Neo-Suprahepatic cava: A case report of a modified technique for domino liver transplantation

Domino liver transplantation, introduced in 1997, originally consisted of a graft from a patient with familial amyloidotic polyneuropathy used as a donor for a compatible recipient, thus increasing the pool of hepatic grafts for liver transplantation. The aim of this report was to present a modification on the technique for outflow reconstruction in domino liver transplantation first proposed by Liu et al and Cescon et al. In this description we proposed a new technique that differs from the one mentioned above by performing a neo-suprahepatic cava, constructed using only an iliac vein graft, facilitating the anastomosis as if it was a regular cadaveric liver transplant.Fil: Padín, J. M.. Fundación Favaloro; ArgentinaFil: Pfaffen, G.. Fundación Favaloro; ArgentinaFil: Pérez Fernández, I.. Fundación Favaloro; ArgentinaFil: Sandi, M.. Fundación Favaloro; ArgentinaFil: Ramisch, D.. Fundación Favaloro; ArgentinaFil: Barros Schelotto, P.. Fundación Favaloro; ArgentinaFil: Gondolesi, Gabriel Eduardo. Fundación Favaloro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Characteristics of Liver Transplantation in Argentina: A Multicenter Study

Introduction: There is a lack of information regarding outcomes after liver transplant in Latin America. Objectives: This study sought to describe outcomes after liver transplant in adult patients from Argentina. Methods: We performed an ambispective cohort study of adult patients transplanted between June 2010 and October 2012 in 6 centers from Argentina. Only patients who survived after the first 48 hours postransplantation were included. Pretransplantation and posttransplantation data were collected. Results: A total of 200 patients were included in the study. Median age at time of transplant was 50 (interquartile range [IQR] 26 to 54) years. In total, 173 (86%) patients had cirrhosis, and the most frequent etiology in these patients was hepatitis C (32%). A total of 35 (17%) patients were transplanted with hepatocellular carcinoma. In patients with cirrhosis, the median Model for End-Stage Liver Disease (MELD) score at time of liver transplant was 25 (IQR 19 to 30). Median time on the waiting list for elective patients was 101 (IQR 27 to 295) days, and 3 (IQR 2 to 4) days for urgent patients. Almost 40% of the patients were readmitted during the first 6 months after liver transplant. Acute rejection occurred in 27% of the patients. Biliary and vascular complications were reported in 39 (19%) and 19 (9%) patients, respectively. Renal failure, diabetes, and dyslipidemia were present in 40 (26%), 87 (57%), and 77 (50%) at 2 years, respectively. Conclusions: We believe the information contained in this article might be of value for reviewing current practices and developing local policies.Fil: Haddad, L.. Instituto Universitario del Hospital Italiano de Buenos Aires; ArgentinaFil: Marciano, S.. Instituto Universitario del Hospital Italiano de Buenos Aires; ArgentinaFil: Cleres, M.. Fundación Favaloro; ArgentinaFil: Zerega, A.. Sanatorio Allende; ArgentinaFil: Piñero, F.. Hospital Universitario Austral; ArgentinaFil: Orozco, F.. Hospital Aleman; ArgentinaFil: Braslavsky, G.. Hospital General de Agudos Cosme Argerich; ArgentinaFil: Mendizabal, M.. Hospital Universitario Austral; ArgentinaFil: Gondolesi, Gabriel Eduardo. Fundación Favaloro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Medicina Traslacional, Trasplante y Bioingeniería. Fundación Favaloro. Instituto de Medicina Traslacional, Trasplante y Bioingeniería; ArgentinaFil: Gil, O.. Sanatorio Allende; ArgentinaFil: Silva, M.. Hospital Universitario Austral; ArgentinaFil: Mastai, Ricardo. Hospital Aleman; ArgentinaFil: Imvertaza, O.. Hospital General de Agudos Cosme Argerich; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Medicina Traslacional, Trasplante y Bioingeniería. Fundación Favaloro. Instituto de Medicina Traslacional, Trasplante y Bioingeniería; ArgentinaFil: Descalzi, V.. Fundación Favaloro; ArgentinaFil: Gadano, A.. Instituto Universitario del Hospital Italiano de Buenos Aires; Argentin

Morphological evaluation of experimental autologous rectus fascia sheath vascular grafts used for arterial replacement in a dog model

Although experimental autologous patch or tubular conduit vascular grafts made from the internal rectus fascia sheath (IRFS) have been reported in the literature, thorough morphological evaluation and verification of the histological arterialisation of such grafts are lacking. Four purpose-bred Beagle dogs were utilised to create eight arterial internal rectus fascia sheath (ARFS) grafts implanted between bisected ends of the external iliac arteries. Four out of the eight ARFS grafts were patent after three months. Haematoxylin-eosin and Azan staining verified that the grafts gained a vessel-like layered structure with the presence of large amounts of collagen fibres. Although the inner surface of the intact IRFS was originally covered with claudin-5-negative and pancytokeratin-positive mesothelial cells in control samples, the internal cells of the ARFS grafts became claudin-5 positive and pancytokeratin negative like in intact arteries. Spindle-shaped cells of the wall of ARFS grafts were α-smooth muscle actin (α-SMA) positive just like the smooth muscle cells of intact arteries, but α-SMA immunoreactivity was negative in the intact IRFS. According to these findings, the fibroblast cells of the ARFS graft have changed into myofibroblast cells. The study has proved that ARFS grafts may be used as an alternative in arterial replacement, since the graft becomes morphologically and functionally similar to the host vessel via arterialisation

Thomas Starzl, Video Interview for His Living Legend Award at the ISBTS 2015.

At the 14th International Small Bowel Transplant Symposium, (ISBTS2015) held in Buenos Aires, a session to recognize the pioneers that have dedicated their lives to make our current field possible was organized. Dr Thomas Starzl received the first Living Legend Award. A video interview was obtained at his office, edited, and later presented during the scientific meeting. More than 600 people saw Dr Starzl´s interview, which captivated the audience for 40 minutes, before smiles, tears and the final applause erupted at the conclusion. We would like to share this video with all of you to inspire the current generations and the generations to come. The manuscript has the main parts of the interview, which can also be accessed at http://isbts2015.tts.org/starzl.mp4.Fil: Gondolesi, Gabriel Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación Favaloro; ArgentinaFil: Mazariegos, G. Thomas E Starzl Transplantation Institute; Estados UnidosFil: Starzl, T. E.. University of Pittsburgh; Estados Unido