Transplant2018-10-19T17:54:41+03:00

Hypothermic Machine Perfusion in Liver Transplantation—A Randomised Trial and Beyond

The randomised controlled trial of oxygenated hypothermic machine perfusion of DCD livers, reported by van Rijn et al. in NEJM in February 2021 is of great importance, not only because of the novel technology under investigation, but also because of the trial design and methodology. After several decades in which static cold storage (SCS) has been the organ preservation methodology of choice, there is now great interest in the development of machine perfusion systems of abdominal and cardiothoracic organs. Whereas [...]

Current practice of normothermic regional perfusion and machine perfusion in donation after circulatory death liver transplants in Italy

Background Normothermic regional perfusion (NRP) and machine perfusion (MP) are variously used in many European centers to improve the outcomes after liver transplantation from donation after circulatory death (DCD). In Italy, a combination of NRP and subsequent MP has been used since the start of the activity. While NRP is mandatory for every DCD recovery, the subsequent use of MP is left to each center. Methods We have designed a national survey to investigate practices and policies of these techniques. [...]

National experience with living donor liver transplantation for hepatocellular carcinoma

Living donor liver transplantation (LDLT) is an attractive option to decrease waitlist dropout, particularly for patients with hepatocellular carcinoma (HCC) who face lengthening waiting times. Using the United Network for Organ Sharing (UNOS) national database, trends in LDLT utilization for patients with HCC were evaluated, and post-LT outcomes for LDLT versus deceased donor liver transplantation (DDLT) were compared. From 1998 to 2018, LT was performed in 20,161 patients with HCC including 726 (3.6%) who received LDLT. The highest LDLT utilization [...]

Protective benefit of minimally invasive liver surgery for hepatocellular carcinoma prior to transplant

Aim: The purpose of this study is to assess the benefit of laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) given recurrence and future need for liver transplantation (LT). Methods: Data on liver resections were gathered from the Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT) from 2003-2021. A retrospective analysis of 1408 consecutive adult patients who had a liver resection was performed with categorization based on the underlying disease process. A [...]

Surgical Complications After Liver Transplantation (Vascular and Biliary)

Complications after liver transplantation primarily affect the vasculature of the liver and the bile ducts. While these complications are rare, their impact on morbidity and mortality for the transplant recipient may be serious. Careful pre-transplant assessment of the vascular supply of the liver and bile ducts may help preventing these complications. Vascular complications include hepatic artery stenosis and thrombosis, portal vein stenosis and thrombosis, vena cava stenosis and splenic artery steal syndrome. Bile leakage is the most common biliary complication, [...]

Textbook of Liver Transplantation – A Multidisciplinary Approach

Liver transplantations require a complex and varied, multidisciplinary approach involving not only hepatologists and surgeons but also pathologists, psychologists, professional educators, nurses and, in the case of young patients, also pediatricians and development experts. This textbook provides an overview of the management problems involved in liver transplantation for acute and chronic liver disease, pediatric liver transplantation and the psychosocial aspects of liver transplantation. A closing chapter, focusing on the developments and future prospects in liver transplantation, outlines the potential offered [...]

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