Liver transplantation in patients with post-hepatectomy liver failure - A Northern European multicenter cohort study

Background: Liver transplantation (LTX) has been described as a rescue treatment option in severe, intractable post-hepatectomy liver failure (PHLF), but is not considered to be indicated for this condition by many hepatobiliary and transplant surgeons. In this article we describe the clinical experience of five northern European tertiary centers in using LTX to treat selected patients with severe PHLF. Methods: All patients subjected to LTX due to PHLF at the participating centers were identified from prospective clinical databases. Preoperative variables, surgical outcome (both resection surgery and LTX) and follow-up data were assessed.Results: A total of 10 patients treated with LTX due to severe PHLF from September 2008 to May 2020 were identified and included in the study. All patients but one were male and the median age was 70 years (range 49-72). In all patients the indication for liver resection was suspected malignancy, but in six patients post-resection pathology revealed benign or pre-malignant disease. There was no 90-day mortality after LTX. Patients were followed for a median of 49 months (13-153) and eight patients were alive without recurrence at last follow-up.Discussion: In selected patients with PHLF LTX can be a life-saving procedure with low short-term risk.Peer reviewe

Liver transplantation as a lifesaving procedure for posthepatectomy liver failure and iatrogenic liver injuries

Background Iatrogenic injuries to vital structures of the liver and posthepatectomy liver failure are associated with high mortality. The current donor situation in Norway allows liver transplantation of patients beyond conventional criteria. Methods From 1984 to 2017, a total of 1510 liver transplantations were performed. In this retrospective study, we report the results of 13 patients undergoing liver transplantation due to iatrogenic injuries to the liver vasculature or posthepatectomy liver failure. Results Twelve men and one woman with a median age of 55 years (range 22–69) were included. Seven patients underwent radical surgery for cancer prior to transplantation. The median follow-up time was 70.5 months (range 2.2–177). Three of the patients with malignant disease did not experience disease recurrence, whereas four patients had cancer recurrence and died 7, 24, 45, and 78 months after transplantation. Five of six patients with non-malignant disease fully recovered, but one patient died after 9 months due to infectious complications. Conclusions Liver transplantation for liver failure due to portal vein and hepatic artery injury in patients with non-malignant disease seems justified. However, it may be questioned whether patients with malignant disease beyond established criteria should be offered liver transplantation

Liver energy, atresia and oocyte stage influence fecundity regulation in Northeast Arctic cod

Marine ecosystems are changing; global warming-induced increases in water temperatures and fishing have caused truncated age structures and small sizes at maturity in many stocks. This may affect both populations’ total reproductive output and the link between population demography and recruitment, yet detailed information on fecundity regulation is generally lacking for marine fishes. We therefore examined associations between liver energy, oocyte stage, leading cohort oocyte size (LC20), atresia and fecundity for the Northeast Arctic cod (NEAC) Gadus morhua L. from 2006 to 2008 in a comprehensive field and laboratory study. The relationship between the relative liver size (hepatosomatic index, HSI) and specific liver energy content was best described by an asymptotic curve, increasing rapidly at first, then levelling of at HSI > 6%. LC20 increased towards the spawning season, but was also positively associated with total length. At present there is thus a tendency towards larger NEAC females spawning earlier. The incidence of atresia was highest during the advanced yolk granule stage. Only 1% of females that reached an LC20 > 300 µm absorbed all oocytes and thereby aborted spawning. Potential fecundity showed a parabolic relationship with LC20, peaking around 614 µm, i.e. approximately on February 1st, and was positively associated with weight, liver energy and, presently, age. In summary, NEAC females that start vitellogenesis will likely spawn. Atresia and fecundity down-regulation appears only to become pronounced close to spawning. Finally, the size-dependent spawning time, which appears to have emerged in the stock recently, may alter the link between population demography and recruitment.2015-04-0

Correction to: The effect of low dose marine protein hydrolysates on short-term recovery after high intensity performance cycling: a double-blinded crossover study

The original article [1] contains errors in Tables 1 and 3: Table 1 erroneously mentions use of a treadmill which should instead state ‘bicycle’, and Table 3 has a minor typesetting mistake

The effect of low dose marine protein hydrolysates on short-term recovery after high intensity performance cycling: A double-blinded crossover study

Background: Knowledge of the effect of marine protein hydrolysate (MPH) supplementation to promote recovery after high intensity performance training is scarce. The aim of this study was to examine the effect of MPH supplementation to whey protein (WP) and carbohydrate (CHO): (CHO-WP-MPH), on short-term recovery following high intensity performance, compared to an isoenergetic and isonitrogenous supplement of WP and CHO: (CHO-WP), in male cyclists. Methods: This was a double-blinded crossover study divided into three phases. Fourteen healthy men participated. In phase I, an incremental bicycle exercise test was performed for establishment of intensities used in phase II and III. In phase II (9–16 days after phase 1), the participants performed first one high intensity performance cycling session, followed by nutrition supplementation (CHO-WP-MPH or CHO-WP) and 4 hours of recovery, before a subsequent high intensity performance cycling session. Phase III (1 week after phase II), was similar to phase II except for the nutrition supplementation, where the participants received the opposite supplementation compared to phase II. Primary outcome was difference in time to exhaustion between the cycling sessions, after nutrition supplementations containing MPH or without MPH. Secondary outcomes were differences in heart rate (HR), respiratory exchange ratio (RER), blood lactate concentration and glucose. Results: The mean age of the participants was 45.6 years (range 40–58). The maximal oxygen uptake (mean ± SD) measured at baseline was 54.7 ± 4.1 ml∙min− 1∙kg− 1. There were no significant differences between the two nutrition supplementations measured by time to exhaustion at the cycling sessions (meandiff = 0.85 min, p = 0.156, 95% confidence interval (CI), − 0.37, 2.06), HR (meandiff = 0.8 beats pr.min, p = 0.331, 95% CI, − 0.9, 2.5), RER (meandiff = − 0.05, p = 0.361, 95% CI -0.07 – 0.17), blood lactate concentration (meandiff = − 0.24, p = 0.511, 95% CI, − 1.00, 0.53) and glucose (meandiff = 0.23, p = 0.094, 95% CI, − 0.05, 0.51). Conclusions: A protein supplement with MPH showed no effects on short-term recovery in middle-aged healthy male cyclists compared to a protein supplement without MPH

The effect of low dose marine protein hydrolysates on short-term recovery after high intensity performance cycling: A double-blinded crossover study

Background Knowledge of the effect of marine protein hydrolysate (MPH) supplementation to promote recovery after high intensity performance training is scarce. The aim of this study was to examine the effect of MPH supplementation to whey protein (WP) and carbohydrate (CHO): (CHO-WP-MPH), on short-term recovery following high intensity performance, compared to an isoenergetic and isonitrogenous supplement of WP and CHO: (CHO-WP), in male cyclists. Methods This was a double-blinded crossover study divided into three phases. Fourteen healthy men participated. In phase I, an incremental bicycle exercise test was performed for establishment of intensities used in phase II and III. In phase II (9–16 days after phase 1), the participants performed first one high intensity performance cycling session, followed by nutrition supplementation (CHO-WP-MPH or CHO-WP) and 4 hours of recovery, before a subsequent high intensity performance cycling session. Phase III (1 week after phase II), was similar to phase II except for the nutrition supplementation, where the participants received the opposite supplementation compared to phase II. Primary outcome was difference in time to exhaustion between the cycling sessions, after nutrition supplementations containing MPH or without MPH. Secondary outcomes were differences in heart rate (HR), respiratory exchange ratio (RER), blood lactate concentration and glucose. Results The mean age of the participants was 45.6 years (range 40–58). The maximal oxygen uptake (mean ± SD) measured at baseline was 54.7 ± 4.1 ml∙min− 1∙kg− 1. There were no significant differences between the two nutrition supplementations measured by time to exhaustion at the cycling sessions (meandiff = 0.85 min, p = 0.156, 95% confidence interval (CI), − 0.37, 2.06), HR (meandiff = 0.8 beats pr.min, p = 0.331, 95% CI, − 0.9, 2.5), RER (meandiff = − 0.05, p = 0.361, 95% CI -0.07 – 0.17), blood lactate concentration (meandiff = − 0.24, p = 0.511, 95% CI, − 1.00, 0.53) and glucose (meandiff = 0.23, p = 0.094, 95% CI, − 0.05, 0.51). Conclusions A protein supplement with MPH showed no effects on short-term recovery in middle-aged healthy male cyclists compared to a protein supplement without MPH

The effect of low dose marine protein hydrolysates on short-term recovery after high intensity performance cycling: A double-blinded crossover study

Background: Knowledge of the effect of marine protein hydrolysate (MPH) supplementation to promote recovery after high intensity performance training is scarce. The aim of this study was to examine the effect of MPH supplementation to whey protein (WP) and carbohydrate (CHO): (CHO-WP-MPH), on short-term recovery following high intensity performance, compared to an isoenergetic and isonitrogenous supplement of WP and CHO: (CHO-WP), in male cyclists. Methods: This was a double-blinded crossover study divided into three phases. Fourteen healthy men participated. In phase I, an incremental bicycle exercise test was performed for establishment of intensities used in phase II and III. In phase II (9–16 days after phase 1), the participants performed first one high intensity performance cycling session, followed by nutrition supplementation (CHO-WP-MPH or CHO-WP) and 4 hours of recovery, before a subsequent high intensity performance cycling session. Phase III (1 week after phase II), was similar to phase II except for the nutrition supplementation, where the participants received the opposite supplementation compared to phase II. Primary outcome was difference in time to exhaustion between the cycling sessions, after nutrition supplementations containing MPH or without MPH. Secondary outcomes were differences in heart rate (HR), respiratory exchange ratio (RER), blood lactate concentration and glucose. Results: The mean age of the participants was 45.6 years (range 40–58). The maximal oxygen uptake (mean ± SD) measured at baseline was 54.7 ± 4.1 ml∙min− 1∙kg− 1. There were no significant differences between the two nutrition supplementations measured by time to exhaustion at the cycling sessions (meandiff = 0.85 min, p = 0.156, 95% confidence interval (CI), − 0.37, 2.06), HR (meandiff = 0.8 beats pr.min, p = 0.331, 95% CI, − 0.9, 2.5), RER (meandiff = − 0.05, p = 0.361, 95% CI -0.07 – 0.17), blood lactate concentration (meandiff = − 0.24, p = 0.511, 95% CI, − 1.00, 0.53) and glucose (meandiff = 0.23, p = 0.094, 95% CI, − 0.05, 0.51). Conclusions: A protein supplement with MPH showed no effects on short-term recovery in middle-aged healthy male cyclists compared to a protein supplement without MPH