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https://www.readbyqxmd.com/read/28938311/feasibility-of-monotherapy-by-rituximab-without-additional-desensitization-in-abo-incompatible-living-donor-liver-transplantation
#1
Hidekazu Yamamoto, Koshi Uchida, Seiichi Kawabata, Kaori Isono, Kohei Miura, Shintaro Hayashida, Yuki Oya, Yasuhiko Sugawara, Yukihiro Inomata
BACKGROUND: Rituximab is a cornerstone in the regimens of desensitization for ABO-incompatible living donor liver transplantation (ABO-i LT) that makes this modality an acceptable option for liver transplantation. Plasmapheresis (PP) to reduce anti-ABO antibody titer and local infusion therapy (LI) were practiced as the strategies for desensitization before the application of rituximab and were reported as additional treatments. The aim of this study was to clarify the feasibility of monotherapy by rituximab without any additional desensitization treatments in ABO-i LT...
September 20, 2017: Transplantation
https://www.readbyqxmd.com/read/28936686/comparable-short-and-long-term-outcomes-in-deceased-donor-and-living-donor-liver-retransplantation
#2
Kenneth Siu Ho Chok, Albert C Y Chan, James Y Y Fung, Wing Chiu Dai, Tan To Cheung, Chung Mau Lo
BACKGROUND AND PURPOSE: There is a big controversy over liver retransplantation, the only life-saving treatment for patients with a failing or failed liver graft. This retrospective study tried to determine if living-donor liver retransplantation (re-LDLT) is a justifiable alternative to deceased-donor liver retransplantation (re-DDLT). METHODS: Anonymous data of liver transplant patients from January 2000 to April 2016 were reviewed. Recipients of retransplantation were divided into the re-DDLT and re-LDLT groups...
September 21, 2017: Hepatology International
https://www.readbyqxmd.com/read/28936685/living-donor-liver-transplantation-in-south-asia-single-center-experience-on-intermediate-term-outcomes
#3
Faisal S Dar, Abu Bakar H Bhatti, Ammal I Qureshi, Nusrat Y Khan, Zahaan Eswani, Haseeb H Zia, Eitzaz U Khan, Nasir A Khan, Atif Rana, Najmul H Shah, Mohammad Salih, Rashid Nazer
BACKGROUND: There is paucity of data on intermediate-term post liver transplant outcomes from South Asia. The objective of this study was to determine survival outcomes in patients who underwent living donor liver transplantation (LDLT) in a busy liver transplant center in Pakistan. METHODS: This study was a review of patients who underwent LDLT between 2012 and 2016. A total of 321 patients were included in this study. Early (within 90 days) and late (>90 days) morbidity and mortality was assessed...
September 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28935852/single-center-experience-in-pre-transplant-hepatitis-c-virus-hcv-treatment-among-living-donor-liver-transplant-candidates-bridging-the-direct-acting-antivirals-daa
#4
Ashwini M Niranjan-Azadi, Gokhan Kabacam, Christine M Durand, Saad Anjum, Behnam Saberi, Nabil N Dagher, Benjamin Philosophe, Ahmet Gurakar
BACKGROUND Treatment with DAAs before deceased donor liver transplantation has been shown to be an effective strategy to prevent post-transplant HCV recurrence, with a 95% cure-rate among individuals who achieve undetectable HCV VL for ≥30 days pre- transplant. This strategy has not been evaluated in LDLT. MATERIAL AND METHODS We evaluated outcomes in LDLT recipients treated with DAAs pre-transplant and bridged with 4 weeks of post-transplant SOF. All cases of LDLT at Johns Hopkins (1/1/2014-3/1/15) were retrospectively reviewed...
September 22, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28926171/biliary-reconstructive-techniques-and-associated-anatomic-variants-in-adult-living-donor-liver-transplants-the-a2all-experience
#5
Talia B Baker, Michael A Zimmerman, Nathan P Goodrich, Benjamin Samstein, Elizabeth A Pomfret, James J Pomposelli, Brenda W Gillespie, Carl L Berg, Jean C Emond, Robert M Merion
INTRODUCTION: Living donor liver transplantation (LDLT) is a technically demanding endeavor, requiring command of the complex anatomy of partial liver grafts. We examined the influence of anatomic variation and reconstruction technique on surgical outcomes and graft survival in the nine-center A2ALL Study. METHODS: Data from 272 adult LDLT recipients (2011-2015) included details on anatomic characteristics and types of intraoperative biliary reconstruction. Associations were tested between reconstruction technique and complications, which included first biliary complication ([BC]; leak, stricture, or biloma) and first vascular complication (hepatic artery thrombosis [HAT] or portal vein thrombosis [PVT])...
September 19, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28925086/optimizing-hepatic-venous-outflow-reconstruction-for-hepatic-vein-stenosis-with-indwelling-stent-in-living-donor-liver-retransplantation
#6
Takanobu Shigeta, Seisuke Sakamoto, Kengo Sasaki, Hajime Uchida, Soichi Narumoto, Akinari Fukuda, Mureo Kasahara
The patient was a boy of 7 years and 5 months of age, who underwent LDLT for acute liver failure at 10 months of age. HV stent placement was performed 8 months after LDLT because of intractable HV stenosis. At 7 years of age, his liver function deteriorated due to chronic rejection. The patient therefore underwent living donor liver retransplantation from his father. The HV was transected with the stent in situ. The IVC was resected due to stenosis. The pericardial cavity was opened and detached around the IVC to elongate the IVC...
September 18, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28923636/effect-of-preoperative-growth-status-on-clinical-outcomes-after-living-donor-liver-transplantation-in-infants
#7
Y Lu, Q Xia, Y Yang, P Wan, J Hou, Y Wang, B Qiu, M Feng, K He, M Huang, X Ren, L Gao, J Zhang
OBJECTIVE: The aim of this study was to evaluate the impact of preoperative growth status on clinical outcomes of infantile living-donor liver transplantation (LDLT). METHODS: From January 2009 to December 2014, 131 LDLT recipients ≤1 year of age met the eligibility criteria of this study, of whom 31 patients with weight z-scores less than -2 constituted the abnormal growth group. Patients in the abnormal growth group were randomly matched (1:1) to patients with normal growth status by means of a multivariate case-matched method, and thus 31 patients in the normal growth group and 31 patients in the abnormal growth group were finally enrolled into the study...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28916322/intraductal-transanastomotic-stenting-in-duct-to-duct-biliary-reconstruction-after-living-donor-liver-transplantation-a-randomized-trial
#8
Ky Santosh Kumar, Johns Shaji Mathew, Dinesh Balakrishnan, Viju Kumar Bharathan, Binoj Sivasankara Pillai Thankamony Amma, Unnikrishnan Gopalakrishnan, Ramachandran Narayana Menon, Puneet Dhar, Sudheer Othiyil Vayoth, Sudhindran Surendran
BACKGROUND: Biliary complications continue to be the 'Achilles heel' of living donor liver transplantation (LDLT). The use of biliary stents in LDLT to reduce biliary complication is a controversial issue. We performed a randomized trial to study the impact of intraductal biliary stents on postoperative biliary complications following LDLT. STUDY DESIGN: Of the 94 LDLT's, that were performed during a period of 16 months, ABO incompatible transplants, left lobe grafts, ≥3 ducts on the graft and those requiring bilio-enteric drainage were excluded...
September 12, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28905009/living-donor-liver-transplantation-for-hepatocellular-cancer-an-almost-exclusive-eastern-procedure
#9
REVIEW
Rafael S Pinheiro, Daniel R Waisberg, Lucas S Nacif, Vinicius Rocha-Santos, Rubens M Arantes, Liliana Ducatti, Rodrigo B Martino, Quirino Lai, Wellington Andraus, Luiz A C D'Albuquerque
Hepatocellular carcinoma (HCC) is the fifth most prevalent cancer and it is linked with chronic liver disease. Liver transplantation (LT) is the best curative treatment modality, since it can cure simultaneously the underlying liver disease and HCC. Milan criteria (MC) are the benchmark for selecting patients with HCC for LT, achieving up to 91% 1-year survival post transplantation. However, when considering intention-to-treat (ITT) rates are substantially lower, mainly due dropout. Additionally, Milan criteria (MC) are too restrictive and more inclusive criteria have been reported with good outcomes...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28889651/living-donor-liver-transplantation-for-biliary-atresia-an-analysis-of-2-085-cases-in-the-registry-of-the-japanese-liver-transplantation-society
#10
Mureo Kasahara, Koji Umeshita, Seisuke Sakamoto, Akinari Fukuda, Hiroyuki Furukawa, Shotaro Sakisaka, Eiji Kobayashi, Eiji Tanaka, Yukihiro Inomata, Seiji Kawasaki, Mitsuo Shimada, Norihiro Kokudo, Hiroto Egawa, Hideki Ohdan, Shinji Uemoto
Biliary atresia (BA) is the most common indication for liver transplantation (LT) in pediatric population. This study analyzed the comprehensive factors that might influence the outcomes of patients with BA who undergo living donor LT by evaluating the largest cohort with the longest follow-up in the world. Between November 1989 and December 2015, 2,085 BA patients underwent LDLT in Japan. There were 763 male and 1,322 female recipients with a mean age of 5.9 years and body weight of 18.6 kg. The 1-, 5-, 10-, 15-and 20-year graft survival rates for the BA patients undergoing LDLT were 90...
September 10, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28888776/living-donor-liver-transplantation-for-hepatocellular-carcinoma-results-of-prospective-patient-selection-by-kyushu-university-criteria-in-7-years
#11
Hideaki Uchiyama, Shinji Itoh, Tomoharu Yoshizumi, Toru Ikegami, Norifumi Harimoto, Yuji Soejima, Noboru Harada, Kazutoyo Morita, Takeo Toshima, Takashi Motomura, Yoshihiko Maehara
BACKGROUND: Expanding patient selection beyond the Milan criteria in living donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC) has long been a matter for debate. We have used the Kyushu University Criteria - maximum tumor diameter <5 cm or des-γ-carboxy prothrombin <300 mAU/ml - in LDLT for HCC since June 2007. The aim of the present study was to present the results of our prospective patient selection by Kyushu University Criteria and to confirm whether or not our criteria were justified...
September 7, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28885774/small-for-size-grafts-increase-recurrence-of-hepatocellular-carcinoma-in-liver-transplantation-beyond-milan-criteria
#12
Eung Chang Lee, Seong Hoon Kim, Jae Ryong Shim, Sang-Jae Park
BACKGROUND: Living donor liver transplantation (LDLT) has been reported to have high rates of hepatocellular carcinoma (HCC) recurrence compared to deceased donor liver transplant (DDLT). This has been assumed to be due to the frequent use of small-for-size grafts (SFSG) in LDLT rather than DDLT, but the relationship between graft size and prognosis remains controversial. This study aimed to clarify the effect of SFSG on the oncologic outcomes of patients with HCC who underwent LDLT. METHODS: Between January 2005 and December 2015, 597 consecutive patients underwent LDLT...
September 8, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28883387/significance-of-proper-graft-selection-in-adult-living-donor-liver-transplant-recipients-with-preoperative-deteriorated-condition
#13
Taku Iida, Koji Masuda, Takehisa Matsuyama, Shumpei Harada, Tsukasa Nakamura, Katsuhiro Koshino, Tomoyuki Suzuki, Shuji Nobori, Hidetaka Ushogome, Takashi Ito, Seisuke Sakamoto, Kenji Uryuhara, Hideaki Okajima, Satoshi Kaihara, Shinji Uemoto, Norio Yoshimura
BACKGROUND The outcome of living-donor liver transplantation (LDLT) is poor for recipients with severely deteriorated preoperative condition. This study therefore evaluated the proper graft selection according to the recipients' preoperative condition. MATERIAL AND METHODS We evaluated the clinical outcomes in 66 patients who underwent adult LDLT from October 2003 to June 2016 in our institution, excluding fulminant liver failure and ABO-incompatible cases. Preoperative risk factors included MELD score >20, preoperative hospitalization for over 2 weeks or intensive care unit admission and bacterial infection within 1 month before LDLT...
September 8, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28881059/pancreas-preserving-duodenectomy-after-living-donor-liver-transplantation-for-invasive-cytomegalovirus-disease
#14
Rodrigo Vincenzi, Eduardo A Fonseca, Paulo Chapchap, Marcel C C Machado, Karina M O Roda, Helry L Candido, Marcel R Benavides, Marco A D'Assuncao, Rogerio C Afonso, Plinio Turine, Fernando P Marson, João Seda Neto
CMV infection plays an important role in the postoperative course following solid organ transplantation. We present the case of an 11-year-old male patient who underwent LDLT due to severe hepatopulmonary syndrome and biliary cirrhosis. Four weeks after LDLT, he developed persistent GI bleeding and was subjected to repeated endoscopic treatment and radiological arterial embolization to stop the bleeding from duodenal ulcers. Diagnostic workup was negative for CMV disease. Because the bleeding persisted, surgical treatment was indicated, and a pancreas-preserving duodenectomy was performed...
September 7, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28838456/successful-treatment-of-stricture-of-duct-to-duct-biliary-anastomosis-after-living-donor-liver-transplantation-of-the-left-lobe-a%C3%A2-case%C3%A2-report
#15
Y Nakaseko, H Shiba, E Yamanouchi, Y Takano, T Sakamoto, H Imazu, H Ashida, K Yanaga
Biliary complications, such as stricture or obstruction, after living-donor liver transplantation (LDLT) remain major problems to be solved. Magnetic compression anastomosis (MCA) is a minimally invasive method of biliary anastomosis without surgery in patients with biliary stricture or obstruction. A 66-year-old woman had undergone LDLT for end-stage liver disease for primary biliary cholangitis 20 months previously at another hospital. Computerized tomography showed dilation of the intrahepatic bile duct (B2)...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28838451/hepatic-artery-reconstruction-using-3-in-1-segmental-resection-in-pediatric-living-donor-liver-transplantation-a-case-report-and-literature-review
#16
Y Luo, D Zhao, M Zhang, T Zhou, B-J Qiu, J-J Zhang, Q Xia
We report a transplant of the left lateral liver segments with 3 arteries for a pediatric recipient from a living donor. A 6-month-old female infant was diagnosed with liver cirrhosis secondary to biliary atresia and scheduled for living donor liver transplantation (LDLT; mother as donor). Left lateral hepatectomy was performed at the donor site. The dissection of the left hepatic artery (HA), which was divided immediately after its origin, showed 3 branches for segments II, III, and IV. The arteries for segment II, segment III, and segment IV were anastomosed to the recipient HA...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28838449/successful-blood-transfusion-management-of-a-living-donor-liver-transplant-recipient-in-the-presence-of-anti-jr-a-a-case-report
#17
N Kurata, Y Onishi, H Kamei, T Hori, M Komagome, C Kato, T Matsushita, Y Ogura
A 48-year-old Japanese woman was diagnosed with Budd-Chiari syndrome and transferred for possible living donor liver transplantation (LDLT). Examinations before LDLT revealed that the recipient had anti-Jr(a) and preformed donor-specific anti-human leukocyte antigen (HLA) antibodies (DSA). Rituximab was administrated at 16 days prior to the patient's scheduled LDLT for the prophylaxis of antibody-mediated rejection by DSA. The clinical significance of anti-Jr(a) has not been clearly established because of the rarity of this antibody, so we discussed blood transfusion strategy with the Department of Blood Transfusion Service and prepared for Jr(a)-negative packed red blood cells (RBCs)...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28834141/fatal-graft-versus-host-disease-after-living-donor-liver-transplantation-from-an-hla-dr-mismatched-donor
#18
Keita Shimata, Rieko Sakamoto, Tadashi Anan, Koushi Uchida, Masaki Honda, Masahiko Kouroki, Tomonari Urabe, Shintaro Hayashida, Hidekazu Yamamoto, Yasuhiko Sugawara, Yukihiro Inomata
Acute GVHD is a rare complication after liver transplantation that has a high mortality rate. We experienced an infant case complicated with acute GVHD. An 8-month-old infant with biliary atresia underwent LDLT with a graft obtained from his mother. Their HLAs showed a donor-dominant one-way match, not at HLA-DR but at HLA-A, HLA-B, and HLA-C (recipient; A 31/33, B 51/54, C 1/14, DR 9/11, donor; A 31/-, B 51/-, C 14/-, DR 8/11). The patient exhibited a high fever, skin rash, and diarrhea, and was diagnosed with acute GVHD based on the blood chimerism test...
August 19, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28831719/petersen-s-hernia-after-living-donor-liver-transplantation
#19
Sodai Sakamoto, Ryoichi Goto, Norio Kawamura, Yasuyuki Koshizuka, Masaaki Watanabe, Minoru Ota, Tomomi Suzuki, Daisuke Abo, Kenichiro Yamashita, Toshiya Kamiyama, Akinobu Taketomi, Tsuyoshi Shimamura
BACKGROUND: Hepaticojejunostomy may be used for biliary reconstruction in certain cases of liver transplantation. In this occasion, Roux-en-Y biliary reconstruction is predominantly performed. Petersen's hernia is an internal hernia that can occur after Roux-en-Y reconstruction, and it may lead to extensive ischemic changes affecting incarcerated portions of the small bowel or Roux limb resulting in severe complications with a poor prognosis. CASE PRESENTATION: The present case was a 44-year-old male who underwent living donor liver transplantation (LDLT) for familial amyloid polyneuropathy and in whom biliary reconstruction was performed with Roux-en-Y hepaticojejunostomy...
August 23, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28827903/predictors-of-outcome-of-living-donor-liver-transplantation-for-hepatocellular-carcinoma
#20
Hazem Mohamed Zakaria, Ahmed N Sallam, Islam I Ayoub, Sherif M Saleh, Doha Maher, Hazem Omar, Mohamed Abou-Shady, Ibrahim A Salama, El-Sayed A Soliman, Khaled Abou El-Ella, Tarek M Ibrahim, Essam M Hammad
The aim of this work is to study the different factors that affect the outcome of living donor liver transplantation for patients with hepatocellular carcinoma (HCC). Between April 2003 to November 2014, 62 patients with liver cirrhosis and HCC underwent living donor liver transplantation (LDLT) in the National Liver Institute, Menoufia University, Egypt. The preoperative, operative, and postoperative data were analyzed. After studying the pathology of explanted liver; 44 (71 %) patients were within the Milan criteria, and 18 (29 %) patients were beyond Milan; 13 (21...
August 2017: Indian Journal of Surgery
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