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Xiaopeng Yang, Jae Do Yang, Hee Chul Yu, Younggeun Choi, Kwangho Yang, Tae Beom Lee, Hong Pil Hwang, Sungwoo Ahn, Heecheon You
BACKGROUND AND OBJECTIVE: Manual tracing of the right and left liver lobes from computed tomography (CT) images for graft volumetry in preoperative surgery planning of living donor liver transplantation (LDLT) is common at most medical centers. This study aims to develop an automatic system with advanced image processing algorithms and user-friendly interfaces for liver graft volumetry and evaluate its accuracy and efficiency in comparison with a manual tracing method. METHODS: The proposed system provides a sequential procedure consisting of (1) liver segmentation, (2) blood vessel segmentation, and (3) virtual liver resection for liver graft volumetry...
May 2018: Computer Methods and Programs in Biomedicine
Takahiro Onuma, Tamotsu Kamishima, Tsuyoshi Shimamura, Norio Kawamura, Kenichiro Yamashita, Kenneth Sutherland, Hiroshi Takeda
Background: The quantity and quality of skeletal muscle have been observed to be closely related with post-transplantation mortality in patients undergoing living donor liver transplantation (LDLT). However, the effect of LDLT on skeletal muscle has not been thoroughly investigated. The aim of this study was to investigate the change of trunk muscle mass and adiposity in recipients of LDLT. Methods: The study population included LDLT recipients at Hokkaido University Hospital who underwent pre- and post-operative computed tomography (CT) scans (31 recipients; 14 males, and 17 females)...
February 2018: Quantitative Imaging in Medicine and Surgery
Brian I Shaw, Lyle J Burdine, Hillary J Braun, Nancy L Ascher, John P Roberts
Background: With the use of split liver grafts as well as living donor liver transplantation (LDLT) it is imperative to know the minimum graft volume to avoid complications. Most current formulas to predict standard liver volume (SLV) rely on weight-based measures that are likely inaccurate in the setting of cirrhosis. Therefore, we sought to create a formula for estimating SLV without weight-based covariates. Methods: LDLT donors underwent computed tomography scan volumetric evaluation of their livers...
December 2017: Transplantation Direct
V Ince, C Kayaalp, E Otan, F Ozdemir, A Dirican, H I Toprak, C Aydin, C Ara, S Yilmaz
Emergency liver transplantation (LT) for acute liver failure (ALF) is a life-saving treatment. Occurrence of this situation in the same patient twice is very rare. Herein, we describe a patient who underwent two emergency LTs for ALF, both from living donors. When she was 26 years old, she underwent a right lobe living donor LT (LDLT) from her sister for ALF due to use of herbal weight loss medications. The next 3 years were uneventful but another ALF developed during a terminal stage pregnancy (37th week)...
2018: International Journal of Organ Transplantation Medicine
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
Hyun Young Woo, In Seok Lee, Jae Hyuck Chang, Seung Bae Youn, Si Hyun Bae, Jong Young Choi, Ho Jong Chun, Young Kyoung You, Dong Goo Kim, Seung Kew Yoon
Background/Aims: Biliary complications are the most common donor complication following living donor liver transplantation (LDLT). The aim of this study is to investigate the long-term outcomes of biliary complications in right lobe adult-to-adult LDLT donors, and to evaluate the efficacy of endoscopic treatment of these donors. Methods: The medical charts of right lobe donors who developed biliary complications between June 2000 and January 2008 were retrospectively reviewed...
March 14, 2018: Korean Journal of Internal Medicine
Amr Badawy, Toshimi Kaido, Atsushi Yoshizawa, Shintaro Yagi, Ken Fukumitsu, Hideaki Okajima, Shinji Uemoto
BACKGROUND: The impact of HLA compatibility and positive lymphocyte cross-match (LCM) on organ transplantation is well-recognized particularly in kidney and heart transplantation, however, it is still debatable in liver transplantation (LT). So, the aim of this study was to evaluate the impact of HLA mismatch and positive LCM on the outcome of LT. METHODS: We retrospectively analyzed the data of all adult recipients who underwent living donor LT at our institute between January 2010 and July 2016...
March 2, 2018: Clinical Transplantation
Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Sangbin Han, Jeejin Yoo, Kyunga Kim, Dong Hyun Sinn, Gyu-Seong Choi, David A Gerber, Hiroto Egawa, Suk-Koo Lee
BACKGROUND: ABO-incompatible (ABO-I) living donor liver transplantation (LDLT) has a high success rate. This study compares HCC recurrence in ABO-I LDLT with that in ABO-compatible (ABO-C) LDLT and explores the effects of rituximab prophylaxis and total plasma exchange (TPE) on HCC recurrence after LDLT. METHODS: Two-hundred forty patients with a diagnosis of HCC underwent LDLT between 2010 and 2015. Fifty-nine patients underwent ABO-I LDLT. RESULTS: Baseline, perioperative, and tumor characteristics did not vary between the two groups...
February 28, 2018: Transplantation
Pooja Bhangui, Prashant Bhangui, Nikunj Gupta, Annu Sarin Jolly, Seema Bhalotra, Nishant Sharma, A S Soin, Vijay Vohra
Background and Aims: Fast tracking (FT) for more efficacious use of resources may be difficult after living donor liver transplantation (LDLT) due to a partial liver graft, complex vascular anastomoses and longer operating time. Our study was aimed at reporting our experience with FT (on table extubation) in LDLT recipients. A secondary objective of our study was to look at defining a subgroup of patients who could be prospectively planned for FT. Methods: We studied the demographics and outcomes of 15 LDLT recipients extubated immediately in the operating suite based on an uneventful intraoperative course, haemodynamic stability after graft reperfusion and improvement of metabolic parameters post-implantation and vascular anastomoses...
February 2018: Indian Journal of Anaesthesia
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
Akinari Fukuda, Seisuke Sakamoto, Kengo Sasaki, Soichi Narumoto, Toshihiro Kitajima, Yoshihiro Hirata, Tomoro Hishiki, Kasahara Mureo
Hepatic venous outflow obstruction (HVOO) can be a critical complication in pediatric living-donor liver transplantation (LDLT). The aim of this study was to evaluate a modified triangular technique of hepatic vein reconstruction for preventing HVOO in pediatric LDLT. METHODS: A total of 298 pediatric LDLTs were performed using a left lateral segment graft by two methods for reconstruction of the hepatic vein. In 177 recipients, slit-shaped anastomosis were indicated with partial clamp of the inferior vena cava (IVC)...
February 27, 2018: Pediatric Transplantation
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
Pauline Brige, Geraldine Hery, Anais Palen, Théophile Guilbaud, Christophe Buffat, Anais Moyon, Jean Hardwigsen, Eric Guedj, Benjamin Guillet, Vincent Vidal, Guillaume Gorincour, Sophie Chopinet, Emilie Gregoire
In order to reduce the morbidity and mortality risk for the donor in living donor liver transplantation (LDLT), we previously identified 20% left portal vein (LPV) stenosis as the effective preconditioning to induce cell proliferation in the contralateral lobe without the downstream ipsilateral atrophy. We report, here, the pathways involved in the first hours after the preconditioning and investigate the changes in liver volume and function. Fourteen pigs entered this study. Five of them were used to study the genetic, cellular and molecular mechanisms set up in the early hours after the establishment of our preconditioning...
February 22, 2018: American Journal of Physiology. Gastrointestinal and Liver Physiology
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
Yuhei Hamaguchi, Toshimi Kaido, Shinya Okumura, Atsushi Kobayashi, Hisaya Shirai, Siyuan Yao, Shintaro Yagi, Naoko Kamo, Hideaki Okajima, Shinji Uemoto
BACKGROUND: The significance of pre-operative body composition has recently attracted much attention in various diseases. However, cut-off values for these parameters remain undetermined, and these factors are not currently included in selection criteria for recipients of living donor liver transplantation (LDLT). METHODS: Using computed tomography of 657 donors for LDLT, skeletal muscle mass, muscle quality, and visceral adiposity were evaluated by using skeletal muscle mass index (SMI), intramuscular adipose tissue content (IMAC), and visceral-to-subcutaneous adipose tissue area ratio (VSR)...
February 17, 2018: Journal of Cachexia, Sarcopenia and Muscle
Juan S Rubio, Carolina Rumbo, Pablo A Farinelli, Nicolás Aguirre, Diego A Ramisch, Hugo Paladini, Pablo D Angelo, Pablo Barros Schelotto, Gabriel E Gondolesi
Collateral circulation secondary to liver cirrhosis may cause the development of large PSSs that may steal flow from the main portal circulation. It is important to identify these shunts prior to, or during the transplant surgery because they might cause an insufficient portal flow to the implanted graft. There are few reports of "steal flow syndrome" cases in pediatrics, even in biliary atresia patients that may have portal hypoplasia as an associated malformation. We present a 12-month-old female who received an uneventful LDLT from her mother, and the GRWR was 4...
February 16, 2018: Pediatric Transplantation
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
Wei Zheng, Kang-Mei Zhao, Li-Hui Luo, Yang Yu, Sheng-Mei Zhu
Background: Although many previous studies have confirmed that perioperative blood transfusion is associated with poor outcomes after liver transplantation (LT), few studies described the influence of single-donor platelet apheresis transfusion in living donor LT (LDLT). This study aimed to assess the effect of blood products on outcomes for LDLT recipients, focusing on apheresis platelets. Methods: This retrospective study included 126 recipients who underwent their first adult-to-adult LDLT...
February 20, 2018: Chinese Medical Journal
Trevor L Nydam, Mettu Srinivas Reddy, Elizabeth A Pomfret, Mohamed Rela
PURPOSE OF REVIEW: Living donor liver transplantation (LDLT) has developed into a well tolerated and viable option when deceased donor transplantation is not available. Transplant and advanced hepatobiliary surgeons from around the world have performed living donor hepatectomies consistently for decades with acceptable donor outcomes. However, optimizing the preoperative workup, donor selection, operative technique, and perioperative care will improve these outcomes. This manuscript reviews recent worldwide literature for the living liver donor...
February 9, 2018: Current Opinion in Organ Transplantation
Takashi Onoe, Asuka Tanaka, Kohei Ishiyama, Kentaro Ide, Hirotaka Tashiro, Hideki Ohdan
BACKGROUND: Portopulmonary hypertension (PPH) is a relatively rare but well-recognized complication of end-stage liver disease. Moderate or severe PPH (mean pulmonary artery pressure [mPAP] ≥ 35 mmHg) is usually a contraindication for liver transplantation due to high operation-related mortality. Here, we report on a patient with moderate PPH whose condition was successfully managed with a phosphodiesterase type 5 (PDE5) inhibitor (tadalafil) and prostaglandin E1, who experienced rapid improvement of PPH after living-donor liver transplantation (LDLT)...
February 7, 2018: Surgical Case Reports
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