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Thomas Gilliland, Sylvie Dufour, Gerald I Shulman, Kitt Falk Petersen, Sukru H Emre
NAFLD is a common condition linked to obesity, type 2 diabetes, and metabolic syndrome. Simple hepatic steatosis is a risk factor for inflammatory reactions in the liver (NASH), which may lead to cirrhosis. While the mechanism is unclear, NAFLD and NASH are associated with panhypopituitarism, which in the pediatric population often results from craniopharyngioma or pituitary adenoma and the sequelae of treatment, causing hypothyroidism, adrenal insufficiency, hypogonadotropic hypogonadism, and GH deficiency...
October 20, 2016: Pediatric Transplantation
Fernando Rotellar, Fernando Pardo, Alberto Benito, Gabriel Zozaya, Pablo Martí-Cruchaga, Francisco Hidalgo, Luis Lopez, Mercedes Iñarrairaegui, Bruno Sangro, Ignacio Herrero
BACKGROUND: The pure laparoscopic approach in right hepatectomy (LRH) for living donor liver transplantation (LDLT) is a controversial issue. Some authors have reported the procedure to be feasible but surgical outcomes and impact on short and long-term morbidity rates are yet to be determined. The aim of this study is to present the results of a preliminary 5 consecutive cases series of LRH for LDLT and to compare it with a successive cohort of open right hepatectomies (ORH) for LDLT...
October 17, 2016: Transplantation
Sung Jung Kim, Je Hwan Won, Young Bae Kim, Hee-Jung Wang, Bong-Wan Kim, Haeryoung Kim, Jinoo Kim
BACKGROUND: Percutaneous biopsy is a widely-accepted technique for acquiring histologic samples of the liver. When there is concern for bleeding, plugged percutaneous biopsy (PPB) may be performed, which involves embolization of the biopsy tract. PURPOSE: To evaluate the efficacy and safety of PPB of the liver in patients suspected to have graft rejection after living-donor liver transplantation (LDLT). MATERIAL AND METHODS: During January 2007 and December 2013, 51 patients who underwent PPB of the liver under the suspicion of post-LDLT graft rejection were retrospectively analyzed...
October 17, 2016: Acta Radiologica
Toru Ikegami, Tomonari Shimagaki, Junji Kawasaki, Tomoharu Yoshizumi, Hideaki Uchiyama, Noboru Harada, Norifumi Harimoto, Shinji Itoh, Yuji Soejima, Yoshihiko Maehara
INTRODUCTION: Biliary anastomosis stricture (BAS) is still among the major concerns after living donor liver transplantation (LDLT), even after the technical refinements including the universal use of the blood flow-preserving hilar dissection technique. The aim of this study is to investigate what are still the factors for BAS after LDLT. METHODS: An analysis of 279 adult-to-adult LDLT grafts (left lobe, n=161; right lobe, n=118) with duct-to-duct (DD) biliary reconstruction, since the universal application of minimal hilar dissection technique and gradual introduction of eversion technique, was performed...
October 12, 2016: Transplantation
Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Gyu-Seong Choi, Jae Berm Park, Eun-Suk Kang, Sung Joo Kim, Suk-Koo Lee
PURPOSE: T lymphocytes are an essential component of allograft rejection and tolerance. The aims of the present study are to analyze the characteristics of T-cell subsets between ABO-incompatible living donor liver transplantation (ABO-I LDLT) and ABO-compatible LDLT (ABO-C LDLT). MATERIALS AND METHODS: Between April 2013 and June 2014, 61 patients underwent adult LDLT. ABO-I LDLT patients received rituximab and all patients received basiliximab as induction therapy and tacrolimus as maintenance therapy...
October 13, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Min-Ho Shin, Deok-Bog Moon, Sung-Gyu Lee, Shin Hwang, Ki-Hun Kim, Chul-Soo Ahn, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung, Gil-Chun Park, Young-In Yun, Wan-Jun Kim, Woo-Hyoung Kang, Seok-Hwan Kim, Gi-Young Ko
BACKGROUND: Although perioperative portal vein (PV) stent implantation is an effective treatment for steno-occlusive disease in adult living donor liver transplantation (LDLT) recipients, we experienced high incidence of biliary anastomotic strictures (BAS) after PV stenting. In this study, we sought to clarify the relation between BAS and PV stenting and to suggest the possible mechanism of BAS and measures to reduce its incidence. METHODS: We retrospectively analyzed 44 LDLT recipients who underwent PV stent implantation across the line of PV anastomosis regardless of the location of steno-occlusion (stent group) and their matched controls (non-stented LDLT recipients, n=131)...
October 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Shaleen Agarwal, Neerav Goyal, Mohammed Nayeem, Shishir Pareek, Subash Gupta
BACKGROUND: Living donor liver transplant (LDLT) in obese patients raises concerns with regards to obtaining grafts of "adequate" graft recipient weight ratio (GRWR) and the impact of obesity on the outcomes of LDLT. METHODS: LDLT outcomes in patients weighing more than 100 kg were compared with those weighing less than 100 kg. Patients weighing more than 100 kg were divided into 3 categories based on GRWR of the grafts they received. Groups 1, 2 and 3 included patients with GRWR equal to or greater than 0...
October 12, 2016: Liver Transplantation
Hae Won Lee, Kyung-Suk Suh
There has been ongoing debate that the Milan criteria may be too strict that a significant number of patients who could benefit from liver transplantation (LT) might have been excluded. Based on this idea, various studies have been conducted to further expand the Milan criteria and give more HCC patients a chance of cure. In deceased donor LT (DDLT) setting, expansion of the criteria is relatively tempered because the results of LT for HCC should be comparable to those of patients with non-malignant indications...
September 2016: Clinical and Molecular Hepatology
Reina Sasaki, Tatsuo Kanda, Masayuki Ohtsuka, Shin Yasui, Yuki Haga, Masato Nakamura, Masayuki Yokoyama, Shuang Wu, Shingo Nakamoto, Makoto Arai, Hitoshi Maruyama, Masaru Miyazaki, Osamu Yokosuka
Direct-acting antivirals (DAAs) are relatively safe and highly effective for the eradication of hepatitis C virus (HCV) in liver transplant recipients. In this case study, we present a female with a graft reinfected with HCV genotype 2 who was treated with a combination of sofosbuvir and ribavirin after living donor liver transplantation (LDLT). Because the graft was from a hepatitis B core antibody-positive donor, passive immunization with hyperimmune hepatitis B immunoglobulin (HBIG) and entecavir were also provided to prevent hepatitis B virus (HBV) reactivation...
May 2016: Case Reports in Gastroenterology
Varvara A Kirchner, Shin Hwang, Gi-Won Song, Chul-Soo Ahn, Deok-Bog Moon, Ki-Hun Kim, Dong-Hwan Jung, Tae-Yong Ha, Gil-Chun Park, Sung-Gyu Lee
BACKGROUND The middle hepatic vein (MHV) interposition vessel graft (IVG) is often occluded within a few months after living-donor liver transplantation (LDLT). We aimed to assess the mechanisms of resolving the hepatic venous congestion (HVC) that develops after gradual occlusion of the MHV-IVG. MATERIAL AND METHODS This study comprised two parts. Part I involved an assessment of the process of HVC resolution in the remnant right liver after donation of an extended left liver graft (n=100). Part II involved an evaluation of the timing and patterns of gradual MHV-IVG occlusion and HVC resolution in LDLT recipients (n=100)...
October 7, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Andrea Lauterio, Stefano Di Sandro, Salvatore Gruttadauria, Marco Spada, Fabrizio Di Benedetto, Umberto Baccarani, Enrico Regalia, Ernesto Melada, Alessandro Giacomoni, Matteo Cescon, Davide Cintorino, Giorgio Ercolani, Matteo Rota, Giorgio Rossi, Vincenzo Mazzaferro, Andrea Risaliti, Antonio Daniele Pinna, Bruno Gridelli, Luciano De Carlis
BACKGROUND: Major concerns about donor morbidity and mortality still limit the use of living donor liver transplantation (LDLT) to overcome the organ shortage. METHODS: The present study assessed donor safety in LDTL in Italy reporting donor postoperative outcomes in 246 living donation procedures performed by seven transplant centers. Outcomes were evaluated over two time periods using the validated Clavien 5-tier grading system, and several clinical variables were analyzed to determine the risk factors for donor morbidity...
October 6, 2016: Liver Transplantation
Silke Rummler, Astrid Bauschke, Erik Bärthel, Heike Jütte, Katrin Maier, Patrice Ziehm, Christina Malessa, Utz Settmacher
For a long time, it was considered medical malpractice to neglect the blood group system during transplantation. Because there are far more patients waiting for organs than organs available, a variety of attempts have been made to transplant AB0-incompatible (AB0i) grafts. Improvements in AB0i graft survival rates have been achieved with immunosuppression regimens and plasma treatment procedures. Nevertheless, some grafts are rejected early after AB0i living donor liver transplantation (LDLT) due to antibody mediated rejection or later biliary complications that affect the quality of life...
September 24, 2016: World Journal of Transplantation
Yukihiro Sanada, Yasunaru Sakuma, Hideki Sasanuma, Atsushi Miki, Takumi Katano, Yuta Hirata, Noriki Okada, Naoya Yamada, Yoshiyuki Ihara, Taizen Urahashi, Naohiro Sata, Yoshikazu Yasuda, Koichi Mizuta
Utilizing the opened round ligament as venous grafts during liver transplantation is useful but controversial, and there are no pathological analyses of this procedure. Herein, we describe the first reported case of a pathological analysis of an opened round ligament used as a venous patch graft in a living donor liver transplantation (LDLT). A 13-year-old female patient with biliary atresia underwent LDLT using a posterior segment graft from her mother. The graft had two hepatic veins (HVs), which included the right HV (RHV; 15 mm) and the inferior RHV (IRHV; 20 mm)...
September 14, 2016: World Journal of Gastroenterology: WJG
Rieko Sakamoto, Kimitoshi Nakamura, Jun Kido, Shiro Matsumoto, Hiroshi Mitsubuchi, Yukihiro Inomata, Fumio Endo
Liver transplant is a treatment option for patients with MMA-emia. While this therapy does not bring about a complete cure, it is expected to prolong survival and improve the QOL of patients. The aim of this study was to evaluate the significance of LDLT for patients with MMA-emia in Japan. Clinical information on 13 patients with MMA-emia who underwent LDLT was acquired using a self-developed questionnaire sent to the doctors who provided medical care to patients with MMA-emia after LDLT. Almost all of the patients continued on a protein-restricted diet, and the number of acidosis attacks had significantly decreased...
September 26, 2016: Pediatric Transplantation
Toshimi Kaido, Yumiko Tamai, Yuhei Hamaguchi, Shinya Okumura, Atsushi Kobayashi, Hisaya Shirai, Shintaro Yagi, Naoko Kamo, Ahmed Hammad, Nobuya Inagaki, Shinji Uemoto
OBJECTIVE: Sarcopenia is characterized by muscle mass depletion and decrease in muscle power or physical activity. We previously reported that low skeletal muscle mass (SMM) is closely involved with posttransplant mortality in patients undergoing living donor liver transplantation (LDLT). The aim of this study was to prospectively investigate the effects of pretransplant sarcopenia on survival and examine sequential changes in sarcopenic parameters after LDLT. METHODS: Sarcopenia was defined by measuring SMM using a multifrequency body composition analyzer and assessing grip strength (GS) in 72 adults who underwent LDLT at Kyoto University Hospital between January 2013 and October 2015...
July 27, 2016: Nutrition
Katrina Ray
No abstract text is available yet for this article.
October 2016: Nature Reviews. Gastroenterology & Hepatology
Batsaikhan Bat-Erdene, Sergelen Orgoi, Erdene Sandag, Ulzii-Orshikh Namkhai, Bat-Ireedui Badarch, Batsaikhan Batsuuri
The sinusoidal obstructive syndrome (SOS) is a complication that usually follows hematopoietic stem cell transplantation. It is also known as veno-occlusive disease, which is a rare complication of living donor liver transplantation (LDLT). Herein, we reported a 34 year-old female patient presenting SOS after LDLT. Its underlying cause was presumed to be associated with liver abscess and subsequent inferior vena cava stenosis. SOS led to graft failure, thus requiring retransplantation with a deceased donor liver graft...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Shin Hwang, Tae-Yong Ha, Chul-Soo Ahn, Deok-Bog Moon, Ki-Hun Kim, Gi-Won Song, Dong-Hwan Jung, Gil-Chun Park, Sung-Gyu Lee
After having experienced more than 2,000 cases of adult living donor liver transplantation (LDLT), we established the concepts of right liver graft standardization. Right liver graft standardization intends to provide hemodynamics-based and regeneration-compliant reconstruction of vascular inflow and outflow. Right liver graft standardization consists of the following components: Right hepatic vein reconstruction includes a combination of caudal-side deep incision and patch venoplasty of the graft right hepatic vein to remove the acute angle between the graft right hepatic vein and the inferior vena cava; middle hepatic vein reconstruction includes interposition of a uniform-shaped conduit with large-sized homologous or prosthetic grafts; if the inferior right hepatic vein is present, its reconstruction includes funneling and unification venoplasty for multiple short hepatic veins; if donor portal vein anomaly is present, its reconstruction includes conjoined unification venoplasty for two or more portal vein orifices...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Daniel Azoulay, Etienne Audureau, Prashant Bhangui, Jacques Belghiti, Olivier Boillot, Paola Andreani, Denis Castaing, Daniel Cherqui, Sabine Irtan, Yvon Calmus, Olivier Chazouillères, Olivier Soubrane, Alain Luciani, Cyrille Feray
OBJECTIVE: An intent-to-treat analysis of overall survival (ITT-OS) of cirrhotic patients with hepatocellular carcinoma (HCC) listed for living donor liver transplantation (LDLT) or brain-dead donor liver transplantation (BDLT) across 5 French liver transplant (LT) centers. BACKGROUND: Comparisons of HCC outcomes after LDLT and BDLT measured from time of transplantation have yielded conflicting results. METHODS: Records from 861 cirrhotic patients with HCC consecutively listed for either LDLT (n = 79) or BDLT (n = 782) from 2000 to 2009 were analyzed for ITT-OS using a Cox model; and tumor recurrence using 2 competitive risk models...
September 9, 2016: Annals of Surgery
T Bittermann, A Shaked, D S Goldberg
Outcomes of retransplantation after initial living donor liver transplantation (LDLT) are poorly understood. The aim of this study is to better understand the indications, timing, and outcomes of retransplantation after initial LDLT when compared to after initial deceased donor transplantation (DDLT). From 2002 to 2013, 209 retransplant recipients after initial LDLT and 2893 after initial DDLT were identified in Organ Procurement and Transplantation Network/United Network for Organ Sharing. Multivariable logistic models evaluated the association between initial transplant type and 1-year mortality...
October 6, 2016: American Journal of Transplantation
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