Ileostomy or colostomy formation is an important component of many surgical procedures performed for a wide range of disorders of the gastrointestinal tract. Despite the frequency with which intestinal stomas are created, stoma-related complications remain common and are associated with significant morbidity as well as cost. Some of the most prevalent complications of stoma formation which will be detailed in this article include peristomal skin complications, retraction, stomal necrosis, stomal stenosis, prolapse, bleeding, dehydration from high ostomy output, and parastomal hernia. The authors will review these common complications, detail means to avoid or prevent them, and outline recommendations for management.

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Patients with pretransplant DT of ≥10 years had worse outcomes than patients pre-emptively transplanted or transplanted with shorter DT. Durations of dialysis dependence beyond 10 years were associated with further deterioration in short-term but not long-term post-transplant outcomes.

Although the transplant and resection populations differ, occult multifocality is common in transplant explants and similar to the 46% early recurrence rate following partial hepatectomy. These data suggest that noncurative resection often results from occult intrahepatic multifocality present at the time of resection rather than a malignant predisposition of the remnant liver with de novo tumorigenesis.

Early studies of national data suggest that the Share 35 allocation policy increased liver transplants without compromising post-transplant outcomes. Changes in center-specific volumes and practice patterns in response to the national policy change are not well characterized. Understanding center-level responses to Share 35 is crucial for optimizing the policy and constructing effective future policy revisions. Data from the United Network for Organ Sharing were analyzed to compare center-level volumes of allocation-MELD ≥35 transplants pre- and post-policy implementation. There was significant center-level variation in the number and proportion of allocation-MELD ≥35 transplants performed from the pre- to post-Share 35 period; eight centers accounted for 33.7% of the total national increase in allocation-MELD ≥35 transplants performed in the 2.5-year post-Share 35 period, while 25 centers accounted for 65.0% of the national increase. This trend correlated with increased listing at these centers of patients with MELD ≥35 at the time of initial listing. These centers did not over-represent the total national volume of liver transplants. Comparison of post-Share 35 allocation-MELD to calculated time-of-transplant laboratory MELD showed that only 69.6% of patients transplanted with allocation-MELD ≥35 maintained a calculated laboratory MELD ≥35 at the time-of-transplant. Conclusion Share 35 increased transplantation of allocation-MELD ≥35 recipients on a national level, but the policy asymmetrically impacted practice patterns and volumes of a subset of centers. Longer-term data is necessary to assess outcomes at centers with markedly increased volumes of high-MELD transplants post-Share 35.