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Deceased donor liver transplantation

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https://www.readbyqxmd.com/read/28439714/arterial-and-biliary-complications-after-living-donor-liver-transplantation-a-single-center-retrospective-study-and-literature-review
#1
REVIEW
Shigehito Miyagi, Yuta Kakizaki, Kenji Shimizu, Koji Miyazawa, Wataru Nakanishi, Yasuyuki Hara, Kazuaki Tokodai, Chikashi Nakanishi, Takashi Kamei, Noriaki Ohuchi, Susumu Satomi
AIM: The mortality of patients on the waiting list for deceased donor liver transplantation (DDLT) is high, especially in countries where donation rates are low. Thus, living donor liver transplantation (LDLT) is an attractive option. However, compared with DDLT, LDLT is associated with increased rates of arterial and biliary complications. We examined the rates of complications and risk factors following LDLT. METHODS: We retrospectively investigated and compared the rates of complications of DDLT and LDLT in our institute...
April 24, 2017: Surgery Today
https://www.readbyqxmd.com/read/28437790/utility-in-treating-kidney-failure-in-end-stage-liver-disease-with-simultaneous-liver-kidney-transplantation
#2
Xingxing S Cheng, Margaret R Stedman, Glenn M Chertow, W Ray Kim, Jane C Tan
BACKGROUND: Simultaneous liver-kidney (SLK) transplantation plays an important role in treating kidney failure in patients with end-stage liver disease. It used 5% of deceased donor kidney transplanted in 2015. We evaluated the utility, defined as posttransplant kidney allograft lifespan, of this practice. METHODS: Using data from the Scientific Registry of Transplant Recipients, we compared outcomes for all SLK transplants between January 1, 1995, and December 3, 2014, to their donor-matched kidney used in kidney-alone (Ki) or simultaneous pancreas kidney (SPK) transplants...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28437386/the-international-liver-transplantation-society-living-donor-liver-transplant-recipient-guideline
#3
Charles M Miller, Cristiano Quintini, Anil Dhawan, Francois Durand, Julie K Heimbach, Hyung Leona Kim-Schluger, Eirini Kyrana, Sung-Gyu Lee, Jan Lerut, Chung-Mau Lo, Elizabeth Anne Pomfret
Living donor liver transplantation (LDLT) has been increasingly embraced around the world as an important strategy to address the shortage of deceased donor livers. The aim of this guideline, approved by the International Liver Transplantation Society (ILTS), is to provide a collection of expert opinions, consensus, and best practices surrounding LDLT. Recommendations were developed from an analysis of the National Library of Medicine living donor transplantation indexed literature using the Grading of Recommendations Assessment, Development and Evaluation methodology...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28434081/the-outcomes-of-pediatric-liver-retransplantation-from-a-living-donor-a-17-year-single-center-experience
#4
Kohei Miura, Seisuke Sakamoto, Keita Shimata, Masaki Honda, Takashi Kobayashi, Toshifumi Wakai, Yasuhiko Sugawara, Yukihiro Inomata
PURPOSE: Liver retransplantation is the only therapeutic option for patients with graft failure after liver transplantation. The aim of this study is to evaluate the outcomes of pediatric retransplantation from living donor at a single center. METHODS: Between December 1998 to August 2015, retransplantation from a living donor was performed for 14 children (<18 years of age) at Kumamoto University Hospital. The characteristics of the retransplantation recipient and the clinicopathological factors between primary transplantation and retransplantation were analyzed to detect the prognostic factors...
April 22, 2017: Surgery Today
https://www.readbyqxmd.com/read/28426586/predictive-modeling-of-massive-transfusion-requirements-during-liver-transplantation-and-its-potential-to-reduce-utilization-of-blood-bank-resources
#5
Aliaksei Pustavoitau, Maggie Lesley, Promise Ariyo, Asad Latif, April J Villamayor, Steven M Frank, Nicole Rizkalla, William Merritt, Andrew Cameron, Nabil Dagher, Benjamin Philosophe, Ahmet Gurakar, Allan Gottschalk
BACKGROUND: Patients undergoing liver transplantation frequently but inconsistently require massive blood transfusion. The ability to predict massive transfusion (MT) could reduce the impact on blood bank resources through customization of the blood order schedule. Current predictive models of MT for blood product utilization during liver transplantation are not generally applicable to individual institutions owing to variability in patient population, intraoperative management, and definitions of MT...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28425187/significance-of-measured-intraoperative-portal-vein-flows-after-thrombendvenectomy-in-deceased-donor-liver-transplants-with-portal-vein-thrombosis
#6
Mark Draoua, Nicole Titze, Amar Gupta, Hoylan T Fernandez, Michael Ramsay, Giovanna Saracino, Gregory McKenna, Testa Giuliano, Goran B Klintmalm, Peter T W Kim
BACKGROUND: Adequate portal vein (PV) flow in liver transplantation is essential for a good outcome, and it may be compromised in patients with portal vein thrombosis (PVT). This study evaluated the impact of intraoperatively measured PV flow after PV thrombendvenectomy on outcomes after deceased donor liver transplantation. STUDY DESIGN: The study included 77 patients over a 16-year period who underwent PV thrombendvenectomy with complete flow data. Patients were classified into two groups: high PV flow (>1300 mL/min, N = 55) and low PV flow (≤1300 mL/min, N = 22)...
April 20, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28421681/early-clinical-xenotransplantation-experiences-an-interview-with-thomas-e-starzl-md-phd
#7
REVIEW
David K C Cooper
Dr Thomas E. Starzl, who died on March 4, 2017, was one of the great pioneers of organ transplantation. He was also a pioneer in the field of xenotransplantation. In 1964, he carried out baboon kidney transplants in six patients with terminal renal disease for whom no living or deceased donor became available; graft survival was for 19-60 days, the grafts being lost largely through continuous complement activation. Between 1966 and 1974, he carried out one ex vivo liver perfusion and three orthotopic liver transplants using chimpanzees as sources of organs; graft survival was for <14 days...
March 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28415168/an-update-on-endoscopic-management-of-post-liver-transplant-biliary-complications
#8
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/28411361/liver-transplant-in-children-with-hepatoblastoma
#9
Mehmet Hanifi Okur, Yücel Yankol, Bayındır Cimşit, Nesimi Mecit, Gökhan Ertuğrul, Turan Kanmaz, Ceyhun Bozkurt, Koray Acarlı, Münci Kalayoğlu
OBJECTIVES: In this paper, the results of liver transplant due to hepatoblastoma in 10 pediatric patients at Istanbul Şişli Memorial Hospital Transplantation Center are presented. MATERIALS AND METHODS: We retrospectively evaluated medical records of pediatric patients diagnosed with hepatoblastoma and who underwent liver transplant at our clinic between January 2009 and March 2014. We examined age, weight, chemotherapy regimen, graft type for liver transplant, duration of hospital stay, complications, follow-up duration, and survival information...
April 14, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28410631/comparison-of-three-caval-reconstruction-techniques-in-orthotopic-liver-transplantation-a-retrospective-review
#10
Tiffany Chan, Kristin DeGirolamo, Stephanie Chartier-Plante, Andrzej K Buczkowski
BACKGROUND: Classic caval reconstruction during liver transplantation involves complete cross-clamping and resection of the recipient inferior vena cava (IVC) followed by donor IVC interposition. Other techniques preserve the IVC, with piggyback (PB) to the hepatic veins or side-to-side (SS) caval anastomosis. Avoidance of cross-clamping may be beneficial for minimizing hemodynamic instability and transfusion requirements. METHODS: Retrospective review of a provincial transplant database (2007-2011)...
April 6, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28405138/long-term-follow-up-and-outcome-of-liver-transplantation-from-hepatitis-b-surface-antigen-positive-donors
#11
EDITORIAL
Roberto Ballarin, Alessandro Cucchetti, Francesco Paolo Russo, Paolo Magistri, Matteo Cescon, Umberto Cillo, Patrizia Burra, Antonio Daniele Pinna, Fabrizio Di Benedetto
Liver transplant for hepatitis B virus (HBV) currently yields excellent outcomes: it allows to rescue patients with an HBV-related advanced liver disease, resulting in a demographical modification of the waiting list for liver transplant. In an age of patient-tailored treatments, in liver transplantation as well the aim is to offer the best suitable graft to the patient who can benefit from it, also expanding the criteria for organ acceptance and allocation. With the intent of developing strategies to increase the donor pool, we set-up a multicenter study involving 3 Liver Transplant Centers in Italy: patients undergoing liver transplantation between March 03, 2004, and May 21, 2010, were retrospectively evaluated...
March 28, 2017: World Journal of Gastroenterology: WJG
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
#12
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/28397153/meldna-score-is-associated-with-psychopathology-and-reduced-quality-of-life-in-cirrhotic-patients-with-a-liver-transplant-perspective
#13
Gabriele Cavaggioni, Edoardo Poli, Flaminia Ferri, Lucia Parlati, Valentina Monaco, Claudia Melcore, Barbara Lattanzi, Manuela Merli, Gianluca Mennini, Fabio Melandro, Massimo Rossi, Stefano Ginanni Corradini
Psychopathological symptoms and reduced health related quality of life (HRQoL) are frequent in cirrhotics, but no data on their association with cirrhosis prognosis assessed by the MELDNa score are available. Prospective data on the long-term effect of deceased donor liver transplantation (LT) on psychopathological symptoms are needed. Before entering the LT waiting list, 44 consecutive LT cirrhotic candidates without a major psychiatric disorder underwent a psychopathological assessment, including Symptom Checklist-90-revised (SCL-90-R) and Defense Style Questionnaire (DSQ)...
April 11, 2017: Metabolic Brain Disease
https://www.readbyqxmd.com/read/28390101/geographic-disparities-in-liver-availability-accidents-of-geography-or-consequences-of-poor-social-policy
#14
Keren Ladin, Gregory Zhang, Douglas W Hanto
Recently, a redistricting proposal intended to equalize MELDs recommended expanding liver sharing to mitigate geographic variation in liver transplantation. Yet, it is unclear whether variation in liver availability is arbitrary and a disparity requiring rectification, or whether it reflects differences in access to care. We evaluate the proposal's claim that organ supply is an "accident of geography" by examining the relationship between local organ supply and the uneven landscape of social determinants and policies that contribute to differential death rates across the United States...
April 8, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28381305/fair-is-fair-we-must-re-allocate-livers-for-transplant
#15
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/28377543/mycobacterium-tuberculosis-in-solid-organ-transplantation-incidence-before-and-after-expanded-isoniazid-prophylaxis
#16
Suad Mohamed Al-Mukhaini, Hassan Al-Eid, Fatima Alduraibi, Hanan Ibrahim Hakami, Haifa Al Talhi, Mohamed Shoukri, Ahmed M Ahmed, Yusuf Ahmed, Abdulrahman A Alrajhi
BACKGROUND: The risk of tuberculosis is increased in solid organ transplantation. Rates remain high in developed and developing countries. We developed protocols to better identify transplant recipients at risk of tuberculosis and initiate interventions to prevent tuberculosis. OBJECTIVES: Report tuberculosis incidence in solid-organ transplant recipients and the results of expanded isoniazid prophylaxis in deceased-donor renal transplantation. DESIGN: Retrospective cohort study, comparing two time periods...
March 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28359777/kidney-transplantation-in-children-weighing-15%C3%A2-kg-or-less-is-challenging-but-associated-with-good-outcome
#17
REVIEW
Romy Gander, Marino Asensio, Gloria Fatou Royo, Jose Andrés Molino, Gema Ariceta, Luis Enrique Lara, Josep Lloret
OBJECTIVE: Pediatric kidney transplantation (KT) in small children is assumed to be related to potential surgical complications that may cause severe morbidity and graft loss. The aim of our study was to analyze the outcome of KT recipients weighing ≤15 kg, focusing on surgical complications, associated morbidity and mortality, as well as allograft loss. METHODS: We reviewed our retrospective institutional database for recipients of KT between January 2000 and December 2014 with body weight ≤15 kg...
March 18, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28357506/the-long-term-outcomes-of-hepatitis-c-virus-core-antigen-positive-japanese-renal-allograft-recipients
#18
Kazuaki Okino, Yuki Okushi, Kiyotaka Mukai, Yuki Matsui, Norifumi Hayashi, Keiji Fujimoto, Hiroki Adachi, Hideki Yamaya, Hitoshi Yokoyama
BACKGROUND: The impact of hepatitis C virus (HCV) infections on patient long-term survival after renal transplants is unclear. METHOD: To clarify the long-term outcomes of Japanese renal allograft recipients with HCV infections, we studied the cases of 187 patients (118 males and 69 females; 155 living donor cases, and 32 deceased donor cases; median follow-up period: 250 months) who underwent an initial renal transplant at Kanazawa Medical University from 1974 onwards...
March 29, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28324141/early-hepatic-artery-thrombosis-after-liver-transplantation-what-is-the-impact-of-the-arterial-reconstruction-type
#19
Astrid Herrero, Regis Souche, Emmanuel Joly, Gildas Boisset, Hussein Habibeh, Hassan Bouyabrine, Fabrizio Panaro, Jose Ursic-Bedoya, Samir Jaber, Boris Guiu, Georges Philippe Pageaux, Francis Navarro
OBJECTIVE: Hepatic artery thrombosis (HAT) is the most severe vascular complication occurring after liver transplantation, with an incidence ranging from 2 to 9% in adults. Although the ideal arterial reconstruction is often described as a short and non-redundant anastomosis fashioned between the recipient and donor hepatic arteries, there is no strong evidence about this ideal reconstruction in the literature. The aim of this study was to assess the impact of the type of arterial reconstruction on early HAT after primary liver transplantation...
March 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28319169/high-meld-score-and-extended-operating-time-predict-prolonged-initial-icu-stay-after-liver-transplantation-and-influence-the-outcome
#20
Panagiota Stratigopoulou, Andreas Paul, Dieter P Hoyer, Stylianos Kykalos, Fuat H Saner, Georgios C Sotiropoulos
BACKGROUND: The aim of the present study is to determine the incidence of a prolonged (>3 days) initial ICU-stay after liver transplantation (LT) and to identify risk factors for it. PATIENTS AND METHODS: We retrospectively analyzed data of adult recipients who underwent deceased donor first-LT at the University Hospital Essen between 11/2003 and 07/2012 and showed a primary graft function. RESULTS: Of the 374 recipients, 225 (60.16%) had prolonged ICU-stay...
2017: PloS One
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