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Deceased donor liver transplantation

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https://www.readbyqxmd.com/read/29144592/ex-vivo-reduction-of-thickness-in-the-left-lateral-section-to-tailor-the-graft-size-in-infantile-split-deceased-donor-liver-transplantation
#1
Seisuke Sakamoto, Kengo Sasaki, Hajime Uchida, Toshihiro Kitajima, Soichi Narumoto, Yoshihiro Hirata, Tomoro Hishiki, Akinari Fukuda, Mureo Kasahara
No abstract text is available yet for this article.
November 16, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29125670/use-of-a-hepatitis-c-virus-hcv-rna-positive-donor-in-a-treated-hcv-rna-negative-liver-transplant-recipient
#2
Isabel Campos-Varela, Eliana Z Agudelo, Monika Sarkar, John P Roberts, Norah A Terrault
The shortage of livers has led most transplant centers to use extended criteria donors. Hepatitis C virus (HCV) RNA-positive donors are typically not given to patients who have cleared HCV. A 64-year-old male with chronic hepatitis C, genotype 1b was listed for LT with hepatocellular carcinoma. While on the waiting list, the patient was treated with sofosbuvir, ledipasvir, and ribavirin and achieved an HCV RNA <15 IU/mL by week 10. At week 18 of a planned 24-week treatment course, the patient underwent deceased-donor LT and received an organ from an anti-HCV-positive donor...
November 10, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29122905/healthy-donor-faecal-transplant-for-corticosteroid-non-responsive-severe-alcoholic-hepatitis
#3
Cyriac Abby Philips, Nikhil Phadke, Karthik Ganesan, Philip Augustine
Patients with severe alcoholic hepatitis (SAH) have high mortality in the presence of steroid unresponsiveness in the absence of clear treatment recommendations. Liver transplantation is the curative option in such cases but is controversial in the wake of severe infections, post-transplant recidivism and long waiting on deceased donor listing. Animal and human studies have shed light on the beneficial effects of gut microbiota modulation in alcoholic liver disease. We present the first report of faecal microbiota transplantation (FMT) in a steroid non-responder in whom, clinical, biochemical and liver disease severity scores improved post-FMT and demonstrate distinct bacterial population changes pre-FMT and post-FMT...
November 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29108512/individual-surgeon-experience-yields-bimodal-effects-on-patient-outcomes-after-deceased-donor-liver-transplant-results-of-a-quantile-regression-for-survival-data
#4
Michał Grąt, Zbigniew Lewandowski, Waldemar Patkowski, Karolina Grąt, Karolina Maria Wronka, Maciej Krasnodębski, Tadeusz Wróblewski, Paweł Nyckowski, Marek Krawczyk
OBJECTIVES: Data on the relevance of surgeon experience in liver transplant procedures are scarce. In this study, we evaluated the effects of individual surgeon experience on survival outcomes after deceased-donor liver transplant. MATERIALS AND METHODS: In this retrospective analysis of 1193 liver transplant procedures, quantile regression for survival data was performed to assess the effects of surgeon experience. Conditional quantiles of mortality and graft loss were set as primary and secondary outcome measures, respectively, which were categorized as early, midterm, and late...
October 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29100996/should-living-donor-liver-transplantation-be-an-option-when-deceased-donation-is-not
#5
Sarah R Lieber, Thomas D Schiano, Rosamond Rhodes
When a liver transplantation candidate is declined for listing to receive a deceased organ, sometimes a loved one comes forward and offers to be a living donor. This raises the ethical question of whether a patient who is not eligible for deceased donor liver transplantation should be eligible for living donor liver transplantation. We compare living organ donation in kidney and liver transplantation and explore key ethical concepts of justice, fairness, and societal trust. Ultimately, because there is no alternative life-preserving therapy in end-stage liver disease, and because transplantation with a living donor organ does not involve removing a resource from the common pool of transplant organs, we argue that a "slightly less benefit" than what is required for deceased transplantation listing standard should be used to determine the acceptability of living donor liver transplantation...
October 31, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29090502/endoscopic-treatment-of-anastomotic-biliary-stricture-after-adult-deceased-donor-liver-transplantation-with-multiple-plastic-stents-versus-self-expandable-metal-stents-a-systematic-review-and-meta-analysis
#6
REVIEW
Filippo Landi, Nicola de'Angelis, Ailton Sepulveda, Aleix Martínez-Pérez, Iradj Sobhani, Alexis Laurent, Olivier Soubrane
BACKGROUND: Anastomotic biliary strictures (ABSs) occur in up to 15% of patients after liver transplantation (LT). The aim of this study was to compare the efficacy and safety of self-expandable metal stents (SEMS) versus multiple plastic stents (MPS). METHODS: Databases were searched through April 2017. The outcome measures were technical success, stricture resolution, recurrence and complications. We synthesized the findings descriptively and performed a meta-analysis...
November 1, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29080900/association-between-flushed-fluid-potassium-concentration-and-severe-postreperfusion-syndrome-in-deceased-donor-liver-transplantation
#7
Liang Zhang, Ming Tian, Liying Sun, Zhijun Zhu
BACKGROUND Predicting the occurrence of severe postreperfusion syndrome (PRS) is clinically challenging. We investigated whether the flushed fluid potassium concentration (FFK) was associated with severe PRS in deceased donor liver transplantation (DDLT). MATERIAL AND METHODS Forty adult DDLT recipients were enrolled in this retrospective study. Effluent solution samples were collected at the end of the portal vein flush, and the FFK was determined using a point-of-care blood gas analyzer. The risk factors associated with severe PRS and the clinical outcomes in 2 groups were compared...
October 29, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29045352/impact-of-race-and-ethnicity-on-outcomes-for-children-waitlisted-for-pediatric-liver-transplantation
#8
Douglas B Mogul, Xun Luo, Eric K Chow, Allan B Massie, Tanjala S Purnell, Kathleen B Schwarz, Andrew M Cameron, John F P Bridges, Dorry L Segev
OBJECTIVE: African Americans and other minorities are known to face barriers to health care influencing their access to organ transplantation but it is not known whether these barriers exist among pediatric liver transplant waitlist candidates. We sought to determine whether outcomes on the waitlist (i.e., mortality, deceased donor liver transplantation (DDLT), and living-donor liver transplantation (LDLT)) varied by race/ethnicity. METHODS: National registry data were studied to estimate the race/ethnicity-specific risk of waitlist mortality, DDLT and LDLT in children (<18 years) waitlisted between March, 2002 and March, 2015...
October 17, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29044682/systematic-review-and-meta-analysis-of-liver-transplantation-using-grafts-from-deceased-donors-aged-over-70-years
#9
REVIEW
B V Dasari, H Mergental, J R Isaac, P Muiesan, D F Mirza, M T P R Perera
INTRODUCTION: Due to the current organ shortage, nearly 20% of patients die waiting for a liver transplant (LT). The average donor age is on the rise, and grafts from elderly donors are offered as extended criteria grafts. METHODS: This is a meta-analysis comparing the outcome differences of adult patients undergoing LT using grafts from <70-year-old donors versus >70-year-old donors. The primary end-points were graft and patient survival. Secondary outcomes were biliary and vascular complications as well as graft function...
October 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29032588/clinical-significance-of-lactate-clearance-for-the-development-of-early-allograft-dysfunction-and-short-term-prognosis-in-deceased-donor-liver-transplantation
#10
Deok Gie Kim, Jee Youn Lee, Yoon Bin Jung, Seung Hwan Song, Jae Geun Lee, Han Dai Hoon, Dong Jin Joo, Man Ki Ju, Gi Hong Choi, Jin Sub Choi, Myoung Soo Kim, Soon Il Kim
This retrospective study evaluated lactate clearance (LC), measured at 6, 12, 18, and 24 hours after reperfusion, as a predictor of early allograft dysfunction (EAD) and short-term outcomes in patients receiving deceased donor liver transplantation. Of 181 transplant recipients, 44 (24.3%) developed EAD and had lower LCs than those who did not develop EAD. A receiver operating characteristic analysis showed that LC determined at 6 hours showed the highest area under curve value of 0.828 (95% confidence interval [CI]: 0...
October 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29026597/endoscopic-approach-for-management-of-biliary-strictures-in-liver-transplant-recipients-a-systematic-review-and-meta-analysis
#11
Dayse Pereira da Silva Aparício, José Pinhata Otoch, Edna Frasson de Souza Montero, Muhammad Ali Khan, Everson Luiz de Almeida Artifon
The most common biliary complication after liver transplantation is anastomotic stricture (AS) and it can occur isolated or in combination with other complications. Liver graft from a cadaveric donor or a living donor has an influence on the incidence of biliary strictures as well as on the response to endoscopic treatment. Endoscopic treatment using balloon dilation and insertion of biliary stents by endoscopic retrograde cholangiopancreatography (ERCP) is the initial approach to these complications. AIM: The aim of this article is to compare different endoscopic techniques to treat post-liver transplantation biliary strictures...
October 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29024048/the-impact-of-adult-to-adult-living-donor-liver-transplantation-on-transplant-center-outcomes-reporting
#12
John F Renz, Geraldine C Diaz
BACKGROUND: The Scientific Registry of Transplant Recipients (SRTR) has released a 5-tier performance ranking system based upon results of deceased-donor and living-donor liver transplantation. MATERIALS AND METHODS: An analysis of Spring 2017 SRTR Program Specific Reports for outcomes of adult living-donor and deceased-donor liver transplantation. RESULTS: Utilizing the current SRTR performance algorithm, living-donor liver transplant results may disproportionately affect transplant center performance ranking...
October 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29023920/the-rise-of-the-opioid-epidemic-and-hepatitis-c-positive-organs-a-new-era-in-liver-transplantation
#13
REVIEW
Stevan A Gonzalez, James F Trotter
The use of hepatitis C virus (HCV) positive organs in liver transplantation has increased in the era of direct-acting antiviral therapy. A rising demand for organs, the ability to effectively treat HCV infection in the transplant setting, and an unprecedented increase in HCV positive donors have all contributed to this trend. A recent abrupt rise in opioid use in the US has resulted in a surge of injection drug use, transmission of HCV, and opioid-related overdose deaths. Geographic areas most affected by the opioid epidemic have experienced a rapid increase in recovery and utilization of HCV positive donor organs, in which the proportion of deceased donor liver transplants in the US from donors who are HCV positive has increased nearly two-fold within the last three years...
October 10, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29020665/high-serum-soluble-cd40l-levels-previously-to-liver-transplantation-in-patients-with-hepatocellular-carcinoma-are-associated-with-mortality-at-one-year
#14
Leonardo Lorente, Sergio T Rodriguez, Pablo Sanz, Antonia Pérez-Cejas, Javier Padilla, Dácil Díaz, Antonio González, María M Martín, Alejandro Jiménez, Manuel A Barrera
PURPOSE: CD40L and its soluble form (sCD40L) are proteins of the tumor necrosis factor superfamily (TNFSF) that exhibit prothrombotic and proinflammatory properties when binding to CD40, which is a cell surface receptor of the tumor necrosis factor receptor superfamily (TNFRSF). High circulating levels of sCD40L have been associated with poor prognosis in patients with hepatocellular carcinoma (HCC). However, it is unknown whether there is an association between circulating sCD40L levels and survival in patients with HCC underwent to liver transplantation (LT), and this was the objective of that study...
September 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29019539/evaluation-of-the-treatment-of-the-hepatocarcinoma-nodules-in-the-patients-in-waiting-list-for-liver-transplant
#15
Gustavo Pilotto Domingues Sá, Jorge Roberto Marcante Carlotto, Fernando Pompeu Piza Vicentine, Luiz Romero, Dario Fernandes Perdomo Tejada, Alcides Augusto Salzedas, Gaspar de Jesus Lopes, Adriano Miziara Gonzalez
OBJECTIVE: to compare the outcome of liver transplantation for hepatocarcinoma in submitted or not to locoregional treatment and downstaging regarding survival and risk of recurrence in transplant waiting list patients. METHODS: retrospective study of patients with hepatocarcinoma undergoing liver transplantation in the metropolitan region of São Paulo, between January 2007 and December 2011, from a deceased donor. The sample consisted of 414 patients. Of these, 29 patients were included in the list by downstaging...
July 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28983074/use-of-hepatitis-c-positive-deceased-liver-donors-in-response-to-the-organ-shortage-in-an-endemic-area
#16
Duilio Pagano, Aurelio Seidida, Alessandro Tropea, Giada Pietrosi, Fabrizio di Francesco, Giovanni Battista Vizzini, Angelo Luca, Salvatore Gruttadauria
The region of Sicily, Italy, is witnessing a chronic organ shortage. Thus, to face this critical issue, the use of marginal donors has increased over time. An example of marginal donor expansion is the use of liver donors who are positive for the hepatitis C antibody (HCV+) for HCV+ patients requiring liver transplantation (LT). In view of new advances in HCV therapy, including direct-acting agents (DAAs) to treat HCV in the post-transplant setting, our study focused on a monocentric experience in a series of consecutive LTs performed in adult patients receiving HCV+ liver donor allografts...
October 6, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28972946/recent-advances-in-decellularization-and-recellularization-for-tissue-engineered-liver-grafts
#17
Yujia Wang, Clara T Nicolas, Harvey S Chen, Jeffery J Ross, Silvana B De Lorenzo, Scott L Nyberg
Liver transplantation from deceased or living human donors remains the only proven option for patients with end-stage liver disease. However, the shortage of donor organs is a significant clinical concern that has led to the pursuit of tissue-engineered liver grafts generated from decellularized liver extracellular matrix and functional cells. Investigative efforts on optimizing both liver decellularization and recellularization protocols have been made in recent decades. In the current review, we briefly summarize these advances, including the generation of high-quality liver extracellular matrix scaffolds, evaluation criteria for quality control, modification of matrix for enhanced properties, and reseeding strategies...
2017: Cells, Tissues, Organs
https://www.readbyqxmd.com/read/28970703/in-situ-splitting-of-the-cadaver-liver-for-two-adult-recipients-by-ldlt-technique
#18
Nilesh S Patil, Neerav Goyal, Shishir Pareek, Mohammed Nayeem, Subhash Gupta
BACKGROUND: To expand the donor pool, split liver transplantation is conventionally performed for one adult and one pediatric recipient. Application of this technique for two adult recipients can produce remarkable impact on the waiting list. Proper donor and recipient selection is crucial for the favorable outcome following full-right and full-left liver split. Right lobe adult to adult living donor liver transplantation (LDLT) is essentially a full right and full left split. However, LDLT techniques have not been used for full right and left split...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28968350/coexistence-of-bilirubin-%C3%A2-10-mg-dl-and-prothrombin-time-international-normalized-ratio-%C3%A2-1-6-on-day-7-a-strong-predictor-of-early-graft-loss-after-living-donor-liver-transplantation
#19
Yusuke Okamura, Shintaro Yagi, Toshiya Sato, Koichiro Hata, Eri Ogawa, Atsushi Yoshizawa, Naoko Kamo, Noriyo Yamashiki, Hideaki Okajima, Toshimi Kaido, Shinji Uemoto
BACKGROUND: Early allograft dysfunction (EAD) defined by serum total bilirubin (TB) ≥10 mg/dL or prothrombin time-international normalized ratio (PT-INR) ≥1.6 on postoperative day 7 (POD7) or aminotransferase >2000 IU/L within the first week, is associated with early graft loss after deceased-donor liver transplantation. We aimed to determine the prognostic impact of the EAD definition in living-donor liver transplantation (LDLT). METHODS: We analyzed the validity of the EAD definition and its impact on early graft survival in 260 adult recipients who underwent primary LDLT...
September 29, 2017: Transplantation
https://www.readbyqxmd.com/read/28964478/pediatric-living-donor-liver-transplantation
#20
Mureo Kasahara, Seisuke Sakamoto, Akinari Fukuda
Living-donor liver transplantation is an important component of all liver transplant programs especially in those that care for the pediatric population. Over the last 30 years, innovations in surgical technique have converted living donation from an experimental procedure to a standard of care. Many of these innovations occurred in countries where culturally, deceased donation is limited leaving no alternatives but living donation. The Organ Transplantation Center at the National Center for Child Health and Development (NCCHD) in Tokyo, Japan, was established in 2005 where we have generated some of those innovations and in so doing, have performed living-donor liver transplantation in over 400 children...
August 2017: Seminars in Pediatric Surgery
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