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Living related liver transplantation

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https://www.readbyqxmd.com/read/28433231/liver-transplantation-for-acute-liver-failure
#1
Amelia J Hessheimer, Lucas Nacif, Eduardo Flores Villalba, Constantino Fondevila
Before liver transplantation became widely applicable as a treatment option, the mortality rate for acute liver failure was as high as 85%. Today, acute liver failure is a relatively common transplant indication in some settings, but the results of liver transplantation in this context appear to be worse than those for chronic forms of liver disease. In this review, we discuss the indications and contraindications for urgent liver transplantation. In particular, we consider the roles of auxiliary, ABO-incompatible, and urgent living donor liver transplantation and address the management of a «status 1» patient with total hepatectomy and portocaval shunt for toxic liver syndrome...
April 19, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28431203/donor-safety-in-living-donor-liver-transplantation-the-korean-organ-transplantation-registry-kotry-study
#2
Jae Geun Lee, Kwang-Woong Lee, Choon Hyuck David Kwon, Chong Woo Chu, Bong-Wan Kim, Dong Lak Choi, Young Kyoung You, Dong-Sik Kim, Yang Won Nah, Koo Jeong Kang, In Soek Choi, Hee Chul Yu, Geun Hong, Ho-Seong Han, Shin Hwang, Myoung Soo Kim
Major concerns about donor safety cause controversy and limit the use of living donor liver transplantation to overcome organ shortages. The Korean Organ Transplantation Registry established a nationwide organ transplantation registration system in 2014. We reviewed the prospectively collected data of all 832 live liver donors who underwent procedures between April 2014 and December 2015. We allocated the donors to a left lobe group (n=59) and a right lobe group (n=773) and analyzed the relations between graft types and remaining liver volumes and complications (graded using the Clavien five-tier grading system)...
April 21, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28427741/management-of-biliary-anastomotic-strictures-after-liver-transplantation
#3
REVIEW
Aydin Seref Koksal, Ahmet Tarik Eminler, Erkan Parlak, Ahmet Gurakar
Biliary strictures constitute 40% to 60% of the biliary complications after liver transplantation. They are more common after living donor related liver transplantation (LDLT) than orthotopic liver transplantation (OLT). Balloon dilation followed by multiple plastic stent insertion leads to a mean resolution rate of 84% in the treatment of ASs after OLT. Endoscopic treatment of ASs after LDLT is more difficult because of the small size of the ASs, their multiple number and peripheral location. Balloon dilation followed by multiple plastic stent insertion had a mean resolution rate of 53%...
March 30, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28422392/hepatic-artery-reconstruction-in-living-donor-liver-transplantation-using-surgical-loupes-achieving-low-rate-of-hepatic-arterial-thrombosis-in-consecutive-741-recipients-tips-and-tricks-to-overcome-the-poor-hepatic-arterial-flow
#4
Ping-Chun Li, Ashok Thorat, Long-Bin Jeng, Horng-Ren Yang, Ming-Li Li, Chun-Chieh Yeh, Te-Hung Chen, Shih-Chao Hsu, Kin-Shing Poon
BACKGROUND: The reconstruction of hepatic artery (HA) is most complex step in living donor liver transplantation (LDLT) due to smaller diameter of the artery and increased risk of HA related complications. Due to smaller diameter of the HA, many centres use microsurgical technique with interrupted sutures for arterial anastomosis. Aim of our study was to retrospectively investigate the outcomes after HA reconstruction performed under magnifying loupes using "parachute technique". MATERIALS AND METHODS: From August 2002 to 31(st) August 2016, LDLT was performed in 766 recipients...
April 19, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28415168/an-update-on-endoscopic-management-of-post-liver-transplant-biliary-complications
#5
Hyun Woo Lee, Najmul Hassan Shah, Sung Koo Lee
Biliary complications are the most common post-liver transplant (LT) complications with an incidence of 15%-45%. Furthermore, such complications are reported more frequently in patients who undergo a living-donor LT (LDLT) compared to a deceased-donor LT (DDLT). Most post-LT biliary complications involve biliary strictures, bile leakage, and biliary stones, although many rarer events, such as hemobilia and foreign bodies, contribute to a long list of related conditions. Endoscopic treatment of post-LT biliary complications has evolved rapidly, with new and effective tools improving both outcomes and success rates; in fact, the latter now consistently reach up to 80%...
April 17, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28413066/temporary-portal-vein-embolization-is%C3%A2-as%C3%A2-efficient-as-permanent-portal-vein%C3%A2-embolization-in-mice
#6
Andrea Wirsching, Emmanuel Melloul, Ksenia Lezhnina, Anton A Buzdin, Omolara O Ogunshola, Pieter Borger, Pierre-Alain Clavien, Mickaël Lesurtel
BACKGROUND: Temporary portal vein embolization may be a safe alternative to permanent portal vein embolization. Such a new approach could be applied in living-related liver transplantation to increase graft volume before procurement. The impact of temporary portal vein embolization on occluded liver after recanalization, however, has never been assessed. Using a mouse model of temporary portal vein embolization, we investigated (1) the efficiency of temporary portal vein embolization in inducing nonoccluded liver hypertrophy and (2) the regeneration potential and functional recovery of embolized liver after recanalization...
April 13, 2017: Surgery
https://www.readbyqxmd.com/read/28411347/pure-3d-laparoscopic-living-donor-right-hemihepatectomy-in-a-donor-with-separate-right-posterior-and-right-anterior-hepatic-ducts-and-portal-veins
#7
Suk Kyun Hong, Kyung-Suk Suh, Hyo-Sin Kim, Kyung Chul Yoon, Sung-Woo Ahn, Dongkyu Oh, Hyeyoung Kim, Nam-Joon Yi, Kwang-Woong Lee
BACKGROUND: Despite increases in the performance of pure laparoscopic living donor hepatectomy, variations in the bile duct or portal vein have been regarded as relative contraindications to this technique [1-3]. This report describes a donor with separate right posterior and right anterior hepatic ducts and portal veins who underwent pure laparoscopic living donor right hemihepatectomy, integrated with 3D laparoscopy and indocyanine green (ICG) near-infrared fluorescence cholangiography [1, 4, 5]...
April 14, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28405602/cognitive-evaluation-in-liver-transplant-patients-under-calcineurin-inhibitor-maintenance-therapy
#8
Nils Heits, Dalibor Keserovic, Niclas Mund, Nicola Ehmke, Alexander Bernsmeier, Alexander Hendricks, Rainer Gunther, Karsten Witt, Thomas Becker, Felix Braun
BACKGROUND: Neurological disorders due to calcineurin inhibitor (CNI) treatment pose a well-known problem after liver transplantation (LTx). In this study, the impact of CNIs on cognitive functioning during maintenance therapy was analyzed. A possible improvement of cognitive functioning, compliance and health-related quality of life (HRQoL) after conversion to a once-daily tacrolimus formulation was prospectively assessed. METHODS: In a cross-section analysis cognitive functioning of living donors (LD), waiting list patients and LTx patients was tested using a 4 times trail making test (4-TTMT)...
April 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28403531/short-term-effects-of-extracorporeal-graft-rinse-versus-circulatory-graft-rinse-in-living-donor-liver-transplantation-a-prospective-randomized-controlled-trial
#9
Amr M Yassen, Waleed R Elsarraf, Mohamed A Elmorshedi, Mohamed Abdel Wahab, Tarek Salah, Ahmed M Sultan, Ahmed N Elghawalby, Mohamed M Elshobari, Mohamed Elsadany, Khaled Zalata, Usama Shiha
BACKGROUND: Living donor liver transplantation has shorter cold ischemia time, less preservative volume and lower metabolic load compared to transplantation from deceased donors. We investigated the impact of rinsing the graft contents into the systemic circulation on operative course and post-operative outcomes. PATIENTS AND METHODS: Donors had right hepatectomy and grafts were preserved with cold Histidine-Tryptophan-Ketoglutarate solution. On ending portal vein anastomosis, grafts were flushed by patient's portal blood; either through incompletely anastomosed hepatic vein (Extracorporeal Rinse group, EcRg, n=40) or into systemic circulation (Circulatory Rinse group, CRg, n=40)...
April 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28381305/fair-is-fair-we-must-re-allocate-livers-for-transplant
#10
Brendan Parent, Arthur L Caplan
The 11 original regions for organ allocation in the United States were determined by proximity between hospitals that provided deceased donors and transplant programs. As liver transplants became more successful and demand rose, livers became a scarce resource. A national system has been implemented to prioritize liver allocation according to disease severity, but the system still operates within the original procurement regions, some of which have significantly more deceased donor livers. Although each region prioritizes its sickest patients to be liver transplant recipients, the sickest in less liver-scarce regions get transplants much sooner and are at far lower risk of death than the sickest in more liver-scarce regions...
April 5, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28340842/surgical-treatment-of-portal-vein-thrombosis-with-the-use-of-cadaveric-venous-patch-after-donor-hepatectomy-a-case-report
#11
F Ozdemir, V Ersan, A Baskiran, V Ince, S Karakaş, A S Kahraman, S Yilmaz
Live donors should be the priority of transplant professionals to prevent surgery-related morbidity and mortality during living-donor liver transplantation. Portal vein thrombosis after donor hepatectomy is an important complication which can be prevented by careful preoperative as well as perioperative evaluation. If portal vein thrombus occurs after donor hepatectomy, anticoagulation and surgical thrombectomy and even portal vein reconstruction should be kept in mind. Cadaveric venous patches can be used for the reconstruction of narrowed and angulated portal veins...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340800/long-term-results-of-living-donors-in-simultaneous-kidney-and-liver-transplantations
#12
T Unek, T Egeli, M Özbilgin, A Çelik, K Atilla, C Ağalar, N Ç Arslan, S Karademir, S Bora, H Gülay, Z S Derici, I Astarcıoğlu
INTRODUCTION: Because of the shortage of organs available for transplantation, living related sequential transplantation with the use of liver and a kidney from the same donor has emerged as a reasonable therapeutic alternative. However, there is insufficient literature about the complications that living donors experience after simultaneous kidney and liver transplantations. METHODS: From December 2001 to October 2009, 5 living donors provided simultaneous donation of livers and kidneys and 1 living donor donated first her kidney and then her liver...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28295952/long-term-outcomes-of-living-related-small-intestinal-transplantation-in-children-a-single-center-experience
#13
Sandra Garcia Aroz, Ivo Tzvetanov, Elizabeth Anne Hetterman, Hoonbae Jeon, Jose Oberholzer, Giuliano Testa, Eunice John, Enrico Benedetti
Pediatric patients with irreversible intestinal failure present a significant challenge to meet the nutritional needs that promote growth. From 2002 to 2013, 13 living-related small intestinal transplantations were performed in 10 children, with a median age of 18 months. Grafts included isolated living-related intestinal transplantation (n=7), and living-related liver and small intestine (n=6). The immunosuppression protocol consisted of induction with thymoglobulin and maintenance therapy with tacrolimus and steroids...
March 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28288061/impact-of-donor-age-on-recipient-survival-in-adult-to-adult-living-donor-liver-transplantation
#14
Toyonari Kubota, Koichiro Hata, Takashi Sozu, Yoshihide Ueda, Hirofumi Hirao, Yusuke Okamura, Ichiro Tamaki, Junichi Yoshikawa, Jiro Kusakabe, Hirokazu Tanaka, Shoichi Kageyama, Takayuki Anazawa, Atsushi Yoshizawa, Shintaro Yagi, Noriyo Yamashiki, Hideaki Okajima, Toshimi Kaido, Shinji Uemoto
OBJECTIVE: To investigate the influence of donor age on recipient outcome after living-donor partial liver transplantation (LDLT). BACKGROUND: Donor age is a well-known prognostic factor in deceased donor liver transplantation; however, its role in LDLT remains unclear. METHODS: We retrospectively analyzed 315 consecutive cases of primary adult-to-adult LDLT in our center between April 2006 and March 2014. Recipients were divided into 5 groups according to the donor age: D-20s (n = 60); D-30s (n = 72); D-40s (n = 57); D-50s (n = 94); and D-60s (n = 32)...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28281236/simultaneous-liver-transplantation-and-sleeve-gastrectomy-prohibitive-combination-or-a-necessity
#15
Eviatar Nesher, Eytan Mor, Amir Shlomai, Michal Naftaly-Cohen, Renana Yemini, Alexander Yussim, Marius Brown, Andrei Keidar
Previously, many morbidly obese (MO) patients were denied liver transplantation (LT) because of the higher operative risk. However, nowadays, 5 and 10 years graft survival is the rule, and patients whose lives can be prolonged with LT are dying of obesity-related comorbidities. Recent experience suggests that weight reduction in MO liver transplant recipients would improve their long-term survival. The bariatric surgery before LT is contraindicated for patients with decompensated cirrhosis, while post-transplant intervention is associated with increased technical difficulty...
March 9, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28260480/living-donor-liver-transplant-follow-up-a-singlecenter-experience
#16
Syed Mudassir Laeeq, Farina M Hanif, Nasir Hassan Luck, Rajesh Kumar Mandhwani, Jawed Iqbal, Syed Haider Mehdi
OBJECTIVES: Liver transplant is a definite treatment of decompensated liver disease. Because of the shortage of livers from deceased donors, living-donor liver transplant is becoming more common. Here, we analyzed our clinical experience in the follow-up care of these patients. MATERIALS AND METHODS: Liver transplant recipients seen at the Sindh Institute of Urology and Transplantation (Karachi, Pakistan) were included in this analysis. Baseline characteristics and follow-up events were recorded...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260467/outcome-of-kidney-transplant-in-patients-with-polycystic-kidney-disease-a-single-center-study-in-tunisia
#17
Samia Barbouch, Meriam Hajji, Hafedh Hedri, Fethi El Younsi, Fathi Ben Hamida, Mohammed Mongi Bacha, Mondher Ounissi, Ezzedine Abderrahim, Taieb Ben Abdallah
OBJECTIVES: Autosomal dominant polycystic kidney disease is a common cause of end-stage renal disease and a common indication for renal transplant. This study was undertaken to evaluate the demographics, outcomes, and complications of renal transplant in patients with autosomal dominant polycystic kidney disease compared with other nephropathies. MATERIALS AND METHODS: In a retrospective case-control design, we reviewed the records of 7 patients with autosomal dominant polycystic kidney disease from a total of 701 renal transplant patients over a 30-year period (1986-2016)...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260463/auxiliary-partial-orthotopic-living-liver-transplant-for-wilson-disease
#18
Mehmet Haberal, Aydincan Akdur, Gokhan Moray, Sedat Boyacioglu, Adnan Torgay, Gulnaz Arslan, Gulnaz Arslan, Binnaz Handan Ozdemir
Wilson disease is a genetic disease involving copper metabolism disturbances that result in copper accumulations, especially in the liver and brain. Wilson disease can be treated with pharmacologic agents, such as chelators that induce urinary excretion of copper or zinc salts that inhibit copper absorption in the digestive tract. Liver transplant is the only treatment option for Wilson disease when liver failure has occurred. In some patients, that is, in those with Child-Pugh A score, neurologic disease can be seen without hepatic failure...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28242867/living-donor-liver-transplantation-for-combined-hepatocellular-carcinoma-and-cholangiocarcinoma-experience-of-a-single-center
#19
Cheng-Chih Chang, Ying-Ju Chen, Tzu-Hao Huang, Chun-Han Chen, Fang-Ying Kuo, Hock-Liew Eng, Chee-Chien Yong, Yueh-Wei Liu, Ting-Lung Lin, Wei-Feng Li, Yu-Hung Lin, Chih-Che Lin, Chih-Chi Wang, Chao-Long Chen
BACKGROUND Because the outcome of liver transplantation for cholangiocarcinoma is often poor, cholangiocarcinoma is a contraindication for liver transplantation in most centers. Combined hepatocellular carcinoma and cholangiocarcinoma is a rare type of primary hepatic malignancy containing features of hepatocellular carcinoma and cholangiocarcinoma. Diagnosing combined hepatocellular carcinoma and cholangiocarcinoma pre-operatively is difficult. Because of sparse research presentations worldwide, we report our experience with living donor liver transplantation for combined hepatocellular carcinoma and cholangiocarcinoma...
February 28, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28240812/reconstruction-of-anomalous-portal-venous-branching-in-right-lobe-living-donor-liver-transplantation-malatya-approach
#20
Sezai Yilmaz, Cuneyt Kayaalp, Burak Isik, Veysel Ersan, Emrah Otan, Sami Akbulut, Abuzer Dirican, Ramazan Kutlu, Aysegul Sagir Kahraman, Cengiz Ara, Mehmet Yilmaz, Bulent Unal, Cemalettin Aydin, Turgut Piskin, Dincer Ozgor, Mustafa Ates, Fatih Ozdemir, Volkan Ince, Cemalettin Koc, Adil Baskiran, Sait Murat Dogan, Bora Barut, Fatih Sumer, Serdar Karakas, Koray Kutluturk, Saim Yologlu, Harika Gozukara
BACKGROUND: Reconstruction of anomalous portal venous branching (APVB) during right lobe living donor liver transplantation (LDLT) can be challenging. OBJECTIVE: To describe our surgical technique, named the Malatya Approach, in case of APVP during right lobe LDLT. The technique includes the unification of the APVB and to obtain a funnel shaped common extension with a circumferential fence by a saphenous vein conduit. METHODS: Total 126 (10...
February 27, 2017: Liver Transplantation
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