Kinetics of biochemical parameters after orthotopic liver transplantation

El estudio: “Caracterización morfológica y morfométrica del espermatozoide de cuy (Cavia porcellus) colectado por electroeyaculación”, se realizó desde el mes de abril a septiembre del 2018, en el Centro de Investigación en Camélidos Sudamericanos CICAS- La Raya de la Facultad de Ciencias Agrarias de la Universidad Nacional de San Antonio Abad del Cusco, con el objetivo de determinar las características morfológicas y morfométricas del espermatozoide de cuy (Cavia porcellus) colectado por electroeyaculación (EE). Se colectó muestras de esperma de cinco cuyes machos tipo 1 de cuatro meses de edad, con un peso promedio de 1.190 g, realizándose un total de 22 colectas. Para la determinación de las características macroscópicas se realizó una evaluación visual, no se hallaron diferencias significativos entre cuyes (>0.05) para el volumen (0.38 ml), pH (7.05) y el color predominante fue el blanco lechoso de 64% usando un DCA. Las características morfológicas se analizaron con un arreglo factorial en la cual si se hallaron diferencias significativas entre clase (0.05). Las características morfométrica se evaluaron en un arreglo factorial, se hallaron diferencias significativas entre clases (<0.05) para el largo (7.45 μm), ancho (6.55 μm), área (43.02 μm2), perímetro (26.56 μm), elipticidad (1.14 μm), rugosidad (0.77 μm), elongación (0.06 μm), regularidad (0.89 μm) de la cabeza del espermatozoide; también para el área (66.18 μm2) y perímetro (33.17 μm) del acrosoma, para el largo de la pieza intermedia (12.02 μm) y de la cola (92.96 μm). Estas variables se evaluaron en el Motic Plus Imagen 2.0 (BA310).Tesi

Metabolic complications in liver transplant

The majority of the complications we are going to describe are linked to a graft malfunction. In the liver transplant a graft recovery defect has a multifactorial origin and can have clinical features that range from some transitory signs of functional deficit all the way to a fully-fledged primary non-function after orthotopic liver transplant (OLT). In such cases our treatment protocol provides for the use of prostaglandine in order to improve organ perfusion.Although the analysis of the efficacy of this pharmacological therapy is stil in progress, as it lies within the scope of our group\u2019s experience we can state that in a certain number of cases it allows us to achieve a remission in the dysfunction symptoms. In the cases in which this treatment proves to be ineffective, there is a progressive deterioration in the hemocoagulative capacities, the protein synthesis, the neurological situation, the ventilatory exchange and the kidney function. The picture is completed by an increase in the enzymes of hepatic cytonecrosis, with an increase in the bilirubin, within a picture of hyperdynamic syndrome, characterised by an elevated cardiac index and a collapse in the vascular systemic resistances. In an overall dysfunction appears, during the wait for a new organ, one can turn to extracorporeal purification systems

Acute renal failure after liver transplantation in MELD Era

Model for End-Stage Liver Disease (MELD) score was used in our center from 2003 to assess the position of orthotopic liver transplantation (OLT) candidates on a waiting list. A key component of MELD score in the assessment of the degree of the illness is renal function. In this study, we measured the effects of this new scoring system on renal function and therapeutic strategies. We evaluated the incidence of acute renal function (ARF) after OLT requiring renal replacement therapy (hemofiltration or hemodialysis) in two patient groups: 240 transplanted before MELD era and 224 after the introduction of this parameter to select candidates. ARF occurred in 8.3% of patients in the pre-MELD group versus 13% in the MELD group, while the mortality rates were 40% and 27%, respectively. The creatinine level before OLT seemed to be a good predictor of ARF (P < .001), and blood transfusion rates (P < .05) as well as intraoperative diuresis (P < .05). In our analysis we did not observe a correlation between MELD score and postoperative AR

Anesthesia for liver transplantation: the experience of the University of Bologna in the MELD era.

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. Biochemical and hemodynamic variables were evaluated by Swan-Ganz catherization. Dindo's classification of postoperative complications was used for the evaluation of postoperative course. RESULTS: Morbidity occurred in 158 patients (65.2%) and 13 patients died during the hospital stay. Considering the highest grade of complication occurred, non life-threatening complications occurred in the 47.9% of cases (116 patients) and life-threatening complications, excluding patient death, in 17.3% (42 patients). Patients with MELD >30 showed a longer ICU stay, tracheal intubation and in-hospital stay. CONCLUSION: In conclusion MELD score is tightly related to postoperative complications