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Living donor liver transplantation

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https://www.readbyqxmd.com/read/29785692/impact-of-enteral-nutrition-with-an-immunomodulating-diet-enriched-with-hydrolyzed-whey-peptide-on-infection-after-liver-transplantation
#1
Naoko Kamo, Toshimi Kaido, Yuhei Hamaguchi, Ryuji Uozumi, Shinya Okumura, Atsushi Kobayashi, Hisaya Shirai, Shintaro Yagi, Hideaki Okajima, Shinji Uemoto
BACKGROUND: Infection is a leading cause of death after liver transplantation (LT). Therefore, prevention of infection is crucial for improving outcomes after LT. We examined the impact of early enteral nutrition with an immunomodulating diet (IMD) enriched with hydrolyzed whey peptide (HWP) formulation on infection after living donor LT (LDLT), focusing on sarcopenia. METHODS: This study enrolled 279 consecutive patients who underwent primary LDLT at our institute between January 2008 and April 2015...
May 21, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29785075/biliary-strictures-complicating-living-donor-liver-transplantation-problems-novel-insights-and-solutions
#2
REVIEW
Harshavardhan B Rao, Arjun Prakash, Surendran Sudhindran, Rama P Venu
Biliary stricture complicating living donor liver transplantation (LDLT) is a relatively common complication, occurring in most transplant centres across the world. Cases of biliary strictures are more common in LDLT than in deceased donor liver transplantation. Endoscopic management is the mainstay for biliary strictures complicating LDLT and includes endoscopic retrograde cholangiography, sphincterotomy and stent placement (with or without balloon dilatation). The efficacy and safety profiles as well as outcomes of endoscopic management of biliary strictures complicating LDLT is an area that needs to be viewed in isolation, owing to its unique set of problems and attending complications; as such, it merits a tailored approach, which is yet to be well established...
May 21, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29764373/a-subclinical-high-tricuspid-regurgitation-pressure-gradient-independent-of-the-mean-pulmonary-artery-pressure-is-a-risk-factor-for-the-survival-after-living-donor-liver-transplantation
#3
Yosuke Saragai, Akinobu Takaki, Yuzo Umeda, Takashi Matsusaki, Tetsuya Yasunaka, Atsushi Oyama, Ryuji Kaku, Kazufumi Nakamura, Ryuichi Yoshida, Daisuke Nobuoka, Takashi Kuise, Kosei Takagi, Takuya Adachi, Nozomu Wada, Yasuto Takeuchi, Kazuko Koike, Fusao Ikeda, Hideki Onishi, Hidenori Shiraha, Shinichiro Nakamura, Hiroshi Morimatsu, Hiroshi Ito, Toshiyoshi Fujiwara, Takahito Yagi, Hiroyuki Okada
BACKGROUND: Portopulmonary hypertension (POPH) is characterized by pulmonary vasoconstriction, while hepatopulmonary syndrome (HPS) is characterized by vasodilation. Definite POPH is a risk factor for the survival after orthotopic liver transplantation (OLT), as the congestive pressure affects the grafted liver, while subclinical pulmonary hypertension (PH) has been acknowledged as a non-risk factor for deceased donor OLT. Given that PH measurement requires cardiac catheterization, the tricuspid regurgitation pressure gradient (TRPG) measured by echocardiography is used to screen for PH and congestive pressure to the liver...
May 15, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29761829/pretransplant-trends-in-%C3%AE-fetoprotein-levels-as-a-predictor-of-recurrence-after-living-donor-liver-transplantation-for-unresectable-hepatoblastoma-a-single-institution-experience
#4
Kaori Isono, Yuki Ohya, Kwang-Jong Lee, Shintaro Hashimoto, Masashi Kadohisa, Masataka Sakisaka, Keiichi Uto, Shintaro Hayashida, Hidekazu Yamamoto, Hirotoshi Yamamoto, Yasuhiko Sugawara, Yukihiro Inomata
LT is a practical therapeutic alternative for unresectable hepatoblastoma; however, deciding when to perform LT is difficult. The aim of this study was to optimize the timing of LT for hepatoblastoma using pretransplant trends in AFP levels. Trends in pretransplant AFP levels and their influence on post-transplant outcomes were retrospectively evaluated. All patients who underwent living donor LT for hepatoblastoma in our institution since 2002 were included. Variables analyzed included history of prior tumor resection, pretransplant AFP responses to chemotherapy, metastatic disease at diagnosis, and post-transplant chemotherapy...
May 15, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29752783/impact-of-graft-to-recipient-weight-ratio-on-small-for-size-syndrome-following-living-donor-liver-transplantation
#5
REVIEW
Richard Bell, Sanjay Pandanaboyana, Vivek Upasani, Raj Prasad
BACKGROUND: This meta-analysis aimed to compare living donor liver transplantation (LDLT) grafts with a graft-to-recipient weight ratio (GRWR) of <0.8 to grafts with a GRWR ≥0.8 with regards to small-for-size syndrome (SFSS) and short and longer term outcomes. METHODS: An electronic search was performed of the MEDLINE, EMBASE and PubMed databases until December 2016 using both subject headings (MeSH) and free text. Pooled odds ratios and hazard ratios were calculated using fixed- and random-effects models for meta-analysis...
May 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29751198/price-to-pay-portal-vein-arterialization-for-hepatic-artery-thrombosis-after-living-donor-liver-transplantation-a-case-report
#6
Worakitti Lapisatepun, Anon Chotirosniramit, Trichak Sandhu, Kanya Udomsin, Wasana Ko-Iam, Phuriphong Chanthima, Warangkana Lapisatepun, Settapong Boonsri, Suraphong Lorsomradee, Quanhathai Kaewpoowat, Sunhawit Junrungsee
OBJECTIVE: Hepatic artery thrombosis (HAT) is one of the most serious complications of liver transplantation that can potentially lead to loss of the allograft. Retransplantation is the only option when revascularization can't be performed but the donor may be not available in the short period of time. We report the technique of using portal vein arterialization (PVA) for bridging before retransplantation. There are few reports in living donor setting. CASE DESCRIPTION: The recipient of the liver was a 59 year old male who received an extended right lobe graft from his son...
May 2, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29750155/association-between-subclinical-low-serum-25-oh-d-in-donors-and-fatty-liver-disease-in-recipients-after-living-donor-liver-transplantation
#7
King-Wah Chiu, Toshiaki Nakano, Tsung-Hui Hu, Kuang-Den Chen, Li-Wen Hsu, Hock-Liew Eng, Yu-Fan Cheng, Shigeru Goto, Chao-Long Chen
To explore subclinical fatty liver disease (FLD) in donors as a possible mechanism leading to FLD in recipients of living donor liver transplantation (LDLT), we extracted thirty donor-recipient pairs' serum DNA and explored the presence of CYP2R1 single nucleotide polymorphism (SNP) rs10741657 and vitamin D receptor (VDR) SNP rs2228530 A/G alleles using real-time polymerase chain reaction. We measured the serum 25(OH)D concentrations and investigated the CYP2R1 and VDR genotypes of the donors and recipients before and after LDLT for comparison with the histological findings from the donors on wedge biopsy, the recipients' removed native liver, and selective liver biopsy after LDLT...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29749243/the-predictive-value-of-risk-indices-for-cardiac-complications-in-living-donor-liver-transplantation
#8
I P Canbolat, Y Erdogan, G Adali, O Kaplan, M Dayangac, Y Yuzer, Y Tokat
BACKGROUND AND AIMS: The American College of Surgeons' National Surgical Quality Improvement Program (NSQIP) risk tool and Revised Cardiac Risk Index (RCRI) are recommended tools for cardiovascular assessment before non-cardiac surgery to predict early postoperative cardiac morbidity and mortality. Their predictive value for postoperative cardiovascular morbidity and mortality after liver transplantation is unknown. We aimed to evaluate the validity of these two risk tools to predict early (30-day) cardiovascular complications and in-hospital all-cause mortality...
2018: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/29747216/survival-outcomes-in-split-compared-to-whole-liver-transplantation
#9
Kyung Chul Yoon, Sanghee Song, Eun-Kyoung Jwa, Sanghoon Lee, Jong Man Kim, Ok-Kyoung Kim, Suk Kyun Hong, Nam-Joon Yi, Kwang-Woong Lee, Myoung Soo Kim, Shin Hwang, Kyung-Suk Suh, Suk-Koo Lee
Split liver transplantation (SLT) should be cautiously considered because the right tri-sectional (RTS) graft can be a marginal graft in adult recipients. Herein, we analyzed the outcomes of RTS-SLT in Korea, where > 75% of adult liver transplantations are performed by living donor liver transplantation. Among 2,462 patients who underwent deceased donor liver transplantations (DDLT) from 2005 to 2014, we retrospectively reviewed 86 adult patients (3.4%) who received a RTS graft (RTS-SLT group). The outcomes of the RTS-SLT group were compared to those of 303 recipients of whole liver (WL-DDLT group)...
May 10, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29743768/epidemiological-analysis-of-extended-spectrum-beta-lactamase-producing-bacterial-infections-in-adult-live-donor-liver-transplant-patients
#10
Ajeet Singh, Deepak Govil, Usha Krishan Baveja, Anand Gupta, Neha Tandon, Shrikanth Srinivasan, Sachin Gupta, Sweta J Patel, Sanjiv Saigal, Arvinder Singh Soin
Introduction: Bacterial infections are a leading cause of morbidity and mortality in patients receiving solid-organ transplants. Extended-spectrum beta-lactamases (ESBL) pathogens are the most important pathogenic bacteria infecting these patients. Aim: This study aims to evaluate for the incidence and characteristics of ESBL-positive organism, to look for the clinical outcomes in ESBL-positive infected cases, and to evaluate and draft the antibiotic policy in posttransplant patients during the first 28 days posttransplant...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29740069/sarcopenia-as-a-predictor-of-post-transplant-tumor-recurrence-after-living-donor-liver-transplantation-for-hepatocellular-carcinoma-beyond-the-milan-criteria
#11
Young Ri Kim, Sukhee Park, Sangbin Han, Joong Hyun Ahn, Seonwoo Kim, Dong Hyun Sinn, Woo Kyoung Jeong, Justin S Ko, Mi Sook Gwak, Gaab Soo Kim
To evaluate the association between sarcopenia and tumor recurrence after living donor liver transplantation (LDLT) in patients with advanced hepatocellular carcinoma (HCC), we analyzed 92 males who underwent LDLT for treating HCC beyond the Milan criteria. Sarcopenia was defined when the height-normalized psoas muscle thickness was <15.5 mm/m at the L3 vertebra level on computed tomography based on an optimum stratification method using the Gray's test statistic. Survival analysis was performed with death as a competing risk event...
May 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29735030/living-donor-intestinal-transplantation
#12
REVIEW
Ivo G Tzvetanov, Kiara A Tulla, Giuseppe D'Amico, Enrico Benedetti
Living donor intestinal transplantation (LDIT) has been improved leading to results comparable to those obtained with deceased donors. LDIT should be limited to specific indications and patient selection. The best indication is combined living donor intestinal/liver transplantation in pediatric recipients with intestinal and hepatic failure; the virtual elimination of waiting time may avoid the high mortality experienced by candidates on the deceased waiting list. Potentially, LDIT could be used in highly sensitized recipients to allow the application of de-sensitization protocols...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735025/status-of-adult-living-donor-liver-transplantation-in-the-united-states-results-from-the-adult-to-adult-living-donor-liver-transplantation-cohort-study
#13
REVIEW
Samir Abu-Gazala, Kim M Olthoff
This article reviews the Adult-to-Adult Living Donor Liver Transplant Cohort Study (A2ALL). The findings show that the number of adult-to-adult living donor liver transplants is consistently increasing. Living donor liver transplantation has an important benefit for patients with acute liver failure, does not compromise donor safety, and has lower rates of acute cellular rejection in biologically related donor and recipient. The conclusions from the A2ALL consortium have been critical in transplant advancement, supporting increased use to help decrease waitlist death and improve long-term survival of transplant recipients...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735022/living-donor-liver-transplantation-technical-innovations
#14
REVIEW
Kiara A Tulla, Hoonbae Jeon
Living donor liver transplantation (LDLT) has found a place to serve the end-stage liver disease community as the donor safety and recipient suitability has been elucidated. Donor safety is of paramount importance and transplant programs must continue endeavors to maintain the highest possible standards. At the same time, adequacy of grafts based on recipient clinical status via their model for end-stage liver disease (MELD) score and volumetric studies to achieve a GRBWR >0.8, along with special attention to anatomic tailoring and portal venous flow optimization are necessary for successful transplantation...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29731094/how-to-reconstruct-middle-hepatic-vein-branches-with-explanted-portal-vein-and-inferior-mesenteric-vein-graft-a-case-report
#15
S Junrungsee, W Lapisatepun, A Chotirosniramit, T Sandhu, K Udomsin, W Ko-Iam, P Chanthima, W Lapisatepun, S Boonsri, S Lorsomradee
OBJECTIVE: The middle hepatic vein reconstruction is one of the crucial parts in adult living donor liver transplantation. Numerous techniques had been reported by using cadaveric iliac vessel or synthetic graft. The limitations of reported techniques are availability of the vessel and complication of synthetic graft. We report the technique of using explanted portal vein and inferior mesenteric vein graft in sequential fashion. PATIENTS AND METHODS: The recipient was a 54-year-old man with chronic hepatitis B cirrhosis and multiple hepatocellular carcinomas...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29731092/new-left-lobe-transplantation-procedure-with-caval-reconstruction-using-an-inverted-composite-graft-for-chronic-budd-chiari-syndrome-in-living-donor-liver-transplantation-a-case-report
#16
T Yagi, K Takagi, R Yoshida, Y Umeda, D Nobuoka, T Kuise, T Fujiwara, A Takaki
When the Budd-Chiari syndrome (BCS) lesion extends to the inferior vena cava (IVC) or the orifices of the hepatic vein, the thickened IVC and/or hepatic vein wall must be removed and IVC reconstruction is required in living-donor liver transplantation (LDLT). In various reports about IVC resection in LDLT for BCS, there are none about left lobe liver transplantation with reconstruction of the retrohepatic IVC (rhIVC). To overcome removal and reconstruction of the rhIVC in LDLT for BCS, we introduced a composite IVC graft that is applicable to both right and left lobe partial liver grafts for LDLT for BCS...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29731085/comparison-of-two-devices-for-intraoperative-portal-venous-flow-measurement-in-living-donor-liver-transplantation-transit-time-ultrasound-and-conventional-doppler-ultrasound
#17
H-K Wang, C-Y Chen, N-C Lin, C-S Liu, C-C Loong, Y-H Lin, Y-C Lai, H-J Chiou
BACKGROUND: Intraoperative portal venous flow measurement provides surgeons with instant guidance for portal flow modulation during living-donor liver transplantation (LDLT). In this study, we compared the agreement of portal flow measurement obtained by 2 devices: transit time ultrasound (TTU) and conventional Doppler ultrasound (CDU). METHODS: Fifty-four recipients of LDLT underwent intraoperative measurement of portal flow after completion of vascular anastomosis of the implanted partial liver graft...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29731084/impact-of-pretransplant-infections-on-clinical-course-in-liver-transplant-recipients
#18
Y J Kim, J H Yoon, S I Kim, H J Choi, J Y Choi, S K Yoon, Y-K You, D-G Kim
BACKGROUND: Uncontrolled infections are known to be an absolute contraindication for liver transplantation; however, the posttransplant prognosis of recipients treated for pretransplant infection is unclear. The aim of this study was to analyze pretransplant infections among liver transplant recipients and to determine their impact on posttransplant clinical outcomes. METHODS: This study retrospectively analyzed 357 subjects who had undergone living-donor liver transplantation between January 2008 and May 2014...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29731081/prevalence-of-antiphospholipid-antibody-positivity-and-association-of-pretransplant-lupus-anticoagulant-positivity-with-early-allograft-dysfunction-in-liver-transplantation
#19
H-M Kwon, K-W Jung, Y-J Moon, H-W Jung, Y-S Park, I-G Jun, J-G Song, G-S Hwang
BACKGROUND: Antiphospholipid antibodies (aPL), including anticardiolipin (aCL), anti-β2 -glycoprotein I (anti-β2GPI), and lupus anticoagulant (LA) antibodies, are frequently found in liver cirrhosis and associated with splanchnic vein thrombosis. Although the risk factors of early allograft dysfunction (EAD) are known, the association between EAD and aPL has been poorly investigated. We hypothesized that LA, potent aPL with thrombotic potential, may be associated with EAD development after living donor liver transplantation (LDLT)...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29731080/carbapenem-resistant-acinetobacter-baumannii-bacteremia-in-liver-transplant-recipients
#20
Y J Kim, S I Kim, Y D Lee, H J Choi, J Y Choi, S K Yoon, Y-K You, D-G Kim
BACKGROUND: Acinetobacter baumannii has become an increasingly important nosocomial pathogen. Carbapenem is the preferred drug of choice for treatment of multidrug-resistant gram-negative bacilli, but carbapenem-resistant A baumannii (CRAB) has now emerged. The aim of this study was to determine the incidence, outcomes, and risk factors for CRAB bacteremia in liver transplant recipients. METHODS: The medical records of 393 subjects who underwent living donor liver transplant at Seoul St...
May 2018: Transplantation Proceedings
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