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liver transplantation postoperative mortality and treatment

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...
October 11, 2016: 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...
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
Hao Li, Ming-Qi Fan, Tong-Yi Men, Yun-Peng Wang, Tong-Hai Xing, Jun-Wei Fan, Zhi-Hai Peng, Lin Zhong
BACKGROUND: The number and survival rate of simultaneous liver-kidney transplant (SLKT) recipients have increased dramatically since 2002. However, the long-term effectiveness of SLKT in patients with hepatitis B is unknown. MATERIAL/METHODS: Forty-six patients who visited the Organ Transplant Center of the Shanghai First People's Hospital between January 2001 and May 2005 had hepatitis B virus infection and renal failure (any degree), and underwent organ transplantation: 21 patients underwent SLKT and 25 patients underwent liver transplant (LT) alone...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Baltasar Pérez-Saborido, Enrique Asensio-Díaz, Asterio Barrera-Rebollo, Mario Rodríguez-López, Marta Gonzalo-Martín, Beatriz Madrigal-Rubiales, Félix García-Pajares, David Pacheco-Sánchez
UNLABELLED: The graft versus host disease after liver transplant is rare, with an incidence less than 1%, but with a high mortality (75-85%), especially due to infectious complications. It usually affects gastrointestinal tract, skin and blood system in the context of a normal liver graft function. There is no consensus on the most appropriate treatment: some articles support a reduction or even elimination of immunosuppressive drugs, while others published success with a dose increase...
January 2016: Revista Española de Enfermedades Digestivas
Tokan Sultanaliev, Assan Zhexembayev, Adilbek Mukazhanov, Bakhyt Zharkymbekov, Gani Kuttymuratov, Zhanat Spatayev, Bauyrzhan Ibrayev, Kakharman Yesmembetov, Aiymkul Ashimkhanova, Mels Asykbayev
OBJECTIVES: Kazakhstan is experiencing a high demand for liver transplants. More than 1000 patients have end-stage liver disease in the country, and liver transplant is the only viable option for their treatment. MATERIALS AND METHODS: Liver transplant patients, treated from February 2013 to December 2014, were included in this retrospective analysis. RESULTS: From February 2013 to December 2014, seven patients received a liver transplant in our center (1 pediatric patient was excluded)...
November 2015: Experimental and Clinical Transplantation
Gaye Ulubay, Mahir Kirnap, Balam Er Dedekarginoglu, Elif Kupeli, Fusun Oner Eyuboglu, Mehmet Haberal
OBJECTIVES: Cardiovascular and respiratory system complications are the most common causes of early mortality after liver transplant. We evaluated the causes of respiratory failure as an early postoperative pulmonary complication in liver transplant recipients. MATERIALS AND METHODS: Patients who underwent orthotropic liver transplant between 2001 and 2014 were retrospectively evaluated. Clinical and demographic variables and pulmonary complications at the first and second visit after transplant were noted...
November 2015: Experimental and Clinical Transplantation
Sung-Moon Jeong
As surgical and graft preservation techniques have improved and immunosuppressive drugs have advanced, liver transplantation (LT) is now considered the gold standard for treating patients with end-stage liver disease worldwide. However, despite the improved survival following LT, severe hemodynamic disturbances during LT remain a serious issue for the anesthesiologist. The greatest hemodynamic disturbance is postreperfusion syndrome (PRS), which occurs at reperfusion of the donated liver after unclamping of the portal vein...
December 2015: Korean Journal of Anesthesiology
Shaohua Ge, Dingzhi Huang
Hepatocellular carcinoma (HCC) is a common cancer with high incidence and mortality worldwide. The main treatments for HCC include radical hepatectomy, liver transplant, locoregional therapies, and systemic therapies. Systemic treatments include targeted agent treatment, chemotherapies, antiviral therapies, and nutritional treatments. According to the results of SHARP and ORIENTAL study, sorafenib became the standard first-line therapy since 2008 because of nearly three months of survival improvement in patients with advanced HCC...
October 2015: Drug Discoveries & Therapeutics
H M Hau, M Schmelzle, C Benzing, R Ascherl, H M Tautenhahn, G Gäbelein, U Eichfeld, M Bartels
BACKGROUND: The role of surgery in the treatment of metastasized hepatocellular carcinoma (HCC) remains uncertain. We here report our single centre experience with pulmonary metastasectomy (PM) for metachronous HCC metastases to the lung following curative liver resection (LR) and liver transplantation (LT), respectively. METHODS: Of 270 patients with HCC being treated by LR or LT at the University Hospital of Leipzig between January 1996 and July 2014, PM was performed in the follow up of 10 patients because of metachronous pulmonary HCC metastases...
January 2016: Zeitschrift Für Gastroenterologie
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