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Living donor liver transplant

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https://www.readbyqxmd.com/read/28635356/simultaneous-abo-incompatible-living-donor-liver-transplantation-and-splenectomy-without-plasma-exchange-in-china-two-case-reports
#1
Guoyong Chen, Janjun Sun, Sidong Wei, Yongfeng Chen, Gaofeng Tang, Zhantao Xie, Huaen Xu, Janbin Chen, Huibo Zhao, Zhenhua Yuan, Weiwei Wang, Guangbo Liu, Bing Wang, Biao Niu
ABO-incompatible (ABO-i) living-donor liver transplantation (LDLT) is performed if an ABO-compatible graft cannot be obtained. However, a perfect desensitization protocol has not been established worldwide, especially for simultaneous ABO-i LDLT and splenectomy. We herein report two cases of ABO-i LDLT. To the best of our knowledge, this is the first case report of ABO-i LDLT in an adult patient in China. Splenectomy and T-cell-targeted immunosuppression (basiliximab) was used to overcome the blood group barrier in these recipients...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28634617/liver-transplantation-for-hepatocellular-carcinoma
#2
Jennifer Berumen, Alan Hemming
Over the last several years, liver transplantation has evolved to become a widely used treatment for hepatocellular carcinoma (HCC). The criteria used were developed in order to have acceptable outcomes for transplant with survival similar to other indications for transplant. These criteria are discussed in detail along with alternate options, including surgical resection and downstaging of HCC in cirrhotics. Technical considerations of liver transplantation must be considered, and living donor liver transplant is a possibility for treatment...
June 20, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28632515/p4-stump-approach-for-intraoperative-portal-vein-stenting-in-pediatric-living-donor-liver-transplantation-an-innovative-technique-for-a-challenging-problem
#3
Chao-Long Chen, Yu-Fan Cheng, Viola Huang, Ting-Lung Lin, Yi-Chia Chan, Hsin-You Ou, Chee-Chien Yong, Shih-Ho Wang, Chih-Che Lin
OBJECTIVE: The aim of this study was to evaluate the utility of the P4 stump stenting approach for treating portal vein (PV) complications in pediatric living donor liver transplantation (LDLT). BACKGROUND: PV complications cause significant morbidity and mortality in pediatric LDLT. Biliary atresia in the backdrop of pathological PV hypoplasia and sclerosis heightens the complexity of PV reconstruction. The authors developed a novel approach for intraoperative PV stenting via the graft segment 4 PV stump (P4 stump) to address this challenge...
June 19, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28628564/risk-of-post-transplant-hepatocellular-carcinoma-recurrence-is-higher-in-recipients-of-livers-from-male-than-female-living-donors
#4
Sangbin Han, Ju Dong Yang, Dong Hyun Sinn, Jong Man Kim, Gyu Sung Choi, Gangha Jung, Joong Hyun Ahn, Seonwoo Kim, Justin S Ko, Mi Sook Gwak, Choon Hyuck D Kwon, Michael D Leise, Geum-Youn Gwak, Julie K Heimbach, Gaab Soo Kim
OBJECTIVE: To evaluate the relationship between donor sex and hepatocellular carcinoma (HCC) recurrence after living donor liver transplantation. BACKGROUND: HCC shows a male predominance in incidence and recurrence after tumor resection due to sex differences in hepatic sex hormone receptors. There have been no studies evaluating the importance of donor sex on post-transplant HCC recurrence. METHODS: Of 384 recipients of livers, from living donors, for HCC: 104/120 who received grafts from female donors were matched with 246/264 who received grafts from male donors using propensity score matching, with an unfixed matching ratio based on factors like tumor biology...
June 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28626871/a-successful-living-donor-liver-re-transplantation-for-graft-failure-within-seven-days-due-to-acute-de-novo-donor-specific-anti-hla-antibody-mediated-rejection
#5
Yohei Yamada, Ken Hoshino, Teisaburo Mori, Miho Kawaida, Kiyotomo Abe, Hideo Ishihama, Takahiro Shimizu, Nobuhiro Takahashi, Kentaro Matsubara, Taizo Hibi, Yuta Abe, Hiroshi Yagi, Naoki Shimojima, Masahiro Shinoda, Minoru Kitago, Hideaki Obara, Yasushi Fuchimoto, Kaori Kameyama, Yuko Kitagawa, Tatsuo Kuroda
Growing evidence suggests a relationship between antibody-mediated rejection (AMR) and early graft failure due to a previously unknown etiology in liver transplantation (LTx). We herein report a three-year-old boy who developed rapid graft failure due to de novo donor-specific antibody (DSA)-driven AMR a week after living donor LTx, requiring a second transplant on the 10th day after the first LTx. The pathology of the first graft showed massive necrosis in zone 3 along with positive C4d and inflammatory cell infiltrates in portal areas...
June 19, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28624111/biliary-complications-after-liver-transplantation-recent-developments-in-etiology-diagnosis-and-endoscopic-treatment
#6
REVIEW
Floris J M Roos, Jan-Werner Poley, Wojciech G Polak, Herold J Metselaar
Biliary complications are considered to be the Achilles' heel of liver transplantation. The most common complications are leaks and bile duct strictures. Strictures can arise at the level of the anastomosis (anastomotic strictures; AS) or at other locations in the biliary tree (non-anastomotic strictures; NAS). Endoscopic treatment via endoscopic retrograde cholangiopancreatography (ERCP) is considered to be the preferred therapy for these complications. This review will focus on the diagnostic modalities, new insights in etiology of biliary complications and outcomes after different endoscopic therapies, in both deceased donor transplantation and living-donor liver transplantations...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28620674/organ-dysfunction-and-failure-following-brain-death-do-not-preclude-successful-donation
#7
Eno-Obong I Essien, Nehu Parimi, Jennifer Gutwald-Miller, Tyree Nutter, Thomas M Scalea, Deborah M Stein
BACKGROUND: Organ dysfunction is common after neurologic determination of death (NDD) but before organ collection. Reliable markers for graft success following transplant of these organs would be useful. We sought to determine the relationship between the donor after neurologic determination of death (DNDD) pathophysiology and successful organ donation. METHODS: Donor information was obtained through the local organ procurement organization. Donor demographics and clinical data points for cardiovascular, renal, respiratory, hepatic, hematological and neuroendocrine systems were reviewed 12 h before and 12 h after neurologic determination of death was declared...
June 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28620648/effect-of-fc-%C3%AE-receptor-polymorphism-on-rituximab-mediated-b-cell-depletion-in-abo-incompatible-adult-living-donor-liver-transplantation
#8
Hiroshi Sakai, Yuka Tanaka, Hirofumi Tazawa, Seiichi Shimizu, Sapana Verma, Masahiro Ohira, Hiroyuki Tahara, Kentaro Ide, Kohei Ishiyama, Tsuyoshi Kobayashi, Takashi Onoe, Hideki Ohdan
BACKGROUND: The affinity of IgG Fc receptor (FcγR) for rituximab, an anti-CD20 IgG1, differs based on single-nucleotide polymorphisms (SNPs) in FcγRs. This study aimed to explore the effect of such SNPs on clinical response to rituximab and outcomes in patients of ABO-incompatible (ABOi) living donor liver transplantation (LDLT). METHODS: SNPs of FCGR2A[131H/R] and FCGR3A[158F/V], alleles encoding FcγR, were identified in 20 patients desensitized with rituximab before ABOi LDLT...
June 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28620642/early-intervention-with-live-donor-liver-transplantation-reduces-resource-utilization-in-nash-the-toronto-experience
#9
Andrew S Barbas, Nicolas Goldaracena, Martin J Dib, David P Al-Adra, Aloysious D Aravinthan, Leslie B Lilly, Eberhard L Renner, Nazia Selzner, Mamatha Bhat, Mark S Cattral, Anand Ghanekar, Ian D McGilvray, Gonzalo Sapisochin, Markus Selzner, Paul D Greig, David R Grant
BACKGROUND: In parallel with the obesity epidemic, liver transplantation for nonalcoholic steatohepatitis (NASH) is increasing dramatically in North America. Although survival outcomes are similar to other etiologies, liver transplantation in the NASH population has been associated with significantly increased resource utilization. We sought to compare outcomes between live donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT) at a high volume North American transplant center, with a particular focus on resource utilization...
June 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28612395/a-case-of-classical-maple-syrup-urine-disease-that-was-successfully-managed-by-living-donor-liver-transplantation
#10
Chika Takano, Mika Ishige, Erika Ogawa, Hiromi Usui, Reiko Kagawa, Go Tajima, Ryoji Fujiki, Toshiyuki Fukao, Koichi Mizuta, Tatsuo Fuchigami, Shori Takahashi
Classical MSUD is often fatal without appropriate medical interventions because of metabolic crisis. There are numerous reports suggesting the therapeutic potential of deceased donor liver transplantation for MSUD. However, the usefulness of LDLT for MSUD is unknown. We report a case of classical MSUD, which was successfully managed by LDLT from the patient's father at 1 year of age. Abnormal brain findings, which were cured with effective treatment, gradually disappeared after LDLT. The patient then developed normally...
June 14, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28611526/different-techniques-for-harvesting-grafts-for-living-donor-liver-transplantation-a-systematic-review-and-meta-analysis
#11
Hui Li, Jun-Bin Zhang, Xiao-Long Chen, Lei Fan, Li Wang, Shi-Hui Li, Qiao-Lan Zheng, Xiao-Ming Wang, Yang Yang, Gui-Hua Chen, Gen-Shu Wang
AIM: To perform a systematic review and meta-analysis on minimally vs conventional invasive techniques for harvesting grafts for living donor liver transplantation. METHODS: PubMed, Web of Science, EMBASE, and the Cochrane Library were searched comprehensively for studies comparing MILDH with conventional living donor hepatectomy (CLDH). Intraoperative and postoperative outcomes (operative time, estimated blood loss, postoperative liver function, length of hospital stay, analgesia use, complications, and survival rate) were analyzed in donors and recipients...
May 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28608518/liver-transplantation-may-prevent-neurodevelopmental-deterioration-in-high-risk-patients-with-urea-cycle-disorders
#12
Jun Kido, Shirou Matsumoto, Ken Momosaki, Rieko Sakamoto, Hiroshi Mitsubuchi, Fumio Endo, Kimitoshi Nakamura
UCDs are among the most common inherited metabolic diseases in Japan. We investigated the clinical manifestations, treatment, and prognoses of 177 patients with UCDs who were evaluated and treated from January 1999 to March 2009 in Japan, using a questionnaire survey. Among these 177 patients, 42 (seven with carbamoyl phosphate synthetase 1 deficiency, 27 with ornithine transcarbamylase deficiency, seven with argininosuccinate synthetase deficiency, and one with arginase 1 deficiency) underwent living-donor LT...
June 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28607852/microsurgical-hepatic-artery-reconstruction-using-ikuta-a-ii-double-clamp
#13
Masayuki Okochi, Hiromi Okochi, Takao Sakaba, Masanori Momiyama, Kazuki Ueda
We performed hepatic artery (HA) reconstruction on 24 patients between January 2010 and October 2016. Six of 24 patients used an Ikuta type A-II vascular clamp (A-II group). The mean age was 38.0 years (range, 1-61 years). There was no blood leakage at the anastomosed site in any of the patients. No patients required an additional vascular clamp, and none developed HA thrombosis. Eighteen of 24 patients used a conventional vascular clamp. The mean age was 36.1 years (range, 1-65 years; conventional group). Sixteen of 18 patients required an additional vascular clamp due to blood leakage from the HA...
May 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28603862/graft-reduction-using-a-powered-stapler-in-pediatric-living-donor-liver-transplantation
#14
Koichiro Yoshimaru, Toshiharu Matsuura, Yoshiaki Kinoshita, Makoto Hayashida, Yoshiaki Takahashi, Yusuke Yanagi, Norifumi Harimoto, Toru Ikegami, Hideaki Uchiyama, Tomoharu Yoshizumi, Yoshihiko Maehara, Tomoaki Taguchi
Large-for-size syndrome is defined by inadequate tissue oxygenation, which results in vascular complications and graft compression after abdominal closure in living donor liver transplantation recipients. An accurate graft reduction that matches the optimal liver volume for the recipient is essential. We herein initially present the feasibility and safety of graft reduction using a powered stapler to obtain an optimal graft size. From October 1996 to October 2015, a total of eight graft reductions were performed using a powered stapler (group A; n=4) or by the conventional method using a cavitron ultrasonic surgical aspirator and portal triad suturing (group B; n=4)...
June 11, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28600688/endoscopic-management-of-biliary-strictures-after-living-donor-liver-transplantation
#15
REVIEW
Takeshi Tsujino, Hiroyuki Isayama, Hirofumi Kogure, Tatsuya Sato, Yousuke Nakai, Kazuhiko Koike
Living donor liver transplantation (LDLT) is an effective alternative to deceased liver transplantation (DDLT) for end-stage liver disease. Although advances in surgical techniques, immunosuppressive management, and post-transplant care have improved the overall outcomes of LDLT, biliary strictures remain the major unsolved problem. Endoscopic retrograde cholangiopancreatography (ERCP) is currently considered the first-line therapy for biliary strictures following LDLT with duct-to-duct reconstruction, with percutaneous and surgical interventions reserved for patients with unsuccessful management via ERCP...
June 9, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28591031/ct-evaluation-of-living-liver-donor-can-100-kvp-plus-iterative-reconstruction-protocol-provide-accurate-liver-volume-and-vascular-anatomy-for-liver-transplantation-with-reduced-radiation-and-contrast-dose
#16
Morikatsu Yoshida, Daisuke Utsunomiya, Masafumi Kidoh, Hideaki Yuki, Seitaro Oda, Shinya Shiraishi, Hidekazu Yamamoto, Yukihiro Inomata, Yasuyuki Yamashita
We evaluated whether donor computed tomography (CT) with a combined technique of lower tube voltage and iterative reconstruction (IR) can provide sufficient preoperative information for liver transplantation.We retrospectively reviewed CT of 113 liver donor candidates. Dynamic contrast-enhanced CT of the liver was performed on the following protocol: protocol A (n = 70), 120-kVp with filtered back projection (FBP); protocol B (n = 43), 100-kVp with IR. To equalize the background covariates, one-to-one propensity-matched analysis was used...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28590589/living-donor-liver-transplantation-for-post-kasai-biliary-atresia-analysis-of-pretransplant-predictors-of-outcomes-in-infants
#17
Toshihiro Kitajima, Seisuke Sakamoto, Kengo Sasaki, Hajime Uchida, Soichi Narumoto, Akinari Fukuda, Satoshi Teramukai, Shinji Uemoto, Mureo Kasahara
After decades of dramatic surgical innovations in pediatric living donor liver transplantation (LDLT), LDLT for biliary atresia (BA) still poses various challenges. This study reviewed our experience with LDLT for children with post-Kasai BA and evaluated outcomes and prognostic factors. From 2005 to 2016, 168 post-Kasai BA LDLT patients were enrolled and divided into three groups by age. Patient characteristics and perioperative data were compared. Predictors of morbidity and mortality following LDLT were analyzed in 93 infants...
June 7, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28585915/hemodynamic-changes-are-predictive-of-coagulopathic-hemorrhage-after-living-donor-liver-transplant
#18
Chia-En Hsieh, Chen-Te Chou, Chia-Cheng Lin, Kuo-Hua Lin, Ping-Yi Lin, Hui-Chuan Lin, Chih-Jan Ko, Ya-Yin Chang, Su-Han Wang, Yao-Li Chen
OBJECTIVES: Our goal was to evaluate the predictors of coagulopathic hemorrhage after living-donor liver transplant. MATERIALS AND METHODS: We retrospectively evaluated 161 patients who had undergone living-donor liver transplant from July 2005 to April 2014 at a single medical institution. Of these patients, 32 developed hemorrhage after transplant. Patients were separated into those with coagulopathy-related hemorrhage (n=15) or noncoagulopathy-related hemorrhage (n=17) based on the results of computed tomography images...
June 5, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28583652/non-contrast-enhanced-magnetic-resonance-venography-using-magnetization-prepared-rapid-gradient-echo-mprage-in-the-preoperative-evaluation-of-living-liver-donor-candidates-comparison-with-conventional-computed-tomography-venography
#19
Rikiya Yamashita, Hiroyoshi Isoda, Shigeki Arizono, Ayako Ono, Natsuko Onishi, Akihiro Furuta, Kaori Togashi
OBJECTIVE: To compare the diagnostic performance of non-contrast-enhanced magnetic resonance venography using magnetization-prepared rapid gradient-echo (MPRAGE-MRV) and conventional computed tomography venography (CTV) in preoperative evaluation of venous tributaries for living donor liver transplantation. MATERIALS AND METHODS: Institutional review board approval and written informed consent were obtained for this prospective study of 73 donor candidates. Of these, 23 underwent right-sided graft hepatectomy without middle hepatic vein...
May 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28583626/does-apparent-diffusion-coefficient-predict-the-degree-of-liver-regeneration-of-donor-and-recipient-after-living-donor-liver-transplantation
#20
Koichiro Morita, Akihiro Nishie, Yoshiki Asayama, Kousei Ishigami, Yasuhiro Ushijima, Yukihisa Takayama, Daisuke Okamoto, Nobuhiro Fujita, Toru Ikegami, Tomoharu Yoshizumi, Ken Shirabe, Hiroshi Honda
OBJECTIVE: To elucidate the relationship between the ADCs of the liver graft and the remnant liver and the degree of liver regeneration in LDLT. MATERIALS AND METHODS: 15 recipients and 15 corresponding donors underwent magnetic resonance imaging and computed tomography 1-2 weeks after living donor liver transplantation (LDLT). For diffusion-weighted imaging (DWI), a single-shot echo-planar sequence with b-factors of 0, 500, and 1000s/mm(2) was scanned. ADCs of the liver parenchyma were calculated at b factors of 0 and 500 and 1000 (ADC 0-500-1000) or 0 and 500 (ADC 0-500) or 500 and 1000 (ADC 500-1000)...
May 2017: European Journal of Radiology
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