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https://www.readbyqxmd.com/read/28073180/porto-systemic-collaterals-in-living-donor-liver-transplantation-what-s-all-the-fuss-about
#1
REVIEW
Mettu Srinivas Reddy, Mohamed Rela
Porto-systemic collaterals are a common finding in patients with cirrhosis undergoing liver transplantation. Recently, there has been renewed interest regarding their significance in the setting of living donor liver transplantation (LDLT) due to concerns of graft hypo or hyper-perfusion and its impact on early post-transplant outcomes. Presence of these collaterals has greater significance in the LDLT setting when compared to deceased donor liver transplant setting as dictated by the difference in the physiology of partial liver grafts...
January 10, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28072754/initial-outcomes-of-pure-laparoscopic-living-donor-right-hepatectomy-in-an-experienced-adult-living-donor-liver-transplant-center
#2
Ki-Hun Kim, Sung-Hwa Kang, Dong-Hwan Jung, Young-In Yoon, Wan-Joon Kim, Min-Ho Shin, Sung-Gyu Lee
BACKGROUND: Only a limited number of centers have performed laparoscopic living donor hepatectomy to date. In particular, laparoscopic right hepatectomy is rarely performed because the procedure can only be performed by surgeons with significant experience in both laparoscopic liver surgery and liver transplantation with living donor liver grafts. METHODS: Between November 2014 and February 2015, in a pure laparoscopic approach program for living right lobe donors at Asan Medical Center, 92 living donors underwent right hepatectomy for adult living donor liver transplantation (LDLT)...
January 9, 2017: Transplantation
https://www.readbyqxmd.com/read/28054388/good-outcome-of-living-donor-liver-transplantation-in-drug-induced-acute-liver-failure-a-single-centre-experience
#3
Narendra Singh Choudhary, Sanjiv Saigal, Neeraj Saraf, Amit Rastogi, Sanjay Goja, Prashant Bhangui, Vijay Vohra, Deepak Govil, Arvinder S Soin
INTRODUCTION: Drug induced acute liver failure (ALF) is associated with high mortality. There is limited literature on results of living donor liver transplantation (LDLT). MATERIAL AND METHODS: The study was conducted at a tertiary care centre in North India. All patients who received LDLT for drug induced ALF were included. The data is shown as median (IQR). RESULTS: A total of 18 patients (15 females and 3 males), aged 34(25-45) years, underwent LDLT for DILI related ALF...
January 5, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28053303/management-of-liver-allograft-trauma-resulting-in-massive-subcapsular-hematoma-after-living-donor-liver-transplantation-can-we-salvage-the-liver-allograft
#4
Shih-Chao Hsu, Ashok Thorat, Kin-Shing Poon, Chun-Chieh Yeh, Te-Hung Chen, Horng-Ren Yang, Long-Bin Jeng
BACKGROUND Liver allograft trauma resulting in subcapsular hematoma after living donor liver transplantation (LDLT), although rare, is a life-threatening condition and requires prompt management to avoid any catastrophe. Herein we describe our successful experience in dealing with liver allograft hematoma that developed in the post-operative period after LDLT. MATERIAL AND METHODS From January 2002 to May 2015, a total of 616 recipients underwent LDLT at our institute. The intra-operative and postoperative records of these patients were analyzed to study the cases of liver allograft hematoma...
January 5, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28042248/comprehensive-guide-to-laparoscope-assisted-graft-harvesting-in-live-donors-for-living-donor-liver-transplantation-perspective-of-laparoscopic-vision
#5
Tomohide Hori, Toshimi Kaido, Taku Iida, Shintaro Yagi, Shinji Uemoto
BACKGROUND: A living donor (LD) for liver transplantation (LT) is the best target for minimally invasive surgery. Laparoscope-assisted surgery (LAS) for LDs has gradually evolved. A donor safety rate of 100% should be guaranteed. METHODS: We began performing LAS for LDs in June 2012. The aim of this report is to describe the surgical procedures of LAS in detail, discuss various tips and pitfalls, and address the potential for a smooth transition to more advanced LAS...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28039901/living-donor-liver-transplantation-in-a-pediatric-patient-with-preexisting-yolk-sac-tumor
#6
Taiichi Wakiya, Yoshikazu Toyoki, Keinosuke Ishido, Daisuke Kudo, Norihisa Kimura, Shinji Tsutsumi, Tadashi Odagiri, Akiko Suto, Chiaki Uchida, Kenichi Hakamada
There is ongoing discussion regarding the indications and timing of LT for patients with a preexisting extrahepatic malignancy. We herein report a pediatric case that underwent LDLT after therapy for YST. The patient, a 13-year-old female with biliary atresia, had undergone portoenterostomy at 2 months of age. She developed a left ovarian tumor with a high serum alpha-fetoprotein concentration at 10 years of age. She underwent left oophorectomy and was diagnosed with ovarian YST (Stage I). After surgery, hepatopulmonary syndrome progressed gradually...
December 30, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/28027615/living-donor-liver-transplantation-using-an-extended-right-lateral-sector-graft
#7
N Yoshida, T Takamoto, T Hashimoto, Y Maruyama, H Abe, K Shimada, T Takayama, M Makuuchi
There are three grafts (left, right and right lateral sector [RLS]) available for adult living donor liver transplantation (LDLT), and we herein report LDLT performed using an extended RLS graft. An extended RLS graft is an RLS plus right paramedian dorsal sector (RPMS-dorsal) graft. In this case, the proportion of the RLS graft of the predicted graft volume (GV) to the recipient's standard liver volume (SLV) was only 17.7%, preoperatively. A three-dimensional (3D) analysis, showed that the RPMS-dorsal branches of the portal veins branched from the posterior trunk not the anterior trunk...
December 27, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/28009743/comparable-short-and-long-term-outcomes-in-living-donor-and-deceased-donor-liver-transplantations-for-patients-with-model-for-end-stage-liver-disease-scores-%C3%A2-35-in-a-hepatitis-b-endemic-area
#8
Kenneth S H Chok, James Y Y Fung, Albert C Y Chan, Wing Chiu Dai, William W Sharr, Tan To Cheung, See Ching Chan, Chung Mau Lo
OBJECTIVE: To evaluate if living donor liver transplantation (LDLT) should be offered to patients with Model for End-stage Liver Disease (MELD) scores ≥35. BACKGROUND: No data was available to support LDLT of such patients. METHODS: Data of 672 consecutive adult liver transplant recipients from 2005 to 2014 at our center were reviewed. Patients with MELD scores ≥35 were divided into the deceased donor liver transplantation (DDLT) group and the LDLT group and were compared...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28009742/low-platelet-counts-and-prolonged-prothrombin-time-early-after-operation-predict-the-90-days-morbidity-and-mortality-in-living-donor-liver-transplantation
#9
Nobuhisa Akamatsu, Yasuhiko Sugawara, Junichi Kanako, Junichi Arita, Yoshihiro Sakamoto, Kiyoshi Hasegawa, Norihiro Kokudo
OBJECTIVE: The aim of the study was to investigate the association between platelet count/prothrombin time early after transplant and short-term outcomes among living-donor liver transplant (LDLT) recipients. BACKGROUND: Postoperative platelet count and prothrombin time-international normalized ratio (PT-INR) were critical biomarkers in LDLT. METHODS: The study participants consisted of 445 initial LDLT recipients, and perioperative variables, including platelet count and PT-INR, were assessed for their association with severe complications (Clavien-Dindo classification grade IIIb/IV) and mortality within 90 days after operation...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28002655/optimal-dosage-regimen-for-rituximab-in-abo-incompatible-living-donor-liver-transplantation
#10
Hiroto Egawa, Koji Umeshita, Shinji Uemoto
BACKGROUND: Rituximab has greatly improved the outcomes of ABO-incompatible living donor liver transplantation (ABO-I LDLT). To clarify the optimal regimen for rituximab in adult ABO-I LDLT, a multicenter study was conducted in Japan. METHODS: Clinical data of 33 adult patients undergoing ABO-I LDLT at 15 centers in 2013 were retrospectively corrected. RESULTS: The targeted blood type was A1 in 18, B in 14, and AB in 1 patient. Rituximab was administered at 7 to 48 days before LT, at a dose of 375 mg/m(2) in 12 patients, 500 mg in 15 patients, 300 mg in 5 patients, and 100 mg in 1 patient...
December 21, 2016: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/27989547/graft-inflow-modulation-in-adult-to-adult-living-donor-liver-transplantation-a-systematic-review
#11
REVIEW
Roberto I Troisi, Giammauro Berardi, Federico Tomassini, Mauricio Sainz-Barriga
INTRODUCTION: Small-for-size syndrome (SFSS) has an incidence between 0 and 43% in small-for-size graft (SFSG) adult living donor liver transplantation (LDLT). Portal hypertension following reperfusion and the hyperdynamic splanchnic state are reported as the major triggering factors of SFSS. Intra- and postoperative strategies to prevent or to reduce its onset are still under debate. We analyzed graft inflow modulation (GIM) during adult LDLT considering the indications, efficacy of the available techniques, changes in hemodynamics and outcomes...
December 8, 2016: Transplantation Reviews
https://www.readbyqxmd.com/read/27956812/pediatric-living-donor-liver-transplantation-for-congenital-hepatic-fibrosis-using-a-mother-s-graft-with-von-meyenburg-complex-a-case-report
#12
Naoya Yamada, Yukihiro Sanada, Takumi Katano, Masahisa Tashiro, Yuta Hirata, Noriki Okada, Yoshiyuki Ihara, Atsushi Miki, Hideki Sasanuma, Taizen Urahashi, Yasunaru Sakuma, Koichi Mizuta
This is the first report of living donor liver transplantation (LDLT) for congenital hepatic fibrosis (CHF) using a mother's graft with von Meyenburg complex. A 6-year-old girl with CHF, who suffered from recurrent gastrointestinal bleeding, was referred to our hospital for liver transplantation. Her 38-year-old mother was investigated as a living donor and multiple biliary hamartoma were seen on her computed tomography and magnetic resonance imaging scan. The mother's liver function tests were normal and she did not have any organ abnormality, including polycystic kidney disease...
November 28, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27956735/increased-incidence-of-thrombotic-microangiopathy-after-abo-incompatible-living-donor-liver-transplantation
#13
Norihiro Kishida, Masahiro Shinoda, Osamu Itano, Hideaki Obara, Minoru Kitago, Taizo Hibi, Hiroshi Yagi, Yuta Abe, Kentaro Matsubara, Masanori Odaira, Minoru Tanabe, Motohide Shimazu, Yuko Kitagawa
BACKGROUND Thrombotic microangiopathy (TMA) is a severe life-threatening complication associated with solid organ transplantation. We retrospectively investigated the incidence, risk factors, and appropriate treatment of TMA following adult living donor liver transplantation (LDLT). MATERIAL AND METHODS The subjects were 129 adult patients who underwent LDLT in our department from 1997 to 2014. Patients with TMA were identified retrospectively based on diagnostic criteria. We calculated the incidence of TMA and performed a risk factor analysis for TMA occurrence...
December 13, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/27935645/small-for-size-syndrome-in-live-donor-liver-transplantation-pathways-of-injury-and-therapeutic-strategies
#14
REVIEW
Nicolas Goldaracena, Juan Echeverri, Markus Selzner
Due to the severe organ shortage and the increasing gap between the supply and demand for donor grafts, live donor liver transplantation (LDLT) has become an accepted and alternative technique for the expansion of the donor pool. However, donor safety and good recipient outcomes must be balanced regarding risk stratification and decision-making within this patient population. Small-for-size syndrome (SFSS) is one of the complications encountered after LDLT, thus increasing the burden of optimizing donor graft selection and effective treatments during its occurrence...
December 9, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27933716/risks-and-treatment-strategies-for-de-novo-hepatitis-b-virus-infection-from-anti-hbc-positive-donors-in-pediatric-living-donor-liver-transplantation
#15
Chong Dong, Wei Gao, Nan Ma, Chao Sun, Wei-Ping Zheng, Kai Wang, Zhong-Yang Shen
The aim of this study was to analyze the incidence and risk factors of de novo HBV infection in pediatric patients receiving living donor liver transplants (LDLT) from HBcAb-positive donors, and to explore its treatment strategies. The data of 101 pediatric recipients receiving LDLT in Tianjin First Central Hospital between September 2006 and December 2012 were retrospectively analyzed. The HBV markers were regularly tested before and after the surgery, including HBsAb, HBsAg, HBeAg, HBeAb, and HBcAb. The median follow-up period was 25...
December 9, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27932176/intrahepatic-artery-pseudoaneurysm-induced-hemobilia-caused-by-a-plastic-biliary-stent-after-abo-incompatible-living-donor-liver-transplantation-a-case-report
#16
J M Chun, H T Ha, Y Y Choi, Y J Hwang, J Heo, H K Ryeom, Y S Han
Bile leakage after duct-to-duct anastomosis in living-donor liver transplantation (LDLT) can mostly be managed by therapeutic endoscopic retrograde cholangiopancreatography. Following this, various complications such as biliary infection, pancreatitis, perforation, and bleeding can occur, and endoscopic sphincterotomy is primarily associated with post- endoscopic retrograde cholangiopancreatography bleeding; other causes have been published in case reports. In the present case, a plastic biliary stent used for treating liver abscesses and leakage at the bile duct anastomosis site after ABO-incompatible LDLT resulted in an intrahepatic artery pseudoaneurysm and hemobilia, which were managed by angiography and coil embolization...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932174/salvage-splenic-artery-embolization-for-saving-falling-living-donor-graft-due-to-portal-overflow-a-case-report
#17
H Okabe, T Yoshizumi, T Ikegami, H Uchiyama, N Harimoto, S Itoh, K Kimura, H Baba, Y Maehara
Portal decompression is an approach for reducing portal overflow caused by small-for-size syndrome. We report the case of a patient who recovered from rapidly progressing hyperbilirubinemia caused by a small graft by decompressing portal overflow with splenic artery embolization following a living donor liver transplantation (LDLT). The patient was a 54-year-old man with end-stage liver disease secondary to alcoholic liver cirrhosis; the donor was his 54-year-old wife. The graft volume of the left lobe was 444 mL, which was 34...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932171/recurrence-of-progressive-familial-intrahepatic-cholestasis-type-2-phenotype-after-living-donor-liver-transplantation-a-case-report
#18
K Masahata, S Uehara, S Ibuka, K Nakahata, Y Hasegawa, H Kondou, R Kubitz, T Ueno
BACKGROUND: Progressive familial intrahepatic cholestasis 2 (PFIC2) is the result of mutations in the ABCB11, which encodes for bile salt export pump (BSEP). An absence of BSEP in the canalicular membrane causes cholestasis and leads to the development of end-stage liver disease in the first decade of life. Liver transplantation (LT) has been considered curative for BSEP disease. However, patients with PFIC2 having undergone LT have recently been reported to develop recurrence of cholestasis together with the clinical and histological features of primary BSEP disease...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931580/changes-in-muscle-strength-and-six-minute-walk-distance-before-and-after-living-donor-liver-transplantation
#19
Y Mizuno, S Ito, K Hattori, M Nagaya, T Inoue, Y Nishida, Y Onishi, H Kamei, N Kurata, Y Hasegawa, Y Ogura
BACKGROUND: Impaired exercise capacity and muscle weakness are important characteristics of liver transplantation recipients. Perioperative rehabilitation has been introduced to promote early mobilization of patients and to prevent postoperative pulmonary complications. However, it is unknown how physical status recovers during the hospital stay after a liver transplant. The purpose of this study was to evaluate the changes in clinical indicators that represent the functional exercise capacity and muscle strength before and after living donor liver transplantation (LDLT)...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27930598/the-anhepatic-phase-extended-by-temporary-portocaval-shunt-does-not-affect-anesthetic-sensitivity-and-postoperative-cognitive-function-a-case-control-study
#20
Young Gon Son, Sung Hye Byun, Jong Hae Kim
Temporary portocaval shunt (TPCS) prolongs the duration of the anhepatic phase, during which anesthetic sensitivity is highest among the 3 phases of living donor liver transplantation (LDLT). Cognitive dysfunction has been associated with increased anesthetic sensitivity and poor hepatic function. Therefore, we assessed anesthetic sensitivity to desflurane and perioperative cognitive function in patients undergoing LDLT, in whom the duration of the anhepatic phase was extended by TPCS to test the hypothesis that the prolonged anhepatic phase increases anesthetic sensitivity and causes postoperative cognitive decline...
December 2016: Medicine (Baltimore)
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