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https://www.readbyqxmd.com/read/28333889/normothermic-ex-situ-liver-preservation-the-new-gold-standard
#1
Richard W Laing, Hynek Mergental, Darius F Mirza
PURPOSE OF REVIEW: Normothermic machine perfusion of the liver (NMP-L) is a novel technology recently introduced into the practice of liver transplantation. This review recapitulates benefits of normothermic perfusion over conventional static cold storage and summarizes recent publications in this area. RECENT FINDINGS: The first clinical trials have demonstrated both safety and feasibility of NMP-L. They have shown that machine perfusion can entirely replace cold storage or be commenced following a period of cold ischaemia...
March 22, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28331622/c-terminal-proendothelin-1-ct-proet-1-is-associated-with-organ-failure-and-predicts-mortality-in-critically-ill-patients
#2
Lukas Buendgens, Eray Yagmur, Jan Bruensing, Ulf Herbers, Christer Baeck, Christian Trautwein, Alexander Koch, Frank Tacke
BACKGROUND: Endothelin 1 (ET-1) is a strong vasoconstrictor, which is involved in inflammation and reduced tissue perfusion. C-terminal proendothelin-1 (CT-proET-1) is the stable circulating precursor protein of ET-1. We hypothesized that CT-proET-1, reflecting ET-1 activation, is involved in the pathogenesis of critical illness and associated with its prognosis. METHODS: Two hundred seventeen critically ill patients (144 with sepsis, 73 without sepsis) were included prospectively upon admission to the medical intensive care unit (ICU), in comparison to 65 healthy controls...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28328586/percutaneous-isolated-hepatic-perfusion-hemodynamic-monitoring-and-goal-directed-anesthetic-management-a-case-report
#3
Oscar Martin-Delgado, Miguel Rodriguez, Andres Lopez, Miguel A Reina, Emilio De Vicente, Yolanda Quijano, Antonio Echenagusia, Juan A Martinez
The percutaneous isolated hepatic perfusion utilizes a venovenous bypass to administer high-dose chemotherapy exclusively in the liver, getting depurated through a hemofilter before returning to the systemic circulation. The hepatic perfusion is managed under general anesthesia and invasive monitoring as a result of very abrupt changes in venous return and vascular resistances because of the isolation of the hepatic territory and absorption of circulating catecholamines by the hemofilter. We report a case in which we describe the technique, physiologic implications, anesthetic, and goal-directed hemodynamic management for this procedure...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28321540/ct-perfusion-imaging-of-the-liver-and-the-spleen-in-patients-with-cirrhosis-is-there-a-correlation-between-perfusion-and-portal-venous-hypertension
#4
Emina Talakić, Silvia Schaffellner, Daniela Kniepeiss, Helmut Mueller, Rudolf Stauber, Franz Quehenberger, Helmut Schoellnast
OBJECTIVES: To correlate hepatic and splenic CT perfusion parameters with hepatic venous pressure gradient (HVPG) measurements in patients with cirrhosis. METHODS: Twenty-one patients with cirrhosis (males, 17; females, 4; mean ± SD age, 57 ± 7 years) underwent hepatic and splenic perfusion CT on a 320-detector row volume scanner as well as invasive measurement of HVPG. Different CT perfusion algorithms (maximum slope analysis and Patlak plot) were used to measure hepatic arterial flow (HAF), portal venous flow (PVF), hepatic perfusion index (HPI), splenic arterial flow (SAF), splenic blood volume (SBV) and splenic clearance (SCL)...
March 20, 2017: European Radiology
https://www.readbyqxmd.com/read/28320323/changes-in-duration-of-action-of-rocuronium-following-decrease-in-hepatic-blood-flow-during-pneumoperitoneum-for-laparoscopic-gynaecological-surgery
#5
Yang Liu, Wen Cao, Yu Liu, Yun Wang, Ren Lang, Yun Yue, An-Shi Wu
BACKGROUND: A moderate insufflation pressure and deep neuromuscular blockade (NMB) have been recommended in laparoscopic surgery in consideration of the possible reduction in splanchnic perfusion due to the CO2-pneumoperitoneum. Since the liver is the major organ for rocuronium metabolism, the question of whether NMB of rocuronium would change with the variation of liver perfusion during pneumoperitoneum during laparoscopic surgery merits investigation. METHODS: In this prospective study, a total of sixty female patients scheduled for either selective laparoscopic gynaecological surgery (group laparoscopy) or laparotomy for gynaecological surgery (group control) were analyzed...
March 20, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28317117/comparative-pharmacokinetic-evaluation-of-lopinavir-and-lopinavir-loaded-solid-lipid-nanoparticles-in-hepatic-impaired-rat-model
#6
Punna Rao Ravi, Rahul Vats
OBJECTIVE: Drug-induced hepatotoxicity is a major cause of concern in patients receiving HIV/TB co-treatment. Lopinavir (LPV), an anti-HIV drug, shows poor plasma exposure due to hepatic first-pass metabolism. In this study, we investigated the effect of hepatotoxicity on pharmacokinetics of free LPV and LPV-loaded solid lipid nanoparticles (LPV SLNs) in male Wistar rats. METHODS: Hepatic impairment model in rats was developed by injecting CCl4 (i.p., 2 ml/kg). Comparative pharmacokinetic (n = 5) and tissue distribution studies (n = 3) were conducted following oral administration (20 mg/kg) of free LPV and LPV SLNs in normal and hepatic impaired rats...
March 19, 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28314296/perfusion-ct-changes-in-liver-metastases-from-pancreatic-neuroendocrine-tumors-during-everolimus-treatment
#7
Mirko D'Onofrio, Sara Cingarlini, Silvia Ortolani, Stefano Crosara, Riccardo DE Robertis, Paola Vallerio, Elisabetta Grego, Valentina Ciaravino, Andrea Ruzzenente, Luca Landoni, Aldo Scarpa, Claudio Bassi, Giampaolo Tortora
AIM: To evaluate modifications of perfusional parameters assessed by perfusion computed tomography (P-CT) of liver metastases (LM) from pancreatic neuroendocrine tumors (PanNETs) during everolimus treatment. PATIENTS AND METHODS: All patients with LMs from G1-2 PanNETs undergoing everolimus treatment between January 2013 and January 2015 were prospectively evaluated with P-CT at baseline, and after 2 and 4 months of therapy. Size, perfusion, blood volume (BV), peak enhancement intensity (PEI) and time to peak for each lesion were calculated...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28306699/dynamic-measurement-of-arterial-liver-perfusion-with-an-interventional-c-arm-system
#8
Sanjit Datta, Kerstin Müller, Terilyn Moore, Lior Molvin, Sonja Gehrisch, Jarrett Rosenberg, Yamil Saenz, Michael Manhart, Yu Deuerling-Zheng, Nishita Kothary, Rebecca Fahrig
PURPOSE: Objective intraprocedural measurement of hepatic blood flow could provide a quantitative treatment end point for locoregional liver procedures. This study aims to validate the accuracy and reproducibility of cone-beam computed tomography perfusion (CBCTp) measurements of arterial liver perfusion (ALP) against clinically available computed tomography perfusion (CTp) measurements in a swine embolization model. METHODS: Triplicate CBCTp measurements using a selective arterial contrast injection were performed before and after complete embolization of the left lobe of the liver in 5 swine...
March 17, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28302002/preoperative-cardiac-risk-assessment-in-patients-undergoing-liver-transplant-due-to-hepatocellular-carcinoma-should-it-be-different
#9
Haldun Muderrisoglu, Kerem Can Yilmaz, Emir Karacaglar, Ugur Bal, Alp Aydinalp, Gokhan Moray, Mehmet Haberal
OBJECTIVES: Liver transplant is a high-risk surgery for cardiac events. The risk of 30-day major cardiac adverse events is estimated at more than 5%. In this retrospective study, we evaluated our preoperative cardiac risk assessment approach. MATERIALS AND METHODS: We evaluated 58 adult patients who underwent liver transplant between May 2011 and May 2015. Preoperative cardiac risk factors and results of diagnostic tests were noted. Patients were divided into 2 groups: patients with or without hepatocellular carcinoma...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28301945/the-utility-of-the-macro-aggregated-albumin-lung-perfusion-scan-in-the-diagnosis-and-prognosis-of-hepatopulmonary-syndrome-in-cirrhotic-patients-candidates-for-liver-transplantation
#10
Israel Grilo Bensusan, Juan Manuel Pascasio, Juan Luis Tirado, Francisco-Jesús López-Pardo, Francisco Ortega-Ruiz, José Manuel Sousa, María José Rodríguez-Puras, María Teresa Ferrer, Miguel Ángel Gómez-Bravo, Antonio Grilo Reina
BACKGROUND: The macro-aggregated albumin lung perfusion scan (99mTc-MAA) is a diagnostic method for hepatopulmonary syndrome (HPS). GOAL: To determine the sensitivity of 99mTc-MAA in diagnosing HPS, to establish the utility of 99mTc-MAA in determining the influence of HPS on hypoxemia in patients with concomitant pulmonary disease and to determine the correlation between 99mTc-MAA values and other respiratory parameters. METHODS: Data from 115 cirrhotic patients who were eligible for liver transplantation (LT) were prospectively analyzed...
March 17, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28301388/cold-storage-or-normothermic-perfusion-for-liver-transplantation-probable-application-and-indications
#11
Carlo D L Ceresa, David Nasralla, Simon Knight, Peter J Friend
PURPOSE OF REVIEW: Preservation of the liver via normothermic machine perfusion (NMP) is rapidly becoming an area of great academic and clinical interest. This review focuses on the benefits and limitations of NMP and where the role for static cold storage may lie. RECENT FINDINGS: Clinical studies have recently been published reporting the use of NMP in liver preservation for transplantation. They have described the technology to be well tolerated and feasible with potentially improved posttransplant outcomes...
March 15, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28298706/an-assessment-of-fetal-cerebral-and-hepatic-perfusion-in-normal-pregnancy-and-pre-eclampsia-using-three-dimensional-ultrasound
#12
Susan Addley, Amanda Ali, Stephen Ong
BACKGROUND: Pre-eclampsia and placental causes of intrauterine growth restriction (IUGR) are part of the same spectrum of disorders. In IUGR, there is preferential shunting of blood to the fetal brain at the expense of other organs. We wanted to demonstrate that this also occurs in pre-eclampsia using three dimensional (3D) ultrasound. The 3D indices of perfusion are: flow index (FI), vascular index (VI) and vascularisation flow index (VFI) which reflect tissue vascularity and flow intensity...
January 2017: Ulster Medical Journal
https://www.readbyqxmd.com/read/28290711/visualising-a-rare-and-complex-case-of-advanced-hilar-cholangiocarcinoma
#13
Jia Qu, Albert Fung, Paul Kelly, Gordon Tait, Paul D Greig, Anne Agur, Ian D McGilvray, Jodie Jenkinson
The Toronto Video Atlas of Liver, Pancreas, Biliary, and Transplant Surgery (TVASurg) is a free online library of three-dimensional (3D) animation-enhanced surgical videos, designed to instruct surgical fellows in hepato-pancreato-biliary (HPB) and transplant procedures. The video 'Klatskin tumours: Extended left hepatectomy with complex portal vein reconstruction and in situ cold perfusion of the liver', which is available to watch at http://TVASurg.ca , is a unique and valuable visual resource for surgeons in training to assist them in learning this rare procedure...
March 14, 2017: Journal of Visual Communication in Medicine
https://www.readbyqxmd.com/read/28289671/encapsulating-peritoneal-sclerosis-in-liver-transplant-recipients-a-report-of-2-cases
#14
Kyo Won Lee, Chan Woo Cho, Nuri Lee, Sanghoon Lee, Jong Man Kim, Gyu-Seong Choi, Choon Hyuck David Kwon, Jae-Won Joh, Suk-Koo Lee
Encapsulating peritoneal sclerosis (EPS) is a rare cause of intestinal obstruction by a thick fibrous membrane wrapping around the small intestine. It is a possible complication after liver transplantation (LT) that can be fatal. This report describes 2 cases of EPS after LT that were successfully treated with surgery, corticosteroids, tamoxifen, and mammalian target of rapamycin inhibitor. After treatment in both cases, the patients were able to start oral feeding and have been symptom free for more than 1 year...
March 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28288383/effect-of-methoxy-group-position-on-biological-properties-of-18-f-labeled-benzyl-triphenylphosphonium-cations
#15
Shuting Chen, Zuoquan Zhao, Ying Zhang, Wei Fang, Jie Lu, Xianzhong Zhang
INTRODUCTION: (18)F-labeled phosphonium cations targeting mitochondrial membrane potential would be promising for positron emission tomography (PET) myocardial perfusion imaging (MPI). The purpose of this study was to examine the influence of additional methoxy group and its different positions on myocardium uptake and pharmacokinetics properties of (18)F-labeled benzyl triphenylphosphonium cations. METHOD: In this study, three novel (18)F-labeled phosphonium cations, [(18)F]4-(fluoromethyl)benzyltris(4-methoxyphenyl) phosphonium cation (1b), [(18)F]4-(fluoromethyl)benzyltris(2-methoxyphenyl) phosphonium cation (2b) and [(18)F]4-(fluoromethyl)benzyltris(3-methoxyphenyl) phosphonium cation (3b), were efficiently prepared by a One-Pot method starting from the substitution of non-carried-added fluoride-18...
February 24, 2017: Nuclear Medicine and Biology
https://www.readbyqxmd.com/read/28287916/the-effect-of-contrast-medium-on-radiation-dose-in-ct-part-ii-a-systematic-evaluation-across-58-patient-models
#16
Pooyan Sahbaee, Ehsan Abadi, W Paul Segars, Daniele Marin, Rendon C Nelson, Ehsan Samei
Purpose To estimate the radiation dose as a result of contrast medium administration in a typical abdominal computed tomographic (CT) examination across a library of contrast material-enhanced computational patient models. Materials and Methods In part II of this study, first, the technique described in part I of this study was applied to enhance the extended cardiac-torso models with patient-specific iodine-time profiles reflecting the administration of contrast material. Second, the patient models were deployed to assess the patient-specific organ dose as a function of time in a typical abdominal CT examination using Monte Carlo simulation...
March 13, 2017: Radiology
https://www.readbyqxmd.com/read/28280334/mechanism-of-hepatic-targeting-via-oral-administration-of-dspe-peg-cholic-acid-modified-nanoliposomes
#17
Ying Li, Chunyan Zhu
In oral administration, gastrointestinal physiological environment, gastrointestinal epithelial cell membranes, and blood circulation are typical biological barriers to hepatic delivery of ligand-modified nanoparticle drug delivery systems. To elucidate the mechanism of oral hepatic targeting of cholic acid receptor-mediated nanoliposomes (LPs) (distearoyl phosphatidylethanolamine-polyethylene glycol-cholic acid-modified LPs, CA-LPs), evaluations were performed on colon cancer Caco-2 cell monolayers, liver cancer HepG2 cells, and a rat intestinal perfusion model...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28277163/predictions-of-bisphenol-a-hepatic-clearance-in-the-isolated-perfused-rat-liver-iprl-impact-of-albumin-binding-and-of-co-administration-with-naproxen
#18
Sara Bounakta, Michel Bteich, Marc Mantha, Patrick Poulin, Sami Haddad
1. This study aimed (i) to characterise hepatic clearance (CL) of bisphenol A (BPA) and naproxen (NAP) administered alone or in binary mixtures to highlight the influence of a binding to albumin (ALB) using an isolated perfused rat liver (IPRL) system; and (ii) to compare results of prediction algorithms with measured clearance rates. 2. The IPRL system and liver microsomes were used to determine the metabolic constants of BPA and NAP either in the presence or absence of ALB. In this study, the IPRL was used as proxy for the in vivo situation...
March 3, 2017: Xenobiotica; the Fate of Foreign Compounds in Biological Systems
https://www.readbyqxmd.com/read/28276105/adctotal-ratio-and-d-ratio-derived-from-intravoxel-incoherent-motion-early-after-tace-are-independent-predictors-for-survival-in-hepatocellular-carcinoma
#19
Lifang Wu, Pengju Xu, Shengxiang Rao, Li Yang, Caizhong Chen, Hao Liu, Caixia Fu, Mengsu Zeng
PURPOSE: To explore the threshold of intravoxel incoherent motion (IVIM) parameters, apparent diffusion coefficient [ADCtotal and ADC(0,500) ] ratios 24-48 hours after transarterial chemoembolization (TACE) to assess early response in patients with unresectable hepatocellular carcinoma (HCC) and to compare the association between diffusion-weighted imaging with the intravoxel incoherent motion (IVIM-DWI) and mRECIST with survival. MATERIALS AND METHODS: Institutional Review Board approval and informed consent were obtained for this prospective study...
March 9, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28275560/liver-intravoxel-incoherent-motion-ivim-magnetic-resonance-imaging-a-comprehensive-review-of-published-data-on-normal-values-and-applications-for-fibrosis-and-tumor-evaluation
#20
REVIEW
Yáo T Li, Jean-Pierre Cercueil, Jing Yuan, Weitian Chen, Romaric Loffroy, Yì Xiáng J Wáng
A comprehensive literature review was performed on liver intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) technique and its applications. Heterogeneous data have been reported. IVIM parameters are magnetic field strength dependent to a mild extent. A lower Dslow (D) value at 3 T than at 1.5 T and higher perfusion fraction (PF) value at 3 T than at 1.5 T were noted. An increased number of b values are associated with increased IVIM parameter measurement accuracy. With the current status of art, IVIM technique is not yet capable of detecting early stage liver fibrosis and diagnosing liver fibrosis grades, nor can it differentiate liver tumors...
February 2017: Quantitative Imaging in Medicine and Surgery
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