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Deceased donor liver transplantation

Lara Danziger-Isakov, William J Steinbach, Grant Paulsen, Flor M Munoz, Leigh R Sweet, Michael Green, Marian G Michaels, Janet A Englund, Alastair Murray, Natasha Halasa, Daniel E Dulek, Rebecca Pellett Madan, Betsy C Herold, Brian T Fisher
Background: Respiratory virus infection (RVI) in pediatric solid organ transplant (SOT) recipients poses a significant risk; however, the epidemiology and effects of an RVI after pediatric SOT in the era of current molecular diagnostic assays are unclear. Methods: A retrospective observational cohort of pediatric SOT recipients (January 2010 to June 2013) was assembled from 9 US pediatric transplant centers. Charts were reviewed for RVI events associated with hospitalization within 1 year after the transplant...
March 10, 2018: Journal of the Pediatric Infectious Diseases Society
Horng-Ren Yang, Ashok Thorat, Long-Bin Jeng, Shih-Chao Hsu, Ping-Chun Li, Chun-Chieh Yeh, Te-Hung Chen, Kin-SHing Poon
BACKGROUND The prognosis of the patients of acute liver failure (ALF) with onset of hepatic coma is often dismal. ALF is a well-accepted indication for liver transplantation (LT) and has markedly improved the prognosis of these patients. However, its role in ALF patients with onset of hepatic coma has never been elucidated before. The aim of our study was to analyze the outcome in patients of ALF with hepatic coma who underwent LT. MATERIAL AND METHODS From January 2002 to December 2015, a total of 726 liver transplantations were done at China Medical University Hospital, Taiwan...
March 13, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Kakharman Yesmembetov, Tokan Sultanaliyev, Adilbek Mukazhanov, Assan Zhexembayev, Gani Kuttymuratov, Zhanat Spatayev, Yevgeniy Mussin, Yerlan Umbetzhanov, Damesh Orazbayeva
OBJECTIVES: Liver transplant is the only treatment option for patients with end-stage liver disease. MATERIALS AND METHODS: Liver transplant procedures performed from June 2013 to March 2017 were evaluated. We evaluated the postoperative period in recipients of livers from deceased and living donors. RESULTS: Of 31 liver transplant procedures in 30 recipients, 12 were from deceased and 19 from living donors. The final analysis included 24 liver transplants (11 males, 13 females), with 10 from deceased and 14 from living donors...
March 2018: Experimental and Clinical Transplantation
Ebru H Ayvazoglu Soy, Fatih Boyvat, B Handan Ozdemir, Nihan Haberal, Fatih Hilmioglu, Mehmet Haberal
OBJECTIVES: The number of living-donor liver transplants has been increasing due to the growing discrepancy between the number of patients on wait lists for liver transplant and the availability of deceased donations. Evaluations of potential liver donors should ensure the safety of the surgical procedure for both the donor and recipient. Liver biopsy is the criterion standard for selecting optimal donors. In this study, we evaluated the importance of preoperative liver biopsy in selecting donor candidates...
March 2018: Experimental and Clinical Transplantation
Wong Hoi She, Albert Chi Yan Chan, Tan To Cheung, Chung Mau Lo, Kenneth Siu Ho Chok
AIM: To investigate the impact of alpha-fetoprotein (AFP) on long-term recurrence rate and overall survival and we also aimed to define the level of AFP leading to a higher risk of disease recurrence and affecting patient survival. METHODS: Data of adult patients who received liver transplant (LT) for hepatocellular carcinoma (HCC) at our hospital from January 2000 to December 2013 were reviewed. Reviewed data included demographic characteristics, preoperative AFP level, operative details, follow-up details, and survival outcomes...
February 27, 2018: World Journal of Hepatology
Rui Zhang, Zhi-Jun Zhu, Li-Ying Sun, Lin Wei, Wei Qu
Background: The outcome of pediatric deceased donor liver transplantation (LT) has not been well studied, especially pediatric deceased donor livers used in adult transplantation. This study aimed to evaluate the efficacy of LT using pediatric deceased donor livers and compare the outcomes between pediatric-to-pediatric LT and pediatric-to-adult LT. Methods: A retrospective review of LT using pediatric deceased donor livers from June 2013 to August 2016 was performed...
March 20, 2018: Chinese Medical Journal
Ji Soo Lee, Seung Hwan Lee, Kyeong Sik Kim, Eun Mi Gil, Gyu-Seoung Choi, Jong Man Kim, Kyong Ran Peck, Choon Hyuck David Kwon, Jae-Won Joh, Suk-Koo Lee
Purpose: Infection remains the main cause of morbidity and mortality in liver transplantation (LT) recipients; however infection is notoriously difficult to diagnose because its usual signs and symptoms of infection may be masked or absent. This study comprises an analysis of bacterial infections in the early period after LT. Methods: This is a study of 129 adults who underwent LT from January 2013 to December 2013, and it includes patients who were followed daily from the day of transplantation to 1-week posttransplantation using bacteriological cultures of blood, urine, sputum, and drained ascites...
March 2018: Annals of Surgical Treatment and Research
S Perez-Protto, R Nazemian, M Matta, P Patel, K J Wagner, S Q Latifi, D J Lebovitz, J D Reynolds
Many deceased by neurologic criteria donors are administered inhalational agents during organ recovery surgery-a process that is characterised by warm and cold ischaemia followed by warm reperfusion. In certain settings, volatile anaesthetics (VA) are known to precondition organs to protect them from subsequent ischaemia-reperfusion injury. As such, we hypothesised that exposure to VA during organ procurement would improve post-graft survival. Lifebanc (organ procurement organisation [OPO] for NE Ohio) provided the investigators with a list of death by neurologic criteria organ donors cared for at three large tertiary hospitals in Cleveland between 2006 and 2016-details about the surgical recovery phase were extracted from the organ donors' medical records...
March 2018: Anaesthesia and Intensive Care
Hannah Lee, Seung-Young Oh, Je Hyuk Yu, Jeongsoo Kim, Sehee Yoon, Ho Geol Ryu
BACKGROUND: Postoperative delirium after liver transplantation is relatively common, especially due to preexisting conditions such as hepatic encephalopathy. Most studies of delirium after liver transplantation were based on ICU practices using deep hypnosedation. Therefore, risk factors and consequences of postoperative delirium after liver transplantation were evaluated in the light sedation era. METHODS: A total of 253 liver transplantation patients were evaluated for postoperative delirium...
March 6, 2018: World Journal of Surgery
Roberta Angelico, Alessandra Nardi, René Adam, Silvio Nadalin, Wojciech G Polak, Vincent Karam, Roberto Troisi, Paolo Muiesan
BACKGROUND: Split liver transplantation(SLT) has been widely adopted across Europe resulting in remarkable reduction of the paediatric waiting-list mortality. Left split graft(LSG) are commonly used for paediatric recipients, however deceased donor criteria selection aren't universal. METHOD: The aim of this study was to analyse the LSG outcome from the European Liver Transplant Registry and to identify risk factors of graft failure. Data from 1500 children transplanted in 2006-2014 with LSG from deceased donors were retrospectively analysed...
March 5, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
Salman Khan, Timothy Sullivan, Mohsin Ali, Dallas Dunn, Gopi Patel, Shirish Huprikar
BACKGROUND: Liver transplant recipients (LTR) who are seropositive for cytomegalovirus (CMV) (R+) are at intermediate-risk for CMV disease. A preventive strategy following transplant is considered standard of care. Current guidelines recommend high-dose valganciclovir (VGCV) (900 mg/day adjusted for renal function) for prophylaxis given limited data on the efficacy and safety of low-dose VGCV (450 mg/day adjusted for renal function). We describe our experience using low-dose VGCV prophylaxis for R+ LTR at our institution...
March 3, 2018: Liver Transplantation
Joseph T Brooks, Naoru Koizumi, Elizabeth Neglia, Bilel Gdoura, Tina W Wong, Chang Kwon, Tony E Smith, Jorge Ortiz
BACKGROUND: Share 35 prioritizes offers of deceased donor livers to regional candidates with Model for End-Stage Liver Disease (MELD) ≥35 over local candidates with lower MELD scores. Analysis of Share35 has shown that overall 1- or 2-year post-transplant (LTx) outcomes have been unchanged while waitlist mortality has been reduced. However, these studies exclude retransplant (reLTx) recipients. This study aims to investigate the outcomes of liver retransplants in evaluating the impact of the Share35 policy...
February 27, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Dieter C Broering, Yasser Elsheikh, Mohammed Shagrani, Faisal Abaalkhail, Roberto I Troisi
INTRODUCTION: Left lateral sectionectomy for donor hepatectomy is a well-established alternative to deceased donor pediatric liver transplantation. However, very little is available on the laparoscopic approach (L-LLS). With the aim to assess safety, reproducibility under proctorship and outcomes following LDLT in children, a comparative single center series using the propensity score matching (PSM) to evaluate open (O-LLS) vs. L-LLS was carried out in a relatively short time period in a high volume pediatric transplant center...
February 28, 2018: Liver Transplantation
Daniel Mandell, Raymond Planinsic, Fernando Melean, Christopher Hughes, Amit D Tevar, Abhinav Humar, Benjamin J Cassidy, Richard Simmons, Andre Dewolf, Tetsuro Sakai
Tissue plasminogen activator (tPA) has been reported to treat intraoperative pulmonary thromboembolism (PTE) during liver transplantation (LT). However, tPA administration is often delayed due to fear of uncontrolled bleeding and storage in a refrigerator outside of operating rooms. Various dosages of tPA were used. We hypothesize that a policy of tPA storage and low dosage use improves patient outcomes. At a transplantation center, a multidisciplinary committee has implemented a tPA policy since April 2014, which includes the following: (1) timely administering of low-dose tPA (0...
February 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
Marek Szymczak, Piotr Kaliciński, Grzegorz Kowalewski, Dorota Broniszczak, Małgorzata Markiewicz-Kijewska, Hor Ismail, Marek Stefanowicz, Adam Kowalski, Joanna Teisseyre, Irena Jankowska, Waldemar Patkowski
OBJECTIVES: Living donor liver transplantation (LDLT) in patients with acute liver failure (ALF) has become an acceptable alternative to transplantation from deceased donors (DDLT). The aim of this study was to analyze outcomes of LDLT in pediatric patients with ALF based on our center's experience. MATERIAL AND METHODS: We enrolled 63 children (at our institution) with ALF who underwent liver transplantation between 1997 and 2016. Among them 24 (38%) underwent a LDLT and 39 (62%) received a DDLT...
2018: PloS One
Seungjin Lim, Eun Jung Kim, Tae Beom Lee, Byung Hyun Choi, Young Mok Park, Kwangho Yang, Je Ho Ryu, Chong Woo Chu, Su Jin Lee
Background/Aims: Infections following liver transplant (LT) remain a major cause of mortality. This study was conducted to evaluate risk factors for infection and to review clinical characteristics. Methods: Medical records of patients who underwent LT from 2010 to 2014 were retrospectively analyzed. Binary logistic regression analysis was used to investigate risk factors of infection. Kaplan-Meier analysis was used to predict prognosis of infected and non-infected groups...
February 23, 2018: Korean Journal of Internal Medicine
Ana Rita Alves, Dário Gomes, Emanuel Furtado, Luís Tomé
Background and Aims: Biliary tract complications following liver transplant remain an important source of morbidity and mortality. Endoscopic retrograde cholangiopancreatography (ERCP) has become a common therapeutic option before other invasive procedures. The aim of this study was to evaluate ERCP efficacy in managing this type of complications. Methods: Retrospective study of all patients who underwent therapeutic ERCP due to post-liver transplant biliary complications between September 2005 and September 2015, at a deceased donor liver transplantation centre...
January 2018: GE Portuguese Journal of Gastroenterology
Vaishaly K Bharambe, Vasanti U Arole, Vatsalaswamy Puranam, Preeti P Kulkarni, Prashant B Kulkarni
Organ shortage is the greatest challenge facing the field of organ transplantation today. We aimed to study the attitude and knowledge toward body and organ donation among people in rural India. The present study was conducted in a rural town called Lanja, in the Konkan region of Maharashtra in India. A questionnaire covering demographic data, knowledge, and attitude of the participants was distributed to 400 students, middle-aged and senior citizens; 91.5% of the respondents were aware about organ donation...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Siddharth Mehrotra, Naimish Mehta, Prashantha S Rao, Shailendra Lalwani, Vivek Mangla, Samiran Nundy
INTRODUCTION: Acute liver failure (ALF) is an indication for emergency liver transplantation (LT). Although centers performing only deceased donor liver transplants (DDLT) have shown improved outcomes in this situation, they still have relatively long waiting lists. An alternative would be living donor liver transplantation (LDLT), which has shown equivalent outcomes in the elective situation but there is limited evidence of its results in ALF. AIM: The purpose of this study was to assess the outcomes in patients with ALF undergoing emergency LDLT in our center in Delhi, India...
February 17, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Young-In Yoon, Gi-Won Song, Sung-Gyu Lee, Shin Hwang, Ki-Hun Kim, Seok-Hwan Kim, Woo-Hyoung Kang, Hwui-Dong Cho, Eun-Kyoung Jwa, Jae-Hyun Kwon, Eun-Young Tak, Varvara A Kirchner
BACKGROUND & AIMS: Living-donor liver transplantation (LDLT) can simultaneously cure hepatocellular carcinoma (HCC) and underlying liver cirrhosis, improving long-term results in patients with HCC. ABO-incompatible LDLT could expand the living-donor pool, reduce waiting times for deceased-donor liver transplantation, and improve long-term survival for some patients with HCC. METHODS: We retrospectively reviewed the medical records of patients undergoing LDLT for HCC from November 2008 to December 2015 at a single institution in Korea...
February 13, 2018: Journal of Hepatology
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