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Deceased donor liver transplantation

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https://www.readbyqxmd.com/read/27919847/using-on-site-liver-3-d-reconstruction-and-volumetric-calculations-in-split-liver-transplantation
#1
Trevor W Reichman, Brittany Fiorello, Ian Carmody, Humberto Bohorquez, Ari Cohen, John Seal, David Bruce, George E Loss
BACKGROUND: Split liver transplantation increases the number of grafts available for transplantation. Pre-recovery assessment of liver graft volume is essential for selecting suitable recipients. The purpose of this study was to determine the ability and feasibility of constructing a 3-D model to aid in surgical planning and to predict graft weight prior to an in situ division of the donor liver. METHODS: Over 11 months, 3-D volumetric reconstruction of 4 deceased donors was performed using Pathfinder Scout© liver volumetric software...
December 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/27919127/-deceased-donor-kidney-transplantation-from-a-liver-transplantation-recipient
#2
Shuhei Koike, Takashi Kobayashi, Yoshiyuki Okada, Shinsuke Shibuya, Kaoru Sakai, Yukari Tanaka, Shusuke Akamatsu, Hiromitsu Negoro, Naoki Terada, Toshinari Yamasaki, Yoshiyuki Matsui, Takahiro Inoue, Tomomi Kamba, Yumi Umeya, Toshimi Kaido, Osamu Ogawa
We report a 40-year-old man with end-stage renal disease due to IgA nephropathy who underwent deceased donor kidney transplantation. The donor was diagnosed to be brain-dead due to cerebral hemorrhage after her second liver transplantation for non-viral liver cirrhosis. Intraoperative 1-hour biopsy of the graft kidney revealed moderate global glomerular sclerosis (22%) and interstitial fibrosis (40%) consistent with underlying nephrosclerosis or calcineurin inhibitor nephrotoxicity. Although hemodialysis was needed until the graft began functioning several days after the kidney transplantation, the postoperative clinical course thereafter was uneventful and the graft functioned well with stable serum creatinine levels around 2...
October 2016: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/27896854/decreased-graft-survival-in-liver-transplant-recipients-of-donors-with-positive-blood-cultures-a-review-of-the-unos-dataset
#3
Moises A Huaman, Valery Vilchez, Xiaonan Mei, Malay B Shah, Michael F Daily, Jonathan Berger, Roberto Gedaly
Liver transplantation using blood culture positive donors (BCPD) has allowed a significant expansion of the donor pool. We aimed to characterize BCPD and assess the outcomes of BCPD liver transplant recipients. We retrieved data from the United Network for Organ Sharing (UNOS) registry on all adults who underwent primary, single organ deceased-donor liver transplantation in the U.S. between 2008 and 2013. Patients were classified in two cohorts: the BCPD cohort and the non-BCPD cohort. One-year graft and patient survival were compared between cohorts using Kaplan-Meier estimates and Cox models...
November 29, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27888279/predictors-of-liver-transplant-patient-survival-a-critical-review-using-a-holistic-framework
#4
Lisiane Pruinelli, Karen A Monsen, Cynthia R Gross, David M Radosevich, György J Simon, Bonnie L Westra
OBJECTIVE: Liver transplantation is a costly and risky procedure, representing 25 050 procedures worldwide in 2013, with 6729 procedures performed in the United States in 2014. Considering the scarcity of organs and uncertainty regarding prognosis, limited studies address the variety of risk factors before transplantation that might contribute to predicting patient's survival and therefore developing better models that address a holistic view of transplant patients. This critical review aimed to identify predictors of liver transplant patient survival included in large-scale studies and assess the gap in risk factors from a holistic approach using the Wellbeing Model and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement...
November 25, 2016: Progress in Transplantation
https://www.readbyqxmd.com/read/27882068/transplantation-of-deceased-donor-livers-with-elevated-levels-of-serum-transaminases-at-shiraz-transplant-center
#5
Nasir Fakhar, Saman Nikeghbalian, Kourosh Kazemi, Ali Reza Shamsayeefar, Siavash Gholami, Amir Kasraianfard, Seyed Ali Malek-Hosseini
BACKGROUND: The current organ shortage has prompted the use of marginal organs. We conducted this retrospective study to present our experience with transplanting deceased donor livers with elevated levels of serum transaminases and to explain whether elevated levels of serum transaminases in donors affect allograft function and survival of the recipients. METHODS: Data of deceased donor livers and patients, who underwent liver transplantation from March 2013 to March 2015 at Shiraz center for organ transplantation, was reviewed...
October 2016: Hepatitis Monthly
https://www.readbyqxmd.com/read/27862929/effects-of-recipient-size-and-allograft-type-on-pediatric-liver-transplantation-for-biliary-atresia
#6
Sophoclis P Alexopoulos, Victor Nekrasov, Shu Cao, Susan Groshen, Navpreet Kaur, Yuri S Genyk, Lea Matsuoka
RATIONALE: The majority of pediatric patients with end stage liver disease receive a transplant with a whole liver allograft. However, smaller recipients with biliary atresia may have improved outcomes with deceased donor partial liver or living donor allografts. This study compares the national outcomes for liver transplantation in biliary atresia, with attention to the interaction between liver allograft type and recipient size. RESULTS: From 1/2/2002 to 12/30/2014, 2123 pediatric patients underwent a primary liver transplant for biliary atresia...
November 10, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27861290/pathophysiological-trends-during-withdrawal-of-life-support-implications-for-organ-donation-after-circulatory-death
#7
Arjun Iyer, Hong Chee Chew, Ling Gao, Jeanette Villanueva, Mark Hicks, Aoife Doyle, Gayathri Kumarasinghe, Andrew Jabbour, Paul Cassius Jansz, Michael P Feneley, Richard P Harvey, Robert M Graham, Kumud K Dhital, Peter S Macdonald
BACKGROUND: Donation after circulatory death (DCD) provides an alternative pathway to deceased organ transplantation. Although clinical DCD lung, liver, and kidney transplantation are well established, transplantation of hearts retrieved from DCD donors has reached clinical translation only recently. Progress has been limited by concern regarding the viability of DCD hearts. The aim of this study was to document the pathophysiological changes that occur in the heart and circulation during withdrawal of life (WLS) support...
December 2016: Transplantation
https://www.readbyqxmd.com/read/27837276/new-onset-diabetes-mellitus-after-living-donor-liver-transplantation-association-with-graft-synthetic-function
#8
Shintaro Yagi, Toshimi Kaido, Taku Iida, Atsushi Yoshizawa, Hideaki Okajima, Shinji Uemoto
BACKGROUND AND PURPOSE: It is now known that post-transplant graft function after deceased-donor liver transplantation and living-donor liver transplantation (LDLT) differ; however, there is no report assessing the relationship between graft function and the development of new-onset diabetes mellitus after transplantation (NODAT). We conducted this study to identify the predictive risk factors for NODAT, including graft function after LDLT. METHODS: The subjects of this study were 175 adult recipients who underwent LDLT at Kyoto University Hospital between 2006 and 2010, and survived for more than 3 months (median observation period, 1046 days)...
November 11, 2016: Surgery Today
https://www.readbyqxmd.com/read/27826558/indications-for-living-donor-liver-transplantation-in-patients-with-hepatocellular-carcinoma
#9
Yasuhiko Sugawara, Yukihiro Inomata
Liver transplantation is the optimal radical therapy for patients with cirrhosis and hepatocellular carcinoma (HCC). The Milan criteria are widely applied for deceased donor liver transplantation (DDLT) in the western countries. Living donor liver transplantation (LDLT), however, prevails in Asian countries due to the extreme shortage of deceased donor organs. In contrast to DDLT, the feasibility of LDLT is not restricted by the national allocation system, and therefore the indications for LDLT in patients with HCC depend on institutional policies that consider both the operative risk to the donor and the survival benefit for the recipient...
October 2016: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/27826557/liver-transplantation-for-hepatocellular-carcinoma-from-living-donor-vs-deceased-donor
#10
REVIEW
Nobuhisa Akamatsu, Norihiro Kokudo
With the increasing prevalence of living-donor liver transplantation (LDLT), the possible increased recurrence rate of hepatocellular carcinoma (HCC) in LDLT recipients in comparison with deceased-donor liver transplantation (DDLT) recipients has become a matter of debate. The aim of this review is to encompass current opinions and clinical reports regarding differences in the outcome, especially the recurrence of HCC, between LDLT and DDLT. In reviewing literatures, some studies reported increased recurrence rates among LDLT recipients, a majority of authors, including large database studies, reported comparable recurrence-free survival and recurrence rates between LDLT and DDLT...
October 2016: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/27826556/living-donor-liver-transplantation-for-hepatocellular-carcinoma-achieves-better-outcomes
#11
REVIEW
Chih-Che Lin, Chao-Long Chen
Liver transplantation (LT) for hepatocellular carcinoma (HCC) at Kaohsiung Chang Gung Memorial Hospital mainly relies on live donor LT (LDLT). Owing to taking the risk of LD, we are obligated to adopt strict selection criteria for HCC patients and optimize the pre-transplant conditions to ensure a high disease-free survival similar to those without HCC, even better than deceased donor LT (DDLT). Better outcomes are attributed to excellent surgical results and optimal patient selection. The hospital mortality of primary and salvage LDLT are lower than 2% in our center...
October 2016: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/27826554/living-donor-liver-transplantation-for-hepatocellular-carcinoma-at-the-university-of-tokyo-hospital
#12
Junichi Togashi, Nobuhisa Akamastu, Norihiro Kokudo
BACKGROUND: Living donor liver transplantation (LDLT) is an established treatment not only for those with end-stage liver disease but for those with hepatocellular carcinoma (HCC) developing in cirrhotic liver. The aim of this study was to present a single-center experience of LDLT for HCC at the University of Tokyo Hospital, Japan. METHODS: Among 573 liver transplant recipients from January 1996 until the end of 2015, 139 patients have been indicated LDLT for the treatment of HCC, and were the subjects of the present study...
October 2016: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/27805533/lung-biopsy-findings-of-patients-who-have-undergone-a-liver-and-kidney-transplant
#13
Gonca Özgün, Merih Tepeoğlu, Binnaz Handan Özdemir, Eda Yılmaz Akçay, Ebru Şebnem Ayva, Emine Ebru Deniz, Mehmet Haberal
OBJECTIVES: Our objective was to analyze the incidence of pulmonary disorders in solid-organ transplant recipients and report on outcomes in these patients. MATERIALS AND METHODS: Seventy liver and kidney transplant patients, who underwent lung biopsy because of pulmonary symptoms between January 2000 and December 2015, were enrolled in the study. We examined and evaluated histopathologic findings of these patients based on clinical data recorded in patients' files...
November 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27795989/normothermic-machine-perfusion-of-deceased-donor-liver-grafts-is-associated-with-improved-postreperfusion-hemodynamics
#14
Roberta Angelico, M Thamara P R Perera, Reena Ravikumar, David Holroyd, Constantin Coussios, Hynek Mergental, John R Isaac, Asim Iqbal, Hentie Cilliers, Paolo Muiesan, Peter J Friend, Darius F Mirza
BACKGROUND: Graft reperfusion poses a critical challenge during liver transplantation and can be associated with hemodynamic instability/postreperfusion syndrome. This is sequel to ischemia-reperfusion injury and normothermic machine preservation (NMP) may affect hemodynamic changes. Herein, we characterize postreperfusion hemodynamics in liver grafts after NMP and traditional cold preservation. MATERIALS AND METHODS: Intraoperative records of patients receiving grafts after NMP (n = 6; NMP group) and cold storage (CS) (n = 12; CS group) were compared...
September 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27788788/primum-non-nocere-organ-donation-after-electrocution-and-transplantation-of-electricity-damaged-livers-report-of-2-cases
#15
E Giorgakis, M Tedeschi, E Bonaccorsi-Riani, S E Korshandi, H Vilca-Melendez, N Heaton
Liver transplantation remains the treatment of choice for patients with end-stage liver disease. However, allograft availability continues to be a problem, and extending the criteria for organ acceptance is key. Deceased donors after electrical accidents, as well as electricity-traumatized allografts, are not common but should be considered suitable. This study describes 2 cases of heart-beating organ donors with electrical injury to the liver. In 1 case, the electric shock was the cause of death; in the second case, the injury was caused by defibrillation at organ procurement...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27780188/liver-transplantation-with-older-donors-a-comparison-with-younger-donors-in-a-context-of-organ-shortage
#16
Louise Barbier, Manuela Cesaretti, Federica Dondero, François Cauchy, Linda Khoy-Ear, Takeshi Aoyagi, Emmanuel Weiss, Olivier Roux, Safi Dokmak, Claire Francoz, Catherine Paugam-Burtz, Ailton Sepulveda, Jacques Belghiti, François Durand, Olivier Soubrane
BACKGROUND: Older liver grafts have been considered in the past decade due to organ shortage. The aim was to compare outcomes after liver transplantation with either younger or older donors. METHODS: Patients transplanted in our center between 2004 and 2014 with younger donors (younger than 60 years; n = 253) were compared with older donors (older than 75 years; n = 157). Multiorgan transplantations, split grafts, or non-heart-beating donors were not included. RESULTS: Donors in the older group were mostly women deceased from stroke, and only 3 patients had experienced cardiac arrest...
November 2016: Transplantation
https://www.readbyqxmd.com/read/27749626/acute-liver-failure-outcome-and-value-of-pediatric-end-stage-liver-disease-score-in-pediatric-cases
#17
Raquel Núñez-Ramos, Soledad Montoro, Marcello Bellusci, María Rosa Del Fresno-Valencia, Marta Germán-Díaz, Pedro Urruzuno, Enrique Medina, Javier Manzanares
PURPOSE: The aims of this study were to analyze the characteristics of patients with acute liver failure (ALF) in our center and evaluate the prognostic value of the Pediatric End-Stage Liver Disease (PELD) score calculated at admission. PATIENTS AND METHODS: A retrospective analysis of patients with ALF younger than 15 years between 2005 and 2013 was performed. Information collected included age, sex, etiology of ALF, laboratory tests, PELD score, stage of encephalopathy, and need for liver support devices such as MARS and/or liver transplant (LT) and survival...
September 30, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27749296/massive-fulminant-thrombosis-during-liver-transplantation-in-a-patient-with-a-previously-unknown-antithrombin-pathway-mutation
#18
Dmitri Bezinover, Shigekazu Sugino, Yuka Imamura-Kawasawa, Matthew S Bell, Zakiyah Kadry, Piotr K Janicki
We describe a case of fulminant intraoperative thrombosis during deceased donor liver transplantation. Despite significant medical bleeding, the patient suddenly developed diffuse thrombosis in all chambers of the heart and pulmonary vasculature resulting in intraoperative death. The patient's postmortem genetic analysis demonstrated a deleterious missense mutation in a coagulation pathway gene, SERPINC1, which codes for antithrombin III. The level of antithrombin III was not available to directly prove the causality of thrombosis, but our findings suggest that this mutation, in combination with antifibrinolytic administration in a hypercoagulable cirrhotic patient, might have contributed to the development of this catastrophic thrombotic event...
December 1, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27742319/prostate-specific-antigen-positive-deceased-organ-donor-a-pathologist-is-indispensable
#19
K Pabisiak, M Ostrowski, A Kram, K Safranow, M Słojewski, K Ciechanowski
BACKGROUND: Due to demographic projections, and lack of an algorithm in the case of a prostate specific antigen (PSA)-positive donor, the loss of organ recovery may occur more frequently in the near future without approved procedures. In Poland in recent years it has been recommended to determine tumor markers in potential donors. In the first year of the recommendation 10% of potential deceased donors were disqualified in our transplantation center on the basis of the elevated PSA levels (high PSA >10 ng/mL)...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27742304/right-accessory-hepatic-artery-arising-from-celiac-trunk-case-report-of-a-variation-that-must-be-looked-for-during-multiorgan-procurement
#20
D Bastos-Neves, J A da Silva Alves, L G Guedes Dias, M B de Rezende, P R Salvalaggio
Knowledge of the anatomy of the hepatic artery and its variations is important to hepatobiliary and liver transplant surgeons and interventional radiologists. We report a rare anatomic variation of liver hepatic arterial supply: a right accessory hepatic artery arising directly from the celiac trunk and observed at the time of multiorgan procurement. The anatomic variation described in this case occurs in up to 2% of cases and their knowledge is essential to avoid injuries during multiorgan procurement that could require multiple anastomoses or lead to inadvertent vessel injury...
September 2016: Transplantation Proceedings
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