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Deceased donor liver transplantation

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https://www.readbyqxmd.com/read/28517242/race-ethnicity-is-associated-with-abo-non-identical-liver-transplantation-in-the-united-states
#1
Jin Ge, John P Roberts, Jennifer C Lai
United Network for Organ Sharing (UNOS) policies allows for ABO non-identical liver transplantation (LT) in candidates with Model for End-Stage Liver Disease (MELD) scores greater than 30. Previous studies showed ABO non-identical LT resulted in an 18% and 55% net gain in livers for B and AB candidates. These results suggested that the current liver ABO allocation policies may need refinement. There are, however, strong associations between ABO blood groups and race/ethnicity. We hypothesized that race/ethnicity is associated with ABO non-identical LT and that this is primarily influenced by recipient ABO status...
May 18, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28512923/the-braden-scale-a-standard-tool-for-assessing-pressure-ulcer-risk-predicts-early-outcomes-after-liver-transplantation
#2
Vinay Sundaram, Jane Lim, Danielle M Tholey, Sentia Iriana, Irene Kim, Vignan Manne, Nicholas N Nissen, Andrew S Klein, Tram T Tran, Walid S Ayoub, Barry Schlansky
The Braden Scale is a standardized tool to assess pressure ulcer risk, that is reported for all hospitalized patients in the United States (US) per requirements of the Center for Medicare and Medicaid Services. Previous data has shown the Braden Scale can predict both frailty and mortality risk in patients with decompensated cirrhosis. Our aim was to evaluate the association of Braden Scale score with short-term outcomes after liver transplantation (LT). We performed a retrospective cohort study of deceased-donor LT recipients at two centers, and categorized them according to the Braden Scale at hospital admission as low (>18), moderate (16-18), or high risk (<16) for pressure ulcer...
May 17, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28512755/evaluation-of-safety-of-concomitant-splenectomy-in-living-donor-liver-transplantation
#3
Amr Badawy, Yuhei Hamaguchi, Satoru Seo, Tochimi Kaido, Hideaki Okajima, Shinji Uemoto
In Asian countries, concomitant splenectomy in living donor liver transplantation (LDLT) is indicated to modulate the portal vein pressure in the small sized graft to protect against small for size syndrome. While concomitant splenectomy in deceased donor liver transplantation is almost contraindicated based on western reports of increased mortality and morbidity rate due to septic complications, there are few studies about that in LDLT. So, we retrospectively investigated the clinical outcome of adult LDLT at Kyoto University Hospital from July 2010 to July 2016...
May 17, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28497523/high-meld-score-does-not-adversely-affect-outcome-of-living-donor-liver-transplantation-experience-in-1000-recipients
#4
S K Yadav, N Saraf, S Sigal, N S Choudhary, S Goja, A Rastogi, P Bhangui, A S Soin
In countries where deceased organ donation is scarce, there is big gap between demand and supply of organs and living donor liver transplantation (LDLT) plays an important role in meeting this unmet need. This study was conducted to analyse the effect of pre-transplant MELD score on outcomes following LDLT. Outcome of 1000 patients who underwent LDLT from July 2010 to March 2015 was analysed retrospectively. Patients were grouped into low MELD <25 and high MELD ≥25 score to compare short term outcomes...
May 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28489166/anatomic-variations-of-hepatic-artery-a-study-in-479-liver-transplantations
#5
Olival Cirilo Lucena da Fonseca-Neto, Heloise Caroline de Souza Lima, Priscylla Rabelo, Paulo Sérgio Vieira de Melo, Américo Gusmão Amorim, Cláudio Moura Lacerda
Background: The incidence of anatomic variations of hepatic artery ranges from 20-50% in different series. Variations are especially important in the context of liver orthotopic transplantation, since, besides being an ideal opportunity for surgical anatomical study, their precise identification is crucial to the success of the procedure. Aim: To identify the anatomical variations in the hepatic arterial system in hepatic transplantation. Methods: 479 medical records of transplanted adult patients in the 13-year period were retrospectively analyzed, and collected data on hepatic arterial anatomy of the deceased donor...
January 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28480648/korean-patients-undergoing-deceased-donor-liver-transplantation-for-alcoholic-liver-disease-have-non-inferior-survival-outcomes-than-for-hepatitis-b-virus-a-real-world-experience-without-minimum-abstinence-before-transplantation
#6
Suk Kyun Hong, Nam Joon Yi, Hyo Sin Kim, Sung Woo Ahn, Kyung Chul Yoon, Hyeyoung Kim, Kwang Woong Lee, Kyung Suk Suh
Few studies have compared outcomes in patients undergoing liver transplantation (LT) for hepatitis B virus (HBV) and alcoholic liver disease (ALD) in Asian countries in which living donor LT (LDLT) is dominant, where HBV is endemic and where there are no strict regulations on pre-transplant abstinence for ALD. This study compared post-LT outcomes of deceased donor LT (DDLT) in patients with ALD and HBV. Data from 220 patients who underwent primary DDLT at Seoul National University Hospital from January 2010 to December 2014, including 107 with HBV and 38 with ALD, were retrospectively analyzed...
June 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28473952/liver-allocation-policies-for-patients-affected-by-hcc-in-europe
#7
Luciano De Carlis, Stefano Di Sandro, Leonardo Centonze, Andrea Lauterio, Vincenzo Buscemi, Riccardo De Carlis, Fabio Ferla, Raffaella Sguinzi, Stefano Okolicsanyi, Luca Belli, Mario Strazzabosco
The main goal of organ allocation systems is to guarantee an equal access to the limited resource of liver grafts for every patients on the waiting list, balancing between the ethical principles of equity, utility, benefit, need, and fairness. The European heath care scenario is very complex, as it is essentially decentralized and each Nation and Regions inside the nation, operate on a significant degree of autonomy. Furthermore the epidemiology of liver diseases and HCC, which is different among European countries, clearly inpacts on indications and priorities...
December 2016: Current Transplantation Reports
https://www.readbyqxmd.com/read/28439714/arterial-and-biliary-complications-after-living-donor-liver-transplantation-a-single-center-retrospective-study-and-literature-review
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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)...
June 2017: Metabolic Brain Disease
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