Steatosis increases operative morbidity/mortality from ischemia-reperfusion injury (IRI);

A 31-year-old nulliparous patient presents with a three-day history of right sided colicky abdominal pain and associated nausea. This patient has previously presented twice with right sided ovarian torsion with the background of polycystic ovaries in the last two consecutive years. Blood tests were normal. Due to previous history, there was a high index of clinical suspicion that this may be a further torsion. Therefore, the patient was taken to theatre for a diagnostic laparoscopy and a further right sided ovarian torsion was noted. At this time, oophoropexy was performed to the uterosacral ligament to prevent further torsion in order to preserve the patients' fertility. In this article, we detail this case and also provide a discussion of ovarian torsion including risk factors, presentation, and current thoughts on management.

The mainstays of liver graft preservation before transplantation over the past two decades have been the combination of effective preservation solutions and hypothermia. Excellent results have been achieved by minimizing: (i) warm ischemia time; (ii) cellular changes during cold storage time; and (iii) reperfusion injury to the graft after restoration of blood flow in the recipient. Despite better outcomes in liver transplantation, recent data indicate that prolonged preservation injury remains a risk factor for primary graft failure, particularly for 'marginal' or extended criteria donor livers, which are increasingly used because of the shortage of available grafts.