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Living donor liver transplantation

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https://www.readbyqxmd.com/read/28916322/intraductal-transanastomotic-stenting-in-duct-to-duct-biliary-reconstruction-after-living-donor-liver-transplantation-a-randomized-trial
#1
Ky Santosh Kumar, Johns Shaji Mathew, Dinesh Balakrishnan, Viju Kumar Bharathan, Binoj Sivasankara Pillai Thankamony Amma, Unnikrishnan Gopalakrishnan, Ramachandran Narayana Menon, Puneet Dhar, Sudheer Othiyil Vayoth, Sudhindran Surendran
BACKGROUND: Biliary complications continue to be the 'Achilles heel' of living donor liver transplantation (LDLT). The use of biliary stents in LDLT to reduce biliary complication is a controversial issue. We performed a randomized trial to study the impact of intraductal biliary stents on postoperative biliary complications following LDLT. STUDY DESIGN: Of the 94 LDLT's, that were performed during a period of 16 months, ABO incompatible transplants, left lobe grafts, ≥3 ducts on the graft and those requiring bilio-enteric drainage were excluded...
September 12, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28912414/polish-experience-with-liver-transplantation-and-post-transplant-outcomes-in-children-with-urea-cycle-disorders
#2
Edyta Szymańska, Piotr Kaliciński, Joanna Pawłowska, Sylwia Szymańska, Maciej Pronicki, Marek Stefanowicz, Joanna Teisseyre, Dorota Broniszczak, Dariusz Rokicki
BACKGROUND Liver transplantation (LT) is recommended for various metabolic diseases, including urea cycle disorders (UCDs). The aim of this study was to determine indications and outcomes of LT for UCDs in the tertiary reference Children's Hospital in Warsaw, Poland. MATERIAL AND METHODS Medical charts of children with UCD who underwent LT between 2008 and July 2016 were retrospectively reviewed. The following parameters were analyzed: symptoms at time of diagnosis, age at diagnosis, age at transplantation, graft characteristics and survival, postsurgical complications, and biochemical and laboratory results before and after transplantation...
September 15, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28905009/living-donor-liver-transplantation-for-hepatocellular-cancer-an-almost-exclusive-eastern-procedure
#3
REVIEW
Rafael S Pinheiro, Daniel R Waisberg, Lucas S Nacif, Vinicius Rocha-Santos, Rubens M Arantes, Liliana Ducatti, Rodrigo B Martino, Quirino Lai, Wellington Andraus, Luiz A C D'Albuquerque
Hepatocellular carcinoma (HCC) is the fifth most prevalent cancer and it is linked with chronic liver disease. Liver transplantation (LT) is the best curative treatment modality, since it can cure simultaneously the underlying liver disease and HCC. Milan criteria (MC) are the benchmark for selecting patients with HCC for LT, achieving up to 91% 1-year survival post transplantation. However, when considering intention-to-treat (ITT) rates are substantially lower, mainly due dropout. Additionally, Milan criteria (MC) are too restrictive and more inclusive criteria have been reported with good outcomes...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28901029/successful-venoarterial-extracorporeal-membrane-oxygenation-for-postoperative-septic-shock-in-a-child-with-liver-transplantation-a-case-report
#4
Michiko Abe, Kentaro Ide, Nao Nishimura, Satoshi Nakagawa, Akinari Fukuda, Seisuke Sakamoto, Mureo Kasahara
Refractory septic shock after LT is a life-threatening complication. VA ECMO is used to treat refractory cardiorespiratory failure. We present herein the case of a 5-year-old girl with post-Kasai biliary atresia, who underwent a living donor LT and suffered refractory septic shock. VA ECMO was indicated due to progressive cardiac deterioration. After full recovery of her EF, she has been steadily improving and has shown good liver function and no neurological sequelae. This is the first report of successful VA ECMO in a post- LT patient with refractory septic shock...
September 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28889715/-simultaneous-hepatorenal-transplantation-from-a-brain-dead-donor-for-graft-dysfunction-and-renal-insufficiency-in-a-liver-transplant-recipient-a-case-report
#5
Hideaki Takada, Takashi Kobayashi, Kohei Ogawa, Hitomi Miyata, Atsuro Sawada, Shusuke Akamatsu, Hiromitsu Negoro, Ryoichi Saito, Naoki Terada, Toshinari Yamasaki, Takahiro Inoue, Yuki Teramoto, Shinsuke Shibuya, Hironori Haga, Toshimi Kaido, Shinji Uemoto, Osamu Ogawa
We report a case of lethal hepatorenal insufficiency in a 52-year-old man who received successful simultaneous hepatorenal transplantation from a deceased donor. The patient had undergone live-donor liver transplantation for type-C hepatitis and liver cirrhosis 11 years before he developed graft liver dysfunction due to recurrent viral hepatitis and cirrhosis. At that instance, he also developed end-stage renal dysfunction due to calcineurin inhibitor nephropathy and hepatorenal syndrome. Although he needed three open hemostases and abundant blood transfusion, he was withdrawn from continuous hemodiafiltration on the 55th day and discharged from the hospital on the 272nd day postoperatively...
August 2017: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/28889651/living-donor-liver-transplantation-for-biliary-atresia-an-analysis-of-2-085-cases-in-the-registry-of-the-japanese-liver-transplantation-society
#6
Mureo Kasahara, Koji Umeshita, Seisuke Sakamoto, Akinari Fukuda, Hiroyuki Furukawa, Shotaro Sakisaka, Eiji Kobayashi, Eiji Tanaka, Yukihiro Inomata, Seiji Kawasaki, Mitsuo Shimada, Norihiro Kokudo, Hiroto Egawa, Hideki Ohdan, Shinji Uemoto
Biliary atresia (BA) is the most common indication for liver transplantation (LT) in pediatric population. This study analyzed the comprehensive factors that might influence the outcomes of patients with BA who undergo living donor LT by evaluating the largest cohort with the longest follow-up in the world. Between November 1989 and December 2015, 2,085 BA patients underwent LDLT in Japan. There were 763 male and 1,322 female recipients with a mean age of 5.9 years and body weight of 18.6 kg. The 1-, 5-, 10-, 15-and 20-year graft survival rates for the BA patients undergoing LDLT were 90...
September 10, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28888776/living-donor-liver-transplantation-for-hepatocellular-carcinoma-results-of-prospective-patient-selection-by-kyushu-university-criteria-in-7-years
#7
Hideaki Uchiyama, Shinji Itoh, Tomoharu Yoshizumi, Toru Ikegami, Norifumi Harimoto, Yuji Soejima, Noboru Harada, Kazutoyo Morita, Takeo Toshima, Takashi Motomura, Yoshihiko Maehara
BACKGROUND: Expanding patient selection beyond the Milan criteria in living donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC) has long been a matter for debate. We have used the Kyushu University Criteria - maximum tumor diameter <5 cm or des-γ-carboxy prothrombin <300 mAU/ml - in LDLT for HCC since June 2007. The aim of the present study was to present the results of our prospective patient selection by Kyushu University Criteria and to confirm whether or not our criteria were justified...
September 7, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28885774/small-for-size-grafts-increase-recurrence-of-hepatocellular-carcinoma-in-liver-transplantation-beyond-milan-criteria
#8
Eung Chang Lee, Seong Hoon Kim, Jae Ryong Shim, Sang-Jae Park
BACKGROUND: Living donor liver transplantation (LDLT) has been reported to have high rates of hepatocellular carcinoma (HCC) recurrence compared to deceased donor liver transplant (DDLT). This has been assumed to be due to the frequent use of small-for-size grafts (SFSG) in LDLT rather than DDLT, but the relationship between graft size and prognosis remains controversial. This study aimed to clarify the effect of SFSG on the oncologic outcomes of patients with HCC who underwent LDLT. METHODS: Between January 2005 and December 2015, 597 consecutive patients underwent LDLT...
September 8, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28885664/postoperative-acute-kidney-injury-in-living-donor-liver-transplantation-recipients
#9
Hakan K Atalan, Bulent Gucyetmez, Serdar Aslan, Serafettin Yazar, Kamil Y Polat
PURPOSE: There are many risk factors for postoperative acute kidney injury in liver transplantation. The aim of this study is to investigate the risk factors for postoperative acute kidney injury in living donor liver transplantation recipients. METHODS: 220 living donor liver transplantation recipients were retrospectively evaluated in the study. According to the Kidney Disease Improving Global Outcomes Guidelines, acute kidney injury in postoperative day 7 was investigated for all patients...
September 5, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28885494/prevalence-and-predictors-of-patient-reported-long-term-mental-and-physical-health-after-donation-in-the-adult-to-adult-living-donor-liver-transplantation-cohort-study-a2all
#10
Mary Amanda Dew, Zeeshan Butt, Qian Liu, Mary Ann Simpson, Jarcy Zee, Daniela P Ladner, Susan Holtzman, Abigail R Smith, Elizabeth A Pomfret, Robert M Merion, Brenda W Gillespie, Averell H Sherker, Robert A Fisher, Kim M Olthoff, James R Burton, Norah A Terrault, Alyson N Fox, Andrea F DiMartini
BACKGROUND: Prospective and longitudinal studies have examined liver donors' medical outcomes beyond the first 1-2 years postdonation. There is no analogous longitudinal evidence on long-term psychosocial outcomes, including patient-reported clinically significant mental health problems and perceptions of physical well-being. We examined prevalence, descriptive characteristics, and predictors of diagnosable mental health conditions and self-reported physical health problems, including fatigue and pain, in the long-term years after liver donation...
September 6, 2017: Transplantation
https://www.readbyqxmd.com/read/28883401/comparison-of-apache-iv-with-apache-ii-saps-3-meld-meld-na-and-ctp-scores-in-predicting-mortality-after-liver-transplantation
#11
Hannah Lee, Susie Yoon, Seung-Young Oh, Jungho Shin, Jeongsoo Kim, Chul-Woo Jung, Ho Geol Ryu
The Acute Physiology and Chronic Health Evaluation (APACHE) IV score and Simplified Acute Physiology Score (SAPS) 3 include liver transplantation as a diagnostic category. The performance of APACHE IV-liver transplantation (LT) specific predicted mortality, SAPS 3, APACHE II, Model for End-stage Liver Disease (MELD)-Na, MELD, and CTP scores in predicting in-hospital and 1 year mortality in liver transplant patients was compared using 590 liver transplantations in a single university hospital. In-hospital mortality and 1 year mortality were 2...
September 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28883387/significance-of-proper-graft-selection-in-adult-living-donor-liver-transplant-recipients-with-preoperative-deteriorated-condition
#12
Taku Iida, Koji Masuda, Takehisa Matsuyama, Shumpei Harada, Tsukasa Nakamura, Katsuhiro Koshino, Tomoyuki Suzuki, Shuji Nobori, Hidetaka Ushogome, Takashi Ito, Seisuke Sakamoto, Kenji Uryuhara, Hideaki Okajima, Satoshi Kaihara, Shinji Uemoto, Norio Yoshimura
BACKGROUND The outcome of living-donor liver transplantation (LDLT) is poor for recipients with severely deteriorated preoperative condition. This study therefore evaluated the proper graft selection according to the recipients' preoperative condition. MATERIAL AND METHODS We evaluated the clinical outcomes in 66 patients who underwent adult LDLT from October 2003 to June 2016 in our institution, excluding fulminant liver failure and ABO-incompatible cases. Preoperative risk factors included MELD score >20, preoperative hospitalization for over 2 weeks or intensive care unit admission and bacterial infection within 1 month before LDLT...
September 8, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28881059/pancreas-preserving-duodenectomy-after-living-donor-liver-transplantation-for-invasive-cytomegalovirus-disease
#13
Rodrigo Vincenzi, Eduardo A Fonseca, Paulo Chapchap, Marcel C C Machado, Karina M O Roda, Helry L Candido, Marcel R Benavides, Marco A D'Assuncao, Rogerio C Afonso, Plinio Turine, Fernando P Marson, João Seda Neto
CMV infection plays an important role in the postoperative course following solid organ transplantation. We present the case of an 11-year-old male patient who underwent LDLT due to severe hepatopulmonary syndrome and biliary cirrhosis. Four weeks after LDLT, he developed persistent GI bleeding and was subjected to repeated endoscopic treatment and radiological arterial embolization to stop the bleeding from duodenal ulcers. Diagnostic workup was negative for CMV disease. Because the bleeding persisted, surgical treatment was indicated, and a pancreas-preserving duodenectomy was performed...
September 7, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28856568/nutritional-status-using-subjective-global-assessment-independently-predicts-outcome-of-patients-waiting-for-living-donor-liver-transplant
#14
Sanjay Kumar Yadav, Narendra Singh Choudhary, Neeraj Saraf, Sanjiv Saigal, Sanjay Goja, Amit Rastogi, Prashant Bhangui, A S Soin
BACKGROUND: Malnutrition is an important risk factor for adverse outcomes in patients awaiting liver transplant. Living donor liver transplant, being an elective procedure, allows nutritional rehabilitation and optimization of these patients before transplant. AIM: This paper aimed to evaluate the outcome of end-stage liver disease (ESLD) patients with various degrees of malnutrition waiting for living donor liver transplant. METHODS: Nutritional status was assessed using subjective global assessment (SGA) in patients who were evaluated for a liver transplant at our center from January 2015 to September 2015...
August 31, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28856244/design-and-methods-of-the-korean-organ-transplantation-registry
#15
Jaeseok Yang, Jong Cheol Jeong, Joongyub Lee, Young Hoon Kim, Hyo Chae Paik, Jae-Joong Kim, Hyun-Young Park, Myoung Soo Kim, Curie Ahn
BACKGROUND: Beneficial aspects of solid organ transplantation, which encompass survival benefit, improved quality of life, and cost efficacy, have been clearly demonstrated. However, regional and ethnic differences require further studies to identify prognostic factors and transplant outcomes against various backgrounds. After previous efforts of a nationwide, retrospective study on the kidney transplant outcomes in Korea, a new prospective-designed version of the Korean Organ Transplantation Registry (KOTRY) was launched in 2014...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28838457/coexistent-end-stage-nonalcoholic-steatohepatitis-and-colon-cancer-should-we-do-liver-transplantation
#16
V Aliyev, K Yasuchika, A Hammad, A Badawy, Y Nigmet, T Tajima, K Fukumitsu, S Yagi, K Hata, H Okajima, S Uemoto
BACKGROUND: Colon cancer accompanying decompensated liver cirrhosis is a rare clinical condition. Usually, treatment of colon cancer is prioritized, with cirrhosis dealt with later. CASE REPORT: We present a case of end-stage liver disease due to nonalcoholic steatohepatitis evaluated for living donor liver transplant. During the pretransplant examination, an ascending colon cancer was detected. Liver function was too poor to perform colon resection first. Simultaneous living donor liver transplant and colonic resection were carried out...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28838456/successful-treatment-of-stricture-of-duct-to-duct-biliary-anastomosis-after-living-donor-liver-transplantation-of-the-left-lobe-a%C3%A2-case%C3%A2-report
#17
Y Nakaseko, H Shiba, E Yamanouchi, Y Takano, T Sakamoto, H Imazu, H Ashida, K Yanaga
Biliary complications, such as stricture or obstruction, after living-donor liver transplantation (LDLT) remain major problems to be solved. Magnetic compression anastomosis (MCA) is a minimally invasive method of biliary anastomosis without surgery in patients with biliary stricture or obstruction. A 66-year-old woman had undergone LDLT for end-stage liver disease for primary biliary cholangitis 20 months previously at another hospital. Computerized tomography showed dilation of the intrahepatic bile duct (B2)...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28838451/hepatic-artery-reconstruction-using-3-in-1-segmental-resection-in-pediatric-living-donor-liver-transplantation-a-case-report-and-literature-review
#18
Y Luo, D Zhao, M Zhang, T Zhou, B-J Qiu, J-J Zhang, Q Xia
We report a transplant of the left lateral liver segments with 3 arteries for a pediatric recipient from a living donor. A 6-month-old female infant was diagnosed with liver cirrhosis secondary to biliary atresia and scheduled for living donor liver transplantation (LDLT; mother as donor). Left lateral hepatectomy was performed at the donor site. The dissection of the left hepatic artery (HA), which was divided immediately after its origin, showed 3 branches for segments II, III, and IV. The arteries for segment II, segment III, and segment IV were anastomosed to the recipient HA...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28838450/living-donor-liver-transplantation-with-the-use-of-a-left-lobe-graft-from-a-donor-with-anomalous-biliary-anatomy-in-which-b4-joins-the-right-anterior-sectional-duct-a-case-report
#19
Y Wakasa, D Kudo, K Ishido, N Kimura, T Wakiya, Y Mitsuhashi, K Hakamada
When there is an anatomic anomaly in the biliary tract of the donor for living-donor liver transplantation, the risk of postoperative biliary tract complications increases in both the donor and the recipient. We studied a case of living-donor liver transplantation with a left hepatic lobe graft that had anatomic anomalies, in which the medial segmental branch (B4) joined the anterior segmental branch and the posterior segmental branch formed a common trunk with the lateral segmental branch. A 40-year-old man visited our institution as a candidate organ donor for his mother, who had end-stage liver failure...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28838449/successful-blood-transfusion-management-of-a-living-donor-liver-transplant-recipient-in-the-presence-of-anti-jr-a-a-case-report
#20
N Kurata, Y Onishi, H Kamei, T Hori, M Komagome, C Kato, T Matsushita, Y Ogura
A 48-year-old Japanese woman was diagnosed with Budd-Chiari syndrome and transferred for possible living donor liver transplantation (LDLT). Examinations before LDLT revealed that the recipient had anti-Jr(a) and preformed donor-specific anti-human leukocyte antigen (HLA) antibodies (DSA). Rituximab was administrated at 16 days prior to the patient's scheduled LDLT for the prophylaxis of antibody-mediated rejection by DSA. The clinical significance of anti-Jr(a) has not been clearly established because of the rarity of this antibody, so we discussed blood transfusion strategy with the Department of Blood Transfusion Service and prepared for Jr(a)-negative packed red blood cells (RBCs)...
September 2017: Transplantation Proceedings
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