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liver transplantation postoperative mortality and treatment

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https://www.readbyqxmd.com/read/28641515/the-development-of-stem-cell-based-treatment-for-liver-failure
#1
Tiantian Zhu, Yuwen Li, Yusheng Guo, Chuanlong Zhu
Liver failure is a devastating clinical syndrome with a persistently mortality rate despite advanced care. According to the pathological histology, hepatic failure was divided into four categories: acute liver failure (ALF), subacute liver failure (SALF), acute - on - chronic liver failure (ACLF) and chronic liver failure (CLF). Orthotopic liver transplantation protected patients from hepatic failure. Yet, limitations including postoperative complications, high costs, and shortages of donor organs defect its application...
June 15, 2017: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28503555/surgical-options-for-intrahepatic-cholangiocarcinoma
#2
REVIEW
Kui Wang, Han Zhang, Yong Xia, Jian Liu, Feng Shen
Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver cancer, accounting for 10-15% of primary hepatic malignancy. The incidence and cancer-related mortality of ICC continue to increase worldwide. At present, hepatectomy is still the most effective treatment for ICC patients to achieve long-term survival, although its overall efficacy may not be as good as that for patients with hepatocellular carcinoma (HCC) due to the unique pathogenesis and clinical-pathological profiles of ICC. Viral infection, lithiasis and metabolic factors may all be associated with the pathogenesis of ICC...
April 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/28498944/assessment-of-standard-laboratory-tests-and-rotational-thromboelastometry-for-the-prediction-of-postoperative-bleeding-in-liver-transplantation
#3
T M Dötsch, D Dirkmann, D Bezinover, M Hartmann, J W Treckmann, A Paul, F H Saner
Background.: Perioperative bleeding remains a major challenge in liver transplantation. We aimed to compare standard laboratory tests with thromboelastometry (ROTEM ® ) with regard to their ability to predict postoperative non-surgical bleeding. Methods.: Data from 243 adult liver transplant recipients from January 2012 to May 2014 were evaluated retrospectively. Upon admission to the intensive care unit, coagulation status was assessed using standard laboratory tests [prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen concentration, and platelet count] and ROTEM ® whole blood coagulation assays...
May 12, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28473688/long-term-outcome-of-liver-resection-versus-transplantation-for-hepatocellular-carcinoma-in-a-region-where-living-donation-is-a-main-source
#4
Pil Soo Sung, Hyun Yang, Gun Hyung Na, Seawon Hwang, Donghoon Kang, Jeong Won Jang, Si Hyun Bae, Jong Young Choi, Dong Goo Kim, Seung Kew Yoon, Young Kyoung You
BACKGROUND The aim of this study was to define the best curative strategy in patients with hepatocellular carcinoma (HCC) in a hepatitis B virus (HBV)-endemic region where living donation dominates the type of cadaveric donation for liver transplantation (LT). MATERIAL AND METHODS A retrospective cohort comprised those patients whose clinical course could potentially be traced for at least 10 years. We found 262 HCC patients who had undergone curative surgical treatment from March 1997 to August 2006. Among these patients, 156 were treated with liver resection (LR) (R group) and 106 patients underwent LT (T group, 100 patients with living donor)...
May 5, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28411359/incidence-and-treatment-of-bile-stones-after-liver-transplant
#5
Mahir Kırnap, Ebru Hative Ayvazoğlu Soy, Aydıncan Akdur, Sedat Yıldırım, Ali Harman, Gökhan Moray, Mehmet Haberal
OBJECTIVES: Although the incidence of bile stones after liver transplant is rare (2%-6%), various complications can occur, including recurrent cholangitis, biliary strictures, graft loss, and patient mortality. MATERIALS AND METHODS: We retrospectively evaluated bile stone incidence, pathogenesis, and treatment in 352 liver transplant recipients, comparing demographics, transplant indication, blood lipid profile, bile reconstruction technique, postoperative complications, time of diagnosis, and treatment regimens...
April 14, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28404072/distinctive-features-of-hepatocellular-carcinoma-in-non-alcoholic-fatty-liver-disease
#6
REVIEW
Elisabetta Degasperi, Massimo Colombo
Hepatocellular carcinoma is the fifth most common cancer and the second leading cause of cancer-related death worldwide. Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis have been identified as emergent risk factors for this primary liver cancer. Incidence of NAFLD is increasing as a consequence of the epidemic spread of metabolic syndrome, which can result in progressive liver disease, leading to cirrhosis and its complications. Most data about the prevalence and incidence of hepatocellular carcinoma in patients with NAFLD are from a few population and cohort studies; its incidence is increasing and it is likely to become a leading indication for liver transplantation, especially in industrialised countries...
October 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28395663/renal-function-and-oxygenation-are-impaired-early-after-liver-transplantation-despite-hyperdynamic-systemic-circulation
#7
Jenny Skytte Larsson, Gudrun Bragadottir, Bengt Redfors, Sven-Erik Ricksten
BACKGROUND: Acute kidney injury (AKI) occurs frequently after liver transplantation and is associated with the development of chronic kidney disease and increased mortality. There is a lack of data on renal blood flow (RBF), oxygen consumption, glomerular filtration rate (GFR) and renal oxygenation, i.e. the renal oxygen supply/demand relationship, early after liver transplantation. Increased insight into the renal pathophysiology after liver transplantation is needed to improve the prevention and treatment of postoperative AKI...
April 11, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28267230/keep-the-pressure-correlation-of-hemodynamic-instability-after-reperfusion-and-severity-of-acute-kidney-injury-following-liver-transplantation
#8
Jonas Roller, Matthias Glanemann
Acute renal dysfunction and kidney failure represent frequent complications in patients after liver transplantation. Indeed, postoperative acute kidney injury (AKI) may occur in up to 60% and is associated with significantly increased postoperative mortality [1], however, the pathogenesis of AKI is yet not fully understood. To date it is not possible to identify patients with an increased risk for AKI prior to transplantation, thus, the treatment remains clinically challenging. This article is protected by copyright...
March 7, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28164120/coronary-computed-tomography-angiography-in-combination-with-coronary-artery-calcium-scoring-for-the-preoperative-cardiac-evaluation-of-liver-transplant-recipients
#9
REVIEW
Jae Moon Choi, Yu-Gyeong Kong, Joon-Won Kang, Young-Kug Kim
Liver transplantation is the best treatment option for early-stage hepatocellular carcinoma, liver cirrhosis, fulminant liver failure, and end-stage liver diseases. Even though advances in surgical techniques and perioperative care have improved postoperative outcomes, perioperative cardiovascular complications are a leading cause of postoperative morbidity and mortality following liver transplantation. Ischemic coronary artery disease (CAD) and cardiomyopathy are the most common cardiovascular diseases and could be negative predictors of postoperative outcomes in liver transplant recipients...
2017: BioMed Research International
https://www.readbyqxmd.com/read/27989547/graft-inflow-modulation-in-adult-to-adult-living-donor-liver-transplantation-a-systematic-review
#10
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/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/27931579/harm-and-benefits-of-salvage-transplantation-for-hepatocellular-carcinoma-an-updated-meta-analysis
#12
Q Xiong, T-T Geng, L He, H Gao
OBJECTIVE: The aim of this work was to compare salvage liver transplantation (SLT) and primary liver transplantation (PLT) in terms of the harm and benefits. METHODS: The authors searched Pubmed, Embase, and the Cochrane Library from their dates of establishment to December 2015. Based on selection and exclusion criteria, 2 researchers screened the literature independently. The meta-analysis was performed with the use of the Review Manager software. Meta-analysis of the pooled standard mean difference (SMD) and odds ratio (OR) with 95% confidence interval (CI) were calculated based on either a fixed-effects or a random-effects model...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27863693/surgical-treatment-of-non-functioning-pancreatic-neuroendocrine-tumours-based-on-three-clinical-scenarios
#13
Juli Busquets, Elena Ramírez-Maldonado, Teresa Serrano, Núria Peláez, Luís Secanella, Sandra Ruiz-Osuna, Emilio Ramos, Laura Lladó, Juan Fabregat
INTRODUCTION: The treatment of patients with non-functioning pancreatic neuroendocrine tumours (NFPNET) is resection in locally pancreatic disease, or with resectable liver metastases. There is controversy about unresectable liver disease. METHODS: We analysed the perioperative data and survival outcome of 63 patients who underwent resection of NFPNET between 1993 and 2012. They were divided into 3 scenarios: A, pancreatic resection (44patients); B, pancreatic and liver resection in synchronous resectable liver metastases (12patients); and C, pancreatic resection in synchronous unresectable liver metastases (6patients)...
December 2016: Cirugía Española
https://www.readbyqxmd.com/read/27781375/multidisciplinary-management-of-hepatoblastoma-in-children-experience-from-a-developing-country
#14
Naresh Shanmugam, Julius Xavier Scott, Vimal Kumar, Mukul Vij, Priya Ramachandran, Gomathy Narasimhan, Mettu Srinivas Reddy, Venugopal Kota, Deenadayalan Munirathnam, Chayarani Kelgeri, Karthick Sundaram, Mohamed Rela
BACKGROUND: Advances in chemotherapy, liver resection techniques, and pediatric liver transplantation have vastly improved survival in children with hepatoblastoma (HB). These are best managed by a multidisciplinary team (MDT) in a setting where all treatment options are available. Until recently, this was difficult to achieve in India. METHODS: All children (<16 years) with HB treated in a pediatric liver surgery and transplantation unit between January 2011 and July 2016 were reviewed...
March 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27730288/surgical-treatment-of-childhood-hepatoblastoma-in-the-netherlands-1990-2013
#15
Linde A D Busweiler, Marc H W A Wijnen, Jim C H Wilde, Egbert Sieders, Sheila E J Terwisscha van Scheltinga, L W Ernest van Heurn, Joseph Ziros, Roel Bakx, Hugo A Heij
BACKGROUND: Achievement of complete surgical resection plays a key role in the successful treatment of children with hepatoblastoma. The aim of this study is to assess the surgical outcomes after partial liver resections for hepatoblastoma, focusing on postoperative complications, resection margins, 30-day mortality, and long-term survival. METHOD: Chart reviews were carried out on all patients treated for hepatoblastoma in the Netherlands between 1990 and 2013...
January 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/27500230/should-we-exclude-live-donor-liver-transplantation-for-liver-transplant-recipients-requiring-mechanical-ventilation-and-intensive-care-unit-care
#16
Nicolas Goldaracena, Vinzent N Spetzler, Gonzalo Sapisochin, Echeverri J, Kaths Moritz, Mark S Cattral, Paul D Greig, Les Lilly, Ian D McGilvray, Gary A Levy, Anand Ghanekar, Eberhard L Renner, David R Grant, Markus Selzner, Nazia Selzner
UNLABELLED: Patients with acute and chronic liver disease often require admission to intensive care unit (ICU) and mechanical ventilation support before liver transplantation (LT). Rapid disease progression and high mortality on LT waiting lists makes live donor LT (LDLT) an attractive option for this patient population. METHODS: During 2000 to 2011, all ICU-bound and mechanically ventilated patients receiving an LDLT (n = 7) were compared to patients receiving a deceased donor LT (DDLT) (n = 38)...
September 2015: Transplantation Direct
https://www.readbyqxmd.com/read/27438422/is-resection-of-hepatocellular-carcinoma-in-the-era-of-liver-transplantation-worthwile-a-single-center-experience
#17
Paulo Herman, Felipe de Lucena Moreira Lopes, Jaime Arthur Pirola Kruger, Gilton Marques Fonseca, Vagner Birk Jeismann, Fabricio Ferreira Coelho
BACKGROUND: - Liver resection for hepatocellular carcinoma is a potentially curative therapeutic procedure that can be performed readily after its indication, without the need of a long waiting time and lower costs when compared to liver transplantation, being a good alternative in patients with preserved/good liver function. OBJECTIVE: - Evaluate long-term results of liver resection from a high volume single center for selected patients with hepatocellular carcinoma in a context of a long waiting list for liver transplant...
July 2016: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/27358784/ventilator-associated-pneumonia-following-liver-transplantation-etiology-risk-factors-and-outcome
#18
Antonio Siniscalchi, Lucia Aurini, Beatrice Benini, Lorenzo Gamberini, Stefano Nava, Pierluigi Viale, Stefano Faenza
AIM: To determine the incidence, etiology, risk factors and outcome of ventilator-associated pneumonia (VAP) in patients undergoing orthotopic liver transplantation (OLT). METHODS: This retrospective study considered 242 patients undergoing deceased donor OLT. VAP was diagnosed according to clinical and microbiological criteria. RESULTS: VAP occurred in 18 (7.4%) patients, with an incidence of 10 per 1000 d of mechanical ventilation (MV). Isolated bacterial etiologic agents were mainly Enterobacteriaceae (79%)...
June 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/27334479/the-role-of-the-model-of-end-stage-liver-disease-score-in-predicting-outcomes-of-carotid-endarterectomy
#19
Brianna M Krafcik, Alik Farber, Mohammad H Eslami, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Elizabeth G King, Jeffrey J Siracuse
OBJECTIVES: The Model of End-Stage Liver Disease (MELD) score has been traditionally utilized to prioritize for liver transplantation; however, recent literature has shown its value in predicting surgical outcomes for patients with hepatic dysfunction. The benefit of carotid endarterectomy in asymptomatic patients is dependent on low perioperative morbidity. Our objective was to use MELD score to predict outcomes in asymptomatic patients undergoing carotid endarterectomy. METHODS: Patients undergoing carotid endarterectomy were identified in the National Surgical Quality Improvement Program data sets from 2005 to 2012...
August 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27313857/hepatic-schwannoma-a-case-report-and-an-updated-40-year-review-of-the-literature-yielding-30-cases
#20
DA-Long Wan, Zheng-Long Zhai, Kui-Wu Ren, Yun-Chuan Yang, Sheng-Zhang Lin, Shu-Sen Zheng
Hepatic schwannoma is a rare benign disease with a good prognosis. Early diagnosis is difficult due to the absence of specific clinical presentations and its rarity. The present study briefly described a 64-year-old female patient with hepatic schwannoma mimicking intrahepatic cholangiocarcinoma. Furthermore, the clinical data of 30 patients with hepatic schwannoma were also reviewed and analyzed. The mean age of the 30 patients was 51.7 years (range, 21-83 years) and ~2/3 were female. All patients in the benign group underwent surgical treatment and survived until the last follow-up, of whom 19 received complete resection and the remaining 1 underwent liver transplantation...
June 2016: Molecular and Clinical Oncology
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