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liver transplantation postoperative mortality and treatment

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
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
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
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
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
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
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
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
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
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
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
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
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
Servet Karagul, Mehmet Ali Yagci, Ali Tardu, Ismail Ertugrul, Serdar Kirmizi, Fatih Sumer, Burak Isik, Cuneyt Kayaalp, Sezai Yilmaz
BACKGROUND Idiopathic noncirrhotic portal hypertension (INCPH) is a rare disease characterized by increased portal venous pressure in the absence of cirrhosis and other causes of liver diseases. The aim of the present study was to present our results in using portosystemic shunt surgery in patients with INCPH. MATERIAL AND METHODS Patients who had been referred to our Liver Transplantation Institute for liver transplantation and who had undergone surgery from January 2010 to December 2015 were retrospectively analyzed...
May 19, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Brianna M Krafcik, Alik Farber, Mohammad H Eslami, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Nishant K Shah, Jeffrey J Siracuse
OBJECTIVE: The Model for End-Stage Liver Disease (MELD) score has traditionally been used to prioritize liver transplantation. However, its use has been extended to predict overall and postoperative outcomes in patients with hepatic and renal dysfunction. Our objective was to use the MELD score to predict outcomes in patients undergoing lower extremity bypass. METHODS: Patients undergoing infrainguinal bypass were identified in the American College of Surgeons National Surgical Quality Improvement Program data sets from 2005 to 2012...
July 2016: Journal of Vascular Surgery
V Murthy, D Murray, S Hebballi, S Bramhall, W Lester, D Mutimer, J Wilde
INTRODUCTION: Patients with hereditary bleeding disorders who have developed end-stage liver disease as a consequence of hepatitis C infection (HCV) acquired from factor concentrates prior to the introduction of viral inactivation continue to be referred for liver transplantation. METHODS: A retrospective review of case notes and electronic records was performed on all patients with bleeding disorders who have undergone liver transplantation at the University Hospital Birmingham (UHB)...
May 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
Z Milan, C Taylor, D Armstrong, P Davies, S Roberts, B Rupnik, A Suddle
OBJECTIVE: We compared the intraoperative hemodynamic profiles and outcomes of liver transplant (LT) patients receiving preoperative beta-blockers for portal hypertension with those of patients not receiving beta-blockers. METHODS: Beat-to-beat hemodynamic data were recorded with the use of a lithium dilution cardiac output monitor, including heart rate (HR), cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR), SVR index, mean arterial pressure, stroke volume (SV), and SV index...
January 2016: Transplantation Proceedings
Laurence Weinberg, Jeremy Broad, Param Pillai, Guangjun Chen, Micheline Nguyen, Glenn M Eastwood, Nick Scurrah, Mehrdad Nikfarjam, David Story, Larry McNicol, Rinaldo Bellomo
BACKGROUND: Liver transplantation-associated acute kidney injury (AKI) carries significant morbidity and mortality. We hypothesized that sodium bicarbonate would reduce the incidence and/or severity of liver transplantation-associated AKI. METHODS: In this double-blinded pilot RCT, adult patients undergoing orthotopic liver transplantation were randomized to an infusion of either 8.4% sodium bicarbonate (0.5 mEq/kg/h for the first hour; 0.15 mEq/kg/h until completion of surgery); (n = 30) or 0...
May 2016: Clinical Transplantation
Rebeca Sanabria Mateos, Niamh M Hogan, Dimitri Dorcaratto, Helen Heneghan, Venkatesh Udupa, Donal Maguire, Justin Geoghegan, Emir Hoti
AIM: To evaluate the outcomes of two-stage liver transplant at a single institution, between 1993 and March 2015. METHODS: We reviewed our institutional experience with emergency hepatectomy followed by transplantation for fulminant liver failure over a twenty-year period. A retrospective review of a prospectively maintained liver transplant database was undertaken at a national liver transplant centre. Demographic data, clinical presentation, preoperative investigations, cardiocirculatory parameters, operative and postoperative data were recorded...
February 8, 2016: World Journal of Hepatology
Sung-Hoon Kim, Young-Jin Moon, Sooho Lee, Sung-Moon Jeong, Jun-Gol Song, Gyu-Sam Hwang
Hemodynamic perturbation during hepatic graft reperfusion in patients undergoing liver transplantation (LT) is challenging and is frequently accompanied by bradyarrhythmia and even asystole. However, detailed data on electrocardiographic (ECG) changes during reperfusion are almost nonexistent, although the correct diagnosis by record is important for the treatment. We aimed to identify ECG rhythm disturbances during graft reperfusion and to investigate risk factors and outcomes. Data from 1065 consecutive patients who underwent adult LT were analyzed...
July 2016: Liver Transplantation
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