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Living donor liver transplantation

Yu Huang, Mitsuhisa Takatsuki, Akihiko Soyama, Masaaki Hidaka, Shinichiro Ono, Tomohiko Adachi, Takanobu Hara, Satomi Okada, Takashi Hamada, Susumu Eguchi
BACKGROUND Liver transplantation is indicated for patients with Wilson's disease (WD) who present either with acute liver failure or with end-stage liver disease and severe hepatic insufficiency as the first sign of disease. However, almost all reported cases have been treated with death donor liver transplantation. Here we report the case of a patient with WD associated with fulminant hepatic failure (WD-FHF) who underwent living donor liver transplantation (LDLT). CASE REPORT A 17-year-old female was diagnosed with WD-FHF based on high uric copper (10 603 μg/day, normal <100 μg/day), low serum ceruloplasmin (15 mg/dL, normal >20 mg/dL) and Kayser-Fleischer (K-F) corneal ring, and acute liver failure (ALF), acute renal failure (ARF) and grade 2 hepatic encephalopathy (HE)...
March 17, 2018: American Journal of Case Reports
Keri E Lunsford, Milind Javle, Kirk Heyne, Rachna T Shroff, Reham Abdel-Wahab, Nakul Gupta, Constance M Mobley, Ashish Saharia, David W Victor, Duc T Nguyen, Edward A Graviss, Ahmed O Kaseb, Robert S McFadden, Thomas A Aloia, Claudius Conrad, Xian C Li, Howard P Monsour, A Osama Gaber, Jean-Nicolas Vauthey, R Mark Ghobrial
BACKGROUND: At present, intrahepatic cholangiocarcinoma is a contraindication for liver transplantation. However, previous studies in this field did not preselect patients on the basis of chemosensitivity or disease trajectory after neoadjuvant therapy. Experience with hilar cholangiocarcinoma has indicated that neoadjuvant therapy followed by liver transplantation in patients without disease progression results in a long-term survival benefit. We aimed to establish the potential efficacy of liver transplantation in patients with biologically responsive intrahepatic cholangiocarcinoma who have had sustained tumour stability or regression with neoadjuvant therapy...
March 13, 2018: Lancet. Gastroenterology & Hepatology
Xiaopeng Yang, Jae Do Yang, Hong Pil Hwang, Hee Chul Yu, Sungwoo Ahn, Bong-Wan Kim, Heecheon You
BACKGROUND AND OBJECTIVE: The present study developed an effective surgical planning method consisting of a liver extraction stage, a vessel extraction stage, and a liver segment classification stage based on abdominal computerized tomography (CT) images. METHODS: An automatic seed point identification method, customized level set methods, and an automated thresholding method were applied in this study to extraction of the liver, portal vein (PV), and hepatic vein (HV) from CT images...
May 2018: Computer Methods and Programs in Biomedicine
Xiaopeng Yang, Jae Do Yang, Hee Chul Yu, Younggeun Choi, Kwangho Yang, Tae Beom Lee, Hong Pil Hwang, Sungwoo Ahn, Heecheon You
BACKGROUND AND OBJECTIVE: Manual tracing of the right and left liver lobes from computed tomography (CT) images for graft volumetry in preoperative surgery planning of living donor liver transplantation (LDLT) is common at most medical centers. This study aims to develop an automatic system with advanced image processing algorithms and user-friendly interfaces for liver graft volumetry and evaluate its accuracy and efficiency in comparison with a manual tracing method. METHODS: The proposed system provides a sequential procedure consisting of (1) liver segmentation, (2) blood vessel segmentation, and (3) virtual liver resection for liver graft volumetry...
May 2018: Computer Methods and Programs in Biomedicine
Takahiro Onuma, Tamotsu Kamishima, Tsuyoshi Shimamura, Norio Kawamura, Kenichiro Yamashita, Kenneth Sutherland, Hiroshi Takeda
Background: The quantity and quality of skeletal muscle have been observed to be closely related with post-transplantation mortality in patients undergoing living donor liver transplantation (LDLT). However, the effect of LDLT on skeletal muscle has not been thoroughly investigated. The aim of this study was to investigate the change of trunk muscle mass and adiposity in recipients of LDLT. Methods: The study population included LDLT recipients at Hokkaido University Hospital who underwent pre- and post-operative computed tomography (CT) scans (31 recipients; 14 males, and 17 females)...
February 2018: Quantitative Imaging in Medicine and Surgery
Lara Danziger-Isakov, William J Steinbach, Grant Paulsen, Flor M Munoz, Leigh R Sweet, Michael Green, Marian G Michaels, Janet A Englund, Alastair Murray, Natasha Halasa, Daniel E Dulek, Rebecca Pellett Madan, Betsy C Herold, Brian T Fisher
Background: Respiratory virus infection (RVI) in pediatric solid organ transplant (SOT) recipients poses a significant risk; however, the epidemiology and effects of an RVI after pediatric SOT in the era of current molecular diagnostic assays are unclear. Methods: A retrospective observational cohort of pediatric SOT recipients (January 2010 to June 2013) was assembled from 9 US pediatric transplant centers. Charts were reviewed for RVI events associated with hospitalization within 1 year after the transplant...
March 10, 2018: Journal of the Pediatric Infectious Diseases Society
Young-Jin Moon, Sung-Hoon Kim, Jae-Won Kim, Yoon-Kyung Lee, In-Gu Jun, Gyu-Sam Hwang
Donor safety is the major concern in living donor liver transplantation, although hepatic resection may be associated with postoperative coagulopathy. Recently, the use of sugammadex has been gradually increased, but sugammadex is known to prolong prothrombin time (PT) and activated partial thromboplastin time (aPTT). We compared the postoperative coagulation profiles and outcomes of sugammadex versus pyridostigmine group in donors receiving living donor hepatectomy.Consecutive donor hepatectomy performed between September 2013 and August 2016 was retrospectively analyzed...
March 2018: Medicine (Baltimore)
James M West
Anesthesiologists have clearly established their place in the history of medical ethics. Our involvement goes back to 1966 when Henri Beecher published his landmark paper on research and informed consent. Participation in the ethics of transplantation is no less important than our previous work. Organ transplant has been life saving for many but also has given rise to many misunderstandings not just from the public but also among our own colleagues. These include methods of allocation and donation, the role that affluence may play in receiving an organ, the definition of death and donation after circulatory death...
March 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
Chun Han Nigel Tan, Yue Yu, Yan Rui Nicholas Tan, Boon Leng Kieron Lim, Shridhar Ganpathi Iyer, Krishnakumar Madhavan, Alfred Wei Chieh Kow
Backgrounds/Aims: Liver Transplantation (LT) is a recognized treatment for Hepatocellular Carcinoma (HCC). The role of Bridging Therapies (BT) remains controversial. Methods: From January 2001 to October 2012, 192 patients were referred to the National University Hospital, Singapore for consideration of LT for HCC. Sixty-five patients (33.8%) were found suitable for transplant and were placed on the waitlist. Analysis was performed in these patients. Results: The most common etiology of HCC was Hepatitis B (n=28, 43...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Brian I Shaw, Lyle J Burdine, Hillary J Braun, Nancy L Ascher, John P Roberts
Background: With the use of split liver grafts as well as living donor liver transplantation (LDLT) it is imperative to know the minimum graft volume to avoid complications. Most current formulas to predict standard liver volume (SLV) rely on weight-based measures that are likely inaccurate in the setting of cirrhosis. Therefore, we sought to create a formula for estimating SLV without weight-based covariates. Methods: LDLT donors underwent computed tomography scan volumetric evaluation of their livers...
December 2017: Transplantation Direct
Toshihiro Yasui, Tatsuya Suzuki, Fujio Hara, Shunsuke Watanabe, Naoko Uga, Atsuki Naoe, Yasuhiro Kondo
OBJECTIVES: In pediatric patients, renal dysfunction after living-donor liver transplant is a major issue that is difficult to evaluate. Recently, predictive equations for Japanese children have been introduced. MATERIALS AND METHODS: We conducted a retrospective study by prospectively collecting data on 26 patients under 16 years old who underwent living-donor liver transplant between June 2004 and March 2015. Serum creatinine and cystatin C levels were measured...
March 9, 2018: Experimental and Clinical Transplantation
Vanessa Zhao, Brad Li
No abstract text is available yet for this article.
February 2018: Hepatobiliary Surgery and Nutrition
V Ince, C Kayaalp, E Otan, F Ozdemir, A Dirican, H I Toprak, C Aydin, C Ara, S Yilmaz
Emergency liver transplantation (LT) for acute liver failure (ALF) is a life-saving treatment. Occurrence of this situation in the same patient twice is very rare. Herein, we describe a patient who underwent two emergency LTs for ALF, both from living donors. When she was 26 years old, she underwent a right lobe living donor LT (LDLT) from her sister for ALF due to use of herbal weight loss medications. The next 3 years were uneventful but another ALF developed during a terminal stage pregnancy (37th week)...
2018: International Journal of Organ Transplantation Medicine
Horng-Ren Yang, Ashok Thorat, Long-Bin Jeng, Shih-Chao Hsu, Ping-Chun Li, Chun-Chieh Yeh, Te-Hung Chen, Kin-SHing Poon
BACKGROUND The prognosis of the patients of acute liver failure (ALF) with onset of hepatic coma is often dismal. ALF is a well-accepted indication for liver transplantation (LT) and has markedly improved the prognosis of these patients. However, its role in ALF patients with onset of hepatic coma has never been elucidated before. The aim of our study was to analyze the outcome in patients of ALF with hepatic coma who underwent LT. MATERIAL AND METHODS From January 2002 to December 2015, a total of 726 liver transplantations were done at China Medical University Hospital, Taiwan...
March 13, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Hyun Young Woo, In Seok Lee, Jae Hyuck Chang, Seung Bae Youn, Si Hyun Bae, Jong Young Choi, Ho Jong Chun, Young Kyoung You, Dong Goo Kim, Seung Kew Yoon
Background/Aims: Biliary complications are the most common donor complication following living donor liver transplantation (LDLT). The aim of this study is to investigate the long-term outcomes of biliary complications in right lobe adult-to-adult LDLT donors, and to evaluate the efficacy of endoscopic treatment of these donors. Methods: The medical charts of right lobe donors who developed biliary complications between June 2000 and January 2008 were retrospectively reviewed...
March 14, 2018: Korean Journal of Internal Medicine
Kakharman Yesmembetov, Tokan Sultanaliyev, Adilbek Mukazhanov, Assan Zhexembayev, Gani Kuttymuratov, Zhanat Spatayev, Yevgeniy Mussin, Yerlan Umbetzhanov, Damesh Orazbayeva
OBJECTIVES: Liver transplant is the only treatment option for patients with end-stage liver disease. MATERIALS AND METHODS: Liver transplant procedures performed from June 2013 to March 2017 were evaluated. We evaluated the postoperative period in recipients of livers from deceased and living donors. RESULTS: Of 31 liver transplant procedures in 30 recipients, 12 were from deceased and 19 from living donors. The final analysis included 24 liver transplants (11 males, 13 females), with 10 from deceased and 14 from living donors...
March 2018: Experimental and Clinical Transplantation
Ebru H Ayvazoglu Soy, Aydincan Akdur, Sedat Yildirim, Hande Arslan, Mehmet Haberal
OBJECTIVES: Despite surgical advances and effective prophylactic strategies in liver transplant, infection is still a major cause of morbidity and mortality. Up to 80% of liver recipients will develop at least 1 infection during the first year after liver transplant. The spectrum and manifestations of these infections are broad and variable. Their diagnosis and treatment are often delayed because immunosuppressive therapy diminishes inflammatory responses. However, if an infection is not identified early enough and treated properly, it can have devastating consequences...
March 2018: Experimental and Clinical Transplantation
Gulziya Ismailova, Eugene Yenin, Shokan Kaniev, Dinara Bayguisova, Talgat Tajibaev
OBJECTIVES: Hepatocellular carcinoma is the predominant malignancy in patients with cirrhosis and chronic liver disease. Our aim was to assess the morphologic, radiologic, and immunologic charac teristics of hepatocellular carcinoma and liver cirrhosis concerning surgical treatment tactics. MATERIALS AND METHODS: We performed a cross-sectional analysis of a prospective study performed at the JSC National Scientific Center of Surgery (named after A. Syzganov). The study included 58 patients: 31 with hepatocellular carcinoma (53...
March 2018: Experimental and Clinical Transplantation
Ebru H Ayvazoglu Soy, Fatih Boyvat, B Handan Ozdemir, Nihan Haberal, Fatih Hilmioglu, Mehmet Haberal
OBJECTIVES: The number of living-donor liver transplants has been increasing due to the growing discrepancy between the number of patients on wait lists for liver transplant and the availability of deceased donations. Evaluations of potential liver donors should ensure the safety of the surgical procedure for both the donor and recipient. Liver biopsy is the criterion standard for selecting optimal donors. In this study, we evaluated the importance of preoperative liver biopsy in selecting donor candidates...
March 2018: Experimental and Clinical Transplantation
Wong Hoi She, Albert Chi Yan Chan, Tan To Cheung, Chung Mau Lo, Kenneth Siu Ho Chok
AIM: To investigate the impact of alpha-fetoprotein (AFP) on long-term recurrence rate and overall survival and we also aimed to define the level of AFP leading to a higher risk of disease recurrence and affecting patient survival. METHODS: Data of adult patients who received liver transplant (LT) for hepatocellular carcinoma (HCC) at our hospital from January 2000 to December 2013 were reviewed. Reviewed data included demographic characteristics, preoperative AFP level, operative details, follow-up details, and survival outcomes...
February 27, 2018: World Journal of Hepatology
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