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Liver transplant surgery rejection hepatic

José Ruiz Pardo, Pedro Antonio Cascales Campos, Pascual Parrilla Paricio
The indication for liver transplantation in patients with history of lymphoma is little-known, and the references documented in the medical literature are still limited. We present the case of a 63-year-old man who was diagnosed with chronic hepatopathy due to HBV 15 years ago. He was operated on for hepatocellular carcinoma in the segment VI of the liver 4 years ago, finding a macronodular liver cirrhosis during the surgery. Fifteen months later, the patient was diagnosed with diffuse large B-cell gastric lymphoma (fig...
June 2016: Revista Española de Enfermedades Digestivas
Yakun Wu, Yiming Liu, Jianping Gong, Shengwei Li, Wei Zhang
BACKGROUND: This study aimed to investigate the efficacy of hepatitis B surface antigen (HBsAg)-pulsed dendritic cell (DC) complex in the induction and maintenance of anti-HBs in immunosuppressed rats after liver transplantation. MATERIAL AND METHODS: Lewis-Brown Norway (BN) rat liver transplantation models were successfully established. Recipients were injected with tacrolimus (2 mg/Kg) daily post-operation for three months to maintain immunosuppression state; the recipients were then randomly divided into two groups: HBsAg-DC group (n=15) comprised rats intraperitoneally injected with HBsAg-DC complex at 14 and 28 d post-surgery and HBsAg group (n=15) comprised rats injected with HBsAg (200 μL) once a week for 12 weeks...
2015: Annals of Transplantation: Quarterly of the Polish Transplantation Society
C E Koval, A Khanna, A Pallotta, M Spinner, A J Taege, B Eghtesad, M Fujiki, K Hashimoto, B Rodriguez, G Morse, A Bennett, K Abu-Elmagd
The continual improvement in outcome with highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV) infection and visceral transplantation for gut failure stimulated our interest in lifting HIV infection as a contraindication for intestinal and multivisceral transplantation. This report is the first to describe visceral transplantation in a patient with HIV infection. A HAART regimen was introduced in the setting of short-gut syndrome with successful suppression of HIV viral load. The indication for en bloc multivisceral and kidney transplantation was end-stage liver failure with portomesenteric venous thrombosis and chronic renal insufficiency...
January 2016: American Journal of Transplantation
S Ng, K A L Tan, G Anil
The evolution of liver transplantation (LT) from an unusual procedure to a practical therapeutic option for patients with life-threatening liver diseases has brought with it several unique challenges. Although the patient survival rates have been steadily improving, with more complex surgeries being performed and increasing duration of graft survival, the overall post LT complication rate continues to stay high. They include inflow complications related to portal vein (PV) or hepatic artery, outflow complications related to hepatic vein or inferior vena cava, biliary leaks or strictures, postoperative collections or abscesses, graft rejection or post-transplant malignancy...
December 2015: Clinical Radiology
Saiho Ko, Hisanao Chisuwa, Masanori Matsumoto, Yoshihiro Fujimura, Eiji Okano, Yoshiyuki Nakajima
A disintegrin-like and metalloproteinase with thrombospondin type-1 motifs 13 (ADAMTS13) specifically cleaves unusually-large von Willebrand factor (VWF) multimers under high shear stress, and down-regulates VWF function to form platelet thrombi. Deficiency of plasma ADAMTS13 activity induces a life-threatening systemic disease, termed thrombotic microangiopathy (TMA) including thrombotic thrombocytopenic purpura (TTP). Children with advanced biliary cirrhosis due to congenital biliary atresia sometimes showed pathological features of TMA, with a concomitant decrease of plasma ADAMTS13 activity...
July 8, 2015: World Journal of Hepatology
Peixian Chen, Wentao Wang, Lunan Yan, Jiayin Yang, Tianfu Wen, Bo Li, Jichun Zhao, Mingqing Xu
OBJECTIVE: To investigate the frequency of and the risk factors for hospital readmission within the first year after liver transplantation (LT). MATERIALS AND METHODS: Between January 1999 and August 2013, LTs were performed in 890 adult patients at our center. We collected medical data from the Chinese Liver Transplant Registry and performed a retrospective review of the medical records of these patients. We aimed to identify the factors that contribute toward readmission during the first year after LT...
May 2015: European Journal of Gastroenterology & Hepatology
Yoshihiko Kawano, Michio Suzuki, Jun-ichi Kawada, Hiroshi Kimura, Hideya Kamei, Yasuharu Ohnishi, Yasuyuki Ono, Hiroo Uchida, Yasuhiro Ogura, Yoshinori Ito
BACKGROUND: Liver transplantation recipients are at high risk for severe complications due to infections because of being treated with immunosuppressive drugs that affect the immune system. Vaccination for liver transplantation candidates is generally recommended before surgery, but the opportunities for vaccination prior to transplantation in pediatric candidates are often limited by severe disease conditions. METHODS: The participants in this study comprised 39 pediatric recipients of living donor liver transplantation performed between 2005 and 2013...
March 17, 2015: Vaccine
Julius Metts, Lesley Carmichael, Winfred Kokor, Robert Scharffenberg
Hepatitis C virus (HCV)-related cirrhosis and hepatocellular carcinoma account for approximately 40% of the 6,000 adult liver transplantations performed each year in the United States. Survival rates are 76% to 83% at 2 years and 69% to 72% at 5 years. If eligible for surgery and in the absence of contraindications, any patient with HCV infection who develops decompensated liver disease or hepatocellular carcinoma is a candidate for liver transplantation. Most transplantation programs require that a patient with a history of alcohol or drug abuse be abstinent for at least 6 months and active in a substance abuse rehabilitation program...
December 2014: FP Essentials
Yakun Wu, Yunbing Wang, Min Li, Xiaoli Yang, Jianping Gong, Wei Zhang
The aim of the present study was to investigate the mechanism by which gadolinium chloride (GdCl3) inhibits Kupffer cell (KC) activation and its ability to suppress acute rejection and induce tolerance following liver transplantation in rats. Rats were randomly divided into control, liver transplantation with GdCl3 pretreatment and liver transplantation with normal saline pretreatment groups. The survival rate, liver function, hepatic pathological histology, cytokine levels in the liver and bile, activity of nuclear factor κ-light-chain-enhancer of activated B cells (NF-κB) in KCs, and expression levels of membranous molecules on the KCs were observed...
December 2014: Experimental and Therapeutic Medicine
Gemma Sanclemente, Asuncion Moreno, Miquel Navasa, Francisco Lozano, Carlos Cervera
Infection is the leading cause of complication after liver transplantation, causing morbidity and mortality in the first months after surgery. Allograft rejection is mediated through adaptive immunological responses, and thus immunosuppressive therapy is necessary after transplantation. In this setting, the presence of genetic variants of innate immunity receptors may increase the risk of post-transplant infection, in comparison with patients carrying wild-type alleles. Numerous studies have investigated the role of genetic variants of innate immune receptors and the risk of complication after liver transplantation, but their results are discordant...
August 28, 2014: World Journal of Gastroenterology: WJG
Marek Szymczak, Piotr Kaliciński, Wojciech Kwiatkowski, Dorota Broniszczak, Marek Stefanowicz
BACKGROUND: Cavo-portal transposition (CPT) at liver transplantation (LTx) allows portal revascularization of the liver in recipients in whom portal system thrombosis does not allow performance of porto-portal anastomosis. The aim was to present the cases of 2 children who underwent LTx and CPT in our institution. CASE REPORT: 1. A 10-year-old boy, after Kasai procedure and living donor LTx, was qualified for retransplantation 9 years after first LTx complicated with late portal vein thrombosis, portal hypertension, hypersplenism, and multiple GI bleeding episodes, after splenectomy and meso-caval shunt preventing GI bleeding...
2014: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Miwa Uesugi, Mio Kikuchi, Haruka Shinke, Tomohiro Omura, Atsushi Yonezawa, Kazuo Matsubara, Yasuhiro Fujimoto, Shinya Okamoto, Toshimi Kaido, Shinji Uemoto, Satohiro Masuda
OBJECTIVE: We investigated whether the cytochrome P450 3A5*3 (CYP3A5*3) genotype affects tacrolimus pharmacokinetics and the risk of acute cellular rejection in living-donor liver transplant patients in Japan. MATERIALS AND METHODS: Between July 2004 and June 2011, we enrolled 410 living-donor liver transplant patients receiving tacrolimus. Biopsy specimens of intestinal mucosa and graft liver at surgery were obtained to examine the mRNA expression of CYP3A subfamilies as well as the genotyping of CYP3A5*3 polymorphism...
July 2014: Pharmacogenetics and Genomics
Tom Darius, Jairo Rivera, Fabio Fusaro, Quirino Lai, Catherine de Magnée, Christophe Bourdeaux, Magdalena Janssen, Philippe Clapuyt, Raymond Reding
Biliary complications (BCs) still remain the Achilles heel of liver transplantation (LT) with an overall incidence of 10% to 35% in pediatric series. We hypothesized that (1) the use of alternative techniques (reduced size, split, and living donor grafts) in pediatric LT may contribute to an increased incidence of BCs, and (2) surgery as a first treatment option for anastomotic BCs could allow a definitive cure for the majority of these patients. Four hundred twenty-nine primary pediatric LT procedures, including 88, 91, 47, and 203 whole, reduced size, split, and living donor grafts, respectively, that were performed between July 1993 and November 2010 were retrospectively reviewed...
August 2014: Liver Transplantation
José Manuel Asencio, José Luis García Sabrido, Luis Olmedilla
The size of the remnant liver after an extended hepatectomy is currently the main limiting factor for performing curative hepatic surgery in patients with tumors and liver metastasis. The current guidelines for extended hepatectomies require that the future remnant liver volume needs to be higher than 20% of the original liver in healthy organs, of 30% in livers with steatosis or exposed to chemotherapy, and of 40% in patients with cirrhosis in order to prevent the "small-for-size" syndrome, characterized by the development of liver dysfunction with ascites, coagulopathy and cholestasis...
June 2014: Journal of Hepato-biliary-pancreatic Sciences
Seung Duk Lee, Seong Hoon Kim, Sun-Young Kong, Young-Kyu Kim, Soon-Ae Lee, Sang-Jae Park
BACKGROUND: Graft local infusion and splenectomy in ABO-incompatible (ABO-I) living donor liver transplantation (LDLT) are associated with high rates of operative complications. METHODS: Consecutive ABO-I LDLT patients treated at the National Cancer Centre between January 2012 and February 2013 were identified. The protocol for ABO-I LDLT at the study centre included the administration of rituximab (300 mg/m(2)) at 2 weeks preoperatively, followed by plasma exchanges (target isoagglutinin titre: ≤ 1:8), basiliximab (20 mg on the day of surgery and on postoperative day 4), and i...
September 2014: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Tomohiro Tanaka, Yasuhiko Sugawara, Sumihito Tamura, Junichi Kaneko, Yutaka Takazawa, Taku Aoki, Kiyoshi Hasegawa, Yoshihiro Sakamoto, Noriyo Yamashiki, Norihiro Kokudo
AIM: The number of patients referred for liver transplantation (LT) with non-alcoholic steatohepatitis (NASH) continues to increase, but information about living donor liver transplantation (LDLT) for NASH is scarce. We conducted this study to document the details of LDLT for NASH in a Japanese LT center. METHODS: Among all LDLT recipients in our institution from March 1996 to March 2013 (n = 425), we identified seven patients that underwent LDLT for NASH. RESULTS: Of all the seven recipients, most of the patients (86%) were obese...
October 2014: Hepatology Research: the Official Journal of the Japan Society of Hepatology
L D L S Azevedo, R S B Stucchi, E C D Ataíde, I F D F Boin
BACKGROUND: Postoperative poor graft function is a serious complication that can lead to graft loss requiring retransplantation or even death. The postoperative complications of primary nonfunction (PNF), early graft dysfunction (EGD), bleeding due to coagulopathy, and hepatic artery thrombosis (HAT) can lead to graft loss requiring retransplantation or even death. We determined the causes of death after liver transplantation. METHODS: This was an observational descriptive study on adult liver transplant recipients from September 1991 to December 2011...
April 2013: Transplantation Proceedings
Takahito Yagi, Daisuke Nobuoka, Susumu Shinoura, Yuzo Umeda, Daisuke Sato, Ryuichi Yoshida, Masashi Utsumi, Tomokazu Fuji, Hiroshi Sadamori, Toshiyoshi Fujiwara
Establishment of a preferential liver allocation rule for simultaneous liver and kidney transplantation (SLK) and revisions of laws regarding organ transplants from deceased donors have paved the way for SLK in Japan. Very few cases of SLK have been attempted in Japan, and no such recipients have survived for longer than 40 days. The present report describes a case of a 50-year-old woman who had undergone living donor liver transplantation at the age of 38 years for management of post-partum liver failure. After the first transplant surgery, she developed hepatic vein stenosis and severe hypersplenism requiring splenectomy...
March 2014: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Bassem Hegab, Mohamed Rabei Abdelfattah, Ayman Azzam, Hazem Mohamed, Waleed Al Hamoudi, Faisal Aba Alkhail, Hamad Al Bahili, Hatem Khalaf, Mohammed Al Sofayan, Mohammed Al Sebayel
AIM: To study diagnostic laparoscopy as a tool for excluding donors on the day of surgery in living donor liver transplantation (LDLT). METHODS: This study analyzed prospectively collected data from all potential donors for LDLT. All of the donors were subjected to a three-step donor evaluation protocol at our institution. Step one consisted of a clinical and social evaluation, including a liver profile, hepatitis markers, a renal profile, a complete blood count, and an abdominal ultrasound with Doppler...
November 27, 2012: World Journal of Hepatology
Xin-Hua Zhu, Ya-Fu Wu, Yu-Dong Qiu, Chun-Ping Jiang, Yi-Tao Ding
AIM: To investigate the liver-protecting effect of parenteral nutrition (PN) support with omega-3 fatty acids in a randomized controlled clinical trial. METHODS: Sixty-six patients with the diagnosis of end-stage liver disease or hepatic cellular carcinoma were admitted to the Affiliated Drum Tower Hospital, Nanjing University, China for orthotopic liver transplantation. The patients were randomly divided into two groups: PN group (n = 33) and polyunsaturated fatty acid (PUFA) group (n = 33)...
November 14, 2012: World Journal of Gastroenterology: WJG
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