We conclude that the addition of interposed abdominal compression may be a useful adjunct to otherwise standard CPR that can improve resuscitation outcome of patients experiencing in-hospital cardiac arrest from asystole and electromechanical dissociation.

Alcoholic liver disease (ALD) is the second most common diagnosis among patients undergoing liver transplantation (LT). The recovery results of patients transplanted for ALD are often at least as good as those of patients transplanted for other diagnoses and better than those suffering from hepatitis C virus, cryptogenic cirrhosis, or hepatocellular carcinoma. In the case of medically non-responding patients with severe acute alcoholic hepatitis or acute-on chronic liver failure, the refusal of LT is often based on the lack of the required alcohol abstinence period of six months. The obligatory abidance of a period of abstinence as a transplant eligibility requirement for medically non-responding patients seems unfair and inhumane, since the majority of these patients will not survive the six-month abstinence period. Data from various studies have challenged the 6-mo rule, while excellent survival results of LT have been observed in selected patients with severe alcoholic hepatitis not responding to medical therapy. Patients with severe advanced ALD should have legal access to LT. The mere lack of pre-LT abstinence should not be an obstacle for being listed.

BackgroundObesity presents one of the leading causes of many chronic liver disorders and injuries. Nowadays, non-alcoholic steatohepatitis (NASH) demonstrates a challenging issue for the global health system. NASH can progress to life-threatening conditions such as cirrhosis and hepatocellular or cholangio carcinoma. Currently, NASH cirrhosis is a major indication for liver transplant (LT).Case presentationWe present the case of a 37 year-old male who has lost 74 kg after undergoing successful laparoscopic sleeve gastrectomy (SG) four years ago. Recently, he underwent right hepatectomy in the course of living-donor liver transplantation for his sick father in our clinic. Before the SG was conducted four years ago, his weight was at 157 kg and his Body Mass Index (BMI) at 49 kg/m2. At that time, Ultrasound examination showed severe fatty liver changes and intraoperative inspection of the liver was consistent with that observation. At the time of surgery, he weighed 83 kg and his BMI was at 27 kg/m2. An effective weight reduction after bariatric surgery might protect NASH patients from further deterioration of their medical condition.ConclusionTo our knowledge, we report the first successful case of a right lobe living-donor hepatectomy in a patient who previously underwent successful laparoscopic sleeve gastrectomy (LSG).

This technique is a low-tech but efficient donor-dissection technique in living liver transplantation, which is comparable to other well established dissection techniques utilizing technical devices in regards to risk for the donor, performance, and recovery.

Unusual or unexpected effect of treatment Background: Postoperative pulmonary embolism following liver transplantations is still one of the most fatal complications, especially during the early postoperative phase. The use of a thrombolytic agent such as the recombinant tissue-type plasminogen activator (rtPA) is considered a contraindication early after major abdominal surgery such as liver transplantation. However, thrombolysis after major surgery in the early postoperative period carries a substantial risk of surgical site hemorrhage. Case Report: A 55-year-old patient presented with a hepatic mass diagnosed as a combined cholangio/hepatocellular carcinoma. Following the criteria of the University of San Francisco, California (UCSF) for liver transplantation, the case was selected for liver transplantation. The patient received neoadjuvant therapy. After the liver transplantation, on the second postoperative day, an acute, severe dyspnea with sudden onset occurred on the surgical ward. A computed tomography angiography showed a drawn-out embolus, which sprawled into both pulmonary main arteries and occluded them subtotally. A thrombolysis with rtPA was started. Within the first 60 minutes of administration of rtPA, the circulation stabilized effectively, so that epinephrine could be tapered down to zero and the patient was promptly extubated. About 6 hours after administration of rtPA, a sudden and pronounced bleeding via one of the intraperitoneal drains occurred, hemoglobin concentration dropped from 9.7 g/dL to 6.4 g/dL. After immediate re-laparotomy, circulation and hemoglobin concentration were absolutely stable. Conclusions: Even with anticipated high risk of bleeding, thrombolysis with rtPA can be used as a life-savings treatment in a case of pulmonary embolism after liver transplantation.