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Deceased donor liver transplantation

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https://www.readbyqxmd.com/read/28073180/porto-systemic-collaterals-in-living-donor-liver-transplantation-what-s-all-the-fuss-about
#1
REVIEW
Mettu Srinivas Reddy, Mohamed Rela
Porto-systemic collaterals are a common finding in patients with cirrhosis undergoing liver transplantation. Recently, there has been renewed interest regarding their significance in the setting of living donor liver transplantation (LDLT) due to concerns of graft hypo or hyper-perfusion and its impact on early post-transplant outcomes. Presence of these collaterals has greater significance in the LDLT setting when compared to deceased donor liver transplant setting as dictated by the difference in the physiology of partial liver grafts...
January 10, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28060446/successful-treatment-of-donor-derived-hepatitis-c-viral-infection-in-three-transplant-recipients-from-a-donor-at-increased-risk-for-bloodborne-pathogens
#2
Ashesh P Shah, Andrew Cameron, Pooja Singh, Adam M Frank, Jonathan M Fenkel
We report here the successful treatment of hepatitis C virus (HCV) transmitted from a nucleic acid testing (NAT)-negative donor to 3 HCV-negative recipients - 2 renal transplants and 1 liver. Both renal recipients underwent standard deceased-donor renal transplantation with immediate graft function. The liver recipient underwent standard orthotopic liver transplantation and recovered uneventfully. The donor was a 39-year-old woman with a terminal serum creatinine of 0.7 mg/dL. She was high risk for bloodborne pathogens, based upon a history of sexual contact with an HCV-infected male partner...
January 6, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28060242/adult-liver-allocation-in-eurotransplant
#3
Ina Jochmans, Marieke van Rosmalen, Jacques Pirenne, Undine Samuel
Liver allocation in Eurotransplant is complex as allocation rules need to follow not only the guidelines of the European Commission but also the specific regulations of each of the 7 Eurotransplant countries with active liver transplant programs. Thirty-eight liver transplant centers served a population of about 135 million in 2015. Around 1600 deceased donor livers are transplanted annually. The number of deceased organ donors remains stable but donor age is increasing. Nevertheless, liver utilization rates are unchanged at around 80%...
January 6, 2017: Transplantation
https://www.readbyqxmd.com/read/28052608/optn-srtr-2015-annual-data-report-deceased-organ-donation
#4
A K Israni, D Zaun, C Bolch, J D Rosendale, C Schaffhausen, J J Snyder, B L Kasiske
SRTR uses data collected by OPTN to calculate metrics such as donation/conversion rate, organ yield, and rate of organs recovered for transplant but not transplanted. In 2015, 1,072,828 death and imminent death referrals were made to Organ Procurement Organizations, of which 21,559 met the definition of eligible (9793) or imminent (11,766) deaths per OPTN policy. The number of deceased donors was 9080, and this number has been increasing since 2010. The number of organs authorized for recovery increased slightly to 65,086 in 2015, and the number recovered increased slightly to 25,762...
January 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28030865/recent-advances-in-decellularization-and-recellularization-for-tissue-engineered-liver-grafts
#5
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...
December 29, 2016: Cells, Tissues, Organs
https://www.readbyqxmd.com/read/28012856/increased-fndc5-irisin-expression-in-human-hepatocellular-carcinoma
#6
Melania Gaggini, Manuela Cabiati, Serena Del Turco, Teresa Navarra, Paolo De Simone, Franco Filipponi, Silvia Del Ry, Amalia Gastaldelli, Giuseppina Basta
The fibronectin type III domain containing 5 (FNDC5)/Irisin, a novel energy-regulating hormone, is associated with lipid and carbohydrate metabolism. It is produced in low amounts by normal hepatic tissue, while in human hepatocellular carcinoma (HCC), in which aberrant de novo lipogenesis (DNL) occurs, the hepatic expression of FNDC5/Irisin is still unknown. The gene expression of FNDC5/Irisin, associated to key regulators of DNL, inflammation and cancer progression was evaluated in liver tissue of 18 patients with HCC undergoing liver transplantation and of 18 deceased donors...
December 21, 2016: Peptides
https://www.readbyqxmd.com/read/28009743/comparable-short-and-long-term-outcomes-in-living-donor-and-deceased-donor-liver-transplantations-for-patients-with-model-for-end-stage-liver-disease-scores-%C3%A2-35-in-a-hepatitis-b-endemic-area
#7
Kenneth S H Chok, James Y Y Fung, Albert C Y Chan, Wing Chiu Dai, William W Sharr, Tan To Cheung, See Ching Chan, Chung Mau Lo
OBJECTIVE: To evaluate if living donor liver transplantation (LDLT) should be offered to patients with Model for End-stage Liver Disease (MELD) scores ≥35. BACKGROUND: No data was available to support LDLT of such patients. METHODS: Data of 672 consecutive adult liver transplant recipients from 2005 to 2014 at our center were reviewed. Patients with MELD scores ≥35 were divided into the deceased donor liver transplantation (DDLT) group and the LDLT group and were compared...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28004856/effect-of-early-allograft-dysfunction-on-outcomes-following-liver-transplantation
#8
Jana Hudcova, Catlin Scopa, Jawad Rashid, Ahsan Waqas, Robin Ruthazer, Roman Schumann
Early allograft dysfunction (EAD) following liver transplantation (LT) remains a challenge for patients and clinicians. We retrospectively analyzed the effect of predefined EAD on outcomes in a 10-year cohort of deceased-donor LT recipients with clearly defined exclusion criteria. EAD was defined by at least one of the following: AST or ALT > 2000 IU/L within first week post LT, total bilirubin ≥ 10mg/dL, and/or INR ≥ 1.6 on postoperative day 7. Ten patients developed primary graft failure and were analyzed separately...
December 22, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27995739/survival-in-patients-with-child-pugh-class-c-cirrhosis-analysis-of-the-liver-transplant-registry-in-japan
#9
Takuya Genda, Takafumi Ichida, Shotaro Sakisaka, Eiji Tanaka, Satoshi Mochida, Yoshiyuki Ueno, Ayano Inui, Hiroto Egawa, Koji Umeshita, Hiroyuki Furukawa, Seiji Kawasaki, Yukihiro Inomata
AIM: To clarify the survival and prognostic factors in patients with Child-Turcotte-Pugh class C (CTP-C) cirrhosis. METHODS: From all candidates for deceased donor liver transplantation in Japan between 2007 and 2015, 1014 adult patients with CTP-C cirrhosis were retrospectively enrolled in this study. Hazard ratio (HR) of factors associated with mortality was estimated by Cox proportional hazard model. The survival probabilities were evaluated by Kaplan-Meier analysis and the log-rank test...
December 20, 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/27992667/prognostic-impact-of-postoperative-low-platelet-count-after-liver-transplantation
#10
Kazuhiro Takahashi, Shunji Nagai, Krishna G Putchakayala, Mohamed Safwan, Amy Y Li, William J Kane, Priyanka L Singh, Kelly M Collins, Michael D Rizzari, Atsushi Yoshida, Gabriel T Schnickel, Marwan S Abouljoud
BACKGROUND: The positive impact of platelets has been recently implicated in liver transplantation (LT). The aim of this study was to determine the risk factors for graft loss and mortality after LT, focusing on perioperative platelet counts. METHODS: We reviewed all deceased donor LT from 2000 to 2012, and enrolled 975 consecutive recipients. The risk factors for graft loss and mortality were analyzed by multivariate analysis, using Cox's regression model. RESULTS: Using cutoff values acquired by receiver operating characteristics curve analysis, multivariate analyses determined that viral hepatitis C (hazard ratio [HR] =1...
December 19, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27942610/simultaneous-liver-kidney-transplantation-in-liver-transplant-candidates-with-renal-dysfunction-importance-of-creatinine-levels-dialysis-and-organ-quality-in-survival
#11
Bekir Tanriover, Malcolm P MacConmara, Justin Parekh, Cristina Arce, Song Zhang, Ang Gao, Arjmand Mufti, Swee-Ling Levea, Burhaneddin Sandikci, Mehmet U S Ayvaci, Venketash K Ariyamuthu, Christine Hwang, Sumit Mohan, Mutlu Mete, Miguel A Vazquez, Jorge A Marrero
BACKGROUND: The survival benefit from simultaneous liver-kidney transplantation (SLK) over liver transplant alone (LTA) in recipients with moderate renal dysfunction is not well understood. Moreover, the impact of deceased donor organ quality in SLK transplant survival has not been well described in the literature. METHODS: The Scientific Registry of Transplant Recipients was studied for adult recipients receiving LTA (N=2,700) or SLK (N=1,361) transplantation with moderate renal insufficiency between 2003 and 2013...
November 2016: KI Reports
https://www.readbyqxmd.com/read/27941439/report-of-the-22nd-annual-congress-of-the-international-liver-transplantation-society
#12
Geraldine C Diaz, Jeron Zerillo, Ashish Singhal, Taizo Hibi, Alessandro Vitale, Josh Levitsky, John F Renz
The 2016 Annual Congress of the International Liver Transplantation Society was held in Seoul, South Korea in May. The 22nd Congress marked the largest multidisciplinary liver transplantation meeting in Asia since 2010. The principal themes were living donation, allocation, immunosuppression, machine preservation, novel treatment of hepatitis C, and expansion of the deceased-donor allograft pool. This report presents select abstracts from the scientific sessions within the context of the published literature to serve as a quick reference...
December 8, 2016: Transplantation
https://www.readbyqxmd.com/read/27941438/low-measured-hepatic-artery-flow-increases-rate-of-biliary-strictures-in-deceased-donor-liver-transplantation-an-age-dependent-phenomenon
#13
P T W Kim, H Fernandez, A Gupta, G Saracino, M Ramsay, G J McKenna, G Testa, T L Anthony, N Onaca, R M Ruiz, G B Klintmalm
BACKGROUND: This study was conducted to determine effect of lower measured hepatic arterial (HA) flow (<400 mL/min) on biliary complications and graft survival after deceased donor liver transplantation. Hepatic artery is the main blood supply to bile duct and lack of adequate HA flow is thought to be a risk factor for biliary complications. METHODS: A retrospective review of 1300 patients who underwent deceased donor liver transplantation was performed. Patients with arterial complications were excluded to eliminate potential contribution to biliary complications from HA thrombosis...
December 8, 2016: Transplantation
https://www.readbyqxmd.com/read/27935215/donors-with-immune-thrombocytopenia-do-they-pose-a-risk-to-transplant-recipients
#14
P B Trotter, M Robb, D Summers, C J E Watson, M Clatworthy, J A Bradley, Q A Hill, J Neuberger
Transplant-mediated alloimmune thrombocytopenia (TMAT) from donors with immune thrombocytopenia (ITP) can result in significant bleeding complications in the recipient. The risk to a recipient of TMAT if they receive an organ from a donor with ITP is unknown. The outcomes of recipients of organs from deceased donors with ITP recorded in the UK Transplant Registry between 2000 and 2015 were reviewed. Twenty-one deceased organ donors had a predonation diagnosis of ITP. These donors were significantly more likely to have died from intracranial hemorrhage than were all other deceased organ donors (85% vs...
November 7, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27932478/most-apol1-is-secreted-by-the-liver
#15
Khuloud Shukha, Jessica L Mueller, Raymond T Chung, Michael P Curry, David J Friedman, Martin R Pollak, Anders H Berg
Two coding sequence variants in the APOL1 gene (G1 and G2) explain much of the increased risk for FSGS, HIV-associated nephropathy, and hypertension-attributed ESRD among people of recent African ancestry. The ApoL1 protein is expressed in a wide variety of cell tissues. It has been assumed that the majority of circulating ApoL1 is produced by the liver, but this has not been shown. Using mass spectrometry, we genotyped and quantified the circulating ApoL1 in two liver transplant recipients whose native APOL1 genotype differed from the genotype of the deceased donors, allowing us to differentiate liver- from nonliver-produced ApoL1...
December 8, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27932181/use-of-terlipressin-in-an-elderly-patient-with-moderate-aortic-valve-stenosis-accompanied-by-episodic-atrial-fibrillation-during-liver-transplantation-a-case-report
#16
Y J Won, B G Lim, D Chung, E Park, H Kim, I O Lee, M H Kong
Anesthesia for patients with moderate aortic stenosis accompanied by atrial fibrillation during high-risk surgery such as liver transplantation remains a challenge in maintaining control of heart rate and maintenance of cardiac output. The action of terlipressin on vasopressin receptors (mainly V1 receptors) leads to splanchnic vasoconstriction and is the key mechanism responsible for increasing systemic vascular resistance and reducing heart rate. We report successful anesthetic management using low-dose terlipressin infusion in an elderly patient who had moderate aortic stenosis with atrial fibrillation during urgent deceased-donor liver transplantation...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932173/a-case-report-of-severe-hepatic-artery-vasospasm-induced-by-hepatic-arterial-buffer-response-after-liver-transplantation
#17
Y Hiraki, K Uchida, S Nishida, D M Levi, G Selvaggi, A Tekin, J Fan, T Froud, A G Tzakis
The management of severe hepatic artery vasospasm soon after liver transplantation (LT) is challenging because it can lead to hepatic artery thrombosis and subsequent graft failure. A 61-year-old man with hepatitis C cirrhosis and portal vein thrombosis received a deceased donor LT. On postoperative day 1, Doppler ultrasonography revealed a high-resistance waveform in the hepatic artery. Angiography showed severe vasospasm of the donor hepatic artery on postoperative day 3. Strong hepatic arterial buffer response (HABR) was considered for this etiology due to high portal vein velocity...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932147/case-report-demonstrating-the-safe-and-effective-means-of-expanding-the-donor-pool-with-livers-recovered-from-brain-dead-donors-after-ethylene-glycol-toxicity
#18
M H Fujii, J Gierlach, S Alami, C Ericksen, R Kashyap, M S Orloff, C E Marroquin
The growing disparity between organ supply and demand has become the greatest hurdle facing transplant professionals and life-saving transplants. Because the organ shortage has become the rate-limiting step to effective transplants, it is critical for the transplant community to identify viable mechanisms to expand the donor pool and use every available allograft. Although using kidneys from deceased donors whose demise was secondary to ethylene glycol (EG) toxicity requires great deliberation and precise timing as described by Barbas et al [5], using hepatic allografts in this setting involves far less risk...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932125/survival-outcomes-in-liver-transplantation-with-elderly-donors-analysis-of-andalusian-transplant-register
#19
C Cepeda-Franco, C Bernal-Bellido, L Barrera-Pulido, J M Álamo-Martínez, J H Ruiz-Matas, G Suárez-Artacho, L M Marín-Gómez, J Tinoco-González, C Díaz-Aunión, F J Padillo-Ruiz, M Á Gómez-Bravo
Recently, there has been a large discrepancy between the number of patients on the waiting list for a liver transplant and the availability of deceased donors, with an increase in annual wait list mortality rates. Elderly donor livers are thought to be marginal grafts; however, in recent years, their utilization has constantly increased. The aim of this study is to evaluate the utilization of elderly donors in Andalusia and post-transplant outcomes. This retrospective observational study of 2408 liver transplants, performed in Andalusia between 2000 and 2014, analyzes the outcomes from donors aged 70 plus (n = 423) in terms of survival rates of the graft and the recipient, the type of transplant, donor age, and D-MELD score (product of donor age and preoperative Model for End-stage Liver Disease score)...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931583/acute-graft-vs-host-disease-after-liver-transplantation-experience-at-a-high-volume-liver-transplantation-center-in-korea
#20
W H Kang, S Hwang, G W Song, D H Jung, G C Park, C S Ahn, D B Moon, K H Kim, T Y Ha, W J Kim, S H Kim, H D Cho, J H Kwon, E K Jwa, S G Lee
BACKGROUND: Acute graft-vs-host disease (GVHD) is a rare but life-threatening complication of orthotopic liver transplantation (OLT). We present 6 cases of GVHD after OLT. METHODS: Among our 4294 OLT recipients, we identified 6 patients (0.14%) who were diagnosed with GVHD. Their medical records were reviewed retrospectively. RESULTS: Liver graft types included deceased donor whole liver graft (n = 3) and right liver graft from son (n = 3)...
December 2016: Transplantation Proceedings
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