Home About us Contact
|
Home About us Contact | ||
|
|
||
Related Liver Transplantation (relate + liver_transplantation)
Selected AbstractsIschaemic preconditioning of the graft in adult living related right lobe liver transplantation: impact on ischaemia,reperfusion injury and clinical relevanceHPB, Issue 7 2010Paola Andreani Abstract Background:, Ischaemic preconditioning (IPC) of the right liver graft in the donor has not been studied in adult-to-adult living related liver transplantation (LRLT). Objective:, To assess the IPC effect of the graft on ischaemia reperfusion injury in the recipient and compare recipient and donor outcomes with and without preconditioned grafts. Patients and methods:, Alternate patients were transplanted with right lobe grafts that were (n= 22; Group Precond) or were not (n= 22; Group Control) subjected to IPC in the living donor. Liver ischaemia,reperfusion injury, liver/kidney function, morbidity/mortality rates and outcomes were compared. Univariate and multivariate analyses were performed to identify factors predictive of the aspartate aminotransferase (AST) peak and minimum prothrombin time. Results:, Both groups had similar length of hospital stay, morbidity/mortality, primary non-function and acute rejection rates. Post-operative AST (P= 0.8) and alanine aminotransferase (ALT) peaks (P= 0.6) were similar in both groups (307 ± 189 and 437 ± 302 vs. 290 ± 146 and 496 ± 343, respectively). In univariate analysis, only pre-operative AST and warm ischemia time (WIT) were significantly associated with post-operative AST peak (in recipients). In multivariate analysis, the graft/recipient weight ratio (P= 0.003) and pre-operative bilirubin concentration (P= 0.004) were significantly predictive of minimum prothrombin time post-transplantation. Conclusions:, Graft IPC in the living related donor is not associated with any benefit for the recipient or the donor and its clinical value remains uncertain. [source] Late surgical complications following liver transplantationLIVER TRANSPLANTATION, Issue S2 2009Paige M. Porrett Key Points 1. Biliary strictures and incisional hernias are the most common surgical complications encountered late after liver transplantation. 2. Anastomotic biliary strictures are amenable to endoscopic intervention and rarely need surgical intervention. 3. The presence of a biliary stricture mandates an evaluation of the patency of the hepatic artery. 4. Ischemic-type intrahepatic strictures are common indications for retransplantation. 5. Recipients of living related liver transplantation and donation after cardiac death allografts are at the highest risk for biliary and vascular complications late after transplantation. Liver Transpl 15:S12,S18, 2009. © 2009 AASLD. [source] Human herpesvirus 6 infection in adult living related liver transplant recipientsLIVER TRANSPLANTATION, Issue 1 2008Masahiro Ohashi To analyze human herpesvirus 6 (HHV-6) infection in adult living related liver transplantation, we performed a virological analysis, including viral isolation, serological assay, and real-time polymerase chain reaction, of serially collected blood samples from 67 recipients. In addition, cytokine levels were measured to determine their role in viral reactivation. HHV-6 was isolated from only 4 recipients (6.0%), and viral DNA was detected in 15 (22.4%) of the 67 recipients. A significant increase in HHV-6 immunoglobulin G antibody titers was observed in 19 (28.4%) of the 67 recipients. Finally, 26 recipients (38.8%) had HHV-6 reactivation 2-6 weeks after transplantation. HHV-6 associated clinical features were analyzed in the 17 recipients presenting with either viremia or DNAemia. Two recipients with viremia and 3 recipients with DNAemia had unexplained fever at the time of viral infection. An increase in aminotransferase levels was observed in 2 recipients with viremia and 3 recipients with DNAemia. Recipients with liver cirrhosis caused by hepatitis B virus or hepatitis C virus infection as the underlying disease were more likely to have HHV-6 infection (P = 0.025). Mortality at the last follow-up in recipients with HHV-6 reactivation was significantly higher than in those without viral reactivation (P = 0.0118). Plasma interleukin-6 levels were significantly higher in the recipients with HHV-6 viremia than in the recipients without viremia at 4 weeks post-transplant (P = 0.0411). Moreover, tumor necrosis factor , levels were also higher in recipients with HHV-6 viremia (P < 0.0001) or reactivation (P = 0.0011) than in recipients without viremia or reactivation 4 weeks post-transplant. Liver Transpl, 2007. © 2007 AASLD. [source] Comparison of central venous oxygen saturation and mixed venous oxygen saturation during liver transplantationANAESTHESIA, Issue 4 2009A. El Masry Summary Central venous catheterisation is commonly performed during major surgery and intensive care, and it would be useful if central venous oxygen saturation could function as a surrogate for mixed venous oxygen saturation. We studied 50 patients undergoing living related liver transplantation. Blood samples were taken simultaneously from central venous and pulmonary artery catheters at nine time points during the pre-anhepatic, anhepatic, and postanhepatic phases. Four hundred and fifty sets of measurement were obtained. There was a good correlation between central venous oxygen saturation and mixed venous oxygen saturation. The mean (SD) difference (95% limit of agreement) was lowest at the first time point (1.06 (0.65)%, ,1.94% to 2.7%) and then increased throughout the study but remained acceptable. The change in mixed venous oxygen and central venous oxygen saturations occurred mostly in parallel and as a result changes in mixed venous oxygen saturation were reflected adequately in the change in central venous oxygen saturation. The correlation between mixed venous oxygen saturation and cardiac output was poor. [source] Living related liver transplantation in children,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 7 2008N. Heaton Background: Living related liver transplantation (LRLT) has become established for treating children with end-stage liver disease. The aim of this study was to review a single-centre experience of left lateral segment liver transplants from living donors in children. Methods: Fifty left lateral segment LRLT procedures have been performed since 1993. There were 17 girls and 33 boys, of median age 1·5 years (range 0·5 to 13 years), with a median weight of 10 (range 0·7,44) kg. Donors included 23 mothers, 26 fathers and one uncle, with a median age of 33 (range 19,46) years. Results: At a median follow-up of 86 months, there was no donor mortality and low morbidity. Patient and graft survival rates were 98, 96 and 96 per cent, and 98, 96 and 93 per cent at 1, 3 and 5 years respectively. Three children had a second transplant at a median of 9 years after the first. The incidence of hepatic artery thrombosis, portal vein thrombosis and biliary complications was 6, 4 and 14 per cent respectively. Conclusion: Living related liver transplantation has good long-term results in children. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Use of cadaveric superior mesenteric artery as interpositional vascular graft in orthotopic liver transplantationBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 1 2001P. Muiesan Background: Hepatic artery thrombosis remains the most common technical complication that causes graft failure following orthotopic liver transplantation. The development of split liver and living related liver transplantation has led to the use of shorter and smaller arteries for arterial reconstruction to the graft. The present aim was to assess the effectiveness of the superior mesenteric artery as an interpositional graft in arterial reconstruction during liver transplantation. Methods: Cadaveric superior mesenteric artery was used to reconstruct small and short or multiple hepatic arteries in 35 liver transplants including 29 split, three living related, two whole liver transplants and one emergency revascularization post-transplantation. Results and conclusion: A low incidence of hepatic artery thrombosis (one of 35 patients) was achieved utilizing cadaveric superior mesenteric artery as an interpositional vascular graft in liver transplantation. © 2001 British Journal of Surgery Society Ltd [source] | ||||||||||