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Living related liver transplantation

M Mikla, A Rios, A Lopez-Navas, B Gorzkowicz, D Kilanska, L Martinez-Alarcón, G Ramis, P Ramirez, M J Lopez Montesinos
BACKGROUND: Liver transplantation from living donors (LLD) has become a viable and important source of liver grafts. The objective of this study was to analyze the attitude of nursing students at the Pomeranian Medical University in Poland on donation of live liver, and to determine the factors that affect it. METHODS: Academic year 2011-2012, nursing students at a university in Poland, sampling points in 5 compulsory-attendance nursing courses with a completion rate of 80%, validated questionnaire (PCID-DVH Rios) filled out anonymously and self-administered...
September 2016: Transplantation Proceedings
R N Makroo, Soma Agrawal, Mohit Chowdhry, Brinda Kakkar, Uday K Thakur
BACKGROUND: Liver transplantation is one of the solid organs most commonly being transplanted across the world. The indications, affordability and accessibility have grown manifold. To increase the donor pool, inclusion of ABO incompatible liver donors is being considered. To enhance the graft functioning and survival, immunoadsorption apheresis to reduce the ABO hemagglutination titres are on the rise. CASE REPORT: We report three cases ABO incompatible liver transplantation with immunoadsorption protocol...
September 28, 2016: Transfusion and Apheresis Science
Min-Ho Shin, Deok-Bog Moon, Sung-Gyu Lee, Shin Hwang, Ki-Hun Kim, Chul-Soo Ahn, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung, Gil-Chun Park, Young-In Yun, Wan-Jun Kim, Woo-Hyoung Kang, Seok-Hwan Kim, Gi-Young Ko
BACKGROUND: Although perioperative portal vein (PV) stent implantation is an effective treatment for steno-occlusive disease in adult living donor liver transplantation (LDLT) recipients, we experienced high incidence of biliary anastomotic strictures (BAS) after PV stenting. In this study, we sought to clarify the relation between BAS and PV stenting and to suggest the possible mechanism of BAS and measures to reduce its incidence. METHODS: We retrospectively analyzed 44 LDLT recipients who underwent PV stent implantation across the line of PV anastomosis regardless of the location of steno-occlusion (stent group) and their matched controls (non-stented LDLT recipients, n=131)...
October 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Hae Won Lee, Kyung-Suk Suh
There has been ongoing debate that the Milan criteria may be too strict that a significant number of patients who could benefit from liver transplantation (LT) might have been excluded. Based on this idea, various studies have been conducted to further expand the Milan criteria and give more HCC patients a chance of cure. In deceased donor LT (DDLT) setting, expansion of the criteria is relatively tempered because the results of LT for HCC should be comparable to those of patients with non-malignant indications...
September 2016: Clinical and Molecular Hepatology
Giovanni Battista Levi Sandri, Edoardo De Werra, Gianluca Mascianà, Francesco Guerra, Gabriele Spoletini, Quirino Lai
Minimally invasive surgical approaches in transplantation are gaining increasing interest, and many centers are reporting their, mainly laparoscopic, experiences. Robotic surgery (RS) has some hypothetical advantages over traditional laparoscopy, and has been successfully applied, although infrequently to organ transplantation. Our goal was to review and critique the publications reporting RS use in organ transplantation. Most of the RS experience has been with living renal donor organ procurement and, to a lesser extent, with RS procedures in the transplant recipient...
October 11, 2016: Clinical Transplantation
Yinzhe Xu, Jiye Chen, Hongguang Wang, Hui Zheng, Dan Feng, Aiqun Zhang, Jianjun Leng, Weidong Duan, Zhanyu Yang, Mingyi Chen, Xianjie Shi, Shouwang Cai, Wenbin Ji, Kai Jiang, Wenzhi Zhang, Yongliang Chen, Wanqing Gu, Jiahong Dong, Shichun Lu
BACKGROUND: The high prevalence of hepatitis B virus (HBV) imposes a huge burden of hepatocellular carcinoma (HCC) in Asia. Surgical resection remains an important therapeutic strategy for HCC. Hepatic inflow occlusion, known as the Pringle maneuver, is the most commonly used method of reducing blood loss during liver parenchymal transection. A major issue with this maneuver is ischemia-reperfusion injury to the remnant liver, and the hemodynamic disturbance it induces in the tumor-bearing liver raises an oncological concern...
October 11, 2016: Trials
Reina Sasaki, Tatsuo Kanda, Masayuki Ohtsuka, Shin Yasui, Yuki Haga, Masato Nakamura, Masayuki Yokoyama, Shuang Wu, Shingo Nakamoto, Makoto Arai, Hitoshi Maruyama, Masaru Miyazaki, Osamu Yokosuka
Direct-acting antivirals (DAAs) are relatively safe and highly effective for the eradication of hepatitis C virus (HCV) in liver transplant recipients. In this case study, we present a female with a graft reinfected with HCV genotype 2 who was treated with a combination of sofosbuvir and ribavirin after living donor liver transplantation (LDLT). Because the graft was from a hepatitis B core antibody-positive donor, passive immunization with hyperimmune hepatitis B immunoglobulin (HBIG) and entecavir were also provided to prevent hepatitis B virus (HBV) reactivation...
May 2016: Case Reports in Gastroenterology
Pierluigi Toniutto, Alberto Zanetto, Alberto Ferrarese, Patrizia Burra
Liver transplantation is an effective and widely used therapy for several patients with acute and chronic liver diseases. The discrepancy between the number of patients on the waiting list and available donors remains the key issue and is responsible for the high rate of waiting list mortality. The recent news is that the majority of patients with hepatitis C virus related liver disease will be cured by new antivirals therefore we should expect soon a reduction in the need of liver transplantation for these recipients...
September 16, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
Fang Lu, Fa Wu, Peijun Hu, Zhiyi Peng, Dexing Kong
PURPOSE: Segmentation of the liver from abdominal computed tomography (CT) images is an essential step in some computer-assisted clinical interventions, such as surgery planning for living donor liver transplant, radiotherapy and volume measurement. In this work, we develop a deep learning algorithm with graph cut refinement to automatically segment the liver in CT scans. METHODS: The proposed method consists of two main steps: (i) simultaneously liver detection and probabilistic segmentation using 3D convolutional neural network; (ii) accuracy refinement of the initial segmentation with graph cut and the previously learned probability map...
September 7, 2016: International Journal of Computer Assisted Radiology and Surgery
Arianeb Mehrabi, Katrin Hoffmann, Karl Heinz Weiss, Carolin Mogler, Peter Schemmer, Markus W Büchler, Ingo Alldinger
BACKGROUND: Primary Hepatic Epithelioid Hemangioendothelioma is an extremely rare tumor of vascular origin. PATIENTS: In this work we present clinical data and long term results of eight patients who were surgically treated in our institution. Liver transplantation was performed in five patients (four cadaveric and one living related) and major liver resection in three patients. Three patients are alive with recurrent tumor. After a median follow-up of 100 months (48-266) all patients are alive...
November 2016: Annals of Medicine and Surgery
Min Suk Chae, Jung Min Koo, Chul Soo Park
BACKGROUND Early allograft dysfunction (EAD) is considered an important complication in liver transplantation. Serum brain natriuretic peptide (BNP) is a marker of cardiac dysfunction related to end-stage liver disease. We investigated the intraoperative change in the serum BNP level and its contribution to EAD after living donor liver transplantation (LDLT). MATERIAL AND METHODS The perioperative data of 104 patients who underwent LDLT were retrospectively reviewed and compared between patients with and without EAD...
2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Jun Bae Bang, Bong-Wan Kim, Young Bae Kim, Hee-Jung Wang, Hyun Yeong Lee, Joohyun Sim, Taegyu Kim, Kyeong Lok Lee, Xu-Guang Hu, Wei Mao
AIM: To evaluate the risk factors for ischemic-type biliary lesion (ITBL) after ABO-incompatible (ABO-I) adult living donor liver transplantation (ALDLT). METHODS: Among 141 ALDLTs performed in our hospital between 2008 and 2014, 27 (19%) were ABO-I ALDLT and 114 were ABO-identical/compatible ALDLT. In this study, we extensively analyzed the clinico-pathological data of the 27 ABO-I recipients to determine the risk factors for ITBL after ABO-I ALDLT. All ABO-I ALDLT recipients underwent an identical B-cell depletion protocol with preoperative rituximab, plasma exchange (PE), and operative splenectomy...
August 14, 2016: World Journal of Gastroenterology: WJG
K Takeda, Y Sawada, T Kumamoto, K Tanaka, I Endo
BACKGROUND: The post-operative mortality and morbidity rates associated with living-donor liver transplantation (LDLT) are still relatively high. Several papers have reported the risk factors associated with post-operative infectious complications, but few have analyzed the risk factors with respect to the severity of sepsis. The aim of this study was to clarify the risk factors that affect severe sepsis after LDLT. METHODS: For 63 LDLT patients at our institute, we compared peri-operative characteristics in 29 patients who developed sepsis after surgery and 34 patients who did not...
July 2016: Transplantation Proceedings
M J Jeong, S Hwang, G W Song, D H Jung, T Y Ha, G C Park, A A Alshahrani, V A Kirchner, T Beduschi, S G Lee
BACKGROUND: To date, no significant similarities in the anatomy of the hepatic vasculature have been observed between blood-related individuals. However, we have frequently encountered anatomic similarities between parents and their children; thus, we performed an analysis of the genetic traits in the anatomy of the liver. METHODS: The study cohort was 330 adult cases of living-donor liver transplantation (LDLT), in which the donor-recipient relationship was child to parent...
July 2016: Transplantation Proceedings
H Maekawa, M Yazawa, K Koitabashi, N Imai, H Kawarazaki, R Nakazawa, H Sasaki, T Chikaraishi, Y Shibagaki
BACKGROUND: Hepatitis B virus (HBV) infection is a risk factor of mortality in kidney transplant recipients. However, information on the risk of HBV reactivation in kidney recipients with prior resolved HBV infection is limited. This study aimed to evaluate the safety of simply monitoring viral and liver markers in living donor kidney transplantation (LDKT) recipients with prior resolved HBV infection. METHODS: We retrospectively examined the clinical records of LDKT recipients...
July 2016: Transplantation Proceedings
Josh Levitsky, David Goldberg, Abigail R Smith, Sarah A Mansfield, Brenda W Gillespie, Robert M Merion, Anna S F Lok, Gary Levy, Laura Kulik, Michael Abecassis, Abraham Shaked
BACKGROUND & AIMS: Acute rejection is detrimental to most transplanted solid organs, but is considered to be less of a consequence for transplanted livers. We evaluated risk factors for and outcomes after biopsy-proven acute rejection (BPAR) based on an analysis of a large national sample of recipients of liver transplants from living and deceased donors. METHODS: We analyzed data from the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL) from 2003 through 2014 as the exploratory cohort and the Scientific Registry of Transplant Recipients (SRTR) from 2005 through 2013 as the validation cohort...
August 24, 2016: Clinical Gastroenterology and Hepatology
Erkan Parlak, Aydın Seref Koksal, Fahrettin Kucukay, Ahmet Tarık Eminler, Bilal Toka, Mustafa Ihsan Uslan
BACKGROUND AND AIMS: Magnetic compression anastomosis is a rescue technique for recanalization of complete biliary strictures. Here, we present magnetic compression anastomosis with novel through-the-scope magnets in patients with complete duct-to-duct anastomosis obstruction after liver transplantation. METHODS: The magnets were 2 and 2.4 mm in diameter, with a hole at the center for inserting a guidewire. One of the magnets was advanced through the scope up to the distal site of the stricture by using a 7F pusher...
August 24, 2016: Gastrointestinal Endoscopy
Yu Kanzaki, Eiji Kondoh, Kaoru Kawasaki, Haruta Mogami, Yoshitsugu Chigusa, Ikuo Konishi
AIM: There are an increasing number of reports of pregnancy following liver transplantation, but many questions remain regarding preconception counseling and management of the pregnancy. The aim of this study was to report pregnancy outcomes in women who had undergone liver transplants and to gain insight into these issues. METHODS: We conducted a retrospective review of liver transplant recipients who had received prenatal care at Kyoto University Hospital between January 2001 and December 2015...
August 24, 2016: Journal of Obstetrics and Gynaecology Research
Hillary J Braun, Nancy L Ascher, Garrett R Roll, John P Roberts
BACKGROUND: Living donor liver transplantation (LDLT) has become increasingly common in an effort to increase organ availability for the treatment of end-stage liver disease. Donor safety is a primary concern in LDLT. The majority of complications experienced by living donors are infectious or biliary in nature. The purpose of this paper was to review the existing literature on biliary complications in living donors. METHODS: Studies were eligible for inclusion if they were published in English between 2006-present, focused on adult-to-adult LDLT, and were available via PubMed/MEDLINE...
October 2016: Transplantation Reviews
Mahmoud Abdelwahab Ali, Mohamed Morsi Elshobari, Tarek Salah, Al-Refaey Kandeel, Ahmad Mohammad Sultan, Ahmad Nabieh Elghawalby, Ahmed Shehta, Usama Elsayed, Omar Fathy, Amr Yassen, Mohamed Abdel Wahab
Introduction Living donor liver transplantation (LDLT) is a valuable option for expanding donor pool, especially in localities where deceased organ harvesting is not allowed. In addition, rejection rates were found to be lower in LDLT, which is attributed to the fact that LDLT is usually performed between relatives. However, the impact of genetic relation on the outcome of LDLT hasn't been studied. In this study, we examined the difference in rejection rates between LDLT from genetically related (GR) donors and genetically unrelated (GUR) donors...
August 12, 2016: Liver Transplantation
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