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Living related liver transplantation

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https://www.readbyqxmd.com/read/29456414/high-prevalence-of-hepatitis-b-antibody-loss-and-a-case-report-of-de-novo-hepatitis-b-virus-infection-in-a-child-after-living-donor-liver-transplantation
#1
Palittiya Sintusek, Nawarat Posuwan, Piyaporn Wanawongsawad, Suttiruk Jitraruch, Yong Poovorawan, Voranush Chongsrisawat
AIM: To assess the seroprevalence of hepatitis B virus (HBV) immunity among previously vaccinated pediatric liver transplant recipients and present a case report of de novo hepatitis B infection after liver transplantation. METHODS: This study focused on children with chronic liver diseases who received primary hepatitis B immunization and had a complete dataset of anti-HBs before and after liver transplantation between May 2001 and June 2017. Medical records were retrospectively reviewed for potential factors relating to HBV immunity loss...
February 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29455437/live-donor-liver-transplantation-for-acute-liver-failure-a-single-center-experience
#2
Siddharth Mehrotra, Naimish Mehta, Prashantha S Rao, Shailendra Lalwani, Vivek Mangla, Samiran Nundy
INTRODUCTION: Acute liver failure (ALF) is an indication for emergency liver transplantation (LT). Although centers performing only deceased donor liver transplants (DDLT) have shown improved outcomes in this situation, they still have relatively long waiting lists. An alternative would be living donor liver transplantation (LDLT), which has shown equivalent outcomes in the elective situation but there is limited evidence of its results in ALF. AIM: The purpose of this study was to assess the outcomes in patients with ALF undergoing emergency LDLT in our center in Delhi, India...
February 17, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29453832/living-donor-liver-transplantation-for-mild-zellweger-spectrum-disorder-up-to-17-years-follow-up
#3
Tanguy Demaret, Sharat Varma, Xavier Stephenne, Françoise Smets, Isabelle Scheers, Ronald Wanders, Lionel Van Maldergem, Raymond Reding, Etienne Sokal
Mild Zellweger spectrum disorder, also described as Infantile Refsum disease, is attributable to mutations in PEX genes. Its clinical course is characterized by progressive hearing and vision loss, and neurodevelopmental regression. Supportive management is currently considered the standard of care, as no treatment has shown clinical benefits. LT was shown to correct levels of circulating toxic metabolites, partly responsible for chronic neurological impairment. Of three patients having undergone LT for mild ZSD, one died after LT, while the other two displayed significant neurodevelopmental improvement on both the long-term (17 years post-LT) and short-term (9 months post-LT) follow-up...
February 16, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29453782/unusual-spontaneous-porto-systemic-shunt-the-importance-of-diagnosing-non-anatomical-porto-systemic-shunts-to-improve-portal-flow-in-pediatric-living-related-liver-transplantation-case-report
#4
Juan S Rubio, Carolina Rumbo, Pablo A Farinelli, Nicolás Aguirre, Diego A Ramisch, Hugo Paladini, Pablo D Angelo, Pablo Barros Schelotto, Gabriel E Gondolesi
Collateral circulation secondary to liver cirrhosis may cause the development of large PSSs that may steal flow from the main portal circulation. It is important to identify these shunts prior to, or during the transplant surgery because they might cause an insufficient portal flow to the implanted graft. There are few reports of "steal flow syndrome" cases in pediatrics, even in biliary atresia patients that may have portal hypoplasia as an associated malformation. We present a 12-month-old female who received an uneventful LDLT from her mother, and the GRWR was 4...
February 16, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29443826/higher-risk-of-posttransplant-graft-failure-in-male-recipients-of-female-donor-grafts-might-not-be-due-to-anastomotic-size-disparity
#5
Kyo Won Lee, Sangbin Han, Sanghoon Lee, Hyun-Hwa Cha, Soohyun Ahn, Hyeon Seon Ahn, Justin S Ko, Mi Sook Gwak, Gaab Soo Kim, Jae-Won Joh, Suk-Koo Lee, Gyu-Seong Choi
BACKGROUND: Posttransplant liver graft failure occurs most often in male recipients of livers from female donors. The respective role of donor sex itself and the size disparity in graft vessels/bile ducts according to donor sex are unclear. Thus, we aimed to evaluate the importance of donor sex with adjustment for anastomotic size disparity between female and male donor grafts. METHODS: A total of 309 male patients without hepatic tumors who underwent living donor liver transplantation were analyzed (109 female and 200 male donors)...
February 13, 2018: Transplantation
https://www.readbyqxmd.com/read/29432257/progression-of-living-liver-donation-worldwide
#6
Trevor L Nydam, Mettu Srinivas Reddy, Elizabeth A Pomfret, Mohamed Rela
PURPOSE OF REVIEW: Living donor liver transplantation (LDLT) has developed into a well tolerated and viable option when deceased donor transplantation is not available. Transplant and advanced hepatobiliary surgeons from around the world have performed living donor hepatectomies consistently for decades with acceptable donor outcomes. However, optimizing the preoperative workup, donor selection, operative technique, and perioperative care will improve these outcomes. This manuscript reviews recent worldwide literature for the living liver donor...
February 9, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29424768/current-status-of-surgical-incisions-used-in-donors-during-living-related-liver-transplantation-a-nationwide-survey-in-japan
#7
Ken Shirabe, Susumu Eguchi, Hideaki Okajima, Kiyoshi Hasegawa, Shigeru Marubashi, Koji Umeshita, Seiji Kawasaki, Katsuhiko Yanaga, Mitsuo Shimada, Toshimi Kaido, Naoki Kawagishi, Akinobu Taketomi, Koichi Mizuta, Norihiro Kokudo, Shinji Uemoto, Yoshihiko Maehara
BACKGROUND: Smaller surgical incisions have recently been introduced in living donor liver procurement. This study used national data from Japan to clarify the present status of surgical incisions in living donor liver procurement. METHODS: A nationwide, questionnaire-based survey related to 3121 donors and recipients was used. Donors were divided into two groups: left lateral segment graft (LLSG) procurement (n=690) and other types (n=2431). Incisions were classified into six types: type I, upper midline and bilateral subcostal; type II, upper midline and right subcostal; type III: upper midline and right subcostal to the right lateral margin of the abdominal rectus muscle; type IV, upper midline without laparoscopy; type V, upper midline with laparoscopy; and type VI, lower abdominal using the full laparoscopic technique...
February 9, 2018: Transplantation
https://www.readbyqxmd.com/read/29423621/uterine-transplant-a-risk-to-life-or-a-chance-for-life
#8
Alankrita Taneja, Siddhartha Das, Syed Ather Hussain, Mohammed Madadin, Stany Wilfred Lobo, Huda Fatima, Ritesh G Menezes
Being inherently different from any other lifesaving organ transplant, uterine transplantation does not aim at saving lives but supporting the possibility to generate life. Unlike the kidneys or the liver, the uterus is not specifically a vital organ. Given the non-lifesaving nature of this procedure, questions have been raised about its feasibility. The ethical dilemma revolves around whether it is worth placing two lives at risk related to surgery and immunosuppression, amongst others, to enable a woman with absolute uterine factor infertility to experience the presence of an organ enabling childbirth...
February 8, 2018: Science and Engineering Ethics
https://www.readbyqxmd.com/read/29417353/perioperative-management-with-phosphodiesterase-type-5-inhibitor-and-prostaglandin-e1-for-moderate-portopulmonary-hypertension-following-adult-to-adult-living-donor-liver-transplantation-a-case-report
#9
Takashi Onoe, Asuka Tanaka, Kohei Ishiyama, Kentaro Ide, Hirotaka Tashiro, Hideki Ohdan
BACKGROUND: Portopulmonary hypertension (PPH) is a relatively rare but well-recognized complication of end-stage liver disease. Moderate or severe PPH (mean pulmonary artery pressure [mPAP] ≥ 35 mmHg) is usually a contraindication for liver transplantation due to high operation-related mortality. Here, we report on a patient with moderate PPH whose condition was successfully managed with a phosphodiesterase type 5 (PDE5) inhibitor (tadalafil) and prostaglandin E1, who experienced rapid improvement of PPH after living-donor liver transplantation (LDLT)...
February 7, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29407313/development-of-duodenal-ulcers-due-to-the-discontinuation-of-proton-pump-inhibitors-after-the-induction-of-sofosbuvir-plus-ledipasvir-therapy-a-report-of-two-cases
#10
S Miuma, H Miyaaki, Y Miyazoe, T Suehiro, R Sasaki, H Shibata, N Taura, K Nakao
Sofosbuvir plus ledipasvir (SOF-LDV) combination therapy is a promising therapy for post-transplant hepatitis C virus (HCV) reinfection. It is known that gastric pH elevation induces lower absorption of ledipasvir; therefore, the use of proton pump inhibitors (PPIs) should be considered regarding dose reduction after SOF-LDV therapy induction. Here, we report two patients who developed duodenal ulcers due to the discontinuation of PPIs after the induction of SOF-LDV therapy for post-transplant HCV reinfection...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29407312/complication-follow-up-with-ultrasonographic-analyses-of-91-cases-with-donor-gallbladder-preservation-in-living-donor-liver-transplantation-of-left-lateral-sectionectomies
#11
F Su, E He, L Qian, Z Zhu, L Wei, Z Zeng, W Qu, R Xu, Z Yi
BACKGROUND: Preserving the donor's gallbladder during living donor liver transplantation (LDLT) is a better method for liver transplantation surgery, but not enough is known about gallbladder complications after the operation. METHODS: We retrospectively investigated postsurgical donor gallbladder complications in clinical LDLT with gallbladder preservation. The feasibility of retaining the gallbladder during liver graft procurement is discussed. Ninety-one donors with retained gallbladder after LDLT with the hepatic left lateral sectionectomy (from June 2013 to October 2015) were retrospectively analyzed...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29404469/significant-association-between-foxp3-gene-polymorphism-and-steroid-resistant-acute-rejection-in-living-donor-liver-transplantation
#12
Sapana Verma, Yuka Tanaka, Seiichi Shimizu, Naoki Tanimine, Hideki Ohdan
Previous studies have found that preferential accumulation of regulatory T (Treg) cells in liver allografts during acute cellular rejection (ACR) is associated with less severe rejection, suggesting a role of Treg cells in preventing excessive progress of ACR. We investigated the impact of single nucleotide polymorphisms (SNPs) in the Forkhead box P3 ( FOXP3 ) gene, a master regulator gene of Treg cells, on ACR severity in liver transplant (LT) recipients. In total, 102 living donor LT patients were enrolled in this study and categorized into no rejection (n = 86), steroid-sensitive acute rejection (SSAR; n = 11), and steroid-resistant acute rejection (SRAR; n = 5)...
July 2017: Hepatology Communications
https://www.readbyqxmd.com/read/29399279/predicting-early-outcomes-of-liver-transplantation-in-young-children-the-early-study
#13
Rashid Alobaidi, Natalie Anton, Dominic Cave, Elham Khodayari Moez, Ari R Joffe
AIM: To determine potentially modifiable predictors of early outcomes after liver transplantation in children of age < 3 years. METHODS: This study was a retrospective chart review including all consecutive children of age less than 3-years-old having had a liver transplant done at the Western Canadian referral center from June 2005 to June 2015. Pre-specified potential predictor variables and primary and secondary outcomes were recorded using standard definitions and a case report form...
January 27, 2018: World Journal of Hepatology
https://www.readbyqxmd.com/read/29360611/higher-tacrolimus-blood-concentration-is-related-to-increased-risk-of-post-transplantation-diabetes-mellitus-after-living-donor-liver-transplantation
#14
Jiu-Lin Song, Ming Li, Lu-Nan Yan, Jia-Yin Yang, Jian Yang, Li Jiang
BACKGROUND: /Aims: To investigate the association between tacrolimus (TAC) blood concentration and the risk of post-transplantation diabetes mellitus (PTDM) development after living donor liver transplantation (LDLT). METHODS: This study reviewed the clinical data of 158 adult LDLT recipients. A cut-off of mean trough concentration of TAC (cTAC) value at the sixth month postoperatively was identified using a receptor operating characteristic curve. Other clinical complications rates were compared between different cTAC groups...
January 19, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29359020/de-novo-hepatocellular-carcinoma-after-pediatric-living-donor-liver-transplantation
#15
Samuel Torres-Landa, Armando Salim Muñoz-Abraham, Brett E Fortune, Ananta Gurung, Jeffrey Pollak, Sukru H Emre, Manuel I Rodriguez-Davalos, Michael L Schilsky
De-novo malignancies carry an incidence ranging between 3%-26% after transplant and account for the second highest cause of post-transplant mortality behind cardiovascular disease. While the majority of de-novo malignancies after transplant usually consist of skin cancers, there has been an increasing rate of solid tumor cancers over the last 15 years. Although, recurrence of hepatocellular carcinoma (HCC) is well understood among patients transplanted for HCC, there are increasing reports of de-novo HCC in those transplanted for a non-HCC indication...
December 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/29338386/estrogen-estrogen-receptor-%C3%AE-signaling-facilitates-bilirubin-metabolism-in-regenerating-liver-through-regulating-cytochrome-p450-2a6-expression
#16
Ta-Lun Kao, Yao-Li Chen, Yu-Ping Kuan, Wei-Chun Chang, Yu-Chen Ho, Shuyuan Yeh, Long-Bin Jeng, Wen-Lung Ma
BACKGROUND: After living donor liver transplantation (LDLT), rising serum bilirubin levels commonly indicate insufficient numbers of hepatocytes are available to metabolize bilirubin into biliverdin. Recovery of bilirubin levels is an important marker of hepatocyte repopulation after LDLT. Cytochrome P450 (CYP) 2A6 in humans (or cyp2a4 in rodents) can function as "bilirubin oxidase." Functional hepatocytes contain abundant CYP2A6, which is considered a marker for hepatocyte function recovery...
November 2017: Cell Transplantation
https://www.readbyqxmd.com/read/29334530/antegrade-arterial-and-portal-flushing-versus-portal-flushing-only-for-right-lobe-live-donor-liver-transplantation-a-randomized-control-trial
#17
Viniyendra Pamecha, Rommel Sandhyav, Piyush Kumar Sinha, Kishore Gurumoorthy Subramanya Bharathy, Shridhar Sasturkar
INTRODUCTION: In live donor liver transplantation (LDLT) portal flush only of the graft is done on the bench. There is no data on antegrade arterial flush along with portal flush of the graft. METHODS: Consecutive patients undergoing elective right lobe LDLT were block-randomized to receive either portal flush only or both portal and antegrade arterial flush. The primary objectives were safety, rate of early allograft dysfunction (EAD), and impact on vascular and biliary complications RESULTS: After randomization there were 40 patients in each group...
January 12, 2018: Transplantation
https://www.readbyqxmd.com/read/29319622/a-high-portal-venous-pressure-gradient-increases-gut-related-bacteremia-and-consequent-early-mortality-after-living-donor-liver-transplantation
#18
Siyuan Yao, Shintaro Yagi, Ryuji Uozumi, Taku Iida, Miki Nagao, Yusuke Okamura, Takayuki Anazawa, Hideaki Okajima, Toshimi Kaido, Shinji Uemoto
BACKGROUND: Portal hypertension (PHT) is defined as a portal venous pressure gradient (PVPG) exceeding 5 mmHg, which results in severe clinical manifestations. However, the validity of intraoperative PVPG monitoring and the association between PHT and bacterial translocation (BT) after liver transplantation remain unclear. METHODS: In this retrospective study, 223 patients who underwent primary adult-to-adult living donor liver transplantation (ALDLT) from 2008 to 2015 were divided into 2 groups based on the PVPG at the end of the operation: high PVPG (>5 mmHg, n=69) and low PVPG (≤5 mmHg, n=154)...
January 10, 2018: Transplantation
https://www.readbyqxmd.com/read/29311539/tolvaptan-for-fluid-management-in-living-donor-liver-transplant-recipients
#19
Shunichi Imai, Masahiro Shinoda, Hideaki Obara, Minoru Kitago, Taizo Hibi, Yuta Abe, Hiroshi Yagi, Kentaro Matsubara, Hisanobu Higashi, Osamu Itano, Yuko Kitagawa
BACKGROUND Tolvaptan, an antagonist of the vasopressin V2 receptor is a novel oral diuretic that promotes water excretion selectively. We have used furosemide as a primary diuretic and added human atrial natriuretic peptide (hANP) if necessary for fluid management postoperatively in living-donor liver transplantation (LDLT) recipients. Recently we introduced tolvaptan and used both tolvaptan and furosemide as primary diuretics. MATERIAL AND METHODS Clinical outcomes were compared between LDLT recipients whose postoperative fluid management was performed before (control group, n=10) and after (tolvaptan group, n=16) introduction of tolvaptan...
January 9, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29280920/liver-transplantation-for-hepatocellular-carcinoma-within-the-milan-criteria-versus-the-university-of-california-san-francisco-criteria-a-comparative-study
#20
Mohamed R Abdelfattah, Hussein El-Siesy, Hadeel Al-Manea, Dieter C Broering
BACKGROUND: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths worldwide. Currently, liver transplantation (LT) for HCC is the only hope for cure from the tumor and from end-stage liver disease (ESLD). The organ pool shortage in deceased donor LT and the donor-related ethical concerns in living-donor LT necessitate the use of rigorous criteria for LT for HCC. In this respect, two main criteria for LT for HCC were implemented with good outcome, namely, the Milan and the University of California San Francisco criteria...
December 26, 2017: European Journal of Gastroenterology & Hepatology
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