TY - JOUR. T1 - Portal vein grafts in hepatic transplantation. AU - Shaw, B. W.. AU - Iwatsuki, S.. AU - Bron, K.. AU - Starzl, T. E.. PY - 1985/1/1. Y1 - 1985/1/1. N2 - Confirmation of patency of the portal vein by either ultrasound or angiography is a routine part of the evaluation of patients being considered for hepatic transplantation. Complete thrombosis of the portal vein usually has been viewed as precluding successful orthotopic hepatic replacement. In addition, some pediatric patients present with extremely small portal veins which, although patent, have proved to be thick walled and sclerotic. Our recent experience has shown that, in both of these situations, successful and complete revascularization of hepatic allografts is quite feasible by using a vein graft to ensure adequate portal venous flow.. AB - Confirmation of patency of the portal vein by either ultrasound or angiography is a routine part of the evaluation of patients being considered for hepatic transplantation. Complete ...
Since the 1960 s, with the successful development of liver transplantation, it has become an important method for the treatment of patients with end-stage liver disease.Biliary atresia1 is the most frequent causes of pediatric end-stage liver disease,.The morbidity of congenital biliary atresia is 1/8000-18, 0002 ,which influence the patients overall growth and development situation. The rising of living donor liver transplantation has provide children with the chance of a timely treatment since the 1980 s, It is no doubt that pediatric liver transplantation is facing with many complications, including the most importance of neurocognitive development .Now the researches of neurological complications is less .According to statistics, the incidence of neurological complications after pediatric liver transplantation was 8% - 46% . So it is necessary to research the neurological complications and brain protection strategy .Previous studies have studied that some anaesthetic have uncertain affect ...
TY - JOUR. T1 - Living-related liver transplantation in children. T2 - The Parisian strategy to safely increase organ availability. AU - Révillon, Y.. AU - Michel, J. L.. AU - Lacaille, F.. AU - Sauvat, F.. AU - Farges, O.. AU - Belghiti, J.. AU - Rengeval, A.. AU - Jouvet, P.. AU - Sayegh, N.. AU - Sarnacki, S.. AU - Jan, D.. PY - 1999/5. Y1 - 1999/5. N2 - Purpose: The aim of the authors was to report their experience with living related liver transplantation (LRLT) in children, particularly focusing on the safety of the two-center Parisian strategy. Methods: The records of donors and recipients of 26 pediatric living-related donor liver transplantations performed between November 1994 and March 1998 were reviewed retrospectively. Donors were assessed 1 year after transplantation for medical and overall status. Results: Indications for LRLT included biliary atresia (n = 18), Bylers disease (n = 5), alpha-1-antitrypsin deficiency (n = 1), Alagille syndrome (n = 1), and undefined cirrhosis ...
Pediatric Liver Transplant Surgery Hospital in India. Global Hospitals India is the most active pediatric liver transplant hospital in India and has performed many succesful pediatric liver transplantation in India. Global Hospitals India has performed types of pediatric liver transplant like, Deceased donor / cadaveric donor whole liver transplant, Split-liver transplant, Living donor liver transplant, Domino liver transplant , Auxiliary liver transplant in India
Evolution of liver transplantation. Hepatology (1982) 19.54 FK 506 for liver, kidney, and pancreas transplantation. Lancet (1989) 13.70 A flexible procedure for multiple cadaveric organ procurement. Surg Gynecol Obstet (1984) 10.33 Cell migration and chimerism after whole-organ transplantation: the basis of graft acceptance. Hepatology (1993) 8.76 Orthotopic liver transplantation in ninety-three patients. Surg Gynecol Obstet (1976) 8.11 The use of cyclosporin A and prednisone in cadaver kidney transplantation. Surg Gynecol Obstet (1980) 7.40 The use of heterologous antilymphoid agents in canine renal and liver homotransplantation and in human renal homotransplantation. Surg Gynecol Obstet (1967) 7.24 Fifteen years of clinical liver transplantation. Gastroenterology (1979) 7.19 Venous bypass in clinical liver transplantation. Ann Surg (1984) 7.04 Liver transplantation with use of cyclosporin a and prednisone. N Engl J Med (1981) 6.95 The many faces of multivisceral transplantation. Surg Gynecol ...
Absence of a normal left extrahepatic portal vein is considered to be a contraindication to left lobe living-related liver transplantation. This report is of a successful case of living- related liver transplantation using a left lobe procured in a patient presenting with an absent horizontal segment of the left extrahepatic vein. ...
1. Brown RS. Hepatitis C and liver transplantation. Nature. 2005 ;436:973-8 2. Davis GL, Albright JE, Cook SF, Rosenberg DM. Projecting future complications of chronic hepatitis C in the United States. Liver Transpl. 2003 ;9:331-8 3. El-Serag HB. Hepatocellular carcinoma: recent trends in the United States. Gastroenterology. 2004 ;127:S27-34 4. Wiesner RH, Sorrell M, Villamil F, the International Liver Transplantation Society Expert Panel. Report of the first international liver transplantation society expert panel consensus conference on liver transplantation and hepatitis C. Liver Transpl. 2003 ;9:S1-S9 5. Vargas HE, Rodriguez-Luna H. Management of hepatitis C virus infection in the setting of liver transplantation. Liver Transpl. 2005 ;11:479-89 6. Charlton M. Liver biopsy, viral kinetics, and the impact of viremia on severity of hepatitis C virus recurrence. Liver Transpl. 2003 ;9:S58-S62 7. Chopra KB, Demetris AJ, Blakolmer K, Dvorchik I, Laskus T, Wang LF, Araya VR, Dodson F, Fung JJ, ...
TY - JOUR. T1 - Pediatric liver transplantation using left hepatic segments from living related donors. T2 - Surgical experience in 100 recipients at Saint-Luc University Clinics. AU - Darwish, Ahmed A.. AU - Bourdeaux, Christophe. AU - Kader, Hesham A.. AU - Janssen, Magda. AU - Sokal, Etienne. AU - Lerut, Jan. AU - Ciccarelli, Olga. AU - Veyckemans, Francis. AU - Otte, Jean Bernard. AU - Goyet, Jean De Ville De. AU - Reding, Raymond. PY - 2006/5. Y1 - 2006/5. N2 - Living-related liver transplantation was developed in the context of deceased donor organ shortage, which is particularly acute for pediatric recipients. This retrospective study analyzes the surgical technique and complications in the first 100 pediatric liver transplantation using left segmental liver grafts from living donors, performed at Saint-Luc University Clinics between July 1993 and April 2002. Pre-operative evaluation in donors and recipients, analysis of the surgical technique, and postoperative complications were ...
TY - JOUR. T1 - Hepatic protein synthesis rate of liver specimens as a predictor of viability in rat cold ischemia liver transplantation model. AU - Matsui, Yoshifumi. AU - Asano, Takehide. AU - Nakagohri, Toshio. AU - Yokoro, Yoshiharu. AU - Kainuma, Osamu. AU - Kenmochi, Takashi. AU - Isono, Kaich. PY - 1997/11. Y1 - 1997/11. N2 - Background/Aims: We have previously reported that the hepatic protein synthesis rate, calculated as the uptake rate of L-[4.5 3H] leucine by the fraction during a 10-min incubation of a 16-G needle biopsy specimen of liver tissue, represents a high level of liver function and is therefore useful for evaluating liver function. We investigated the hepatic protein synthesis rate level in a pretransplant liver to learn if it might predict the outcome in a rat orthotopic liver transplantation model. Methods: Grafts were stored, liver specimens were obtained using a 21-G Chiba type II skinny needle, and the hepatic protein synthesis rate was calculated. Subsequently, liver ...
BACKGROUND & AIMS: Patients undergoing liver transplantation have complex changes in their hemostatic system, and the net effect of these changes appears a rebalanced hemostatic profile. Recently, a process called NETosis, in which a neutrophil expels DNA and proteins that form a web-like structure, has been described as a mechanism of pathogen entrapment. Increasing evidence suggests a pivotal role for neutrophil extracellular traps (NETs), and their main component cell-free DNA in activation of coagulation. As liver transplantation is associated with substantial (hepatocyte) cell death and intrahepatic neutrophil accumulation, NETs might play an important role in the hemostatic balance during liver transplantation. Here, we determined markers for NETs in plasma of patients undergoing a liver transplantation and examined their association with activation of coagulation.. METHODS: Markers for NETs and markers for activation of coagulation were determined in serial plasma samples taken from ...
govind ram liver transplant consultant of india support group provides information on liver transplant in india, cost of liver transplant, liver diseases, liver transplant, pre-transplant preparation, peri or post transplant care of liver recipient and liver donor, cadaver organ donation,cadaver liver donation, etc. by the most experienced liver transplant coordinator Anshu Gupta in india.,Complete Medical Guide to Organ donation, Organ Transplant, Multi-Organ Transplant,Gastroenterology,Hepatology,GI Surgery,, Liver Cirrhosis,liver diseases,Liver Operation, Liver Specialist,liver surgery,Liver Transplant India, Liver Transplant in India, Liver Transplant Surgeon, Liver Transplantation,Gastrointestinal Surgery,Support Group, Liver Transplant Consultant of India,Govind Ram, Dr Subash Gupta,Anshu Gupta,Liver Transplant India, Liver Transplant,Gastroenterology,Hepatology,GI Surgery,, Liver Cirrhosis,liver diseases,Liver Operation, Liver Specialist,liver surgery Liver Transplant, liver transplant
Abstract 18. Living related liver transplantation now has a history of almost ten years. Although survival of both graft and patients appears good these data are based mainly on historic controls and comparisons between different centers. We reviewed the results of all children (,16 yr.) receiving their first liver transplant at a single center between 1990 and 1997. The recipients of living related liver allografts (LRLT) were compared to those receiving allografts from cadaveric donors (CadLT), and to the sub-group of recipients receiving reduced-size liver transplants (RSCLT) from cadaveric donors. There were 170 primary orthotopic liver transplants in pediatric patients during this period of which 29 were LRLT. Of the 141 CadLT patients 43 received RSCLT. Post-operative care, including immunosuppression, was the same for both groups. The groups receiving cadaveric and living related allografts were different in terms of age at transplant (median 1.45 v 0.86 yr. respectively, p=0.045) and ...
de Ville de Goyet, J ; Reding, Raymond ; Lerut, Jan ; Sokal, Etienne ; Janssen, M. ; et. al. Paediatric orthotopic liver transplantation: lessons from a 532 transplant single centre experience with 532 transplants in 446 children.. In: Acta gastro-enterologica Belgica, Vol. 62, no. 3, p. 290-4 (1999 ...
Until recently, HIV infection was considered as a contraindication for liver transplantation. A dramatic improvement in survival of HIV patients have been observed since the advent of new antiviral treatments against HIV including antiproteases. However an important proportion of patients with HCV-HIV coinfection are suffering from life-threatening liver disease due to HCV infection. Liver transplantation may be considered in this particular group of patients.. The ideal timing for the indication of liver transplantation during HIV disease and during the course of HCV liver disease needs to be defined. Liver transplantation in this particular group of patients raised several questions : a) the role of HIV infection on prevalence and severity of HCV recurrence after transplantation ; b) the role of liver transplantation and immunosuppression on HIV disease ; c) drug interactions between immunosuppressive agents and antiproteases ; d) immunological follow-up and quality of life of these patients. ...
TY - JOUR. T1 - Intrahepatic biliary strictures without hepatic artery thrombosis after liver transplantation. T2 - An analysis of 1,113 liver transplantations at a single center. AU - Nakamura, Noboru. AU - Nishida, Seigo. AU - Neff, Guy R.. AU - Vaidya, Anil. AU - Levi, David M.. AU - Kato, Tomoaki. AU - Ruiz, Phillip. AU - Tzakis, Andreas G.. AU - Madariaga, Juan R.. PY - 2005/2/27. Y1 - 2005/2/27. N2 - Background. Intrahepatic biliary strictures (IHBS) without hepatic artery thrombosis (HAT) is a serious complication and known to increase the risk of graft failure after liver transplantation. This manuscript describes the incidence, risk factors, clinical pictures, management, and outcomes. Methods. Between 1994 and 2002, 1,113 liver transplantations were performed in 974 adult patients. Data was retrospectively analyzed in terms of incidence, risk factors, clinical pictures (type of strictures), management (radiologic, surgical management), and outcomes. Results. Sixteen (1.4%) grafts had ...
HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS. . Hepatic artery complications after liver transplantation are uncommon- improved techniques.However, they represent an important cause of morbidity and mortality and are a m...
Purpose: Left-lobe grafts are underused for adult liver transplantation in the United States. Better strategy is needed to expand the use of left lobe in both deceased split (DST) and living donor transplantation (LDT).. *Methods: Retrospective review of 80 LDT and 68 DST performed between 2004 and 2017 in the single institution. The study period was divided to before and after 2010, when a novel triple hepatic vein outflow technique was introduced and inflow modulation was converted from portocaval shunt to splenectomy.. *Results: Left-lobe utilization in LDT was well with 40% during the overall study period, and that of DST was increased from 0% to 27% in the later period. Selecting smaller recipients for left-lobe DST enabled to have a decent graft-to-recipient weight ratio (GRWR). Compared to DST, LDT using left-lobe was performed with a significantly lower median GRWR (0.79 vs. 1.24), and higher portal flow (150 vs. 106 mL/100gLW), with more frequent inflow modulation (56% vs. 7%). In the ...
The Liver Care Center provides liver donor options, liver transplant techniques and information on the liver transplant process for treatment of end-stage liver disease in children. Learn more about liver transplantation and the pediatric liver transplant program at St. Louis Childrens Hospital.
A recent study by doctors at the University of Washington explained that patients who are significantly underweight or very severely obese prior to liver transplantation are at increased risk of death following transplantation surgery. These findings, from the largest known observation of liver transplantation at the extremes of BMI, are published in the August issue of Liver Transplantation, a journal published by John Wiley & Sons on behalf of the American Association for the Study of Liver Diseases.
Liver transplantation or hepatic transplantation is the replacement of a diseased liver with the healthy liver from another person (allograft). Liver transplantation is a treatment option for end-stage liver disease and acute liver failure, although availability of donor organs is a major limitation. The most common technique is orthotopic transplantation, in which the native liver is removed and replaced by the donor organ in the same anatomic position as the original liver. The surgical procedure is complex, requiring careful harvest of the donor organ and meticulous implantation into the recipient. Liver transplantation is highly regulated, and only performed at designated transplant medical centers by highly trained transplant physicians and supporting medical team. The duration of the surgery ranges from 4 to 18 hours depending on outcome.[medical citation needed] Favorable outcomes require careful screening for eligible recipient, as well as a well-calibrated live or cadaveric donor ...
govind ram liver transplant consultant of india support group provides information on liver transplant in india, cost of liver transplant, liver diseases, liver transplant, pre-transplant preparation, peri or post transplant care of liver recipient and liver donor, cadaver organ donation,cadaver liver donation, etc. by the most experienced liver transplant coordinator Anshu Gupta in india.,Complete Medical Guide to Organ donation, Organ Transplant, Multi-Organ Transplant,Gastroenterology,Hepatology,GI Surgery,, Liver Cirrhosis,liver diseases,Liver Operation, Liver Specialist,liver surgery,Liver Transplant India, Liver Transplant in India, Liver Transplant Surgeon, Liver Transplantation,Gastrointestinal Surgery,Support Group, Liver Transplant Consultant of India,Govind Ram, Dr Subash Gupta,Anshu Gupta,Liver Transplant India, Liver Transplant,Gastroenterology,Hepatology,GI Surgery,, Liver Cirrhosis,liver diseases,Liver Operation, Liver Specialist,liver surgery Liver Transplant, liver transplant
govind ram liver transplant consultant of india support group provides information on liver transplant in india, cost of liver transplant, liver diseases, liver transplant, pre-transplant preparation, peri or post transplant care of liver recipient and liver donor, cadaver organ donation,cadaver liver donation, etc. by the most experienced liver transplant coordinator Anshu Gupta in india.Complete Medical Guide to Organ donation, Organ Transplant, Multi-Organ Transplant, Liver Transplant, Pre-Transplant Preparation, Peri or Post Transplant, Care of Liver Recipient and Liver Donor, Liver Transplant in India, Liver Transplant Specialists, Liver Transplant Surgeons, Liver Donation, Cadaver Organ Donation, Kidney Transplant, Kidney Diseases, Dialysis, Kidney surgery, Kidney Stone, Liver Diseases, Cirrhosis, Liver Cirrhosis, Liver Cancer, Liver Failure, Hepatitis, Jaundice, Liver Transplantation, Jaundice, Liver Surgery in India, Liver transplant in India, Liver Operation in India, Liver
BITENCOURT, Almir Galvão Vieira et al. Incidence and imaging findings of lymphoma after liver transplantation in children. Radiol Bras [online]. 2012, vol.45, n.1, pp.7-11. ISSN 1678-7099. https://doi.org/10.1590/S0100-39842012000100004.. OBJECTIVE: To evaluate the incidence and imaging findings of lymphoma after liver transplantation in children. MATERIALS AND METHODS: The authors reviewed records and imaging studies of children submitted to liver transplantation in the period between 2000 and 2008 in a single institution. RESULTS: Among 241 children submitted to liver transplantation, with a mean follow-up period of 41.4 ± 26.4 months, 16 (6.6%) had lymphoma. The mean age of the patients who developed lymphoma at the moment of transplantation was lower than in children who did not develop malignancy (23.9 ± 18.9 versus 38.0 ± 48.9 months; p = 0.02). The time interval between liver transplantation and the diagnosis of lymphoma ranged from 6 to 103 months. Clinical and radiological ...
Global Hospitals India is the most active pediatric liver transplant hospital in India and has performed many succesful pediatric liver transplantation in India.Get the information on Signs and Symptoms of Pediatric Liver Transplant Surgery and Pediatric Liver Diseases. Best Pediatrci Liver Transplant Hospital in India
Liver transplantation is a treatment option for combined hepatocellular and cholangiocellular carcinoma (cHCC-CC) but its prognostic significance remains unclear. The present study aimed to evaluate the therapeutic effects of liver transplantation on cHCC-CC and analyze the clinicopathological factors affecting prognosis. Retrospective analysis of the clinicopathological data of a case series of 21 patients with cHCC-CC who underwent orthotopic liver transplantation from April 2000 to April 2011 was performed. Cumulative survival rate and tumor-free survival rate were calculated using the Kaplan-Meier method followed by the log-rank test. The operative survival rate of the 21 patients was 100%; the 30 day mortality was 4.8% (1/21) and 90-day mortality was 9.5% (2/21); 1-, 2-, 3-, and 5-year overall cumulative survival rates were 64%, 47%, 39%, and 39%, respectively; and the corresponding cumulative tumor-free survival rates were 64%, 37%, 30%, and 30%, respectively. Cumulative tumor diameter, lymph node
TY - JOUR. T1 - Feasible isolated liver transplantation for a cirrhotic patient on chronic hemodialysis. AU - Morita, Kazutoyo. AU - Shirabe, Ken. AU - Yoshizumi, Tomoharu. AU - Ikegami, Toru. AU - Masuda, Toshiro. AU - Hashimoto, Naotaka. AU - Mano, Yohei. AU - Miyata, Tatsunori. AU - Soejima, Yuji. AU - Maehara, Yoshihiko. PY - 2013/1/1. Y1 - 2013/1/1. N2 - End-stage liver and kidney disease (ELKD) is an indication for deceased donor simultaneous liver-kidney transplantation. Although a few cases of living donor liver-kidney transplantation have been reported, the invasiveness remains to be discussed. Living donor liver transplantation (LDLT) is an alternative choice for ELKD, but has never been reported. Here, we report a case of successful LDLT for a patient with ELKD on hemodialysis. The patient was a 63-year-old male and had decompensated hepatitis C cirrhosis with seronegativity for hepatitis C virus. He had non-diabetic end-stage renal failure and had been on hemodialysis for 3 years. He ...
In spite of the government having spent millions of rupees in terms of expensive machinery, infrastructure and hiring two highly paid foreign "trained" Liver Transplant Surgeons to provide this essential service to the people of Pakistan, Liver Transplantation in Shaikh Zayed Hospital still seems to be a far fetched dream for most of us waiting desperately for this life saving operation. As I am a regular visitor to the Liver Transplant OPD of this hospital, I have been able to gather some alarming facts regarding the safety of Liver Transplantation at this hospital from junior doctors and paramedical staff. The following needs your urgent attention and investigation. To-date only 4 Living Donor Liver Transplant Surgeries have been performed at Shaikh Zayed Hospital, Lahore. The first two Living Donor Liver Transplants were entirely performed and managed by Dr. Subhash Gupta and his team of surgeons, anesthetists and nurses who were specially brought in for this purpose from India. It was a ...
The liver transplant program at UK Transplant Center treats patients with end-stage liver disease and liver tumors. Our team of surgeons, nurse practitioners and nurse coordinators, hepatologists, pharmacists and social workers partner in providing personalized transplant care before, during and after surgery.
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TY - JOUR. T1 - Immunomodulating therapy in liver transplantation. T2 - Principles and practice. AU - Olson, Jody C.. AU - Wiesner, Russell H.. PY - 2012/8. Y1 - 2012/8. N2 - Liver transplantation has enjoyed dramatic success as a treatment option for patients suffering from chronic end-stage liver diseases. It also serves as a definitive treatment for certain genetic conditions such as familial amyloidosis and primary oxalosis, and as a potential curative therapy in selected cases of primary liver cancer. Currently, over 50,000 patients are alive with functioning liver transplants. Liver transplantation owes its success to advances in surgical technique, improvements in anesthesia and critical care, and advances in treatment of post-transplant complications including improved therapies for cytomegalovirus infections. But perhaps the most important advances in liver transplantation arise in the context of improvements in our understanding of the molecular biology of transplant immunology and the ...
Background T cell exhaustion has recently been proposed as an alternative mechanism to prevent memory development and tissue damage arising during ischemia-reperfusion injury (IRI) in murine orthotopic liver transplantation (OLT), with carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) identified as a key ligand for TIM-3-mediated negative immune regulation in the liver. In our cohort of human OLT patients, IRI+ recipients had a 12-fold higher ratio of TIM-1+:TIM-3+ CD4+ T cells at 3 months post-transplant than IRI-. Aim We sought to investigate donor and recipient contributions to CEACAM1 expression in human OLT-IRI. Methods We compared the cellular expression of CEACAM1 biopsies obtained from the donor organ pre- and post-reperfusion with the recipient's portal blood. Additionally, we evaluated CEACAM1 expression of 3rd party healthy donor monocytes co-cultured for 4 days with recipient portal blood obtained both pre- and post-reperfusion through the donor organ. Results ...
Background. The molecular mechanism of small-forsize graft injury remains unclear. The aim of this study is to investigate the gene expression pattern of acute phase response in relation to graft size in a rat-liver transplantation model. Methods. A rat orthotopic liver transplantation model using 30%, 50%, and whole grafts was used. The graft survival rates and liver morphology were compared among the three groups. Two transcription factors, nuclear factor (NF)-κB (p65) and early growth response (Egr-1), and their downstream genes were compared. Results. According to the graft size, the rats were grouped as follows: group 1 (n=20), 32% (24-47%); group 2 (n=10), 56% (50-65%); and group 3 (n=10), 104% (89-120%). The 7-day survival rates were 20% (P=0.039 vs. group 2, P=0.000 vs. group 3), 60%, and 100% in groups 1, 2, and 3, respectively. Dilation of hepatic sinusoids and vacuolization of hepatocytes were observed in group 1. Up-regulation of Egr-1 and endothelin (ET)-1 and over-expression of ...
Liver is transplanted to a patient whose liver is destroyed irreversibly due to various diseases. Cirrhosis is the most common reason for liver transplantation. Cirrhosis is a condition where healthy liver is destroyed and replaced by scar tissue. The common causes for the same are infections by viruses like hepatitis B or Hepatitis C, alcohol abuse, autoimmune diseases, deposition of fat in the liver and hereditary liver diseases. Liver tumours restricted to liver and cant be surgically removed also may be benefited by transplantation. When liver is destroyed without cirrhosis due to acute diseases of liver like infection or drug toxicity, Liver transplantation can be the only way to save the patient in emergency. Children with developmental problems in liver not compatible with life will survive after liver transplantation. During the surgery patients native liver is removed. Then a new liver is transplanted. In living donor liver transplantation, up to 70% of donors liver is removed and ...
TY - JOUR. T1 - Use of extended criteria livers decreases wait time for liver transplantation without adversely impacting posttransplant survival. AU - Tector, A. Joseph. AU - Mangus, Richard S.. AU - Chestovich, Paul. AU - Vianna, Rodrigo. AU - Fridell, Jonathan A.. AU - Milgrom, Martin L.. AU - Sanders, Carrie. AU - Kwo, Paul Y.. PY - 2006/9/1. Y1 - 2006/9/1. N2 - INTRODUCTION: The use of extended criteria donors (ECDs) could minimize shortage of suitable donor livers for transplantation. In 3 years, the aggressive use of ECD livers has reduced the wait list at our center from 257 to 30 patients with a median wait time of 18 days without using living donors. This study compares the graft/patient survival from standard (SD) and ECD for our transplant population between 2001 and 2005. METHODS: Records of all adult liver transplant recipients over 4 years were reviewed (n = 571). ECD criteria included: age ,59 years, BMI ,34.9, maximum AST/ALT ,500, maximum bilirubin ,2.0, peak serum sodium ,170, ...
SCOTTSDALE, Ariz. - In what is a rare occurrence for all but a handful of U.S. medical centers, Mayo Clinic in Arizona is treating a life-threatening cancer of the bile duct by performing a liver transplant - an aggressive protocol that is exhibiting dramatic increases in survival rates, offering new hope for patients with this complex disease.. Mayo Clinic is one of only two liver transplant programs in the region of the U.S. that encompasses Arizona, California, Utah, Nevada and New Mexico performing liver transplants to treat Cholangiocarcinoma, a relatively rare bile duct cancer.. Moreover, Mayo Clinic is the only medical center doing living donor liver transplantation as a treatment protocol for Cholangiocarcinoma. In such a procedure, a healthy person donates half or slightly more of his or her liver to a family member or close friend who otherwise would be on a waiting list. Living donor liver transplants are performed because of the increased number of patients on the liver transplant ...
Do you have a question about the Liver Transplant Program or about the services we offer at Childrens Hospital of Philadelphia? Well do our best to respond quickly, but please remember that it may take several days for us to send you a reply.. Please do not use this form to communicate information about your childs health.. If this is an emergency, please call 911 or your local emergency services provider.. ...
With the improved survival achieved in the 1980s it has become apparent that graft rejection is a major problem following liver transplantation [1]. Hyperacute rejection is uncommon, although syndromes of fulminant graft failure due to immunological mechanisms have been described. Acute cellular rejection occurs in approximately 70% of patients and usually responds to high-dose steroids. Between 10 and 15% develop chronic rejection, characterised by a progressive destruction of intrahepatic bile ducts which is irreversible [2]. The principal targets of both acute and chronic liver allograft rejection are intrahepatic bile ducts and endothelium [2]. The increased ability of these cell types to express MHC antigens and adhesion molecules may be responsible for their involvement [2, 3] and may be enhanced by the release of proinflammatory cytokines associated with viral infection, particularly CMV [3]. Although the importance of HLA matching remains unknown patients transplanted with ABO incompatible
Orthotopic liver transplantation is frequently associated with a complex coagulation disorder, influencing the outcome of the procedure. In this respect, disseminated intravascular coagulation (DIC) had been suggested to be of causative importance for bleeding complications after reperfusion of the liver graft. In 10 consecutive patients undergoing orthotopic liver transplantations, we studied the occurrence of two phagocyte proteinases of different origin in the graft liver perfus-ate and in systemic blood during the operation, as well as their effects on hemostasis. As compared with plasma samples taken at the end of the anhepatic phase, highly significant increases of cathepsin B and thrombin-anti-thrombin III complexes (TAT), as well as highly significant decreases in antithrombin III, protein C, and C1-inhibitor were observed in graft liver perfusate. Von Willebrand factor and fibrinogen were slightly decreased, whereas the elastase-alpha1 proteinase inhibitor complexes (EPI) were elevated. ...
... should ideally be offered to the patient who has a high risk of dying without liver transplantation, but who is likely to have prolonged survival and improved quality of life posttransplantation. Allocation systems for liver transplantation currently do not identify patients who benefit the most from liver transplantation.
In the United States, minority patients account for approximately 30% of all adult liver transplantations performed annually [8]. Racial and ethnic disparities in transplantation have been framed as a combination of barriers in access to care [16]. Overall, the study observed significantly decreased time on waiting list and higher proportion of patients listed with MELD scores over 35 after the Share 35 policy. Subgroups of minority candidates no longer had lower transplant rates than non-Hispanic whites. Hispanics experienced shorter waiting time before the receipt of liver transplantation but still longer than their white counterparts. To the best of knowledge, this study was the first study to explore racial and ethnic inequity in access to liver transplantation for patients with ESLD after the Share 35 policy instituted in June 2013.. Previous disparity-related studies have only stratified on Organ Procurement and Transplant Network (OPTN) regions and some even have not correctly adjusted ...
The Milan criteria represent a milestone in the development of liver transplantation. The implementation of this set of criteria in the United Network for Organ Sharing system proved it successful in the assignment of listing priority for patients with HCC.20 However, concerns remained that the restrictive prerequisites might discard a substantial number of patients who could otherwise have done well after transplantation. In particular in China, around 40% of donor livers are allocated to HCC recipients. If strictly adhered to the Milan criteria, only 43.8% of patients in this study would have the opportunity of transplantation. Meanwhile, in those patients exceeding the Milan criteria, there were still two-thirds of patients who did not have tumour recurrence during the 5-year follow-up. Current organ allocation policies based on the Milan criteria do not adapt to the development of liver transplantation.. Promisingly, recent studies have defined subsets of patients exceeding the Milan ...
Seth Karp, MD, H. William Scott Jr. Professor of Surgery, chair of the Department of Surgery and director of the Vanderbilt Transplant Center, said the success of the liver transplant program is a result of the multidisciplinary approach to care.. "Transplant is the ultimate team sport," Karp said. "Everyones expertise counts. We all play a role to make sure our patients receive the highest quality of care. Everything we do, we do for our patients.. "I see it when I walk around the transplant center - the attitude and collaborative spirit is emblematic of what we do every single day and it makes me proud to be a member of this team.". Roman Perri, MD, medical director of the adult liver transplant program, and Sophoclis Alexopoulos, MD, chief of the Division of Hepatobiliary Surgery and Liver Transplantation and surgical director of the adult program, also gave remarks.. Both applauded the teams commitment and dedication as reasons for the programs success.. Alexopoulos recognized Wright, one ...
Coincidentally, the same team that worked on Hand also treated patient No. 300 - 7-month-old Donovan Daniels.. "Donovans success is truly the culmination of the knowledge and skills from the 299 liver transplants that preceded him, including Lydias," said Dr. Genyk, surgical director of the Pediatric Liver Transplant Program. "It speaks to the expertise and dedication of the entire liver transplant team, as well as the collective support we receive from all the services CHLA provides.". When Donovans parents brought him to Childrens Hospital Los Angeles in October, doctors told them Donovan urgently needed a new liver. His father, Dejon Daniels, volunteered and was found to be a match. The transplant took place Nov. 18, with Dr. Genyk performing both parts - Dejons surgery at USC in the morning and Donovans transplant at CHLA several hours later. Lydia Hand met the Daniels family this month. "Ive heard all the stories about my transplant from my family, but to actually see and hear what ...
R. J. Fontana1,*, E. A. Hughes2, M. Bifano2, H. Appelman3, D. Dimitrova2, R. Hindes4 and W. T. Symonds4. The lack of clinically apparent drug-drug interactions with the calcineurin inhibitors make both daclatasvir and sofosbuvir very attractive for future use in LT recipients with recurrent HCV infection [14, 15]. Of note, another LT recipient with severe recurrent HCV infection was recently treated with DCV, peginterferon and ribavirin for 24 weeks and did not experience any apparent drug-drug interactions with cyclosporine [24]. Abstract. Recurrent HCV infection following liver transplantation can lead to accelerated allograft injury that is difficult to treat with interferon. The aim of this study is to describe the first ever use of an interferon-free, all oral regimen in a liver transplant recipient with severe recurrent HCV. A 54-year-old male with HCV genotype 1b developed severe cholestatic HCV at 6 months posttransplant with ascites, AST 503 IU/mL, alkaline phosphatase of 298 IU/mL, ...
TY - JOUR. T1 - Changes in quality of life after liver transplantation among adults. AU - Belle, S. H.. AU - Porayko, M. K.. AU - Hoofnagle, J. H.. AU - Lake, J. R.. AU - Zetterman, R. K.. PY - 1997/1/1. Y1 - 1997/1/1. N2 - Quality of life is an important factor to consider when assessing the value of liver transplantation. Using a large, prospective database of liver transplantation recipients from three clinical centers in the United States, we examined the quality of life of 346 adults before and 1 year after surgery. Five quality of life domains were evaluated (measures of disease, psychological distress and well-being, personal function, social/role function, and general health perception) with standardized questionnaires completed according to established protocol. The largest numbers of patients were distressed by fatigue and muscle weakness, both before transplantation and 1 year after surgery. Compared to baseline, recipients at follow-up noted fewer disease-related symptoms (P,.001) ...
TY - JOUR. T1 - Pathophysiology of renal disease associated with liver disorders. T2 - Implications for liver transplantation. Part I. AU - Davis, Connie L.. AU - Gonwa, Thomas A.. AU - Wilkinson, Alan H.. PY - 2002. Y1 - 2002. N2 - Renal and hepatic function are often intertwined through both the existence of associated primary organ diseases and hemodynamic interrelationships. This connection occasionally results in the chronic failure of both organs, necessitating combined liver-kidney transplantation (LKT). Since 1988, more than 850 patients in the United States have received such transplants, with patient survival somewhat less than that for patients receiving either organ alone. Patients with renal failure caused by acute injury or hepatorenal syndrome have classically not been included as candidates for combined transplantation because of the reversibility of renal dysfunction after liver transplantation. However, the rate and duration of renal failure before liver transplantation is ...
TY - JOUR. T1 - A randomized trial of primary liver transplantation under immunosuppression with FK 506 vs cyclosporine. AU - Fung, J.. AU - Abu-Elmagd, K.. AU - Jain, Ashokkumar. AU - Gordon, R.. AU - Tzakis, A.. AU - Todo, S.. AU - Takaya, S.. AU - Alessiani, M.. AU - Demetris, A.. AU - Bronster, O.. AU - Martin, M.. AU - Mieles, L.. AU - Selby, R.. AU - Reyes, J.. AU - Doyle, H.. AU - Stieber, A.. AU - Casavilla, A.. AU - Starzl, T.. PY - 1991/12/1. Y1 - 1991/12/1. UR - http://www.scopus.com/inward/record.url?scp=0026323706&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=0026323706&partnerID=8YFLogxK. M3 - Article. C2 - 1721333. AN - SCOPUS:0026323706. VL - 23. SP - 2977. EP - 2983. JO - Transplantation Proceedings. JF - Transplantation Proceedings. SN - 0041-1345. IS - 6. ER - ...
With a five-year survival rate of as high as 82% for liver transplant patients in Taiwan, our liver transplant technology is superior to that of the United States, Europe, and Japan thereby taking a leading position in the world.. Widely famous for its liver transplantation technology, medical institutions in Taiwan have attracted overseas physician from near and far. As of today, hundreds of liver-transplantation surgeons from all over the world have received specialty training in Taiwan. Among them, more than half of the Singaporean liver transplantation physicians are trained in Taiwan.. In addition to the liver transplantation with the best performance in the world, medical teams in Taiwan also have rich experience in heart, lung, kidney, hematopoietic stem cell, and corneal transplantation to provide the patients with the most complete medical services.. ...
Background. Chronic kidney disease (CKD) develops frequently after liver transplantation (LTx), and it is important to identify and correct risk factors that negatively affect kidney function. Risk factors have not been well evaluated in Asian countries where hepatitis B virus (HBV) infection is a dominant cause.. Methods. Four hundred thirty-one Korean recipients who underwent LTx between 1997 and 2008 were analysed. CKD was defined as a sustained decrease in estimated glomerular filtration rate (eGFR) of ,60 (mL/min/1.73 m2) for at least three consecutive months using an abbreviated Modification in Renal Disease (MDRD) formula.. Results. Eighty percent of the patients had HBV-related underlying diseases. The recipients whose pretransplant eGFR had been low (,30 mL/min/1.73 m2) improved their renal function after LTx, but significant functional decline occurred in recipients whose pretransplant eGFR was high (≥60 mL/min/1.73 m2). A multivariate Cox regression analysis revealed that the ...
Controversy remains about the role of protocol liver biopsy for symptom-free recipients and about the long-term use of low-dose steroids after pediatric liver transplantation (LT). We conducted a national cross-sectional study of pediatric recipients who underwent LT between 1987 and 2007. Liver biopsy samples were taken from 54 patients (82% of survivors) after a median posttransplant follow-up of 11 years, and they were reviewed by 2 pathologists blinded to the clinical data. Biopsy samples from 18 patients (33%) showed nearly normal histology with no inflammation, fibrosis, or steatosis. Portal inflammation was detected in 14 samples (26%), showed no correlation with anti-nuclear antibodies, and was less frequent in the 35 patients whose immunosuppression included steroids (14% versus 47% of patients not using steroids, P = 0.009). Fibrosis was present in 21 biopsy samples (39%). According to the Metavir classification, 15 were stage 1, 4 were stage 2, and 2 were stage 3. The fibrosis stage ...