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liver transplantation postoperative mortality and treatment

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https://www.readbyqxmd.com/read/29649828/risk-analysis-for-invasive-fungal-infection-after-living-donor-liver-transplantation-which-patient-needs-potent-prophylaxis
#1
Masashi Utsumi, Yuzo Umeda, Takahito Yagi, Takeshi Nagasaka, Susumu Shinoura, Ryuich Yoshida, Daisuke Nobuoka, Takashi Kuise, Tomokazu Fuji, Kosei Takagi, Akinobu Takaki, Toshiyoshi Fujiwara
BACKGROUND: Invasive fungal infection (IFI) is associated with high mortality after living donor liver transplant (LDLT). The aim of this study was to identify the risk factors for post-LDLT IFI for early diagnosis and improvement of antifungal treatment outcome. METHODS: Risk analysis data were available for all 153 patients who underwent LDLT between January 2005 and April 2012. RESULTS: During the follow-up period (1,553 ± 73 days, range 20-2,946 days), 15 patients (9...
April 12, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29596092/the-impact-of-postreperfusion-syndrome-on-acute-kidney-injury-in-living-donor-liver-transplantation-a-propensity-score-analysis
#2
In-Gu Jun, Hye-Mee Kwon, Kyeo-Woon Jung, Young-Jin Moon, Won-Jung Shin, Jun-Gol Song, Gyu-Sam Hwang
BACKGROUND: Postreperfusion syndrome (PRS) has been shown to be related to postoperative morbidity and graft failure in orthotopic liver transplantation. To date, little is known about the impact of PRS on the prevalence of postoperative acute kidney injury (AKI) and the postoperative outcomes after living donor liver transplantation (LDLT). The purpose of our study was to determine the impact of PRS on AKI and postoperative outcomes after LDLT surgery. METHODS: Between January 2008 and October 2015, we retrospectively collected and evaluated the records of 1865 patients who underwent LDLT surgery...
March 27, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29528013/early-postoperative-infections-after-liver-transplant
#3
Ebru H Ayvazoglu Soy, Aydincan Akdur, Sedat Yildirim, Hande Arslan, Mehmet Haberal
OBJECTIVES: Despite surgical advances and effective prophylactic strategies in liver transplant, infection is still a major cause of morbidity and mortality. Up to 80% of liver recipients will develop at least 1 infection during the first year after liver transplant. The spectrum and manifestations of these infections are broad and variable. Their diagnosis and treatment are often delayed because immunosuppressive therapy diminishes inflammatory responses. However, if an infection is not identified early enough and treated properly, it can have devastating consequences...
March 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29520204/laparoscopic-parenchyma-sparing-liver-resection-for-colorectal-metastases
#4
Davit L Aghayan, Egidijus Pelanis, Åsmund Avdem Fretland, Airazat M Kazaryan, Mushegh A Sahakyan, Bård I Røsok, Leonid Barkhatov, Bjørn Atle Bjørnbeth, Ole Jakob Elle, Bjørn Edwin
Background: Laparoscopic liver resection (LLR) of colorectal liver metastases (CLM) is increasingly performed in specialized centers. While there is a trend towards a parenchyma-sparing strategy in multimodal treatment for CLM, its role is yet unclear. In this study we present short- and long-term outcomes of laparoscopic parenchyma-sparing liver resection (LPSLR) at a single center. Patients and methods: LLR were performed in 951 procedures between August 1998 and March 2017 at Oslo University Hospital, Oslo, Norway...
March 2018: Radiology and Oncology
https://www.readbyqxmd.com/read/29455437/live-donor-liver-transplantation-for-acute-liver-failure-a-single-center-experience
#5
Siddharth Mehrotra, Naimish Mehta, Prashantha S Rao, Shailendra Lalwani, Vivek Mangla, Samiran Nundy
INTRODUCTION: Acute liver failure (ALF) is an indication for emergency liver transplantation (LT). Although centers performing only deceased donor liver transplants (DDLT) have shown improved outcomes in this situation, they still have relatively long waiting lists. An alternative would be living donor liver transplantation (LDLT), which has shown equivalent outcomes in the elective situation but there is limited evidence of its results in ALF. AIM: The purpose of this study was to assess the outcomes in patients with ALF undergoing emergency LDLT in our center in Delhi, India...
February 17, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29417353/perioperative-management-with-phosphodiesterase-type-5-inhibitor-and-prostaglandin-e1-for-moderate-portopulmonary-hypertension-following-adult-to-adult-living-donor-liver-transplantation-a-case-report
#6
Takashi Onoe, Asuka Tanaka, Kohei Ishiyama, Kentaro Ide, Hirotaka Tashiro, Hideki Ohdan
BACKGROUND: Portopulmonary hypertension (PPH) is a relatively rare but well-recognized complication of end-stage liver disease. Moderate or severe PPH (mean pulmonary artery pressure [mPAP] ≥ 35 mmHg) is usually a contraindication for liver transplantation due to high operation-related mortality. Here, we report on a patient with moderate PPH whose condition was successfully managed with a phosphodiesterase type 5 (PDE5) inhibitor (tadalafil) and prostaglandin E1, who experienced rapid improvement of PPH after living-donor liver transplantation (LDLT)...
February 7, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29379006/long-term-outcomes-of-ante-situm-resection-and-auto-transplantation-in-conventionally-unresectable-hepatocellular-carcinoma-a-single-center-experience
#7
Qifa Ye, Cheng Zeng, Yanfeng Wang, Yingzi Ming, Qiquan Wan, Shaojun Ye, Yan Xiong, Ling Li
BACKGROUND Ante-situm resection and auto-transplantation (ante-situm for short) provides a more aggressive approach to conventionally unresectable hepatocellular carcinoma (HCC). We described the long-term outcomes of patients with HCCs who underwent this technique. MATERIAL AND METHODS Between October 2005 and December 2016, we performed 23 ante-situm liver resections. We evaluated postoperative complications, 90-day mortality, recurrence, and long-term survival rates, and reviewed the literature on this topic...
January 30, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29363019/liver-transplantation-and-liver-resection-for-cirrhotic-patients-with-hepatocellular-carcinoma-comparison-of-long-term-survivals
#8
Felix Krenzien, Moritz Schmelzle, Benjamin Struecker, Nathanael Raschzok, Christian Benzing, Maximilian Jara, Marcus Bahra, Robert Öllinger, Igor M Sauer, Andreas Pascher, Johann Pratschke, Andreas Andreou
BACKGROUND: Both liver transplantation (LT) and liver resection (LR) represent curative treatment options for hepatocellular carcinoma (HCC) in patients with liver cirrhosis. In this study, we have compared outcomes between historical and more recent patient cohorts scheduled either for LT or LR, respectively. METHODS: Clinicopathological data of all patients with HCC and cirrhosis who underwent LT or LR between 1989 and 2011 were evaluated. Overall survival of patients with HCC within the Milan criteria (MC) was analyzed focusing on changes between different time periods...
January 23, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29287582/acute-pancreatitis-a-rare-but-serious-complication-for-living-liver-donors-risk-factors-and-outcomes
#9
Adil Baskiran, Metin Kement, Bora Barut, Oguzhan Ozsay, Serdar Karakas, Cemalettin Koç, Sezai Yilmaz
OBJECTIVES: The purposes of this study were to determine the incidence of acute pancreatitis after living donor hepatectomy and to investigate potential risk factors and outcomes. MATERIALS AND METHODS: Clinical data of all donors who underwent donor hepatectomy between January 2015 and December 2016 in our liver transplant institute were reviewed. Donor data were obtained from a prospectively maintained database. The donors were divided into 2 groups according to whether they developed postoperative pancreatitis...
December 29, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29198690/preexisting-cerebral-aspergillosis-successfully-treated-after-liver-transplantation-a-case-report
#10
J S Lee, S-H Kim, J H Kwon, Y C Yoon
BACKGROUND: Invasive aspergillosis (IA) is a rare condition that generally affects immunosuppressed patients. The mortality of IA is known to be >90% in liver transplantation (LT) recipients; the lung is the most commonly affected organ, followed by the brain. There have been reports in the literature of cerebral aspergillosis (CA) in LT recipients. In all previous reports, CA developed after LT. We present the first case (to the best of our knowledge) of preexisting CA diagnosed and successfully treated after LT...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29174777/cardiac-surgery-outcomes-in-abdominal-solid-organ-transplant-recipients
#11
Takushi Kohmoto, Satoru Osaki, Dixon B Kaufman, Glen Leverson, Nilto DeOliveira, Shahab A Akhter, Susan Ulschmid, Lucian Lozonschi, Entela B Lushaj
BACKGROUND: Cardiovascular disease is a cause of morbidity and mortality in organ transplant recipients. Cardiac surgery after organ transplantation is not uncommon in this population. We evaluated 30-day outcomes and long-term survival of abdominal transplant recipients undergoing cardiac surgery at our institution. METHODS: In all, 138 patients with previous kidney, kidney-pancreas, and liver transplants underwent cardiac surgery from 2000 to 2016. Propensity score (ratio 1:3) matched 115 abdominal transplant with 345 patients undergoing cardiac surgery without a history of abdominal transplant...
March 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29171131/cpap-by-helmet-for-treatment-of-acute-respiratory-failure-after-pediatric-liver-transplantation
#12
F Chiusolo, V Fanelli, M L Ciofi Degli Atti, G Conti, F Tortora, R Pariante, L Ravà, C Grimaldi, J de Ville de Goyet, S Picardo
ARF after pediatric liver transplantation accounts for high rate of morbidity and mortality associated with this procedure. The role of CPAP in postoperative period is still unknown. The aim of the study was to describe current practice and risk factors associated with the application of helmet CPAP. In this retrospective observational cohort study, 119 recipients were divided into two groups based on indication to CPAP after extubation. Perioperative variables were studied, and determinants of CPAP application were analyzed in a multivariate logistic model...
February 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29106285/liver-kidney-simultaneous-transplantation-in-adult-patients-with-primary-hyperoxaluria-experience-at-hospital-universitario-12-de-octubre
#13
Javier Martínez Caballero, Alberto Marcacuzco Quinto, Iago Justo Alonso, Oana Anisa Nutu, Alejandro Manrique Municio, Jorge Calvo Pulido, Félix Cambra Molero, Óscar Caso Maestro, Carlos Jiménez Romero
Primary hyperoxaluria (PH) is a metabolic liver disease with an autosomal recessive inheritance that results in oxalate overproduction that cannot be metabolized by the liver. Urinary excretion of oxalate results in lithiasis and nephrocalcinosis leading to a progressive loss of renal function that often requires renal replacement therapy despite medical treatment. Type 1 PH is the most common form and is due to a deficiency in the alanine-glycolate aminotransferase enzyme found in hepatic peroxisomes. Therefore, a liver-kidney simultaneous transplant (LKST) is the definitive treatment for end-stage renal disease (ESRD) patients...
February 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29077657/does-portopulmonary-hypertension-impede-liver-transplantation-in-cirrhotic-patients-a-french-multicentric-retrospective-study
#14
Maud Reymond, Louise Barbier, Ephrem Salame, Camille Besh, Jerome Dumortier, Georges-Philippe Pageaux, Christophe Bureau, Sébastien Dharancy, Claire Vanlemmens, Armand Abergel, Marie-Lorraine Woehl Jaegle, Pascal Magro, Frederic Patat, Emeline Laurent, Jean-Marc Perarnau
BACKGROUND: Portopulmonary hypertension is defined by the presence of pulmonary arterial hypertension associated with portal hypertension. Its presence is a major stake for cirrhotic patients requiring liver transplantation, with increased postoperative mortality and unpredictable evolution after transplantation. The aim was to study outcomes after liver transplantation in patients with portopulmonary hypertension and to identify factors associated with normalization of pulmonary hypertension...
October 26, 2017: Transplantation
https://www.readbyqxmd.com/read/29025297/liver-transplantation-in-patients-with-cardiac-disease
#15
Christopher L Wray
Liver transplantation (LT) is a unique surgical procedure that has major hemodynamic and cardiovascular implications. Recently, there has been significant interest focused on cardiovascular issues that affect LT patients in all phases of the perioperative period. The preoperative cardiac evaluation is a major step in the selection of LT candidates. LT candidates are aging in concordance with the general population; cardiovascular disease and their risk factors are highly associated with older age. Underlying cardiovascular disease has the potential to affect outcomes in LT patients and has a major impact on candidate selection...
October 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29019744/pediatric-liver-transplant-techniques-and-complications
#16
Natally Horvat, Antonio Sergio Zafred Marcelino, Joao Vicente Horvat, Tássia Regina Yamanari, Jose de Arimateia Batista Araújo-Filho, Pedro Panizza, Joao Seda-Neto, Eduardo Antunes da Fonseca, Francisco Cesar Carnevale, Luciana Mendes de Oliveira Cerri, Paulo Chapchap, Giovanni Guido Cerri
Liver transplant is considered to be the last-resort treatment approach for pediatric patients with end-stage liver disease. Despite the remarkable advance in survival rates, liver transplant remains an intricate surgery with significant morbidity and mortality. Early diagnosis of complications is crucial for patient survival but is challenging given the lack of specificity in clinical presentation. Knowledge of the liver and vascular anatomy of the donor and the recipient or recipients before surgery is also important to avoid complications...
October 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29018070/hypothermic-oxygenated-machine-perfusion-hope-for-orthotopic-liver-transplantation-of-human-liver-allografts-from-extended-criteria-donors-ecd-in-donation-after-brain-death-dbd-a-prospective-multicentre-randomised-controlled-trial-hope-ecd-dbd
#17
Zoltan Czigany, Wenzel Schöning, Tom Florian Ulmer, Jan Bednarsch, Iakovos Amygdalos, Thorsten Cramer, Xavier Rogiers, Irinel Popescu, Florin Botea, Jiří Froněk, Daniela Kroy, Alexander Koch, Frank Tacke, Christian Trautwein, Rene H Tolba, Marc Hein, Ger H Koek, Cornelis H C Dejong, Ulf Peter Neumann, Georg Lurje
INTRODUCTION: Orthotopic liver transplantation (OLT) has emerged as the mainstay of treatment for end-stage liver disease. In an attempt to improve the availability of donor allografts and reduce waiting list mortality, graft acceptance criteria were extended increasingly over the decades. The use of extended criteria donor (ECD) allografts is associated with a higher incidence of primary graft non-function and/or delayed graft function. As such, several strategies have been developed aiming at reconditioning poor quality ECD liver allografts...
October 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28863026/transfusion-of-older-red-blood-cells-increases-the-risk-of-acute-kidney-injury-after-orthotopic-liver-transplantation-a-propensity-score-analysis
#18
Yue Wang, Qingshan Li, Tao Ma, Xuemin Liu, Bo Wang, Zheng Wu, Shaonong Dang, Yi Lv, Rongqian Wu
BACKGROUND: Acute kidney injury (AKI) is a common and serious complication of orthotopic liver transplantation (OLT). Transfusion of older red blood cells (RBCs) has been implicated in poor outcomes in trauma, cardiac surgery, and critically ill patients. However, whether transfusion of older RBCs plays any role in post-OLT AKI remained unknown. The aim of this study was to investigate the effect of the age of transfused RBCs on post-OLT AKI. METHODS: The clinical data of consecutive adult patients who received donation after cardiac death and underwent OLT from December 2011 to December 2015 were analyzed...
August 31, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28860900/portal-vein-stenting-for-delayed-jejunal-varix-bleeding-associated-with-portal-venous-occlusion-after-hepatobiliary-and-pancreatic-surgery
#19
Dongho Hyun, Kwang Bo Park, Sung Ki Cho, Hong Suk Park, Sung Wook Shin, Sung Wook Choo, Young Soo Do, In Wook Choo, Dong Wook Choi
OBJECTIVE: The study aimed to describe portal stenting for postoperative portal occlusion with delayed (≥ 3 months) variceal bleeding in the afferent jejunal loop. MATERIALS AND METHODS: Eleven consecutive patients (age range, 2-79 years; eight men and three women) who underwent portal stenting between April 2009 and December 2015 were included in the study. Preoperative medical history and the postoperative clinical course were reviewed. Characteristics of portal occlusion and details of procedures were also investigated...
September 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28834141/fatal-graft-versus-host-disease-after-living-donor-liver-transplantation-from-an-hla-dr-mismatched-donor
#20
Keita Shimata, Rieko Sakamoto, Tadashi Anan, Koushi Uchida, Masaki Honda, Masahiko Kouroki, Tomonari Urabe, Shintaro Hayashida, Hidekazu Yamamoto, Yasuhiko Sugawara, Yukihiro Inomata
Acute GVHD is a rare complication after liver transplantation that has a high mortality rate. We experienced an infant case complicated with acute GVHD. An 8-month-old infant with biliary atresia underwent LDLT with a graft obtained from his mother. Their HLAs showed a donor-dominant one-way match, not at HLA-DR but at HLA-A, HLA-B, and HLA-C (recipient; A 31/33, B 51/54, C 1/14, DR 9/11, donor; A 31/-, B 51/-, C 14/-, DR 8/11). The patient exhibited a high fever, skin rash, and diarrhea, and was diagnosed with acute GVHD based on the blood chimerism test...
November 2017: Pediatric Transplantation
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