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Liver transplant surgery rejection hepatic

Yuchen Hou, Nga Lei Tam, Zhicheng Xue, Xuzhi Zhang, Bing Liao, Jie Yang, Shunjun Fu, Yi Ma, Linwei Wu, Xiaoshun He
RATIONALE: Hepatic vein occlusive disease (HVOD) is a rare complication after liver transplantation, which is characterized by nonthrombotic, fibrous obliteration of the small centrilobular hepatic veins by connective tissue and centrilobular necrosis in zone 3 of the acini. HVOD after solid organ transplantation has been reported; recently, most of these reports with limited cases have documented that acute cell rejection and immunosuppressive agents are the major causative factors. HVOD is relatively a rare complication of liver transplantation with the incidence of approximately 2%...
June 2018: Medicine (Baltimore)
Tufan Egeli, Tarkan Unek, Cihan Ağalar, Serhan Derici, Mucahit Ozbilgin, Mesut Akarasu, Aylin Bacakoglu, Hulya Ellidokuz, Ibrahim Astarcıoglu
OBJECTIVES: We investigated late mortality causes and risk factors in patients who were undergoing deceased-donor liver transplant. MATERIALS AND METHODS: Patients who had deceased-donor liver transplant from February 1997 to June 2014 in the hepatopancreaticobiliary surgery and liver transplant unit at Dokuz Eylul University Hospital were analyzed. Inclusion criteria were patients over 18 years of age and who survived more than 1 year after liver transplant. Causes of mortality and related risk factors after the first year were analyzed...
June 1, 2018: Experimental and Clinical Transplantation
Shoichi Kageyama, Kojiro Nakamura, Takehiro Fujii, Bibo Ke, Rebecca A Sosa, Elaine F Reed, Nakul Datta, Ali Zarrinpar, Ronald W Busuttil, Jerzy W Kupiec-Weglinski
Hepatic ischemia-reperfusion injury (IRI) represents a major risk factor of early graft dysfunction and acute/chronic rejection as well as a key obstacle to expanding the donor pool in orthotopic liver transplantation (OLT). Although glucocorticoid receptor (GR) signaling may enhance cytoprotective programs, clinical use of glucocorticoid is limited due to adverse effects, while clinical relevance of GR-facilitated cytoprotection in OLT remains unknown. We aimed to evaluate the significance of hepatic GR in clinical OLT and verify the impact of recombinant human relaxin (rhRLX), which may function as GR agonist in tissue/disease-specific manner...
January 19, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Nageh Ahmed Elmahdy, Samia Salem Sokar, Mohamed Labib Salem, Naglaa Ibrahim Sarhan, Sherin Hamed Abou-Elela
Liver fibrosis is the consequence of hepatocyte injury that leads to the activation of hepatic stellate cells (HSC). The treatment of choice is Liver transplantation; however, it has many problems such as surgery-related complications, immunological rejection and high costs associated with the procedure. Stem cell-based therapy would be a potential alternative, so the aim of this study is to investigate the therapeutic potential of human umbilical cord mononuclear cells (MNC) and mouse bone marrow cells (BMC) against carbon tetrachloride (CCl4 ) induced liver fibrosis in mice and compare it with that of silymarin...
May 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Aparna Dalal
Patients listed for organ transplant frequently have severe coronary artery disease (CAD), which may be treated with drug eluting stents (DES). Everolimus and zotarolimus eluting stents are commonly used. Newer generation biolimus and novolimus eluting biodegradable stents are becoming increasingly popular. Patients undergoing transplant surgery soon after the placement of DES are at increased risk of stent thrombosis (ST) in the perioperative period. Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor such as clopidogrel, prasugrel and ticagrelor is instated post stenting to decrease the incident of ST...
December 24, 2016: World Journal of Transplantation
Cheng-Maw Ho, Po-Huang Lee, Wing Tung Cheng, Rey-Heng Hu, Yao-Ming Wu, Ming-Chih Ho
Literature on liver transplantation for use in medical education is limited and as yet unsatisfactory. The aim of this article is to help medical students gain enough insight into the reality of being a liver transplant recipient. This is crucial so in the future they can feel confident in approaching these patients with adequate knowledge and confidence. The knowledge-tree based learning core topics are designed for a 2-h class including indication/contraindication in the real-world setting, model for end stage liver disease scoring and organ allocation policy, liver transplantation for hepatic malignancy, transplantation surgery, immunosuppression strategy in practical consideration, and management of viral hepatitis...
December 2016: Annals of Medicine and Surgery
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
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