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https://www.readbyqxmd.com/read/28439714/arterial-and-biliary-complications-after-living-donor-liver-transplantation-a-single-center-retrospective-study-and-literature-review
#1
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/28437386/the-international-liver-transplantation-society-living-donor-liver-transplant-recipient-guideline
#2
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
#3
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/28427741/management-of-biliary-anastomotic-strictures-after-liver-transplantation
#4
REVIEW
Aydin Seref Koksal, Ahmet Tarik Eminler, Erkan Parlak, Ahmet Gurakar
Biliary strictures constitute 40% to 60% of the biliary complications after liver transplantation. They are more common after living donor related liver transplantation (LDLT) than orthotopic liver transplantation (OLT). Balloon dilation followed by multiple plastic stent insertion leads to a mean resolution rate of 84% in the treatment of ASs after OLT. Endoscopic treatment of ASs after LDLT is more difficult because of the small size of the ASs, their multiple number and peripheral location. Balloon dilation followed by multiple plastic stent insertion had a mean resolution rate of 53%...
March 30, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28422392/hepatic-artery-reconstruction-in-living-donor-liver-transplantation-using-surgical-loupes-achieving-low-rate-of-hepatic-arterial-thrombosis-in-consecutive-741-recipients-tips-and-tricks-to-overcome-the-poor-hepatic-arterial-flow
#5
Ping-Chun Li, Ashok Thorat, Long-Bin Jeng, Horng-Ren Yang, Ming-Li Li, Chun-Chieh Yeh, Te-Hung Chen, Shih-Chao Hsu, Kin-Shing Poon
BACKGROUND: The reconstruction of hepatic artery (HA) is most complex step in living donor liver transplantation (LDLT) due to smaller diameter of the artery and increased risk of HA related complications. Due to smaller diameter of the HA, many centres use microsurgical technique with interrupted sutures for arterial anastomosis. Aim of our study was to retrospectively investigate the outcomes after HA reconstruction performed under magnifying loupes using "parachute technique". MATERIALS AND METHODS: From August 2002 to 31(st) August 2016, LDLT was performed in 766 recipients...
April 19, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28415168/an-update-on-endoscopic-management-of-post-liver-transplant-biliary-complications
#6
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/28365891/the-liver-hanging-maneuver-in-laparoscopic-liver-resection-a-systematic-review
#7
REVIEW
Rami Rhaiem, Tullio Piardi, Tarek Kellil, Audrey Cagniet, Mikael Chetboun, Reza Kianmanesh, Daniele Sommacale
PURPOSE: Laparoscopic surgery has gained the acceptance of the hepatobiliary surgical community and expert teams are now advocating major laparoscopic liver resections (LLRs). In this setting, the liver hanging maneuver (LHM) has been described in numerous series. We conducted a systematic review to investigate the effectiveness of the LHM in LLR. METHODS: We performed an electronic literature search using PubMed, EMBASE, and COCHRANE databases. The final search was carried out in December, 2015...
April 1, 2017: Surgery Today
https://www.readbyqxmd.com/read/28365200/postoperative-changes-in-neutrophil-to-lymphocyte-ratio-and-platelet%C3%A2-count-a-simple-prognostic-predictor%C3%A2-for-adult-to-adult-living-donor%C3%A2-liver%C3%A2-transplantation
#8
Hironori Hayashi, Hiroyuki Takamura, Yoshinao Ohbatake, Shinichi Nakanuma, Hidehiro Tajima, Sachio Fushida, Ichiro Onishi, Takashi Tani, Koichi Shimizu, Tetsuo Ohta
BACKGROUND/OBJECTIVE: The neutrophil-to-lymphocyte ratio (NLR) is a simple index that represents systemic inflammatory change. The number of platelets is also known to reflect both post-transplant graft regeneration and dysfunction. Thus, we aimed to investigate the usefulness of NLR and platelet number in predicting the clinical course after adult-to-adult living donor liver transplantation (AA-LDLT) in the acute postoperative period in recipients. METHODS: Between January 1999 and December 2013, 61 patients underwent their first AA-LDLT at our institute...
March 29, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28361122/risk-factors-for-intractable-ascites-after-adult-to-adult-living-donor-liver-transplantation-using-left-lobe
#9
Shinichi Matsudaira, Yoichi Ishizaki, Jiro Yoshimoto, Noriko Fujiwara, Seiji Kawasaki
BACKGROUND: Intractable ascites is one of the causes of graft loss after adult-to-adult living donor liver transplantation (LDLT) using a small graft. Identification of factors associated with increasing posttransplant ascites has important implications for prevention and treatment. METHODS: All 59 consecutive adult patients who underwent left lobe LDLT without portal inflow modulation between October 2002 and February 2016 were prospectively enrolled. Factors associated with the average daily amount of ascites for 2 weeks after LDLT were assessed...
March 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28348472/portal-inflow-in-extensive-portomesenteric-thrombosis-using-the-pericholedochal-varix-in-living-donor-liver-transplantation
#10
Kishore Gurumoorthy Subramanya Bharathy, Shridhar Vasantrao Sasturkar, Piyush Kumar Sinha, Senthil Kumar, Viniyendra Pamecha
Extensive portomesenteric thrombosis presents a technical challenge in liver transplantation. Establishing portal inflow in living donor liver transplantation (LDLT) is indispensable to ensure regeneration of the graft. The use of a pericholedochal varix for inflow has been described only in a few case reports. Described herein is one such instance in the setting of LDLT, highlighting the nuances of this procedure in the light of available literature.
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28340837/complications-in-donors-using-right-liver-graft-analysis-of-280-consecutive-cases
#11
M Özbilgin, T Ünek, T Egeli, C Ağalar, S Ozkardesler, E Karadeniz, H Ellidokuz, F Obuz, I Astarcıoğlu
INTRODUCTION: Living donor liver transplantation (LDLT) is performed with increasing frequency worldwide due to the shortage of donated organs. It is a life-saving procedure for the recipient, but, on the other hand, a major surgical procedure for healthy donors and it may cause morbidity and even mortality. PATIENTS AND METHODS: This research was completed at Dokuz Eylül University Faculty of Medicine Hospital General Surgery Department Liver Transplant Unit and included 280 cases (4 with simultaneous liver and kidney transplants from living donors) who underwent donor right hepatectomy for LDLT from June 2000 to June 2016...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340834/hepatic-artery-reconstruction-with-autologous-inferior-mesenteric-artery-graft-in-living-donor-liver-transplant-recipients
#12
M Özbilgin, T Ünek, T Egeli, C Ağalar, S Ozkardesler, F Obuz, H Ellidokuz, S Karademir, I Astarcıoğlu
INTRODUCTION: In living donor liver transplantation (LDLT), hepatic arterial continuity is crucial to avoid biliary leakage, biliary stricture, cholangitis, and graft and patient loss. Sometimes there exist factors making anastomosis difficult or even impossible. In these cases, a vascular graft may be needed to bridge the two arteries for revascularization. METHOD: Medical records of 297 patients who underwent LDLT between June 2000 and July 2016 at the Hepatopancreatobiliary Surgery and Liver Transplantation Unit of Dokuz Eylul University Hospital were reviewed retrospectively...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28319567/treatment-of-biliary-stricture-after-live-donor-liver-transplantation-with-combined-metal-and-plastic-stent-%C3%A4-nsertion-a-feasibility-and-safety-study
#13
Erkan Parlak, Aydin Seref Koksal, Ahmet Tarik Eminler, Bilal Toka, Mustafa Ihsan Uslan
BACKGROUND: Fully covered-self expandable metal stents (Fc-SEMSs) have a challenging use in the treatment of anastomosis strictures (ASs) after live donor liver transplantation (LDLT) because they can occlude secondary branch biliary ducts when placed above the biliary bifurcation. In this study we evaluated the technical feasibility and safety of combining Fc-SEMSs with plastic stent(s) inserted to the secondary branch biliary ducts for the treatment of ASs after LDLT. METHODS: The study group included 22 patients (12 men, aged 51±11 years) with anastomotic biliary stricture after LDLT...
March 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28294557/double-blind-randomized-controlled-trial-of-the-routine-peri-operative-use-of-terlipressin-in-adult-living-donor-liver-transplantation
#14
Mettu Srinivas Reddy, Ilankumaran Kaliamoorthy, Akila Rajakumar, Selvakumar Malleeshwaran, Ellango Appuswamy, Sukanya Lakshmi, Joy Varghese, Mohamed Rela
BACKGROUND: Peri-operative terlipressin (Tp) during living donor liver transplantation (LDLT) has been shown to reduce intra-operative portal pressures and improve renal function. Its role and safety profile has never been evaluated in a double-blinded RCT. AIM: To evaluate the haemodynamic effects, clinical benefits and safety of peri-operative terlipressin infusion in adult LDLT. METHODS: This was a single centre double-blind RCT. Consenting adults with chronic liver disease and low risk of post-transplant renal dysfunction (PTRD) undergoing their first LDLT were randomized...
March 14, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28294533/evaluation-of-donor-workups-and-exclusions-in-a-single-center-experience-of-living-donor-liver-transplantation
#15
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 outcomes. 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 living liver donor evaluation in a major living donor liver transplantation center. From July 2011 to June 2015, prospectively collected data of 726 potential donors for 588 matched recipients were subsequently evaluated...
May 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28288065/how-has-virtual-hepatectomy-changed-the-practice-of-liver-surgery-experience-of-1194-virtual-hepatectomy-before-liver-resection-and-living-donor-liver-transplantation
#16
Yoshihiro Mise, Kiyoshi Hasegawa, Shouichi Satou, Junichi Shindoh, Kenji Miki, Nobuhisa Akamatsu, Junichi Arita, Junichi Kaneko, Yoshihiro Sakamoto, Norihiro Kokudo
OBJECTIVE: To assess how virtual hepatectomy (VH), conducted using surgical planning software, influences the outcomes of liver surgery. BACKGROUND: Imaging technology visualizes the territories of the liver vessels, which were previously impossible. However, the clinical impact of VH has not been evaluated. METHODS: From 2004 to 2013, we performed 1194 VHs preoperatively. Outcomes of living donor liver transplantation (LDLT) and hepatectomy for hepatocellular carcinoma (HCC)/colorectal liver metastases (CRLM) were compared between patients in whom VH was performed (VH) and those without VH evaluation (non-VH)...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28288061/impact-of-donor-age-on-recipient-survival-in-adult-to-adult-living-donor-liver-transplantation
#17
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/28280701/renoportal-anastomosis-in-living-donor-liver-transplantation-with-prior-proximal-splenorenal-shunt
#18
Fatih Ozdemir, Koray Kutluturk, Bora Barut, Perviz Abbasov, Ramazan Kutlu, Cuneyt Kayaalp, Sezai Yılmaz
For transplant surgeons, end-stage liver disease with portal venous thrombosis and a previous splenorenal shunt (SRS) is a significant challenge during liver transplantation. Thrombosis of the portal vein can be corrected by surgical interventions, such as portal venous thrombectomy or surgical removal of the thrombosed portal vein. Even also placement of a graft between the mesenteric vein and the graft portal vein can be performed. If these maneuvers fail, a renoportal anastomosis (RPA) can be performed to achieve adequate graft inflow...
February 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28275333/abo-incompatible-living-donor-liver-transplantation-in-focus-of-antibody-rebound
#19
Silke Rummler, Astrid Bauschke, Erik Baerthel, Heike Juette, Katrin Maier, Christina Malessa, Dagmar Barz, Utz Settmacher
BACKGROUND: Living donor liver transplantation (LDLT) is an option to expand the donor organ pool for patients with life-threatening diseases who cannot be supplied with a cadaver organ. Next to the donor risks, complications after ABO-incompatible LDLT (ABOi LDLT) in the recipient are subject to controversial discussion. Improvement in ABOi graft survival rates have been achieved with plasma treatment procedures (PTP) and immunosuppression but antibody-mediated rejection (AMR) and graft loss still occur...
January 2017: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/28250667/adult-to-adult-living-donor-liver-transplantation-operative-techniques-to-optimize-the-recipient-s-outcome
#20
REVIEW
Peng Soon Koh, See Ching Chan
Adult-to-adult living donor liver transplantation (LDLT) is widely accepted today with good outcomes and safety reported worldwide for both donor and recipient. Nonetheless, it remained a highly demanding technical and complex surgery if undertaken. The last two decades have seen an increased in adult-to-adult LDLT following our first report of right lobe LDLT in overcoming graft size limitation in adults. In this article, we discussed the operative techniques and challenges of adult right lobe LDLT incorporating the middle hepatic vein, which is practiced in our center for the recipient operation...
January 2017: Journal of Natural Science, Biology, and Medicine
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