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https://www.readbyqxmd.com/read/29350831/randomized-trial-on-extended-versus-modified-right-lobe-grafts-in-live-donor-liver-transplantation
#1
Christi Titus Varghese, Viju Kumar Bharathan, Unnikrishnan Gopalakrishnan, Dinesh Balakrishnan, Ramachandran N Menon, Othiyil Vayoth Sudheer, Puneet Dhar, Sudhindran Surendran
Despite advances in the practice of live donor liver transplantation (LDLT), the optimum surgical approach with respect to the middle hepatic vein (MHV) in right lobe LDLT remains undefined. We designed a randomized trial to compare the early postoperative outcomes in recipients and donors between extended right lobe grafts (ERG: transection plane was maintained to the left of MHV, and division of MHV performed beyond the segment VIII vein) and modified right lobe grafts (MRG: transection plane was maintained to the right of MHV, the segment V and VIII drainage was reconstructed using a conduit of recipient portal vein)...
January 19, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29338386/estrogen-estrogen-receptor-%C3%AE-signaling-facilitates-bilirubin-metabolism-in-regenerating-liver-through-regulating-cytochrome-p450-2a6-expression
#2
Ta-Lun Kao, Yao-Li Chen, Yu-Ping Kuan, Wei-Chun Chang, Yu-Chen Ho, Shuyuan Yeh, Long-Bin Jeng, Wen-Lung Ma
BACKGROUND: After living donor liver transplantation (LDLT), rising serum bilirubin levels commonly indicate insufficient numbers of hepatocytes are available to metabolize bilirubin into biliverdin. Recovery of bilirubin levels is an important marker of hepatocyte repopulation after LDLT. Cytochrome P450 (CYP) 2A6 in humans (or cyp2a4 in rodents) can function as "bilirubin oxidase." Functional hepatocytes contain abundant CYP2A6, which is considered a marker for hepatocyte function recovery...
November 2017: Cell Transplantation
https://www.readbyqxmd.com/read/29334530/antegrade-arterial-and-portal-flushing-versus-portal-flushing-only-for-right-lobe-live-donor-liver-transplantation-a-randomized-control-trial
#3
Viniyendra Pamecha, Rommel Sandhyav, Piyush Kumar Sinha, Kishore Gurumoorthy Subramanya Bharathy, Shridhar Sasturkar
INTRODUCTION: In live donor liver transplantation (LDLT) portal flush only of the graft is done on the bench. There is no data on antegrade arterial flush along with portal flush of the graft. METHODS: Consecutive patients undergoing elective right lobe LDLT were block-randomized to receive either portal flush only or both portal and antegrade arterial flush. The primary objectives were safety, rate of early allograft dysfunction (EAD), and impact on vascular and biliary complications RESULTS: After randomization there were 40 patients in each group...
January 12, 2018: Transplantation
https://www.readbyqxmd.com/read/29328523/improved-portal-vein-venoplasty-with-autogenous-patch-in-pediatric-living-donor-liver-transplantation
#4
Mingxuan Feng, Ping Wan, Bijun Qiu, Tao Zhou, Yi Luo, Lihong Gu, Jiachang Chi, Chengpeng Zhong, Yefeng Lu, Jianjun Zhang, Qiang Xia
BACKGROUND: An atretic or hypoplastic portal vein (PV) represents a challenge for PV reconstruction in pediatric living donor liver transplantation (LDLT). Several PV venoplastic techniques have been developed. However, we still seek improved venoplastic techniques with better efficacy and compatibility. METHOD: From June 2016 to July 2017, 271 LDLT procedures were performed at the Department of Liver Surgery, Ren Ji Hospital. A total of 16 consecutive children with atretic and sclerotic PVs underwent a novel technique - the autogenous PV patch plastic technique...
January 12, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29311539/tolvaptan-for-fluid-management-in-living-donor-liver-transplant-recipients
#5
Shunichi Imai, Masahiro Shinoda, Hideaki Obara, Minoru Kitago, Taizo Hibi, Yuta Abe, Hiroshi Yagi, Kentaro Matsubara, Hisanobu Higashi, Osamu Itano, Yuko Kitagawa
BACKGROUND Tolvaptan, an antagonist of the vasopressin V2 receptor is a novel oral diuretic that promotes water excretion selectively. We have used furosemide as a primary diuretic and added human atrial natriuretic peptide (hANP) if necessary for fluid management postoperatively in living-donor liver transplantation (LDLT) recipients. Recently we introduced tolvaptan and used both tolvaptan and furosemide as primary diuretics. MATERIAL AND METHODS Clinical outcomes were compared between LDLT recipients whose postoperative fluid management was performed before (control group, n=10) and after (tolvaptan group, n=16) introduction of tolvaptan...
January 9, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29298237/elevated-high-sensitivity-troponin-i-during-living-donor-liver-transplantation-is-associated-with-postoperative-adverse-outcomes
#6
Jungchan Park, Seung Hwa Lee, Sangbin Han, Ki Yoon Kim, Go Eun Kim, Myungsoo Park, Suk-Koo Lee, Gyu-Seong Choi, Soohyun Ahn, Hyeon Seon Ahn, Gaab Soo Kim
BACKGROUND: This study aimed to evaluate risk factors and postoperative clinical outcome associated with myocardial injury detected by an elevated high-sensitivity cardiac troponin I (hs-cTnI) immediately after living donor liver transplantation (LDLT). METHODS: Between January 2011 and December 2016, 313 adult recipients undergoing LDLT, with normal preoperative hs-cTnI were selected. Hs-cTnI level above 0.04 ng/mL according to 99th percentile reference limit was defined as myocardial injury...
January 2, 2018: Transplantation
https://www.readbyqxmd.com/read/29285393/chronic-myeloid-leukemia-following-liver-transplantation-a-case-report
#7
Ling Zhang, Bing Long, Xiao-Qing Li, Zhi-Gang Fang, Wen-Xing Lai, Dong-Jun Lin
Long-term utilization of immunosuppression in organ transplant recipients leads to decreased immune-mediated tumor surveillance and increased risk of developing malignant tumors. However, chronic myeloid leukemia (CML) following living donor liver transplantation (LDLT) is rarely reported. The current case report presents a 42-year-old male patient who developed CML 14 months following LDLT. The patient achieved complete hematologic remission and early molecular response at 3 months imatinib treatment and major molecular response at 12 months imatinib treatment...
December 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29250507/increased-survival-in-hepatitis-c-patients-who-underwent-living-donor-liver-transplant-a-case-control-study-with-propensity-score-matching
#8
Jong Man Kim, Kwang-Woong Lee, Gi-Won Song, Bo-Hyun Jung, Hae Won Lee, Nam-Joon Yi, Choon Hyuck David Kwon, Shin Hwang, Kyung-Suk Suh, Jae-Won Joh, Suk-Koo Lee, Sung-Gyu Lee
Purpose: There is no consensus regarding the difference in outcomes of HCV in patients who receive living donor liver transplantation (LDLT) or compared to deceased donor liver transplantation (DDLT). The aims of this study were to compare characteristics between LDLT and DDLT groups and to identify risk factors affecting patient survival. Methods: We retrospectively reviewed the multicenter records of 192 HCV RNA-positive patients who underwent liver transplantation...
December 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29235211/pre-transplant-serum-procalcitonin-level-for-prediction-of-early-post-transplant-sepsis-in-living-donor-liver-transplantation
#9
Takanobu Hara, Akihiko Soyama, Masaaki Hidaka, Koji Natsuda, Tomohiko Adachi, Shinichiro Ono, Satomi Okada, Takashi Hamada, Mitsuhisa Takatsuki, Susumu Eguchi
AIM: Infections are frequent causes of in-hospital mortality after liver transplantation (LT). Elimination of possible risks in the pre-transplant period, early diagnosis of post-transplant sepsis, and prompt administration of antimicrobial agents are important. The objectives of this study were to analyze the impact of early post-transplant sepsis on outcomes and to clarify the value of predictive factors for early post-transplant sepsis. METHODS: The study included 136 patients who underwent initial living donor LT (LDLT) at our institute from April 2009 to December 2016...
December 13, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29234204/middle-hepatic-vein-bleed-during-donor-hepatectomy-technique-for-safe-practice
#10
Madhusudhanan Jegadeesan, Neerav Goyal, Subash Gupta
Safe performance of donor hepatectomy is crucial for sustainability of a living donor liver transplantation (LDLT) program. Middle hepatic vein (MHV) is always encountered during parenchymal transection irrespective of right or left donor hepatectomies. Here we present a safe and effective technique for tackling MHV bleed during LDLT from a single centre experience.
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29226766/a-case-report-of-living-donor-liver-transplantation-for-fulminant-hepatitis-related-to-hepatitis-e-virus-infection
#11
Keita Shimata, Yasuhiko Sugawara, Hidekazu Yamamoto, Hiroaki Okamoto, Koushi Uchida, Seiichi Kawabata, Kaori Isono, Shintaro Hayashida, Yukihiro Inomata
Hepatitis E virus (HEV) infection which may become fulminant, especially in elderly people is more common than previously recognized in develop countries. Here we report successful living-donor liver transplantation (LDLT) in a case of acute liver failure due to HEV. A 63-year-old Japanese man with no previous history of liver disease was admitted for severe acute hepatitis. Detection of anti-HEV immunoglobulin A established a diagnosis of this virus-related liver failure. The patient suffered from hepatic encephalopathy 10 days after symptom onset and underwent LDLT...
January 1, 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/29221981/chest-computed-tomography-image-for-accurately-predicting-the-optimal-insertion-depth-of-left-sided-double-lumen-tube
#12
Zhuo Liu, Li Zhao, Qianqian Jia, Xiaochun Yang, Shu Juan Liang, Wensheng He
OBJECTIVE: The main objective of this study was to assess the feasibility and accuracy of measuring the distance between the vocal cord and carina using chest computer tomography (CT) as a guide for the intubation of a left-sided double-lumen tube (LDLT). DESIGN: Single-center, prospective, randomized study. SETTING: Local hospital in China. PARTICIPANTS: Sixty adult patients undergoing elective thoracic surgery requiring an LDLT for one lung ventilation were enrolled in this study...
September 20, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29218832/necrotizing-enterocolitis-in-the-setting-of-milk-allergy-after-pediatric-living-donor-liver-transplantation
#13
Soichi Narumoto, Seisuke Sakamoto, Hajime Uchida, Kengo Sasaki, Takanobu Shigeta, Akinari Fukuda, Shunsuke Nosaka, Rie Irie, Takako Yoshioka, Mureo Kasahara
NEC is an idiopathic intestinal mucosal injury that may progress to transmural bowel necrosis without mesenteric ischemia. NEC usually affects 7- to 10-day-old neonates following enteral feeding. A 10-month-old girl with no history of laparotomy underwent LDLT for acute liver failure. After starting enteral feeding on postoperative day 5, she developed abdominal distention. Diffuse PVG and PI were detected by radiologic modalities. Exploratory laparotomy revealed patchy necrosis of the intestine without perforation...
December 7, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29216531/living-donor-liver-transplantation-for-adult-budd-chiari-syndrome-resection-without-replacement-of-retrohepatic-ivc-a-case-report
#14
Tarek Abdelazeem Sabra, Hideaki Okajima, Tetsuya Tajima, Ken Fukumitsu, Koichiro Hata, Kentaro Yasuchika, Toshihiko Masui, Kojiro Taura, Toshimi Kaido, Shinji Uemoto
INTRODUCTION: Suprahepatic caval resection and replacement of inferior vena cava (IVC) is standard procedure in deceased donor liver transplantation for patients with Budd-Chiari syndrome (BCS). However, replacement of IVC in living donor liver transplantation (LDLT) is difficult. We report a case of BCS successfully treated by LDLT without replacement of IVC. PRESENTATION OF CASE: A 52-years-old female with a primary BCS due to IVC thrombosis. A vena cava (VC) stent placed after angioplasty without improvement of the hepatic, portal venous flow and liver functions, Transjugular intrahepatic portosystemic shunt was considered and the patient had a rapid deterioration and increased ascites...
December 1, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29194959/standardized-hybrid-living-donor-hemi-hepatectomy-in-adult-to-adult-living-donor-liver-transplantation
#15
Susumu Eguchi, Akihiko Soyama, Takanobu Hara, Koji Natsuda, Satomi Okada, Takashi Hamada, Taiichiro Kosaka, Shinichiro Ono, Tomohiko Adachi, Masaaki Hidaka, Mitsuhisa Takatsuki
The aim of this study was to analyze the most updated and largest outcome of our standardized hybrid (laparoscopic mobilization and hepatectomy through midline incision) living donor (LD) hemihepatectomy compared to conventional laparotomy in adult-to-adult LD liver transplantation (LT). Of 237 adult-to-adult LDLT from August 1997 to March 2017, 110 LD underwent the hybrid procedure. Pre-operative and operative factors were analyzed and compared to conventional laparotomy (n=126). The median duration of laparoscopic usage was 26 minutes in the hybrid group...
December 1, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29176268/hemodynamic-implications-of-carbon-monoxide-co-and-nitrogen-oxide-no-during-living-donor-liver-transplantation
#16
Hyunyoung Lim, Suk-Koo Lee, Gaabsoo Kim
Carbon monoxide (CO) and nitrogen oxide (NO) affect vasodilation and cause hemodynamic change. Hemodynamic instability due to liver transplantation may result in poor prognosis of graft. This study investigated the hemodynamic implications of CO and NO levels measured using carboxyhemoglobin (COHb) and methemoglobin (MetHb) during living donor liver transplantation (LDLT). The hemodynamic instability with a pressor dose (norepinephrine equivalent) was estimated 1 hour after graft reperfusion. COHb and MetHb were used as indexes of CO and NO, and were measured using an arterial blood gas analyzer...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29163966/risk-factors-and-survival-outcomes-of-biliary-complications-after-adult-to-adult-living-donor-liver-transplantation
#17
Seogsong Jeong, Xin Wang, Ping Wan, Meng Sha, Jianjun Zhang, Lei Xia, Ying Tong, Yi Luo, Qiang Xia
The objective of this study was to evaluate the risk factors and survival outcomes of biliary complications (BCs) after living donor liver transplantation (LDLT) based on our single-center experience. From 2007 to 2010, 112 adult patients were assessed. Forty-nine patients (43.8%) experienced at least one episode of BCs, including biliary stricture and bile leak, occurring in 37.5% and 16.1% of the patients, respectively. Multivariate analysis indicated that hepatic artery thrombosis (relative risk (RR), 5...
November 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29160909/revisiting-chronic-rejection-following-living-donor-liver-transplantation-in-the-tacrolimus-era-a-single-centre-experience
#18
Narendra Singh Choudhary, Neeraj Saraf, Sanjiv Saigal, Dheeraj Gautam, Amit Rastogi, Sanjay Goja, Prashant Bhangui, Thiagrajan Srinivasan, Sanjay Kumar Yadav, Arvinder Soin
BACKGROUND AND AIMS: Chronic rejection (CR) is an uncommon but important cause of graft dysfunction, leading to graft loss and often requires re-transplantation. This study evaluates the incidence and outcome of patients with CR at a large living donor liver transplant (LDLT) centre. METHODS: Data of patients with CR was retrospectively analyzed in 1232 adult (age >18 years) LDLT on Tacrolimus (mainly) based immunosuppression. Sirolimus/Everolimus (mTOR inhibitors) were added to baseline immunosuppression as rescue therapy in patients with CR...
November 21, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29156640/clinical-beneficial-effects-of-using-crystalloid-only-in-recipients-of-living-donor-liver-transplantation
#19
Chia-Jung Huang, Kwok-Wai Cheng, Chao-Long Chen, Shao-Chun Wu, Tsung-Hsiao Shih, Sheng-Chun Yang, Sin-Ei Juang, Ying-En Lee, Chiu-En Huang, Bruno Jawan, Chih-Hsien Wang
OBJECTIVE: Liver transplantation (LT) is a major surgery associated with intraoperative massive fluid shift, which is usually replaced by crystalloid, 5% albumin (colloid) and blood products. We studied 15 patients from 477 consecutive recipients of adult living donor liver transplantation. Each patient received crystalloid only during LT. Whether LT provides any clinical benefit is not clear and must be determined. METHODS AND PATIENTS: The anesthesia records of 477 adult LDLT were reviewed retrospectively...
November 20, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29154411/effect-of-graft-size-matching-on-pediatric-living-donor-liver-transplantation-at-a-single-center
#20
Jun-Jie Li, Cai-Hua Zu, Shi-Peng Li, Wei Gao, Zhong-Yang Shen, Jin-Zhen Cai
We retrospectively analyzed 252 patients with end-stage liver disease who had undergone LDLT from January 2009 to September 2015. Of these, 25 had a GRWR of <2.0% (Group A), 204 had a GRWR of ≥2.0% or <4.0% (Group B), and 23 had a GRWR ≥4.0% (Group C). The three GRWR groups demonstrated similar characteristics, except for recipient age and recipient BMI. The overall one, two, and three-year graft survival rates were 95.1%, 93.5%, and 93.5%, respectively. However, among the three groups, graft survival rates at one year, two years and three years were significantly different (P=0...
November 20, 2017: Clinical Transplantation
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