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liver transplantation postoperative mortality and treatment

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https://www.readbyqxmd.com/read/29025297/liver-transplantation-in-patients-with-cardiac-disease
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28761617/hepatocellular-carcinoma-a-clinicopathological-study-of-64-cases
#7
Faten Limaiem, Marwa Bouhamed, Ghada Sahraoui, Sabeh Mzabi
Hepatocellular carcinoma (HCC) is the most common of all liver cancers and is a major worldwide public health problem. The aim of this study was to provide an updated overview on clinicopathological features, treatment and outcome of HCC. In our retrospective study, we reviewed 64 cases of HCC that were diagnosed at the pathology department of Mongi Slim hospital over a fifteen-year period (2000- 2014). Relevant clinical information and microscopic slides were retrospectively reviewed. Our study group included 38 men and 26 women (sex ratio M/F = 1,26) aged between 8 and 83 years (mean = 56,64 years)...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28746468/ischemic-preconditioning-vs-adenosine-vs-prostaglandin-e1-for-protection-against-liver-ischemia-reperfusion-injury
#8
M Radojkovic, M Stojanovic, G Stanojevic, D Radojkovic, J Gligorijevic, I Ilic, N Stojanovic
Ischemia/reperfusion injury is still a major cause of morbidity and mortality during liver surgery and transplantation. A variety of surgical and pharmacological therapeutic strategies have been investigated to minimize the effects of ischemia/reperfusion. The aim of our study was to analyze and compare preventive influences of ischemic preconditioning, adenosine and prostaglandin E1 in the experimental model of hepatic ischemia/reperfusion injury. Adult chinchilla rabbits were divided into four groups: 10 rabbits subjected to liver ischemic preconditioning (3-min period of inflow occlusion followed by a 5-min period of reperfusion) followed by 45 min of Pringle maneuver; 10 rabbits subjected to pre-treatment with intraportal injection of adenosine followed by 45 min of Pringle maneuver; 10 rabbits subjected to pre-treatment with intraportal injection of prostaglandin E1 followed by 45 min of Pringle maneuver; and control group of 10 rabbits subjected to 45 min of inflow liver ischemia without any preconditioning...
July 20, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28697720/early-onset-pneumonia-after-liver-transplant-microbial-causes-risk-factors-and-outcomes-mansoura-university-egypt-experience
#9
Mohammad Khairy El-Badrawy, Raed El-Metwaly Ali, Amr Yassen, Mohammad Ahmad AbouElela, Rehab Ahmad Elmorsey
OBJECTIVES: Pneumonia has a negative effect on the outcome of liver transplant. Our aim was to analyze early-onset pneumonia that developed within the first month after transplant. MATERIALS AND METHODS: This prospective single-center study included 56 adult living-donor liver transplant recipients; those who developed early-onset pneumonia based on clinical and radiologic criteria were investigated as to causative pathogens and then followed up and compared with other recipients without pneumonia to illustrate risk factors, outcomes, and related mortality of posttransplant pneumonia...
October 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28675358/living-donor-liver-transplantation
#10
Birkan Bozkurt, Murat Dayangac, Yaman Tokat
In 50 years after the first liver transplantation, the medical world has witnessed the liver transplantation to become one of the widely recognized and leading branches of surgery. In this period, liver transplantation combined with surgical technique, patient selection, advancements in anesthesia and postoperative care and increased experience has become the most effective treatment option in treatment of several acute and chronic liver diseases. Yet, the worldwide organ restriction and associated high mortality rates in organ transplantation waiting list has compelled referring to living donors in order to expand the donor pool...
May 2017: Chirurgia
https://www.readbyqxmd.com/read/28641515/the-development-of-stem-cell-based-treatment-for-liver-failure
#11
Tiantian Zhu, Yuwen Li, Yusheng Guo, Chuanlong Zhu
BACKGROUND: Liver failure is a devastating clinical syndrome with a persistently mortality rate despite advanced care. Orthotopic liver transplantation protected patients from hepatic failure. Yet, limitations including postoperative complications, high costs, and shortages of donor organs defect its application. The development of stem cell therapy complements the deficiencies of liver transplantation, due to the inherent ability of stem cells to proliferate and differentiate. OBJECTIVE: Understand the source of stem cells, as well as the advantages and disadvantages of stem cell therapy...
2017: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28503555/surgical-options-for-intrahepatic-cholangiocarcinoma
#12
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
#13
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...
September 1, 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
#14
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
#15
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
#16
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
#17
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
#18
Jonas Roller, Matthias Glanemann
No abstract text is available yet for this article.
July 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
#19
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
#20
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
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