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Living donor liver transplantation

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https://www.readbyqxmd.com/read/29149975/clinical-outcomes-of-living-liver-transplantation-according-to-the-presence-of-sarcopenia-as-defined-by-skeletal-muscle-mass-hand-grip-and-gait-speed
#1
N Harimoto, T Yoshizumi, T Izumi, T Motomura, N Harada, S Itoh, T Ikegami, H Uchiyama, Y Soejima, A Nishie, T Kamishima, R Kusaba, K Shirabe, Y Maehara
BACKGROUND: Sarcopenia is an independent predictor of death after living-donor liver transplantation (LDLT). However, the ability of the Asian Working Group for Sarcopenia criteria for sarcopenia (defined as reduced skeletal muscle mass plus low muscle strength) to predict surgical outcomes in patients who have undergone LDLT has not been determined. METHODS: This study prospectively enrolled 366 patients who underwent LDLT at Kyushu University Hospital. Skeletal muscle area (determined by computed tomography), hand-grip strength, and gait speed were measured in 102 patients before LDLT...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149971/fibrinolysis-in-living-donor-liver-transplantation-recipients-evaluated-using-thromboelastometry-impact-on-mortality
#2
T Shimauchi, K Yamaura, M Higashi, K Abe, T Yoshizumi, S Hoka
BACKGROUND: Inadequate hemostasis during living donor liver transplantation (LDLT) is mainly due to coagulopathy but may also include fibrinolysis. The purpose of this study was to determine the incidence of fibrinolysis and assess its relevance to mortality in LDLT. METHODS: The incidence and prognosis of fibrinolysis were retrospectively studied in 76 patients who underwent LDLT between April 2010 and February 2013. Fibrinolysis was evaluated and defined by maximum lysis (ML) >15% within a 60-minute run time using thromboelastometry (ROTEM)...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29142481/rescue-case-of-low-birth-weight-infant-with-acute-hepatic-failure
#3
Noriki Okada, Yukihiro Sanada, Taizen Urahashi, Yoshiyuki Ihara, Naoya Yamada, Yuta Hirata, Takumi Katano, Kentaro Ushijima, Shinya Otomo, Shujiro Fujita, Koichi Mizuta
We report a case involving a rescued low birth weight infant (LBWI) with acute liver failure. CASE: The patient was 1594 g and 32(3/7) gestational wk at birth. At the age of 11 d, she developed acute liver failure due to gestational alloimmune liver disease. Exchange transfusion and high-dose gamma globulin therapy were initiated, and body weight increased with enteral nutrition. Exchange transfusion was performed a total of 33 times prior to living donor liver transplantation (LDLT)...
October 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29140601/pilot-study-of-living-donor-liver-transplantation-for-patients-with-hcc-exceeding-milan-criteria-bclc-extended-criteria
#4
Josep M Llovet, Mihai Pavel, Jordi Rimola, Maria Alba Diaz, Jordi Colmenero, David Saavedra, Constantino Fondevila, Carmen Ayuso, Josep Fuster, Pere Ginès, Jordi Bruix, Juan Carlos Garcia Valdecasas
BACKGROUND & AIMS: A subset of patients with hepatocellular carcinoma (HCC) beyond Milan criteria might obtain acceptable survival outcomes after liver transplantation. Living donor liver transplantation (LDLT) has emerged as a feasible alternative to overcome the paucity of donors. METHODS: In 2001 we started a protocol for LDLT in Child A-B patients with HCC fulfilling a set of criteria - the BCLC expanded criteria- that expanded the conventional indications of transplantation: 1 tumor ≤ 7cm, 5 tumors ≤ 3cm, 3 tumors ≤ 5cm without macrovascular invasion or down-staging to Milan after loco-regional therapies...
November 15, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29137593/central-pontine-myelinolysis-after-living-donor-liver-transplant-a-report-of-2-cases
#5
Ya-Lan Hsu, Chia-En Hsieh, Kuo-Hua Lin, Chen-Te Chou, Ping-Yi Lin, Su-Han Wang, Yao-Li Chen
Here, we present 2 patients who developed central pontine myelinolysis after living-donor liver transplant. Both patients had abnormal sodium level before living-donor liver transplant. Patient 1 presented with severe hyponatremia on admission. After administration of 3% saline, her sodium level during the first 24 hours was kept at 100 mEq/L and then increased to 116 mEq/L during the next 24 hours. The level increased 5.8 mEq/L during the 4- to 5-hour transplant procedure. Patient 2 was admitted to the hospital with an unprovoked seizure...
November 15, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29130558/right-lobe-donor-hepatectomy-is-it-safe
#6
Sanjay Goja, Sanjay Kumar Yadav, Sanjiv Saigal, Arvinder Singh Soin
INTRODUCTION: Donor safety is utmost important in Living donor liver transplantation (LDLT). Small for size syndrome in some recipients with left lobe donors led to the evolution of right lobe LDLT. AIM: To analyse the safety of large series of right lobe (RL) donor hepatectomies and compare outcomes with left lobe (LL) and left lateral segment (LLS) donations. MATERIAL AND METHODS: A consecutive cohort of 726 donors from January 2011 to January 2014 were studied; RL (n=641, 88...
November 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29129228/preoperative-low-muscle-mass-has-a-strong-negative-effect-on-pulmonary-function-in-patients-undergoing-living-donor-liver-transplantation
#7
Hisaya Shirai, Toshimi Kaido, Yuhei Hamaguchi, Siyuan Yao, Atsushi Kobayashi, Shinya Okumura, Naoko Kamo, Shintaro Yagi, Hideaki Okajima, Shinji Uemoto
OBJECTIVE: This study investigated the effect of preoperative sarcopenia on cardiopulmonary function in patients undergoing living donor liver transplantation (LDLT). METHODS: A retrospective analysis was performed of 207 patients who underwent LDLT between January 2008 and April 2015. The quantity and quality of skeletal muscle were evaluated by the psoas muscle mass index (PMI) and intramuscular adipose tissue content (IMAC), respectively, using preoperative computed tomography imaging...
January 2018: Nutrition
https://www.readbyqxmd.com/read/29125895/impact-of-preserved-collateral-veins-on-small-for-size-grafts-in-living-donor-liver-transplantation
#8
Seong Hoon Kim, Eung Chang Lee, Sang Jae Park
AIM: Graft size is a critical issue in living donor liver transplantation (LDLT). We hypothesized that too much portal flow could possibly be diverted into pre-existing collateral veins, alleviating small-for-size syndrome (SFSS) in LDLT. This study evaluated the impact of the preserved collateral veins in the outcomes of LDLT using a small-for-size graft (SFSG). METHODS: For patient safety, a graft-to-recipient weight ratio (GRWR) < 0.8% was strictly confined to patients with collateral veins (group A), and the patient group was compared in a 1:3 ratio to a matched group of patients with GRWR ≥ 0...
November 10, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29118691/vanishing-tumor-in-a-liver-graft-from-a-hepatitis-b-virus-surface-antigen-positive-donor
#9
Mayo Fuchino, Kazuto Tajiri, Masami Minemura, Toshiro Sugiyama
We report a case of vanishing tumor considered as inflammatory pseudotumor (IPT) found in the liver after living donor liver transplantation (LDLT) from a hepatitis B virus surface antigen-positive donor. The radiological findings were similar to those of hepatocellular carcinoma (HCC). However, the tumor disappeared completely within several months and was suggested to have been an IPT. IPT is known to be associated with biliary duct operation or biliary infection, and it can show various enhancement patterns in radiological studies, sometimes resembling HCC...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29118687/renoportal-anastomosis-in-left-lateral-lobe-living-donor-liver-transplantation-a-pediatric-case
#10
Hiroyuki Ogasawara, Chikashi Nakanishi, Shigehito Miyagi, Kazuaki Tokodai, Yasuyuki Hara, Wataru Nakanishi, Koji Miyazawa, Kenji Shimizu, Hiroyuki Kumata, Hitoshi Goto, Masafumi Goto, Michiaki Unno, Takashi Kamei
In adult liver transplantation, renoportal anastomosis (RPA) has been introduced as a useful technique for patients with grade 4 portal vein thrombosis and a splenorenal shunt. Here, we report a pediatric case in which RPA allowed a left lateral lobe living donor liver transplantation (LDLT) despite portal vein thrombosis and a large splenorenal shunt. At 36 days old, the patient underwent a Kasai operation for biliary atresia. At 17 months old, she underwent LDLT because of repetitive cholangitis. Pretransplant examinations revealed a large splenorenal shunt and portal vein thrombosis...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29116679/functional-status-healthcare-utilization-and-the-costs-of-liver-transplantation
#11
Marina Serper, Therese Bittermann, Michael Rossi, David S Goldberg, Arwin M Thomasson, Kim M Olthoff, Abraham Shaked
The Model for End-stage Liver Disease (MELD) score predicts higher transplant healthcare utilization and costs; however, the independent contribution of functional status towards costs is understudied. The study objective was to evaluate the association between functional status, as measured by Karnofsky Performance Status (KPS), and liver transplant (LT) costs in the first post-transplant year. In a cohort of 598 LT recipients from 7/1/2009-11/30/2014, multivariable models assessed associations between KPS and outcomes...
November 8, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29114099/risk-factors-and-management-for-biliary-complications-following-adult-living-donor-liver-transplantation
#12
Tsukasa Nakamura, Taku Iida, Hidetaka Ushigome, Masafumi Osaka, Koji Masuda, Takehisa Matsuyama, Shumpei Harada, Shuji Nobori, Norio Yoshimura
BACKGROUND Biliary complications (BCs) following liver transplantation are very serious. Nevertheless, it is still uncertain which components influence the incidence of BCs the most. MATERIAL AND METHODS A consecutive sample of 74 adult recipients who underwent living-donor liver transplantation were enrolled in this study. BCs that were Clavien-Dindo classification grade II or higher were determined as BCs. RESULTS There were 11 out of the 74 recipients who experienced BCs. There were no differences in preoperative background factors between the BCs+ and BCs- group...
November 8, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29108187/-advances-in-liver-transplantation-for-patients-with-liver-failure
#13
J F Liu, X Zhang
Liver transplantation is the most effective salvage treatment for advanced liver failure, but its clinical application is limited by a shortage of liver donor, strict technology admittance, and complex and diverse issues in liver damage control before transplantation. We need to better understand the indications for liver transplantation in liver failure patients, select surgical timing correctly, and develop proper surgical regimens, in order to improve the rescue and cure rate of such patients. In addition, great achievements have been made in living-donor liver transplantation, auxiliary liver transplantation, and ABO-incompatible liver transplantation, which should be taken seriously in clinical practice...
September 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29100996/should-living-donor-liver-transplantation-be-an-option-when-deceased-donation-is-not
#14
Sarah R Lieber, Thomas D Schiano, Rosamond Rhodes
When a liver transplantation candidate is declined for listing to receive a deceased organ, sometimes a loved one comes forward and offers to be a living donor. This raises the ethical question of whether a patient who is not eligible for deceased donor liver transplantation should be eligible for living donor liver transplantation. We compare living organ donation in kidney and liver transplantation and explore key ethical concepts of justice, fairness, and societal trust. Ultimately, because there is no alternative life-preserving therapy in end-stage liver disease, and because transplantation with a living donor organ does not involve removing a resource from the common pool of transplant organs, we argue that a "slightly less benefit" than what is required for deceased transplantation listing standard should be used to determine the acceptability of living donor liver transplantation...
October 31, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29100944/regulatory-dendritic-cells-for-promotion-of-liver-transplant-operational-tolerance-rationale-for-a-clinical-trial-and-accompanying-mechanistic-studies
#15
REVIEW
Angus W Thomson, Abhinav Humar, Fadi G Lakkis, Diana M Metes
Dendritic cells (DC) are rare, bone marrow (BM)-derived innate immune cells that critically maintain self-tolerance in the healthy steady-state. Regulatory DC (DCreg) with capacity to suppress allograft rejection and promote transplant tolerance in pre-clinical models can readily be generated from BM precursors or circulating blood monocytes. These DCreg enhance allograft survival via various mechanisms, including promotion of regulatory T cells. In non-human primates receiving minimal immunosuppressive drug therapy (IS), infusion of DCreg of donor origin, one week before transplant, safely prolongs renal allograft survival and selectively attenuates anti-donor CD8(+) memory T cell responses in the early post-transplant period...
October 31, 2017: Human Immunology
https://www.readbyqxmd.com/read/29092970/extracorporeal-membrane-oxygenation-for-post-transplant-hypoxaemia-following-very-severe-hepatopulmonary-syndrome
#16
Lakshmi Kumar, Dinesh Balakrishnan, Rekha Varghese, Sudhindran Surendran
Hepatopulmonary syndrome (HPS) associated with end-stage liver disease has a high morbidity when room air PaO2 is less than 50 mm Hg. Safe levels of oxygenation to facilitate transplantation have not been defined despite advancement in care. Postoperatively, hypoxaemia worsens due to ventilation perfusion mismatch contributed by postoperative pulmonary vasoconstriction and due to decrease in endogenous nitric oxide. A 16-year-old boy with cirrhosis presented with HPS and a PaO2 of 37 mm Hg on room air and underwent living donor liver transplant...
November 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29078900/upregulation-of-nm23-e2-accelerates-the-liver-regeneration-after-40-decreased-size-liver-transplantation-in-rats
#17
Hongqiang Gao, Yongmei Cao, Shuo Wan, Jing Liu, Gang Chen, Zhiqiang Li, Hailei Wang, Li Li
BACKGROUND: Potential of liver regeneration after living-donor liver transplantation is closely associated with the recipient's prognosis, whereas exogenous gene might regulate the liver regeneration progress. NM23 is a multifunctional gene, which inhibits tumor metastasis and regulates cell proliferation, differentiation, development, and apoptosis; however, there is little research about NM23 in promoting liver cell proliferation. METHODS: To investigate the effect of NM23-E2 on the liver cell proliferation, the NM23-E2 overexpression vector or negative control vector was transfected into BRL-3A cells and donor liver, respectively...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29078606/depicting-surgical-anatomy-of-the-porta-hepatis-in-living-donor-liver-transplantation
#18
Paul Kelly, Albert Fung, Joy Qu, Paul Greig, Gordon Tait, Jodie Jenkinson, Ian McGilvray, Anne Agur
Visualizing the complex anatomy of vascular and biliary structures of the liver on a case-by-case basis has been challenging. A living donor liver transplant (LDLT) right hepatectomy case, with focus on the porta hepatis, was used to demonstrate an innovative method to visualize anatomy with the purpose of refining preoperative planning and teaching of complex surgical procedures. The production of an animation-enhanced video consisted of many stages including the integration of pre-surgical planning; case-specific footage and 3D models of the liver and associated vasculature, reconstructed from contrast-enhanced CTs...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29067750/quality-of-life-of-biliary-atresia-after-living-donor-liver-transplant-in-japan
#19
Ryota Kikuchi, Koichi Mizuta, Taizen Urahashi, Yukihiro Sanada, Naoya Yamada, Erika Onuma, Iori Sato, Kiyoko Kamibeppu
BACKGROUND: Health-related quality of life (HRQOL) is an important outcome in solid organ transplantation. This study evaluated and explored the factors of generic and transplant-specific HRQOL in Japanese pediatric and adolescent patients with biliary atresia (BA) after living donor liver transplant (LDLT). METHODS: A cross-sectional survey using anonymous questionnaires was completed between April and July 2015. Patients' medical records were accessed. The Japanese version of Pediatric Quality of Life Inventory(™) Generic Core Scales and Transplant Modules (child self-report and parent proxy-report) was administered...
October 25, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29056477/biliary-complications-among-live-donors-following-live-donor-liver-transplantation
#20
Johns Shaji Mathew, K Manikandan, K Y Santosh Kumar, S T Binoj, Dinesh Balakrishnan, Unnikrishnan Gopalakrishnan, Ramachandran Narayana Menon, Puneet Dhar, O V Sudheer, S Aneesh, Surendran Sudhindran
INTRODUCTION: In live donor liver transplantation (LDLT), bile duct division is a critical step in donor hepatectomy. Biliary complications hence are a feared sequelae even among donors. Long term data on biliary complications in donors from India are sparse. METHODS: Prospective evaluation of 452 live donors over 10 years was performed to ascertain the incidence & risk factors of clinically significant biliary complications. RESULTS: Of the 452 donor hepatectomies (M: F = 114:338, median age = 38), 66...
October 19, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
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