Use of donation after circulatory death donors in pediatric liver transplantation

After advancement of technical aspects, use of well-established and novel immunosuppressive therapies, and better pre and postoperative care, which resulted in high overall survival rates with liver transplantation, waiting list mortality has become the main issue for pediatric patients with end stage liver disease. Insufficient organ donors have become a challenging issue especially in the pediatric patient population, for whom size match of donor or graft is harder to achieve. In order to expand the donor pool and decrease the gap between the demand and supply of donor organs, use of donation after circulatory death (DCD) donors have been proportionally increased. In this chapter we aim to discuss current practices, issues and outcomes with DCD in pediatric liver transplantation, as well as future strategies for improvement of results. © 202

A comparison of the caval clamping techniques during adult to adult right lobe liver transplantation.

11th Annual Meeting of the International-Liver-Transplant-Society -- JUL 20-23, 2005 -- Los Angeles, CAWOS: 000230158500279Int Liver Transplant So

Hepatocellular carcinoma in cirrhotic liver: Accuracy of pretransplantation ultrasonography

Aim: To assess the accuracy of ultrasonography in detecting hepatocellular carcinoma in patients with advanced cirrhosis undergoing liver transplantation. Materials and Methods: Four hundred ninety five patients, who underwent liver transplantation and had histopathologically proved liver cirrhosis, were included in the study. Reports of pretransplantation ultrasonography and histopathologic evaluation of the explanted liver were retrospectively reviewed and compared for the presence of hepatocellular carcinoma. Results: Hepatocellular carcinoma was detected in the explanted liver in 88 (17,8%) patients. The hepatomas ranged in size from 0.1 to 11cm. One or more solid focal lesions were reported in the pretransplant ultrasonography examination in 58 of these patients. In 16 patients, with a focal lesion reported in the pretransplant US examination, no hepatocellular carcinoma was detected in the histopathologic examination. The patient detection sensitivity of ultrasonography for hepatocellular carcinoma was 66%, specificity was 96%, the positive predictive value was 78% and negative predictive value was 93%. Conclusion: Sensitivity of utrasonography for hepatocellular carcinoma detection mostly depends on tumor size and is low in liver transplant candidates. On the other hand, the specificity is high and all solid lesions discovered with the ultrasonography should be considered hepatocellular carcinoma until proven otherwise.Amaç: Karaciğer nakil adayı olan sirozlu hastalarda hepatosellüler karsinoma saptamada ultrasonografinin etkinliğinin araştırılması. Gereç ve Yöntem: Ortotopik karaciğer nakli uygulanan 495 hastanın nakil öncesi ultrasonografi bulguları fokal karaciğer lezyonu açısından geriye dönük değerlendirildi. Ultrasonografide saptanan tüm solid lezyonlar olası hepatosellüler karsinoma kabul edildi. Eksplant karaciğer materyalinde hepatosellüler karsinoma odaklarının varlığı ve sayısı nakil öncesi ultrasonografi bulguları ile karşılaştırıldı. Bulgular: Seksen sekiz (%17.8) olguda eksplant karaciğerde hepatosellüler karsinoma saptandı. Hepatosellüler karsinoma boyutları 1mm-11cm arasında değişiyordu. Nakil öncesi ultrasonografi ile bu olguların 58'inde karaciğerde fokal solid lezyon saptanmıştı. Ultrasonografide solid lezyon gözlenen 16 olguda, histopatolojik incelemede hepatosellüler karsinoma saptanmadı. Ultrasonografinin sirotik karaciğerde hepatosellüler karsinoma için duyarlılığı %66, özgüllüğü %96, pozitif öngörü değeri %78, negative öngörğü değeri %93bulundu. Sonuç: Sirotik karaciğerde ultrasonografinin hepatosellüler karsinoma saptamada duyarlılığı tümör boyutu ile ilişkilidir ve düşüktür. Bununla beraber, özgüllüğü yüksektir ve ultrasonografide saptanan tüm solid lezyonlar aksi ispatlanana kadar hepatosellüler karsinoma gibi kabul edilmelidir

Predictive Value of Red Blood Cell Distribution Width, Platelet Count to Lymphocyte Count Ratio, and Neutrophil Count to Lymphocyte Count Ratio Values for the Detection of Postoperative Infection in Patients Undergoing Liver Transplantation

Background: The red blood cell distribution width (RDW) value is a simple and fast parameter that shows an elevation in the presence of infectious disease. It is thought that proinflammatory signals cause changes in the cell wall of the erythrocytes. In our study, we aimed to investigate the prognostic value of RDW and other parameters in patients undergoing liver transplantation. Methods: We retrospectively investigated 200 patients who underwent liver transplantation (LT) in our center. The study group was 100 patients who underwent LT and developed a postoperative abdominal or catheter-related infection in the early period between the first and second weeks of hospitalization. The control group comprises 100 patients who underwent LT and were discharged without complications. In 4 different periods, inflammatory markers and RDW, platelet count to lymphocyte count ratio, and neutrophil count to lymphocyte count ratio (NLR) values were compared in the 2 groups. Results: In our study, we found RDW and NLR parameters to be elevated in correlation with infection in patients who underwent LT (P .05). Other markers were elevated but not significantly correlated with infection. Conclusions: These parameters can be simple and effective additional tools to implement in patients suspected of infection. Further prospective studies with larger patient groups and varying infection states are required for validating RDW and NLR as additional diagnostic markers. © 2023 Elsevier Inc

Postoperative adjuvant gemcitabine alone and concurrent with radiation after resection of locally advanced pancreatic carcinoma

WOS: 00024756480070

Vascular conduits to drain anterior sector in right lobe living donor liver transplantation

Joint International Congress of the ILTS, ELITA, AND LICAGE -- MAY 03-06, 2006 -- Milan, ITALYWOS: 000237037100388ILTS, ELITA, LICAG