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Deceased donor liver transplantation

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https://www.readbyqxmd.com/read/28324141/early-hepatic-artery-thrombosis-after-liver-transplantation-what-is-the-impact-of-the-arterial-reconstruction-type
#1
Astrid Herrero, Regis Souche, Emmanuel Joly, Gildas Boisset, Hussein Habibeh, Hassan Bouyabrine, Fabrizio Panaro, Jose Ursic-Bedoya, Samir Jaber, Boris Guiu, Georges Philippe Pageaux, Francis Navarro
OBJECTIVE: Hepatic artery thrombosis (HAT) is the most severe vascular complication occurring after liver transplantation, with an incidence ranging from 2 to 9% in adults. Although the ideal arterial reconstruction is often described as a short and non-redundant anastomosis fashioned between the recipient and donor hepatic arteries, there is no strong evidence about this ideal reconstruction in the literature. The aim of this study was to assess the impact of the type of arterial reconstruction on early HAT after primary liver transplantation...
March 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28319169/high-meld-score-and-extended-operating-time-predict-prolonged-initial-icu-stay-after-liver-transplantation-and-influence-the-outcome
#2
Panagiota Stratigopoulou, Andreas Paul, Dieter P Hoyer, Stylianos Kykalos, Fuat H Saner, Georgios C Sotiropoulos
BACKGROUND: The aim of the present study is to determine the incidence of a prolonged (>3 days) initial ICU-stay after liver transplantation (LT) and to identify risk factors for it. PATIENTS AND METHODS: We retrospectively analyzed data of adult recipients who underwent deceased donor first-LT at the University Hospital Essen between 11/2003 and 07/2012 and showed a primary graft function. RESULTS: Of the 374 recipients, 225 (60.16%) had prolonged ICU-stay...
2017: PloS One
https://www.readbyqxmd.com/read/28301992/effect-of-downstaging-and-bridging-of-hepatocellular-carcinoma-on-survival-following-liver-transplant-a-single-center-experience
#3
Mohammed I Al Sebayel, Hussien Elsiesy, Waleed Al-Hamoudi, Saleh Alabbad, Yasser ElSheikh, Hany Elbeshbeshy, Isam Salih, Sarra Yousif, Yahia Saleh, Abdulmoneim Eldali, Faisal A Abaalkhail
OBJECTIVES: Hepatocellular carcinoma is among the leading causes of cancer death. The Milan criteria are the first and most widely used criteria for selecting patients with hepatocellular carcinoma for a good transplant outcome. Studies have shown that patients with hepatocellular carcinoma outside the Milan criteria have good outcomes if they are successfully downstaged before transplant. We report our experience with locoregional therapy for hepatocellular carcinoma, either for bridging or for downstaging prior to transplant...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28301471/genomic-confirmation-of-vancomycin-resistant-enterococcus-transmission-from-deceased-donor-to-liver-transplant-recipient
#4
Ali Bashir, Oliver Attie, Mitchell Sullivan, Robert Sebra, Kavindra V Singh, Deena Altman, Theodore Pak, Jayeeta Dutta, Kieran Chacko, Elizabeth Webster, Martha Lewis, Camille Hamula, Kristin W Delli Carpini, Barbara E Murray, Andrew Kasarskis, Harm van Bakel, Shirish Huprikar
In a liver transplant recipient with vancomycin-resistant Enterococcus (VRE) surgical site and bloodstream infection, a combination of pulsed-field gel electrophoresis, multilocus sequence typing, and whole genome sequencing identified that donor and recipient VRE isolates were highly similar when compared to time-matched hospital isolates. Comparison of de novo assembled isolate genomes was highly suggestive of transplant transmission rather than hospital-acquired transmission and also identified subtle internal rearrangements between donor and recipient missed by other genomic approaches...
2017: PloS One
https://www.readbyqxmd.com/read/28294533/evaluation-of-donor-workups-and-exclusions-in-a-single-center-experience-of-living-donor-liver-transplantation
#5
Adianto Nugroho, Ok-Kyung Kim, Kwang-Woong Lee, Sanghee Song, Hyeyoung Kim, Suk Kyun Hong, Kyung Chul Yoon, Hyo-Sin Kim, YoungRok Choi, Hae Won Lee, Nam-Joon Yi, Kyung-Suk Suh
The process of evaluating potential donors in liver transplantation is important to ensure donor safety and provide optimal recipient outcome. However, there has been no report about donor exclusion rates and reasons for such exclusion in Korea. In this study, we aimed to elucidate the outcomes of potential live liver donor evaluation in a major LDLT center. From July 2011 to June 2015, prospectively collected data of 726 potential donors for 588 matched recipients were subsequently evaluated. Among 726 potential donors, 374 potential donors (51...
March 14, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28288061/impact-of-donor-age-on-recipient-survival-in-adult-to-adult-living-donor-liver-transplantation
#6
Toyonari Kubota, Koichiro Hata, Takashi Sozu, Yoshihide Ueda, Hirofumi Hirao, Yusuke Okamura, Ichiro Tamaki, Junichi Yoshikawa, Jiro Kusakabe, Hirokazu Tanaka, Shoichi Kageyama, Takayuki Anazawa, Atsushi Yoshizawa, Shintaro Yagi, Noriyo Yamashiki, Hideaki Okajima, Toshimi Kaido, Shinji Uemoto
OBJECTIVE: To investigate the influence of donor age on recipient outcome after living-donor partial liver transplantation (LDLT). BACKGROUND: Donor age is a well-known prognostic factor in deceased donor liver transplantation; however, its role in LDLT remains unclear. METHODS: We retrospectively analyzed 315 consecutive cases of primary adult-to-adult LDLT in our center between April 2006 and March 2014. Recipients were divided into 5 groups according to the donor age: D-20s (n = 60); D-30s (n = 72); D-40s (n = 57); D-50s (n = 94); and D-60s (n = 32)...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28266292/two-and-a-half-hours-of-cardiopulmonary-resuscitation-in-a-deceased-brain-dead-donor-before-liver-transplantation-a-good-idea-to-accept
#7
Dieter P Hoyer, Gernot M Kaiser, Andreas Paul, Nikolaos Machairas, Ernesto P Molmenti, Georgios C Sotiropoulos
The sequelae of cardiac arrest (CA) and cardiopulmonary resuscitation (CPR) in organ donors potentially results in ischemic organ injury and graft dysfunction after transplantation. Thresholds of resuscitation times in brain dead liver donors have not been established so far. We report the case of a brain dead liver donor who experienced 2.5 hours of CPR whose liver was successfully transplanted. A 75-year-old male experienced CA and was treated by CPR with streptokinase application for 2.5 hours until stabilization of cardiac function...
January 2017: Chirurgia
https://www.readbyqxmd.com/read/28261944/early-complications-after-liver-transplantation-in-children-and-adults-are-split-grafts-equal-to-each-other-and-equal-to-whole-livers
#8
Dehlia Moussaoui, Christian Toso, Anna Nowacka, Valérie A McLin, Marek Bednarkiewicz, Axel Andres, Thierry Berney, Pietro Majno, Barbara E Wildhaber
Split-liver transplantation (LT) allows transplantation of two recipients from one deceased donor, thereby increasing pool of grafts. However, split LT may be hampered by technical problems, and split grafts are still considered suboptimal organs in some centres. We analysed the outcomes in split- and whole-liver recipients in a combined adult-to-paediatric transplantation programme. Records of paediatric and adult patients having undergone LT from 1999 to 2013 were analysed retrospectively. All splits were performed in situ...
March 5, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28260480/living-donor-liver-transplant-follow-up-a-singlecenter-experience
#9
Syed Mudassir Laeeq, Farina M Hanif, Nasir Hassan Luck, Rajesh Kumar Mandhwani, Jawed Iqbal, Syed Haider Mehdi
OBJECTIVES: Liver transplant is a definite treatment of decompensated liver disease. Because of the shortage of livers from deceased donors, living-donor liver transplant is becoming more common. Here, we analyzed our clinical experience in the follow-up care of these patients. MATERIALS AND METHODS: Liver transplant recipients seen at the Sindh Institute of Urology and Transplantation (Karachi, Pakistan) were included in this analysis. Baseline characteristics and follow-up events were recorded...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260469/a-new-consideration-in-hepatic-artery-reconstruction-in-adult-liver-transplant-arterial-transposition-versus-extra-anatomic-jump-grafts
#10
Kourosh Kazemi, Pirooz Samidoost, Hamed Nikoupour Deilami, Seyed Ali Malek Hosseini, Saman Nikeghbalian, Alireza Shamsaeefar, Masood Dehghani, Mohsenreza Mansoorian, Siavash Gholami, Bahareh Khosravi
OBJECTIVES: In some cases of liver transplant, standard hepatic artery reconstruction may be difficult or impossible due to inadequate flow of the recipient's hepatic artery, as a result of stenosis, intimal dissection, or anomalies of the hepatic artery. We compared splenic artery transposition with extra-anatomic jump graft as 2 alternative methods for hepatic artery reconstruction in these situations. MATERIALS AND METHODS: We reviewed the files of 2135 liver transplant recipients from March 2011 to February 2016 at the Shiraz Transplant Center...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260429/low-utility-of-fluorodeoxyglucose-positron-emission-tomography-computed-tomography-for-detecting-hepatocellular-carcinoma-in-patients-before-liver-transplantation
#11
Faisal Alotaibi, Monther Kabbani, Faisal Abaalkhail, Alicia Chorley, Hany Elbeshbeshy, Waleed Al-Hamoudi, Saleh Alabbad, Markus U Boehnert, Mohammad Alsofayan, Wael Al-Kattan, Baderaldeen Ahmed, Dieter Broering, Mohamed Al Sebayel, Hussien Elsiesy
OBJECTIVES: Our program routinely used fluorodeoxyglucose-positron emission tomography/computed tomography as part of the liver transplant evaluation of patients with hepatocellular carcinoma. The aim of this study was to evaluate the role of this imaging modality in the pretransplant work-up. MATERIALS AND METHODS: This was a retrospective chart review of our liver transplant database from January 2011 to December 2014 for all patients with hepatocellular carcinoma who underwent a liver transplant...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260422/pre-versus-posttransplant-treatment-of-hepatitis-c-virus-with-direct-acting-antivirals-in-liver-transplant-recipients-more-issues-to-be-solved
#12
Abdelhai Abdelqader, Gokhan Kabacam, Tinsay A Woreta, James P Hamilton, Harry Luu, Kawtar Al Khalloufi, Behnam Saberi, Benjamin Philosophe, Andrew M Cameron, Ahmet Gurakar
OBJECTIVES: Our goal was to investigate wait times related to hepatitis C virus treatment with direct acting antivirals before versus after liver transplant at a single center as well as wait times for insurance approval for preemptive treatment with these agents after liver transplant. MATERIALS AND METHODS: We retrospectively evaluated hepatitis C virus infections in transplant recipients of deceased liver donations in 2014 and 2015. Demographics, hepatocellular carcinoma incidence, Model for End-Stage Liver Disease scores, and transplant wait times were compared between patients treated before or after liver transplant...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28239914/-d-10-meld-as-a-novel-predictor-of-patient-and-graft-survival-after-adult-to-adult-living-donor-liver-transplantation
#13
Arvinder Singh Soin, Sanjay Goja, Sanjay Kumar Yadav, Tseten Yonjen Tamang, Amit Rastogi, Prashant Bhangui, S Thiagrajan, Vikram Raut, Raghvendra Y Babu, Neeraj Saraf, Narendra Singh Chaudhary, Vijay Vohara
We modified the previously described DMELD score in deceased donor liver transplant, to (D+10)MELD to account for living donors being about 10 years younger than deceased donors, and tested it on living donor liver transplantation (LDLT) recipients. 500 consecutive LDLT, between July 2010 and December 2012 were retrospectively analyzed to see the effect of (D+10)MELD on patient and graft survival. Donor age alone did not influence survival. Recipients were divided into 6 classes on based on the (D+10)MELD score: Class 1 (0-399), Class 2 (400-799), Class 3 (800-1199), class 4 (1200-1599), Class 5 (1600-1999) and Class 6 (>2000)...
February 26, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28223731/risk-of-alcohol-use-relapse-after-liver-transplantation-for-alcoholic-liver-disease
#14
Yasuharu Onishi, Hiroyuki Kimura, Tomohide Hori, Shinichi Kishi, Hideya Kamei, Nobuhiko Kurata, Chisato Tsuboi, Naoko Yamaguchi, Mayu Takahashi, Saki Sunada, Mitsuaki Hirano, Hiroshige Fujishiro, Takashi Okada, Masatoshi Ishigami, Hidemi Goto, Norio Ozaki, Yasuhiro Ogura
AIM: To investigate factors, including psychosocial factors, associated with alcoholic use relapse after liver transplantation (LT) for alcoholic liver disease (ALD). METHODS: The clinical records of 102 patients with ALD who were referred to Nagoya University Hospital for LT between May 2003 and March 2015 were retrospectively evaluated. History of alcohol intake was obtained from their clinical records and scored according to the High-Risk Alcoholism Relapse scale, which includes duration of heavy drinking, types and amount of alcohol usually consumed, and previous inpatient treatment history for alcoholism...
February 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28223040/red-blood-cell-exchange-as-an-approach-for-treating-a-case-of-severe-tacrolimus-overexposure
#15
Valentina Spallanzani, Lucia Bindi, Irene Bianco, Arianna Precisi, Paolo DeSimone, Alessandro Mazzoni, Gianni Biancofiore
Immunosuppressive medication dosing errors are not unfrequent and may present a number of challenges to transplant clinicians. Tacrolimus (TAC) is a widely used immunosuppressant with a narrow therapeutic index and potential severe side effects, including neurotoxicity and kidney injury. We herein report a case of 60-year-old woman who underwent deceased-donor liver transplantation at our center and due to inadvertent TAC overexposure was admitted to the Intensive Care Unit because of severe neurologic impairment, kidney injury and arterial hypotension...
February 2, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28220747/three-cases-of-neurologic-syndrome-caused-by-donor-derived-microsporidiosis
#16
Rachel M Smith, Atis Muehlenbachs, Joanna Schaenmann, Sanjiv Baxi, Sophia Koo, Dianna Blau, Peter Chin-Hong, Anna R Thorner, Matthew J Kuehnert, Kristina Wheeler, Alexis Liakos, Jonathan W Jackson, Theresa Benedict, Alexandre J da Silva, Jana M Ritter, Dominique Rollin, Maureen Metcalfe, Cynthia S Goldsmith, Govinda S Visvesvara, Sridhar V Basavaraju, Sherif Zaki
In April 2014, a kidney transplant recipient in the United States experienced headache, diplopia, and confusion, followed by neurologic decline and death. An investigation to evaluate the possibility of donor-derived infection determined that 3 patients had received 4 organs (kidney, liver, heart/kidney) from the same donor. The liver recipient experienced tremor and gait instability; the heart/kidney and contralateral kidney recipients were hospitalized with encephalitis. None experienced gastrointestinal symptoms...
March 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28218989/liver-transplantation-from-donors-with-positive-blood-cultures-increased-risk-of-graft-failure-or-opportunity-to-expand-the-donor-pool
#17
Paolo Antonio Grossi
Organ transplantation is considered the therapy of choice for end-stage organ failure. However, the growing gap between the number of patients waiting for transplantation and available organs continue to be the number one issue facing the transplant community. As a consequence the major focus in liver transplantation has been developing strategies to increase available donors, including the use of live donor liver segments, splitting deceased donor grafts for two patients and the use of organs procured from donors after circulatory death (DCD)...
February 20, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28216707/combined-liver-and-kidney-transplantation-our-experience-and-review-of-literature
#18
Kusuma Ramachandra Halemani, N Bhadrinath
Increased awareness of organ donation has increased the availability of deceased donors, and it has boosted the opportunities for treating patients with multiple organ dysfunction. Simultaneously replacing two organs gives advantages of single surgery, lower immunosuppression dose and better survival than when one organ alone is transplanted. We present reports of management of three cases of combined liver and kidney transplantation (CLKT) from deceased donors. Based on management of these cases we discuss the importance of CLKT and anaesthetic concerns during such complex procedures...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28212159/liver-allocation-and-distribution-time-for-a-change
#19
Ranjit Deshpande, Ryutaro Hirose, David Mulligan
PURPOSE OF REVIEW: Liver allograft allocation has been a topic of hot debate for over a decade. New redistricting changes have been proposed by the Liver and Intestinal Transplant Committee to the existing United Network for Organ Sharing (UNOS) liver allocation policy. The basis of this new proposal is similar to the old one with an aim to distribute organs in a fair, efficient and equitable fashion. In this review, we plan to look in depth at the redistribution proposals thus far, their merits and how they may help patients who do not have adequate access to livers...
February 15, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28211259/liver-transplantation-from-a-deceased-donor-with-%C3%AE-thalassemia-intermedia-is-not-contraindicated-a-case-report
#20
Ersin Gumus, Osman Abbasoglu, Cahit Tanyel, Fatma Gumruk, Hasan Ozen, Aysel Yuce
The use of extended criteria donors who might have previously been deemed unsuitable is an option to increase the organ supply for transplantation. This report presents a pediatric case of a successful liver transplantation from a donor with β-thalassemia intermedia. A patient, 6-year-old female, with a diagnosis of cryptogenic liver cirrhosis underwent deceased donor liver transplantation from a thalassemic donor. Extreme hyperferritinemia was detected shortly after transplantation. The most probable cause of hyperferritinemia was iron overload secondary to transplantation of a hemosiderotic liver...
February 17, 2017: Pediatric Transplantation
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