The perioperative period of liver transplantation from unconventional extended criteria donors: data from two high-volume centres

Background: As literature largely focuses on long-term outcomes, this study aimed at elucidating the perioperative outcomes of liver transplant patients receiving a graft from two groups of unconventional expanded criteria donors: brain dead aged > 80 years and cardiac dead.Methods: Data of 247 cirrhotic patients transplanted at two high volume liver transplant centers were analysed. Confounders were balanced using a stabilized inverse probability therapy weighting and a propensity score for each patient on the original population was generated. The score was created using a multivariate logistic regression model considering a Comprehensive Complication Index & GE; 42 (no versus yes) as the dependent variable and 11 possible clinically relevant confounders as covariate.Results: Forty-four patients received the graft from a cardiac-dead donor and 203 from a brain-dead donor aged > 80 years. Intraoperatively, cardiac-dead donors liver transplant cases required more fresh frozen plasma units (P < 0.0001) with similar reduced need of fibrinogen to old brain-dead donors cases. The incidence of reperfusion syndrome was similar (P = 0.80). In the Intensive Care Unit, both the groups presented a comparable low need for blood transfusions, renal replacement therapy and inotropes. Cardiac-dead donors liver transplantations required more time to tracheal extubation (P < 0.0001) and scored higher Comprehensive Complication Index (P < 0.0001) however the incidence of a severe complication status (Comprehensive Complication Index & GE; 42) was similar (P = 0.52). ICU stay (P = 0.97), total hospital stay (P = 0.57), in hospital (P = 1.00) and 6 months (P = 1.00) death were similar.Conclusion: Selected octogenarian and cardiac-dead donors can be used safely for liver transplantation

Safety of liver resection and effect on quality of life in patients with benign hepatic disease: Single center experience

<p>Abstract</p> <p>Background</p> <p>Although liver resection has long been established for selected patients with benign hepatic disease, the success of surgical treatment of these patients cannot be evaluated exclusively through postoperative morbidity and mortality. Therefore, the aim of the study was to prove the safety of liver resection in the treatment of benign liver tumors and to evaluate the effect of surgical treatment on the patients' qauality of life.</p> <p>Methods</p> <p>A total of 146 patients who underwent liver resection because of benign liver tumors were included in this study. Postoperative outcome was assessed and patients evaluated their quality of life before surgery and at the present time using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (QLQ C-30).</p> <p>Results</p> <p>The rate of serious (> grade 2) complications was 4.1% with no postoperative death. The quality of life assessment revealed an overall improvement of general health status after resection (0.7 vs. 0.56, p < 0.001) and additionally a significant reduction of 6 out of 9 symptoms. Furthermore, compelling benefits in the patients' social and emotional coping could be detected after surgery.</p> <p>Conclusions</p> <p>Liver resection for benign liver disease is a safe procedure and leads to a significant improvement of quality of life in selected patients.</p

Low levels of linoleic acid in plasma total lipids of HIV-1 seropositive children

OBJECTIVE: To assess the plasma fatty acid status of a group of well-nourished children with the human immunodeficiency virus type-1 (HIV-1) and how this relates to the blood total CD4+ lymphocyte count. SUBJECTS: Fourteen HIV-1 seropositive children at various stages of disease and with adequate growth indices were assessed and compared to a control group of 30 healthy children. RESULTS: The concentrations (mg/dL) of plasma total fatty acids were not different between the two groups. HIV-1 seropositive children presented lower levels of 18-C essential polyunsaturated fatty acids (PUFA: linoleic acid, LA, and alpha-linolenic acid) and higher levels of their 20-C long-chain derivatives (di-homo-gamma-linolenic acid, arachidonic acid, AA, and eicosapentaenoic acid) and docosahexaenoic acid in their plasma total lipids. The lowest plasma LA levels were observed in the subgroup of patients with more advanced stages of disease. In bivariate analyses the plasma LA levels related positively (Spearman r = 0.50, p = 0.06), while the LA/AA ratio related negatively (Spearman r = -0.51, p = 0.06), to the total CD4+ count. CONCLUSIONS: Childhood HIV-1 infection is associated with changes in plasma fatty acid profile suggestive of an increased PUFA turnover. Decreased levels of LA (together with higher plasma AA levels) appear to be associated with more advanced clinical and biochemical stages of disease

Carta Geologica alla scala 1:25000 Foglio 257 "Dolceacqua" e Foglio 270 "Ventimiglia" con note illustrative.

I Fogli 257 Dolceacqua e 270 Ventimiglia alla scala 1:25.000 (Fig. 1) sono stati realizzati nell'ambito del progetto Strategico Alcotra-RiskNat: in data 12.10.2009 la Regione Liguria ha affidato al Dipartimento di Scienze della Terra dell'Universit \ue0 di Pavia l'incarico di eseguire le attivit\ue0 previste per la parte a terra. Per la parte a mare l'incarico stato successivamente affidato al Dipartimento di Matematica e Geoscienze dell'Universit\ue0 di Trieste. I rilevamenti geologici sono stati effettuati negli anni 2010-2011 utilizzando, come base topografica, le Carte Tecniche Regionali della Regione Liguria alla scala 1:10.000, le 7 e 2 sezioni nelle quali i fogli Dolceacqua e Ventimiglia sono rispettivamente suddivisi. I Fogli 257 Dolceacqua e 270 Ventimiglia ricadono, dal punto di vista amministrativo, interamente nella Provincia di Imperia che confina, a ovest e a nord, con la Francia

Carta Geologica alla scala 1:25000 F. 259 "Imperia" con note illustrative.

Il Foglio 259 Imperia, alla scala 1:25.000 (Fig. 1) \ue8 stato realizzato nell\u2019ambito del progetto Strategico Alcotra-RiskNat: in data 12.10.2009 la Regione Liguria ha affidato al Dipartimento di Scienze della Terra e dell\u2019Ambiente dell\u2019Universit\ue0 di Pavia l\u2019incarico di eseguire le attivit\ue0 previste della parte a terra. Per la parte a mare l\u2019incarico \ue8 stato successivamente affidato al Dipartimento di Matematica e Geoscienze dell\u2019Universit\ue0 di Trieste. I rilevamenti geologici sono stati effettuati negli anni 2010-2011 utilizzando, come base topografica, le 5 sezioni alla scala 1:10.000 della Carta Tecnica Regionale della Regione Liguria in cui il foglio \ue8 suddiviso. Dal punto di vista amministrativo il Foglio Imperia ricade per tre quarti (circa 100 km2) nella Provincia di Imperia e per la rimanente parte (circa 36 km2), nella Provincia di Savona

Dating shallow thrusts with zircon (U-Th)/He thermochronometry--The shear heating connection

New zircon (U-Th)/He (ZHe) ages from a shallow (<6–7 km) thrust fault zone and surrounding wall rocks in the Helminthoid Flysch of the Ligurian Alps were measured to test the applicability of the thermochronometer for dating brittle or brittle-ductile faults. The ages are integrated with X-ray diffraction analysis of clay minerals and fluid inclusion microthermometry on vein-filling minerals to constrain the temperature conditions of the damage zone and the wall rocks during thrusting. The wall rocks yield pre-depositional inherited ZHe ages (125.3 ± 15 to 312.3 ± 37 Ma) while ages from the fault core are reset (28.8 ± 3.4 to 33.8 ± 4.0 Ma). This is consistent with independent geological and thermochronometric evidence for early Oligocene motion of the thrust. This implies that the fault zone exceeded 200 °C during faulting, and confirms the illite crystallinity and fluid inclusion constraints, which indicate temperatures of 220–300 °C in the fault zone, while in those the wall rocks were <180–200 °C. Thermal modeling of the fault zone suggests that the shear heating associated with the fault motion is an efficient mechanism for generating temperature increases of 50–70 °C during a displacement of 10–25 km in 2–10 m.y. Our results underscore the validity of the ZHe technique for dating brittle or brittle-ductile faults characterized by relatively high strain rate