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Living donor liver transplantation

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https://www.readbyqxmd.com/read/29351366/living-donor-liver-transplantation-for-hepatocellular-carcinoma-to-expand-beyond-milan-or-downstage-to-milan
#1
EDITORIAL
Neil Mehta, Francis Y Yao
No abstract text is available yet for this article.
January 19, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29350831/randomized-trial-on-extended-versus-modified-right-lobe-grafts-in-live-donor-liver-transplantation
#2
Christi Titus Varghese, Viju Kumar Bharathan, Unnikrishnan Gopalakrishnan, Dinesh Balakrishnan, Ramachandran N Menon, Othiyil Vayoth Sudheer, Puneet Dhar, Sudhindran Surendran
Despite advances in the practice of live donor liver transplantation (LDLT), the optimum surgical approach with respect to the middle hepatic vein (MHV) in right lobe LDLT remains undefined. We designed a randomized trial to compare the early postoperative outcomes in recipients and donors between extended right lobe grafts (ERG: transection plane was maintained to the left of MHV, and division of MHV performed beyond the segment VIII vein) and modified right lobe grafts (MRG: transection plane was maintained to the right of MHV, the segment V and VIII drainage was reconstructed using a conduit of recipient portal vein)...
January 19, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29343286/diagnosis-and-management-of-transthyretin-familial-amyloid-polyneuropathy-in-japan-red-flag-symptom-clusters-and-treatment-algorithm
#3
REVIEW
Yoshiki Sekijima, Mitsuharu Ueda, Haruki Koike, Sonoko Misawa, Tomonori Ishii, Yukio Ando
Hereditary ATTR (ATTRm) amyloidosis (also called transthyretin-type familial amyloid polyneuropathy [ATTR-FAP]) is an autosomal-dominant, adult-onset, rare systemic disorder predominantly characterized by irreversible, progressive, and persistent peripheral nerve damage. TTR gene mutations (e.g. replacement of valine with methionine at position 30 [Val30Met (p.Val50Met)]) lead to destabilization and dissociation of TTR tetramers into variant TTR monomers, which form amyloid fibrils that deposit in peripheral nerves and various organs, giving rise to peripheral and autonomic neuropathy and several non-disease specific symptoms...
January 17, 2018: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/29338386/estrogen-estrogen-receptor-%C3%AE-signaling-facilitates-bilirubin-metabolism-in-regenerating-liver-through-regulating-cytochrome-p450-2a6-expression
#4
Ta-Lun Kao, Yao-Li Chen, Yu-Ping Kuan, Wei-Chun Chang, Yu-Chen Ho, Shuyuan Yeh, Long-Bin Jeng, Wen-Lung Ma
BACKGROUND: After living donor liver transplantation (LDLT), rising serum bilirubin levels commonly indicate insufficient numbers of hepatocytes are available to metabolize bilirubin into biliverdin. Recovery of bilirubin levels is an important marker of hepatocyte repopulation after LDLT. Cytochrome P450 (CYP) 2A6 in humans (or cyp2a4 in rodents) can function as "bilirubin oxidase." Functional hepatocytes contain abundant CYP2A6, which is considered a marker for hepatocyte function recovery...
November 2017: Cell Transplantation
https://www.readbyqxmd.com/read/29334530/antegrade-arterial-and-portal-flushing-versus-portal-flushing-only-for-right-lobe-live-donor-liver-transplantation-a-randomized-control-trial
#5
Viniyendra Pamecha, Rommel Sandhyav, Piyush Kumar Sinha, Kishore Gurumoorthy Subramanya Bharathy, Shridhar Sasturkar
INTRODUCTION: In live donor liver transplantation (LDLT) portal flush only of the graft is done on the bench. There is no data on antegrade arterial flush along with portal flush of the graft. METHODS: Consecutive patients undergoing elective right lobe LDLT were block-randomized to receive either portal flush only or both portal and antegrade arterial flush. The primary objectives were safety, rate of early allograft dysfunction (EAD), and impact on vascular and biliary complications RESULTS: After randomization there were 40 patients in each group...
January 12, 2018: Transplantation
https://www.readbyqxmd.com/read/29328523/improved-portal-vein-venoplasty-with-autogenous-patch-in-pediatric-living-donor-liver-transplantation
#6
Mingxuan Feng, Ping Wan, Bijun Qiu, Tao Zhou, Yi Luo, Lihong Gu, Jiachang Chi, Chengpeng Zhong, Yefeng Lu, Jianjun Zhang, Qiang Xia
BACKGROUND: An atretic or hypoplastic portal vein (PV) represents a challenge for PV reconstruction in pediatric living donor liver transplantation (LDLT). Several PV venoplastic techniques have been developed. However, we still seek improved venoplastic techniques with better efficacy and compatibility. METHOD: From June 2016 to July 2017, 271 LDLT procedures were performed at the Department of Liver Surgery, Ren Ji Hospital. A total of 16 consecutive children with atretic and sclerotic PVs underwent a novel technique - the autogenous PV patch plastic technique...
January 12, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29323760/donor-cd163-and-nestin-positive-cells-predict-graft-function-in-living-donor-liver-transplant
#7
Neha Nigam, Chhagan Bihari, Deepika Lal, Archana Rastogi, Senthil Kumar, Viniyendra Pamecha, Savneet Kaur, Anupam Kumar, Shiv K Sarin
AIMS: To evaluate the effect of donor liver resident mesenchymal cells, M2 macrophages on liver graft outcome after living donor liver transplantation. MATERIALS AND METHODS: 70 donor biopsies were included in the study. Outcomes at day 3, 7, 30 and 180 post liver transplantation were assessed. Mesenchymal stem cells and M2 macrophages in donor liver biopsies were evaluated. RESULTS: Mean age of recipients was 40.9 ± 13.6 years. Sex mismatched transplants were 44 (M→F=9; F→M=35)...
January 11, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29322327/combined-and-sequential-liver-kidney-transplantation-in-children
#8
Ryszard Grenda, Piotr Kaliciński
Combined and sequential liver-kidney transplantation (CLKT and SLKT) is a definitive treatment in children with end-stage organ failure. There are two major indications: - terminal insufficiency of both organs, or - need for transplanting new liver as a source of lacking enzyme or specific regulator of the immune system in a patient with renal failure. A third (uncommon) option is secondary end-stage renal failure in liver transplant recipients. These three clinical settings use distinct qualification algorithms...
January 10, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29319622/a-high-portal-venous-pressure-gradient-increases-gut-related-bacteremia-and-consequent-early-mortality-after-living-donor-liver-transplantation
#9
Siyuan Yao, Shintaro Yagi, Ryuji Uozumi, Taku Iida, Miki Nagao, Yusuke Okamura, Takayuki Anazawa, Hideaki Okajima, Toshimi Kaido, Shinji Uemoto
BACKGROUND: Portal hypertension (PHT) is defined as a portal venous pressure gradient (PVPG) exceeding 5 mmHg, which results in severe clinical manifestations. However, the validity of intraoperative PVPG monitoring and the association between PHT and bacterial translocation (BT) after liver transplantation remain unclear. METHODS: In this retrospective study, 223 patients who underwent primary adult-to-adult living donor liver transplantation (ALDLT) from 2008 to 2015 were divided into 2 groups based on the PVPG at the end of the operation: high PVPG (>5 mmHg, n=69) and low PVPG (≤5 mmHg, n=154)...
January 10, 2018: Transplantation
https://www.readbyqxmd.com/read/29312971/impact-of-sarcopenic-overweight-on-the-outcomes-after-living-donor-liver-transplantation
#10
Ahmed Hammad, Toshimi Kaido, Yuhei Hamaguchi, Shinya Okumura, Atsushi Kobayashi, Hisaya Shirai, Naoko Kamo, Shintaro Yagi, Shinji Uemoto
Background: The effect of body composition disturbances has been recently in focus. Sarcopenic obesity, a co-occurrence of low muscle mass and high body fat was reportedly predictive of high mortality in patients with cirrhosis. However, the impact of the interacting sarcopenia and overweight on the outcomes after liver transplantation is still unclear. Methods: We evaluated 200 patients undergoing adult-to-adult living donor liver transplantation at our institution between January 2008 and November 2013 classified according to BMI and psoas muscle index (PMI) on admission to transplant into 4 subgroups; sarcopenic overweight (SO), sarcopenic non-overweight (SN), non-sarcopenic overweight and non-sarcopenic non-overweight (NN)...
December 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/29311539/tolvaptan-for-fluid-management-in-living-donor-liver-transplant-recipients
#11
Shunichi Imai, Masahiro Shinoda, Hideaki Obara, Minoru Kitago, Taizo Hibi, Yuta Abe, Hiroshi Yagi, Kentaro Matsubara, Hisanobu Higashi, Osamu Itano, Yuko Kitagawa
BACKGROUND Tolvaptan, an antagonist of the vasopressin V2 receptor is a novel oral diuretic that promotes water excretion selectively. We have used furosemide as a primary diuretic and added human atrial natriuretic peptide (hANP) if necessary for fluid management postoperatively in living-donor liver transplantation (LDLT) recipients. Recently we introduced tolvaptan and used both tolvaptan and furosemide as primary diuretics. MATERIAL AND METHODS Clinical outcomes were compared between LDLT recipients whose postoperative fluid management was performed before (control group, n=10) and after (tolvaptan group, n=16) introduction of tolvaptan...
January 9, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29307930/hepatocyte-specific-contrast-agent-enhanced-magnetic-resonance-cholangiography-perioperative-evaluation-of-the-biliary-tree
#12
Luciana Carmen Zattar-Ramos, Regis Otaviano Franca Bezerra, Luis Tenório de Brito Siqueira, Marcos Roberto Menezes, Claudia da Costa Leite, Giovanni Guido Cerri
A large number of gadolinium chelates have recently been tested in clinical trials. Some of those have already been approved for clinical use in the United States and Europe. Thus, new diagnostic perspectives have been incorporated into magnetic resonance imaging studies. Among such gadolinium chelates are hepatobiliary-specific contrast agents (HSCAs), which, due to their property of being selectively taken up by hepatocytes and excreted by the biliary ducts, have been widely used for the detection and characterization of focal hepatic lesions...
November 2017: Radiologia Brasileira
https://www.readbyqxmd.com/read/29307689/fifteen-year-trends-in-pediatric-liver-transplants-split-whole-deceased-and-living-donor-grafts
#13
Douglas B Mogul, Xun Luo, Mary G Bowring, Eric K Chow, Allan B Massie, Kathleen B Schwarz, Andrew M Cameron, John F P Bridges, Dorry L Segev
OBJECTIVE: To evaluate changes in patient and graft survival for pediatric liver transplant recipients since 2002, and to determine if these outcomes vary by graft type (whole liver transplant, split liver transplant [SLT], and living donor liver transplant [LDLT]). STUDY DESIGN: We evaluated patient and graft survival among pediatric liver-only transplant recipients the PELD/MELD system was implemented using the Scientific Registry of Transplant Recipients. RESULTS: From 2002-2009 to 2010-2015, survival for SLT at 30 days improved (94% vs 98%; P < ...
January 4, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29298237/elevated-high-sensitivity-troponin-i-during-living-donor-liver-transplantation-is-associated-with-postoperative-adverse-outcomes
#14
Jungchan Park, Seung Hwa Lee, Sangbin Han, Ki Yoon Kim, Go Eun Kim, Myungsoo Park, Suk-Koo Lee, Gyu-Seong Choi, Soohyun Ahn, Hyeon Seon Ahn, Gaab Soo Kim
BACKGROUND: This study aimed to evaluate risk factors and postoperative clinical outcome associated with myocardial injury detected by an elevated high-sensitivity cardiac troponin I (hs-cTnI) immediately after living donor liver transplantation (LDLT). METHODS: Between January 2011 and December 2016, 313 adult recipients undergoing LDLT, with normal preoperative hs-cTnI were selected. Hs-cTnI level above 0.04 ng/mL according to 99th percentile reference limit was defined as myocardial injury...
January 2, 2018: Transplantation
https://www.readbyqxmd.com/read/29288697/mesenchymal-stromal-cells-for-tolerance-induction-in-organ-transplantation
#15
REVIEW
Federica Casiraghi, Norberto Perico, Giuseppe Remuzzi
The primary challenge in organ transplantation continues to be the need to suppress the host immune system long-term to ensure prolonged allograft survival. Long-term non-specific immunosuppression can, however, result in life-threatening complications. Thus, efforts have been pursued to explore novel strategies that would allow minimization of maintenance immunosuppression, eventually leading to transplant tolerance. In this scenario, bone marrow-derived mesenchymal stromal cells (MSC), given their given unique immunomodulatory properties to skew the balance between regulatory and memory T cells, have emerged as potential candidates for cell-based therapy to promote immune tolerance...
December 27, 2017: Human Immunology
https://www.readbyqxmd.com/read/29287582/acute-pancreatitis-a-rare-but-serious-complication-for-living-liver-donors-risk-factors-and-outcomes
#16
Adil Baskiran, Metin Kement, Bora Barut, Oguzhan Ozsay, Serdar Karakas, Cemalettin Koç, Sezai Yilmaz
OBJECTIVES: The purposes of this study were to determine the incidence of acute pancreatitis after living donor hepatectomy and to investigate potential risk factors and outcomes. MATERIALS AND METHODS: Clinical data of all donors who underwent donor hepatectomy between January 2015 and December 2016 in our liver transplant institute were reviewed. Donor data were obtained from a prospectively maintained database. The donors were divided into 2 groups according to whether they developed postoperative pancreatitis...
December 29, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29285393/chronic-myeloid-leukemia-following-liver-transplantation-a-case-report
#17
Ling Zhang, Bing Long, Xiao-Qing Li, Zhi-Gang Fang, Wen-Xing Lai, Dong-Jun Lin
Long-term utilization of immunosuppression in organ transplant recipients leads to decreased immune-mediated tumor surveillance and increased risk of developing malignant tumors. However, chronic myeloid leukemia (CML) following living donor liver transplantation (LDLT) is rarely reported. The current case report presents a 42-year-old male patient who developed CML 14 months following LDLT. The patient achieved complete hematologic remission and early molecular response at 3 months imatinib treatment and major molecular response at 12 months imatinib treatment...
December 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29281863/impact-of-abdominal-shape-on-living-liver-donor-outcomes-in-mini-incision-right-hepatic-lobectomy-comparison-among-three-techniques
#18
Mohamed Safwan, Shunji Nagai, Kelly Collins, Michael Rizzari, Atsushi Yoshida, Marwan Abouljoud
While minimally invasive techniques for living donor hepatectomy have been developed, the surgical feasibility and limitations remain to be elucidated. The risks and outcomes involved need to be better understood prior to their widespread application. The aim of this study was to assess feasibility of minimally invasive donor hepatectomy by reviewing our experience. A total of 99 living donor liver transplantation (LDLTs) performed between 2000 and 2016 were retrospectively reviewed. All 99 living liver donors underwent right hepatectomy...
December 27, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29280920/liver-transplantation-for-hepatocellular-carcinoma-within-the-milan-criteria-versus-the-university-of-california-san-francisco-criteria-a-comparative-study
#19
Mohamed R Abdelfattah, Hussein El-Siesy, Hadeel Al-Manea, Dieter C Broering
BACKGROUND: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths worldwide. Currently, liver transplantation (LT) for HCC is the only hope for cure from the tumor and from end-stage liver disease (ESLD). The organ pool shortage in deceased donor LT and the donor-related ethical concerns in living-donor LT necessitate the use of rigorous criteria for LT for HCC. In this respect, two main criteria for LT for HCC were implemented with good outcome, namely, the Milan and the University of California San Francisco criteria...
December 26, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29279503/lung-metastases-from-bile-duct-adenocarcinoma-mimicking-chronic-airway-infection-and-causing-diagnostic-difficulty
#20
Mitsuo Sato, Shotaro Okachi, Jun Fukihara, Yoshie Shimoyama, Keiko Wakahara, Toshihiro Sakakibara, Tetsunari Hase, Yasuharu Onishi, Yasuhiro Ogura, Osamu Maeda, Yoshinori Hasegawa
We herein report a case of lung metastases with unusual radiological appearances that mimicked those of chronic airway infection, causing diagnostic difficulty. A 60-year-old woman who underwent liver transplantation from a living donor was incidentally diagnosed with bile duct adenocarcinoma after a histopathological analysis of her explanted liver. Six months later, chest computed tomography (CT) revealed bilateral bronchogenic dissemination that had gradually worsened, suggesting chronic airway infection...
December 27, 2017: Internal Medicine
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