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Liver transplanation

Michael Linecker, Tanja Krones, Thomas Berg, Claus U Niemann, Randolph H Steadman, Philipp Dutkowski, Pierre-Alain Clavien, Ronald W Busuttil, Robert D Truog, Henrik Petrowsky
Liver transplantation has emerged as a highly efficient treatment for a variety of acute and chronic liver diseases. However, organ shortage is becoming an increasing problem globally, limiting the applicability of liver transplantation. In addition, potential recipients are becoming sicker, thereby increasing the risk of losing the graft during transplantation or in the initial postoperative period after liver transplantation (three months). This trend is challenging the model for end-stage liver disease allocation system, where the sickest candidates are prioritised and no delisting criteria are given...
November 11, 2017: Journal of Hepatology
Vikas Jain, Anshu Srivastava, Surender K Yachha, Niraj Kumari, Rachana Kathuria, Moinak S Sarma, Ujjal Poddar, Narendra Krishnani
OBJECTIVES: Presentation as autoimmune acute liver failure (AI-ALF) and seronegative autoimmune liver disease (SN-AILD) represents two uncommon variants of AILD. We compared the clinical profile and outcome of AI-ALF with autoimmune-non-acute liver failure (AI-non-ALF) and also SN-AILD with seropositive autoimmune liver disease (SP-AILD). MATERIALS AND METHODS: Children managed as AI-ALF and AI-non-ALF including SN-AILD and SP-AILD were enrolled and compared. AI-non-ALF was diagnosed by simplified diagnostic criteria and AI-ALF by Pediatric Acute Liver Failure Study Group criteria with positive autoantibody, exclusion of other etiologies, elevated immunoglobulin G and histology when available...
December 2017: European Journal of Gastroenterology & Hepatology
David Mutimer
BACKGROUND: Hepatitis C (HCV) is a common cause of liver failure and liver cancer, and is a frequent indication for liver transplantation (LT). Until recently, a majority of transplanted patients were viraemic at the time of transplantation and they inevitably underwent recurrent infection of the graft. Prior to the availability of specific direct-acting antiviral (DAA) drugs, HCV infection was seldom successfully treated before or after transplantation. Key Messages: During the past 2 years, the use of interferon-free DAA therapy has transformed the management of patients post-LT and of patients on the transplant waiting list...
2017: Digestive Diseases
Showkathali Iqbal, Raiz Iqbal, Faiz Iqbal
The Couinaud's liver segmentation is based on the identification of portal vein bifurcation and origin of hepatic veins. It is widely used clinically, because it is better suited for surgery and is more accurate in localizing and monitoring various intra parenchymal lesions. According to standard anatomy, the portal vein bifurcates into right and left branches; the left vein drains segment II, III and IV and the right vein divides into two secondary branches - the anterior portal vein drains segments V and VIII, and the posterior drains segments VI and VII...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
Takeshi Itoh, Hitomi Nishinakamura, Kenjiro Kumano, Hiroyuki Takahashi, Shohta Kodama
Alternative islet transplantation sites have the potential to reduce the marginal number of islets required to ameliorate hyperglycemia in recipients with diabetes. Previously, we reported that T cell leukemia homeobox 1 (Tlx1)+ stem cells in the spleen effectively regenerated into insulin-producing cells in the pancreas of non-obese diabetic mice with end-stage disease. Thus, we investigated the spleen as a potential alternative islet transplantation site. Streptozotocin-induced diabetic C57BL/6 mice received syngeneic islets into the portal vein (PV), beneath the kidney capsule (KC), or into the spleen (SP)...
2017: PloS One
Małgorzata Kościelska, Paweł Żebrowski
Acute kidney injury (AKI) is a common complication in liver transplant recipients. Affecting ~25% of patients preoperatively, and up to 60% postoperatively significantly worsens the prognosis. Etiology differs depending on the time of its onset, from mostly prerenal before the transplantation, ischemic in the early postoperative period to toxic AKI later on. Liver transplantation is a lenghty and complex procedure with a significant risk of hemodynamic instability, metabolic acidosis and electrolyte disturbances...
2015: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
(no author information available yet)
In 14 patients with cirrhosis and portal hypertention autologous mesenclyme multipotential stem cells (AMMSC) transplanation was performed in portal vein (I group, n=7) and common trunk of the hepatic artery (II group, n=6). Duration of pathological processes since diagnosis is 1-8 years (3,7±2,4 years). The initial severity was evaluated by a set of child-Pugh score: Class A - 6 (42,9%), Class B - 8 (57,1%). Cell cultures indentication and characteristics consistent with International Society of cell technology guidanes (ISCT) since 2006...
September 2014: Georgian Medical News
Xing Li, Da-Xiang Wen, Yan-Hong Zhao, Yan-Nan Hang, M Susan Mandell
BACKGROUND: Postoperative cognitive dysfunction (POCD) is an adverse condition characterized by declined cognitive functions following surgeries and anesthesia. POCD has been associated with increased hospital stay and mortality. There are histological similarities to Alzheimer's disease. Most early studies were conducted in patients receiving cardiac surgery. Since there is no information about POCD in liver transplant recipients, we measured the incidence of POCD in patients after liver transplantation and examined the correlation between neurological dysfunction and biological markers of dementia-based diseases...
August 2013: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Shu-ichi Ikeda
No abstract text is available yet for this article.
March 10, 2013: Nihon Naika Gakkai Zasshi. the Journal of the Japanese Society of Internal Medicine
Harvey Ho, Keagan Sorrell, Adam Bartlett, Peter Hunter
In this paper we present a hybrid OD-3D modeling method to investigate the hepatic flow in a virtual right lobe hepatectomy (RLH), the surgical procedure for adult-to-adult living donor liver transplanation (LDLT). The 3D method is employed to simulate complex 3D flow in the portal vein, and the OD model is used to study the systemic hepatic circulation. In particular, we quantify the flow velocity and wall shear stress (WSS) in the left portal vein which increase dramatically post-RLH, and also simulate the essential hepatic distribution features in a healthy adult pre- and post-procedure...
2012: Medical Image Computing and Computer-assisted Intervention: MICCAI ..
Michael D Kluger, James V Guarrera, Sonja K Olsen, Robert S Brown, Jean C Emond, Daniel Cherqui
BACKGROUND: ABO-incompatible organ transplantation typically induces hyperacute rejection. A2-to-O liver transplantations have been successful. This study compared overall and graft survival in O recipients of A2 and O grafts based on Organ Procurement and Transplantation Network data. METHODS: Scientific Registry of Transplant Recipients data were used. The first A2-to-O liver transplantation was entered on March 11, 1990; all previous transplantations were excluded...
September 15, 2012: Transplantation
Alexander J Bondoc, Janice A Taylor, Maria H Alonso, Jaimie D Nathan, Yu Wang, William F Balistreri, Jorge A Bezerra, Frederick C Ryckman, Gregory M Tiao
OBJECTIVE: To determine whether portoenterostomy (PE) revision in patients afflicted with biliary atresia (BA) is a viable treatment option and, if so, identify which patients may benefit. BACKGROUND: BA, the most common cause of neonatal liver disease, results in biliary tract obstruction and hepatic fibrosis. Kasai PE is the initial surgical intervention performed and, if successful, restores drainage and preserves the native liver. Portoenterostomy failure warrants liver transplantation, but because of complications related to transplantation, treatment strategies to salvage the native liver may be beneficial...
March 2012: Annals of Surgery
T Casanovas, A Argudo, M C Peña-Cala
Treatment of recurrent hepatitis C after liver transplantation is indicated in selected cases. During the combined treatment with pegylated interferon and ribavirin, some patients develop immune-mediated liver dysfunction similar to the previously described "de novo" autoimmune hepatitis. Herein we have presented three liver transplant patients who during or after combined antiviral treatment were diagnosed as autoimmune hepatitis related to interferon based on their clinical, biochemical, and liver histology features...
July 2011: Transplantation Proceedings
Kurinchi Selvan Gurusamy, Rahul Koti, Viniyendra Pamecha, Brian R Davidson
BACKGROUND: Veno-venous bypass is used to overcome the effects of clamping of the inferior vena cava and portal vein during liver transplanation. The routine use of veno-venous bypass is, however, controversial. OBJECTIVES: To compare the benefits and harms of veno-venous bypass (irrespective of open or percutaneous technique; heparin-coated or no heparin-coating) versus no veno-venous bypass during liver transplantation. To compare the benefits and harms of the different techniques of veno-venous bypass during liver transplantation...
March 16, 2011: Cochrane Database of Systematic Reviews
A Siniscalchi, Z Miklosova, S Spedicato, E Bernardi, A Zanoni, A Dante, E Pierucci, M Cimatti, I Riganello, L Aurini, L Bernabè, S Faenza
AIM: The hepatic cirrhosis is associated with an important cardiovascular alterations. In this report, we review our transplant center experience with liver transplantation in the Model for End-Stage Liver Disease (MELD) era, in particular this study investigate the relationship between severity of liver disease assessed by MELD score and postoperative events. METHODS: Our retrospective review was performed on 242 cirrhotic patients underwent liver transplanation at the Department of Surgery and Transplantation of the University of Bologna...
September 2010: Minerva Gastroenterologica e Dietologica
Ya-ni Zhang, Ling Liu, Chang-quan Ling
OBJECTIVE: To study the inhibition effect of active fraction from maorenshen (MA, MB) on the growth of transplanted mouse tumor cells H22 and its mechanism. METHOD: The transplanted mouse tumor model in vivo was used to observe the antitumor activity of MA, MB. The cell cycle distributions were determined by flow cytometry (FCM). The apoptosis in tumor was measured by TdT-mediated biotinyated-dUTP nick end-labeling (TUNEL) method. RESULT: MA, MB showed antitumor activitiy on transplanted mouse tumor...
June 2006: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
Christoph E Broelsch, Andrea Frilling, Massimo Malago
The most frequent tumors of the liver originate from the hepatocytes, bile duct epithelium, and endothelial cells. Hepatocellular carcinoma accounts for 80% to 90% of primary liver cancer. Cholangiocarcinoma, a neoplasm that arises from the biliary tree, is the second most common primary hepatic malignancy. This article deals with the epidemiology and clinical presentation and the diagnostic confirmation and classification of both conditions, and with the use of liver resection and transplanation treatment for both...
April 2004: Surgical Clinics of North America
J Loriau, D Manaouil, F Mauvais
The treatment of umbilical hernia in the setting of cirrhosis poses unique and specific management problems due to the pathophysiology of cirrhotic ascites. The high intra-abdominal pressures generated by ascites when applied to areas of parietal weakness are the cause of hernia formation and enlargement. Successful surgical treatment depends on minimization or elimination of ascites. Umbilical rupture and hernia strangulation are the most life-threatening complications of umbilical hernia with ascites and they demand urgent surgical intervention...
June 2002: Journal de Chirurgie
Valerie Byrnes, Nezam Afdhal
Since the description by Klatskin in 1965, the management of patients with adenocarcinoma of the hepatic bile duct bifurcation is viewed as a challenging clinical problem with a relatively poor prognosis. Surgery continues to be the mainstay of therapy. Complete resection of the tumor with negative histologic margins offers the best possibility of long-term survival, and hepatic resection is a critical component of the operative approach. Adjuvant chemoradiotherapy has failed to provide a significant survival benefit...
April 2002: Current Treatment Options in Gastroenterology
S R Bramhall, E Minford, B Gunson, J A Buckels
INTRODUCTION: This paper provides a review of the practice of liver transplantation with the main emphasis on UK practice and indications for transplantation. REFERRAL AND ASSESSMENT: This section reviews the process of referral and assessment of patients with liver disease with reference to UK practice. DONOR ORGANS: The practice of brainstem death and cadaveric organ donation is peculiar to individual countries and rates of donation and potential areas of improvement are addressed...
October 2001: World Journal of Gastroenterology: WJG
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