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Deceased donor liver transplantation

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https://www.readbyqxmd.com/read/29773782/diagnosis-incidence-predictors-and-management-of-postreperfusion-syndrome-in-pediatric-deceased-donor-liver-transplantation-a-single-center-study
#1
Liang Zhang, Ming Tian, Fushan Xue, Zhijun Zhu
BACKGROUND Postreperfusion syndrome (PRS) is a dreadful and well-documented complication in adult liver transplantation (LT). However, information regarding PRS in pediatric LT is still scarce. We aimed to identify the incidence, risk factors and associated outcomes of pediatric LT in a single-center study. MATERIAL AND METHODS The medical records of 75 consecutive pediatric patients who underwent deceased donor liver transplantation (DDLT) from July 2015 to October 2017 were retrospectively reviewed. PRS was determined according to the Peking criteria when significant arrhythmia or refractory hypotension occurred following revascularization of the liver graft...
May 18, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29764373/a-subclinical-high-tricuspid-regurgitation-pressure-gradient-independent-of-the-mean-pulmonary-artery-pressure-is-a-risk-factor-for-the-survival-after-living-donor-liver-transplantation
#2
Yosuke Saragai, Akinobu Takaki, Yuzo Umeda, Takashi Matsusaki, Tetsuya Yasunaka, Atsushi Oyama, Ryuji Kaku, Kazufumi Nakamura, Ryuichi Yoshida, Daisuke Nobuoka, Takashi Kuise, Kosei Takagi, Takuya Adachi, Nozomu Wada, Yasuto Takeuchi, Kazuko Koike, Fusao Ikeda, Hideki Onishi, Hidenori Shiraha, Shinichiro Nakamura, Hiroshi Morimatsu, Hiroshi Ito, Toshiyoshi Fujiwara, Takahito Yagi, Hiroyuki Okada
BACKGROUND: Portopulmonary hypertension (POPH) is characterized by pulmonary vasoconstriction, while hepatopulmonary syndrome (HPS) is characterized by vasodilation. Definite POPH is a risk factor for the survival after orthotopic liver transplantation (OLT), as the congestive pressure affects the grafted liver, while subclinical pulmonary hypertension (PH) has been acknowledged as a non-risk factor for deceased donor OLT. Given that PH measurement requires cardiac catheterization, the tricuspid regurgitation pressure gradient (TRPG) measured by echocardiography is used to screen for PH and congestive pressure to the liver...
May 15, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29747216/survival-outcomes-in-split-compared-to-whole-liver-transplantation
#3
Kyung Chul Yoon, Sanghee Song, Eun-Kyoung Jwa, Sanghoon Lee, Jong Man Kim, Ok-Kyoung Kim, Suk Kyun Hong, Nam-Joon Yi, Kwang-Woong Lee, Myoung Soo Kim, Shin Hwang, Kyung-Suk Suh, Suk-Koo Lee
Split liver transplantation (SLT) should be cautiously considered because the right tri-sectional (RTS) graft can be a marginal graft in adult recipients. Herein, we analyzed the outcomes of RTS-SLT in Korea, where > 75% of adult liver transplantations are performed by living donor liver transplantation. Among 2,462 patients who underwent deceased donor liver transplantations (DDLT) from 2005 to 2014, we retrospectively reviewed 86 adult patients (3.4%) who received a RTS graft (RTS-SLT group). The outcomes of the RTS-SLT group were compared to those of 303 recipients of whole liver (WL-DDLT group)...
May 10, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29744353/donation-after-circulatory-death-in-paediatric-liver-transplantation-current-status-and-future-perspectives-in-the-machine-perfusion-era
#4
REVIEW
Roberta Angelico, M Thamara P R Perera, Tommaso Maria Manzia, Alessandro Parente, Chiara Grimaldi, Marco Spada
Efforts have been made by the transplant community to expand the deceased donor pool in paediatric liver transplantation (LT). The growing experience on donation after circulatory death (DCD) for adult LT has encouraged its use also in children, albeit in selective cases, opening new perspectives for paediatric patients. Even though there has recently been a slight increase in the number of DCD livers transplanted in children, with satisfactory graft and patient outcomes, the use of DCD grafts in paediatric recipients is still controversial due to morbid outcomes associated with DCD grafts...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29735030/living-donor-intestinal-transplantation
#5
REVIEW
Ivo G Tzvetanov, Kiara A Tulla, Giuseppe D'Amico, Enrico Benedetti
Living donor intestinal transplantation (LDIT) has been improved leading to results comparable to those obtained with deceased donors. LDIT should be limited to specific indications and patient selection. The best indication is combined living donor intestinal/liver transplantation in pediatric recipients with intestinal and hepatic failure; the virtual elimination of waiting time may avoid the high mortality experienced by candidates on the deceased waiting list. Potentially, LDIT could be used in highly sensitized recipients to allow the application of de-sensitization protocols...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29731083/single-center-experience-using-marginal-liver-grafts-in-korea
#6
P-J Park, Y-D Yu, Y-I Yoon, S-R Kim, D-S Kim
BACKGROUND: Liver transplantation (LT) is an established therapeutic modality for patients with end-stage liver disease. The use of marginal donors has become more common worldwide due to the sharp increase in recipients, with a consequent shortage of suitable organs. We analyzed our single-center experience over the last 8 years in LT to evaluate the outcomes of using so-called "marginal donors." METHODS: We retrospectively analyzed the database of all LTs performed at our institution from 2009 to 2017...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29731074/postoperative-doppler-ultrasonography-in-liver-transplantation
#7
Y K Chung, H J Choi, G H Na, Y K You, I Y Park
BACKGROUND: Doppler ultrasonography plays an important role in the postoperative management of liver transplantation. We present our initial experiences evaluating liver transplants with the use of postoperative Doppler sonography. METHODS: In our hospital, we performed 20 liver transplantations from July 2014 to October 2016. Among 20 patients, we performed 15 deceased-donor liver transplantations (DDLTs) and 5 living-donor liver transplantations (LDLTs). For deceased donors, inferior vena cava anastomoses were performed with the use of the piggyback technique, and for living donors, modified right grafts were used with middle hepatic vein reconstruction by Dacron graft...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29731058/characteristics-of-recipients-with-10-or-more-years-of-allograft-survival-in-deceased-donor-kidney-transplantation
#8
S S Kang, W Y Park, K Jin, S B Park, S Han
BACKGROUND: The development of immunosuppressants improved the short-term outcomes of deceased donor kidney transplantation (DDKT), but the long-term survival rate was not improved. METHODS: The study included 127 patients who received first-time kidneys from deceased donors at Keimyung University Dongsan hospital between October 1994 and June 2007. We analyzed the clinical features of recipients with long-term allograft survival. RESULTS: The mean follow-up period was 163 months...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29723674/the-surgical-challenges-of-salvage-living-donor-liver-transplantation-for-hepatocellular-carcinoma-the-cumulative-experience-of-100-cases-a-retrospective-cohort-study-and-a-propensity-score-analysis
#9
Chee-Chien Yong, Ahmed M Elsarawy, Shih-Ho Wang, Tsan-Shiun Lin, Chih-Chi Wang, Wei-Feng Li, Ting-Lung Lin, Fang-Ying Kuo, Yu-Fan Cheng, Chao-Long Chen, Chih-Che Lin
BACKGROUND: Hepatocellular carcinoma (HCC) is increasingly managed by liver resection first then salvage liver transplantation in case of recurrence within accepted criteria. Many reports compared the safety of the salvage against the primary surgery in the setting of deceased donation but the difference in case of living donation is not sufficiently defined. Salvage living donor liver transplantation (SLDLT) is believed to be a more challenging surgery than primary living donor liver transplantation (PLDLT) due to operative field adhesions, in addition to the inherent difficulties particularly short vasculobiliary stumps...
April 30, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29722107/the-key-roles-of-hepatologists-in-successful-liver-transplantation
#10
REVIEW
Tomomi Kogiso, Katsutoshi Tokushige
Liver transplantation (LT) has been performed for acute liver failure, end-stage liver disease, and congenital metabolic disease in more than 7,000 cases in Japan. LT has been established as a treatment option, and survival rates have improved. In 2016, a new registration/allocation policy and a new scoring system for deceased-donor LT (DDLT) were established. The management of perioperative patients and preoperative therapy for liver failure, nutrition, and preventing infection were upgraded. Moreover, methods for preventing disease recurrence, and treating hepatitis C and B have been developed and are particularly crucial for good outcomes in LT...
May 2, 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29720579/congenital-esophageal-atresia-and-microtia-in-a-newborn-secondary-to-mycophenolate-mofetil-exposure-during-pregnancy-a-case-report-and-review-of-the-literature
#11
Musaed Mohammed Alsebayel, Faisal Abdulrahman Abaalkhail, Faisal Mohammed Alsebayel, Dema A Alissa, Ahmed Hamdan Al-Jedai, Hussien Elsiesy
BACKGROUND Mycophenolate mofetil (MMF) is one of the most commonly prescribed drugs to prevent organ transplant rejection in combination with calcineurin inhibitors and steroids. It has a different toxicity profile than tacrolimus and cyclosporine.  Gastrointestinal tract disturbances are the most common adverse effects. The use of MMF in pregnant women, however, holds great risk of miscarriage and fetal development defects such as external ear malformation, ocular anomalies, cleft lip and palate, and abnormality of distal limbs, heart, esophagus, and kidneys...
May 3, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29713134/compared-efficacy-of-preservation-solutions-on-the-outcome-of-liver-transplantation-meta-analysis
#12
Ágnes Lilla Szilágyi, Péter Mátrai, Péter Hegyi, Eszter Tuboly, Daniella Pécz, András Garami, Margit Solymár, Erika Pétervári, Márta Balaskó, Gábor Veres, László Czopf, Bastian Wobbe, Dorottya Szabó, Juliane Wagner, Petra Hartmann
AIM: To compare the effects of the four most commonly used preservation solutions on the outcome of liver transplantations. METHODS: A systematic literature search was performed using MEDLINE, Scopus, EMBASE and the Cochrane Library databases up to January 31st , 2017. The inclusion criteria were comparative, randomized controlled trials (RCTs) for deceased donor liver (DDL) allografts with adult and pediatric donors using the gold standard University of Wisconsin (UW) solution or histidine-tryptophan-ketoglutarate (HTK), Celsior (CS) and Institut Georges Lopez (IGL-1) solutions...
April 28, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29712886/outcomes-of-adult-liver-transplantation-from-donation-after-brain-death-followed-by-circulatory-death-in-china
#13
Jiabin Zhang, Hui Ren, Yanling Sun, Zhijie Li, Hongbo Wang, Zhenwen Liu, Shaotang Zhou
BACKGROUND Organ donation from a deceased donor, which is donation after brain death followed by circulatory death, is a unique transplantation practice in China. Pathological features of grafts help guide the utilization of grafts. MATERIAL AND METHODS We retrospectively reviewed our experiences in 188 DBCD allografts from May 2014 to April 2017. We divided 183 transplanted allografts into 3 groups according to pretransplant histology: the good quality graft group (n=62), the preservation injury group (n=27), and the steatotic graft group (n=94)...
May 1, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29710288/the-drug-overdose-epidemic-and-deceased-donor-transplantation-in-the-united-states-a-national-registry-study
#14
Christine M Durand, Mary G Bowring, Alvin G Thomas, Lauren M Kucirka, Allan B Massie, Andrew Cameron, Niraj M Desai, Mark Sulkowski, Dorry L Segev
Background: The epidemic of drug overdose deaths in the United States has led to an increase in organ donors. Objective: To characterize donors who died of overdose and to analyze outcomes among transplant recipients. Design: Prospective observational cohort study. Setting: Scientific Registry of Transplant Recipients, 1 January 2000 to 1 September 2017. Participants: 138 565 deceased donors; 337 934 transplant recipients at 297 transplant centers...
April 17, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29694726/treatment-and-management-options-for-the-hepatitis-c-virus-infected-kidney-transplant-candidate
#15
REVIEW
Adriana Dejman, Marco A Ladino, David Roth
A substantial body of literature has unequivocally established that prevalent hepatitis C virus infection in chronic kidney disease (CKD), end stage renal disease (ESRD) and kidney transplant recipients is associated with a negative impact on patient survival. As a consequence of remarkable work that explained the details of the hepatitis C virus (HCV) genome, a class of drugs referred to as the direct-acting antiviral (DAA) agents were developed that targeted specific key sites in viral replication. Large clinical trials in the HCV-infected general population followed soon after that demonstrated cure rates exceeding 95%...
April 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29688072/steroid-free-immunosuppression-with-low-dose-tacrolimus-is-safe-and-significantly-reduces-the-incidence-of-new-onset-diabetes-mellitus-following-liver-transplantation
#16
M Castedal, C Skoglund, C Axelson, W Bennet
OBJECTIVES: Corticosteroids (CS) are traditionally used as part of the basal immunosuppression (IS) following liver transplantation (LT) but are known to be associated with an increased risk of new-onset diabetes mellitus (NODM), cardiovascular morbidity and mortality. The aim of this study was to retrospectively compare the incidence of transient as well as persistent NODM, rejection rate and patient- and graft survival between patients receiving steroid-based and steroid-free maintenance IS...
April 24, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29684000/split-liver-transplantation-and-pediatric-waitlist-mortality-in-the-united-states-potential-for-improvement
#17
Emily R Perito, Garrett Roll, Jennifer L Dodge, Sue Rhee, John P Roberts
BACKGROUND: In the United States, 1 in 10 infants and 1 in 20 older children die on the liver transplant waiting list. Increasing split liver transplantation could increase organ availability for these children, without decreasing transplants in adults. METHODS: Using UNOS STAR data, we identified livers transplanted 2010-2015 that could potentially have been used for split transplant, based on strict criteria. Livers not suitable for pediatric patients or allocated to high-risk recipients were excluded...
April 21, 2018: Transplantation
https://www.readbyqxmd.com/read/29677070/heavy-alcohol-use-among-deceased-donors-does-not-impact-recipient-outcomes-after-liver-transplantation
#18
Sumant S Arora, Khushdeep S Chahal, Page Axley, Devin E Eckhoff, Yong-Fang Kuo, Sanjaya K Satapathy, Russell Wiesner, Ashwani K Singal
BACKGROUND: Data on liver transplant (LT) outcomes using deceased donors with heavy drinking (HD) (>2 drinks/day) are scanty. METHODS: Using the United Network for Organ Sharing database (2002-2014), we examined outcomes after LT in adults comparing deceased HD donors with not heavy drinking (ND) donors. RESULTS: Of 56 182 first LTs performed in the US for 10 common indications using deceased donors, 47 882 with available information on alcohol use were analyzed...
April 19, 2018: Transplantation
https://www.readbyqxmd.com/read/29676390/receiving-hypertensive-donor-grafts-is-associated-with-inferior-prognosis-in-simultaneous-liver-kidney-transplantation-recipients
#19
Zebin Zhu, Shanzhou Huang, Qiang Zhao, Yunhua Tang, Zhiheng Zhang, Linhe Wang, Weiqiang Ju, Zhiyong Guo, Xiaoshun He
BACKGROUND The impact of hypertensive (HTN) donor grafts on the prognosis of simultaneous liver-kidney transplantation (SLKT) patient is not known, and an applicable risk scoring system for SLKT patient survival is lacking. This study aimed to evaluate the impact of donor HTN on patient survival of SLKT recipients and to identify independent risk factors. MATERIAL AND METHODS Data from 3844 adult SLKT recipients receiving deceased donor grafts from March 2002 to December 2014 in the Scientific Registry of Transplant Recipients (SRTR) database were retrospectively analyzed...
April 20, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29672442/more-than-just-wait-time-regional-differences-in-liver-transplant-outcomes-for-hepatocellular-carcinoma
#20
Rachel Hogen, Mary Lo, Joseph DiNorcia, Lingyun Ji, Yuri Genyk, Linda Sher, Kiran Dhanireddy
BACKGROUND: Regional allocation of deceased donor livers has led to variable wait times for HCC patients on the liver transplant list. The purpose of our study was to evaluate how regional differences in wait time affect outcomes for HCC patients. METHODS: A retrospective, observational study was performed using the OPTN database from 2/27/2002 to 9/25/2015. The cumulative incidences of transplant and waitlist death as well as intention-to-treat and posttransplant survival were evaluated for patients ≥ 18 years of age listed for DDLT with stage II HCC exception points in each UNOS region...
April 18, 2018: Transplantation
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