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Liver transplantion

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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
#1
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/27933567/impact-of-endoscopic-ultrasound-guided-fine-needle-aspiration-in-prospective-liver-transplant-recipients-with-hepatocellular-carcinoma-and-lymphadenopathy
#2
Narendra S Choudhary, Rajesh Puri, Sanjiv Saigal, Prashant Bhangui, Neeraj Saraf, Vinit Shah, Mukesh Nasa, Haimanti Sarin, Mridula Guleria, Randhir Sud, Arvinder S Soin
BACKGROUND: Diagnosis of metastatic disease is important in patients with cirrhosis and hepatocellular carcinoma (HCC) to prevent futile liver transplantation. Some of these patients have metastatic lymphadenopathy; however, it is difficult to perform percutaneous fine-needle aspiration due to presence of collateral and anatomic location. Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) of lymph nodes offers several advantages like real-time vision, proximity to target, and avoidance of collaterals...
December 8, 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/27933471/factors-associated-with-medication-non-adherence-in-patients-with-end-stage-liver-disease
#3
Selena Z Kuo, Marta Haftek, Jennifer C Lai
BACKGROUND: Low medication adherence is known to contribute to worse health outcomes in the general population. AIM: We aimed to evaluate the medication regimen and determine the adherence levels among patients with end-stage liver disease. METHODS: We measured adherence in patients awaiting liver transplantation at a single center using the 8-item Morisky Medication Adherence Scale (MMAS-8), with a score <8 classified as low adherence...
December 8, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27932478/most-apol1-is-secreted-by-the-liver
#4
Khuloud Shukha, Jessica L Mueller, Raymond T Chung, Michael P Curry, David J Friedman, Martin R Pollak, Anders H Berg
Two coding sequence variants in the APOL1 gene (G1 and G2) explain much of the increased risk for FSGS, HIV-associated nephropathy, and hypertension-attributed ESRD among people of recent African ancestry. The ApoL1 protein is expressed in a wide variety of cell tissues. It has been assumed that the majority of circulating ApoL1 is produced by the liver, but this has not been shown. Using mass spectrometry, we genotyped and quantified the circulating ApoL1 in two liver transplant recipients whose native APOL1 genotype differed from the genotype of the deceased donors, allowing us to differentiate liver- from nonliver-produced ApoL1...
December 8, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27932184/intrapancreatic-splenule-in-a-pancreas-allograft-case-report
#5
K Yadav, O K Serrano, R Kandaswamy
A 16-year-old white man was involved in a motor vehicle collision and suffered head, chest, and abdominal trauma. Despite initial resuscitative efforts, he progressed to brain death and was designated to be an organ donor by his family. He had no earlier medical or surgical history and no high-risk behaviors. Blood work revealed normal creatinine, liver function tests, lipase, and amylase. Viral serologies were negative except for cytomegalovirus IgG and Epstein-Barr virus nucleic acid. Imaging revealed a right kidney contusion, a manubrial fracture, and fractures of right first rib and bilateral scapulae...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932183/rhino-orbita-maxillary-mucormycosis-after-liver-transplantation-a-case-report
#6
R Farojov, O Aydın, C Yılmaz, Z Iakobadze, L Doğanay, D Camlı, A Demireller, S C Küçükgül, M Kılıç
Mucormycosis is a rare lethal complication of organ transplantation that progresses rapidly, and the prognosis is dismal if diagnosed late. We present a surviving liver transplant recipient in whom severe rhino-orbita-maxillary mucormycosis developed 1 month after liver transplantation. Prompt diagnosis with tissue biopsy, local control of the underlying condition with aggressive surgical debridement, and appropriate administration of systemic antifungal therapies are essential to improve prognosis and survival...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932182/recovery-after-critical-illness-polyneuropathy-in-a-patient-with-orthotopic-liver-transplantation-a-case-report
#7
J Watanabe, E Ito, M Hatano, T Tohyama, Y Okada, Y Takada
After liver transplantation, some patients show neuromuscular abnormalities. A 43-year-old man with liver cirrhosis due to hepatitis C virus underwent living-donor liver transplantation. He developed severe neuromuscular dysfunction after sepsis, and acute respiratory distress syndrome. After the inflammatory reaction gradually improved, we observed bilateral weakness of the extremities and foot drop. Electrophysiological studies indicated primary axonal degeneration of peripheral motor and sensory fibers without inflammation...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932181/use-of-terlipressin-in-an-elderly-patient-with-moderate-aortic-valve-stenosis-accompanied-by-episodic-atrial-fibrillation-during-liver-transplantation-a-case-report
#8
Y J Won, B G Lim, D Chung, E Park, H Kim, I O Lee, M H Kong
Anesthesia for patients with moderate aortic stenosis accompanied by atrial fibrillation during high-risk surgery such as liver transplantation remains a challenge in maintaining control of heart rate and maintenance of cardiac output. The action of terlipressin on vasopressin receptors (mainly V1 receptors) leads to splanchnic vasoconstriction and is the key mechanism responsible for increasing systemic vascular resistance and reducing heart rate. We report successful anesthetic management using low-dose terlipressin infusion in an elderly patient who had moderate aortic stenosis with atrial fibrillation during urgent deceased-donor liver transplantation...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932180/liver-transplant-recipient-with-tumefactive-demyelinating-lesions-a-case-report-and-literature-review
#9
D-L Wan, K-W Ren, L-L Zhang, B Wang, Z L Zhai, X-Y Zhang, Y-C Yang, S-S Zheng
Tumefactive demyelinating lesions (TDLs) that may resemble brain neoplasms or abscesses are uncommon but noteworthy. A solid knowledge of how to distinguish TDLs from malignancy or infection is a key step to avoid unnecessary medical or surgical interventions. Almost all the intracranial demyelination diseases after liver transplantation (LT) refer to central pontine myelinolysis or extrapontine myelinolysis; TDLs after LT have never been reported. In 2005, a 45-year-old Chinese male underwent orthotopic LT due to "acute on chronic liver failure" in our hospital...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932179/combined-kidney-transplantation-and-splenic-fossa-auxiliary-heterotopic-liver-transplantation-in-a-highly-sensitized-recipient-a-case-report
#10
G Zhang, Y Zhu, W Qin, L Yu, G Wu, S Ma, F Wang, R Qin, X Yang, K Tao, S Yue, G Zhao, Z Yang, J Yuan, K Dou, J Yuan
BACKGROUND: Combined kidney and auxiliary orthotopic liver transplantation from the same donor is used to treat highly sensitized renal transplant recipients. Auxiliary liver can protect the transplanted kidney against hyperacute rejection. METHODS: In the current case, combined kidney and splenic fossa auxiliary heterotopic liver transplantation was performed from the same donor for a highly sensitized recipient without preoperative preconditioning. No postoperative hyperacute rejection occurred...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932178/extra-anatomical-meso-portal-venous-jump-graft-repair-for-early-portal-vein-thrombosis-after-liver-transplant-in-an-infant-with-a-hypoplastic-portal-vein-a-case-report
#11
R Matsumoto, K Uchida, S Nishida, E R Island, D M Levi, J Fan, A Tekin, G Selvaggi, A G Tzakis
BACKGROUND AND PURPOSE: Small infants with biliary atresia and hypoplastic portal veins (PV) are at risk for portal vein thrombosis (PVT) after liver transplantation (LT), which can lead to graft loss and mortality. Extra-anatomical PV reconstruction techniques have been established for adult cases of PVT; however, they have not been widely accepted for infants. METHODS: Here, we report the successful use of an extra-anatomical meso-portal venous jump graft to treat early PVT after LT in a 6-month-old infant with biliary atresia and PV hypoplasia...
November 2016: Transplantation Proceedings
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
#12
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/27932175/first-attempt-of-sequential-living-donor-liver-and-hematopoietic-stem-cell-transplantation-in-a-child-with-advanced-hepatocellular-carcinoma-case-report
#13
J A Picoraro, N Ovchinsky, M Martinez, S J Lobritto, P Satwani, R Ramphal, M S Cairo, T Kato
Effective therapeutic options for advanced hepatocellular carcinoma are limited. Hematopoietic stem cell transplantation may offer a graft-versus-tumor effect. Combined liver and hematopoietic stem cell transplantation from the same donor with preparatory conditioning may promote tolerogenicity to the liver allograft and offers the potential for immunosuppression withdrawal. We report our experience with the use of this approach in a pediatric patient with invasive hepatocellular carcinoma and pulmonary metastases who underwent a living-donor liver transplantation followed by reduced-toxicity myeloablative conditioning and hematopoietic stem cell transplant from the same parental donor...
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
#14
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/27932173/a-case-report-of-severe-hepatic-artery-vasospasm-induced-by-hepatic-arterial-buffer-response-after-liver-transplantation
#15
Y Hiraki, K Uchida, S Nishida, D M Levi, G Selvaggi, A Tekin, J Fan, T Froud, A G Tzakis
The management of severe hepatic artery vasospasm soon after liver transplantation (LT) is challenging because it can lead to hepatic artery thrombosis and subsequent graft failure. A 61-year-old man with hepatitis C cirrhosis and portal vein thrombosis received a deceased donor LT. On postoperative day 1, Doppler ultrasonography revealed a high-resistance waveform in the hepatic artery. Angiography showed severe vasospasm of the donor hepatic artery on postoperative day 3. Strong hepatic arterial buffer response (HABR) was considered for this etiology due to high portal vein velocity...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932172/liver-transplantation-in-an-adult-recipient-with-situs-inversus-totalis-case-report-and-review-of-the-literature
#16
P Tabrizian, T T Joseph, P Radkani, E Cohen, M Facciuto
BACKGROUND: Over the past few decades, reports have demonstrated the feasibility of liver transplantation in adult patients with situs inversus. However, this disease entity remains rare and experience remains limited in adult recipients with situs inversus undergoing transplantation. METHODS: A 23-year-old woman with situs inversus totalis and end-stage liver disease secondary to congenital biliary atresia was referred to our center and underwent a successful orthotopic liver transplantation...
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
#17
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/27932170/living-donor-liver-transplantation-in-a-patient-with-extensive-portomesenteric-venous-thrombosis-case-report
#18
S Choi, K K Kim, W S Lee, J M Kang, Y H Park
Extensive portomesenteric venous thrombus preventing restoration of adequate portal venous flow used to be considered a contraindication to liver transplantation. The subject was a 49-year-old male with hepatitis B cirrhosis and extensive thrombosis of portal, splenic, and superior mesenteric veins, and two large collateral vessels; one dilated and tortuous inferior to the pancreaticoduodenal vein and relevant to splanchnic venous return and the other a dilated coronary vein relevant to splenic venous return...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932169/invasive-aspergillosis-of-the-stomach-and-co-infection-with-candida-krusei-in-a-patient-with-terminal-liver-failure-a-case-report
#19
B Sulik-Tyszka, W Figiel, M Krawczyk, M Wróblewska
Invasive aspergillosis (IA) is diagnosed almost exclusively in immunocompromised patients. It is located mainly in the lungs or paranasal sinuses, but occasionally other organs and the gastrointestinal tract may also be affected either alone or as a part of a disseminated disease. The main risk factors predisposing to IA are neutropenia, immunosuppressive and steroid therapy, as well as severe underlying disease. Despite progress in diagnostics and therapy of IA, it is still characterized by a high mortality rate...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932161/sofosbuvir-monotherapy-for-asymptomatic-and-noncirrhotic-hepatitis-c-infection-in-a-renal-retransplantation-recipient-a-case-report
#20
G Deng, J Ma, S Shen, Q Li, L Peng, S Meng, J Zhou, J Wu, D Liu
Renal transplant recipients infected with hepatitis C virus (HCV) have a high risk of progressing to cirrhosis, end-stage liver diseases, and hepatocellular carcinoma. It is also considered as an independent risk for graft loss and is correlated with proteinuria, transplant glomerulopathy, HCV-associated glomerulonephritis, and chronic rejection. Previous therapy involving interferon alfa and ribavirin led to treatment complications, including toxicity, anemia, sepsis, and drug-drug interactions with calcineurin inhibitors, as well as reduced tolerability and efficacy...
November 2016: Transplantation Proceedings
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