transplant donor can occur and develop an appropriate risk management program. METHODS AND RESULTS: We describe how Nagasaki University Hospital established and implemented a Donor Advocacy Team (DAT) program: a risk management program for initiation in the event of serious, persistent, or fatal impairment of an organ, tissue, or cell transplantation from a living donor...
February 15, 2017: Surgery Today
https://www.readbyqxmd.com/read/28199752/effect-of-transversus-abdominis-plane-block-in-combination-with-general-anesthesia-on-perioperative-opioid-consumption-hemodynamics-and-recovery-in-living-liver-donors-the-prospective-double-blinded-randomized-study
#15
Mehmet Ali Erdogan, Ulku Ozgul, Muharrem Uçar, Rıdvan Yalin, Yusuf Ziya Colak, Cemil Çolak, Huseyin Ilksen Toprak
BACKGROUND: Transversus abdominis plane (TAP) block provides effective postoperative analgesia after abdominal surgeries. It can be also a useful strategy to reduce perioperative opioid consumption, support intraoperative hemodynamic stability and promote early recovery from anesthesia. The aim of this prospective randomized double-blind study was to assess the effect of subcostal TAP blocks on perioperative opioid consumption, hemodynamic and recovery time in living liver donors. METODS: The prospective, double-blinded, randomized controlled study was conducted with 49 living liver donors, aged 18-65 years, who were scheduled to undergo right hepatectomy...
February 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28196987/living-donor-liver-transplantation-eliminating-the-wait-for-death-in-end-stage-liver-disease
#16
REVIEW
Robert A Fisher
Adult-to-adult living donor liver transplantation (A2ALDLT), outside of Asia, remains an important yet underutilized gift of life. For patients with end-stage liver disease, A2ALDLT is a proven transplantation option, with lower waiting list mortality and suffering, and equivalent or better allograft and patient survival than deceased-donor liver transplantation (DDLT). The risks to living donors and the benefit to their recipients have been carefully defined with long-term level 1 and 2 evidence-based study...
February 15, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28193994/predictive-role-of-intraoperative-plasma-fibrinogen-for-postoperative-portal-venous-flow-in-living-donor-liver-transplantation
#17
Min Suk Chae, Chul Soo Park, Su A Oh, Sang Hyun Hong
BACKGROUND Previous studies have reported poor graft regeneration after living donor liver transplantation (LDLT) due to inappropriate portal venous flow (PVF). In this study, we investigated the perioperative factors affecting postoperative PVF after LDLT. MATERIAL AND METHODS The perioperative data of 366 LDLT patients were retrospectively reviewed. The average PVF on postoperative days 1, 3, and 5 was measured and dichotomized at a cut-off value for patient survival of 1,477 mL/min. Perioperative variables, including coagulation profiles, were compared between high and low postoperative PVF groups...
February 14, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28191866/laparoscopic-liver-resection-a-review-of-current-status
#18
Yihe Yan, Xiaoyong Cai, David A Geller
BACKGROUND: Laparoscopic liver resection (LLR) has been increasing since it was first reported in 1991. Two international expert consensus conferences on LLR surgery were held in Louisville, KY, USA, in 2008 and in Morioka, Japan, in 2014, respectively. While most initial minimally invasive liver resections were typically done for benign lesions in anterior or left lateral segments, LLR is currently being applied for major anatomic resections, malignancy, cirrhosis, and live donor hepatectomy...
February 13, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28185429/tips-for-pure-laparoscopic-right-hepatectomy-in-the-live-donor
#19
Olivier Soubrane, Choon Hyuck David Kwon
Donor right hepatectomy is a technically complex and challenging procedure. It is one of the most debated applications of laparoscopy and donor safety is the main concern. The technique described herein uses pure laparoscopic approach with five trocars. After mobilization of the right liver, the right hepatic artery and portal vein are dissected. The liver parenchyma is then divided using an ultrasonic aspirator and an energy device. The middle hepatic vein is kept intact with the left remaining liver. Intra-operative cholangiography allows to determine a safe site for right bile duct division...
February 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28181820/preoperative-volume-rather-than-area-of-skeletal-muscle-is-a-better-predictor-for-postoperative-risks-for-respiratory-complications-in-living-donor-liver-transplantation
#20
Yuki Wada, Tamotsu Kamishima, Tsuyoshi Shimamura, Norio Kawamura, Kenichiro Yamashita, Kenneth Sutherland, Hiroshi Takeda
OBJECTIVES: To demonstrate the superiority of total psoas volume (TPV) over total psoas area (TPA) in terms of predicting postoperative complications in living-donor liver transplantation (LDLT). METHODS: TPA and TPV were assessed in 32 recipients who underwent computed tomography (CT) before LDLT. TPA was measured using an axial CT image at the level of the upper margin of the 4th lumbar vertebral body. TPV was calculated using all the CT images from the muscle origin through the level of pubic symphysis...
February 9, 2017: British Journal of Radiology
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