2018 Clinical Update in Liver Transplantation

Markin, Nicholas W.; Ringenberg, Kyle J.; Kassel, Cale A.; Walcutt, Charles R.; Chacon, M. Megan

doi:10.1053/j.jvca.2019.02.004

Cited by 16 publications

(19 citation statements)

References 95 publications

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“…Thus, important predictors of death in patients with CCM are: diastolic dysfunction, increasing age, increased left atrial dimension, increased E/e' ratio, and Model for End‐Stage Liver Disease, as well as a decrease in left ventricular mass, cardiac index, and mean arterial pressure 13,55 . Due to overall unfavorable prognosis, LT seems to be the sole cure for this syndrome, 14,15,55 although even after it, cirrhotics with pretransplant diastolic dysfunction are significantly more likely to develop acute cellular rejection as well as graft failure and all causes of mortality 40,57,58 …”

Section: Prognosismentioning

confidence: 99%

Analogies and differences between cirrhotic cardiomyopathy and hepatopulmonary syndrome

Zardi

Giorgi²,

Dobrina

et al. 2020

Medicinal Research Reviews

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Cirrhotic cardiomyopathy and hepatopulmonary syndrome are two quite frequent clinical entities that may complicate the course of liver cirrhosis. The common pathophysiological origin and the same clinical presentation make them difficult to compare. Cirrhotic cardiomyopathy and hepatopulmonary syndrome may start with dyspnea and breathlessness but the former is characterized by a chronic cardiac dysfunction and the latter by a defect of oxygenation due to pulmonary shunts formation. The focus is to differentiate them as soon as possible since the treatment is different until the patient undergoes liver transplant that is the real unique cure for them.

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Section: Prognosismentioning

confidence: 99%

Analogies and differences between cirrhotic cardiomyopathy and hepatopulmonary syndrome

Zardi

Giorgi²,

Dobrina

et al. 2020

Medicinal Research Reviews

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“…Hypervolemia occurs either from intraoperative over-resuscitation or coexistence of renal dysfunction. It can result in capillary leak syndrome with loss of fluids in the third space, further congestion and graft edema due to vascular permeability disorder, caused by ischemia/reperfusion injury (I/R) that is more pronounced in grafts with higher preservation injury, greater steatosis, or in older donors [7,25]. Studies also indicate that massive administration of fluids and blood is a risk factor for complications of the respiratory system postoperatively and is correlated with increased mortality [26].…”

Section: Hemodynamic Stabilization and Monitoringmentioning

confidence: 99%

“…Recovery of the graft is a combination mainly of the severity of the recipient's condition, donor quality, intraoperative events, perioperative hemodynamic stability, and preservation injuries, while adequate blood flow to the organs and prevention of venous stasis in the new liver have to be ensured ( Table 2) [49]. On the other hand, the risk of poor outcome is increased in case of ESLD-associated syndromes and co-morbidities coexistence, especially in sicker patients, as estimated by the MELD score [4,7]. Donor quality has a major impact on the graft function since the use of marginal donors is now commonplace [4].…”

Section: Liver Allograft Functionmentioning

confidence: 99%

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Management of Patients with Liver Transplantation in ICU

Karapanagiotou¹,

Pitsoulis²,

Vasileiou³

et al. 2019

Liver Disease and Surgery [Working Title]

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Liver transplantation constitutes the most effective and indispensable treatment of end-stage liver disease (ESLD). Major advances in surgical techniques, anesthesiological management, postoperative care, immunosuppression, and diagnostic approach have led to increased overall survival of patients. Postoperative care poses a great challenge since detrimental occurrences that need prompt treatment may affect the graft or distant organ functionality. Adequate graft function is strongly associated with distant organ restoration and rapid patient recovery. In the ICU setting, the main focal points are hemodynamic stabilization, coagulation and electrolyte disturbances correction, respiratory support, early weaning from mechanical ventilation, and evaluation of graft functionality. It is of paramount importance to facilitate early graft recovery, recognize and promptly treat systematic complications and life-threatening sequelae, and individualize treatment protocols considering graft quality, donor's and recipient's health status, and potential co-morbidities. To achieve those goals, technological advancements in continuous patient monitoring, graft functionality, and its metabolic reserves must be assimilated and implemented in the ICU.

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“…Organ transplantation, including liver transplantation, has become more prevalent in recent years. Liver transplantation is the gold standard treatment for acute liver failure, end-stage liver disease and primary hepatic malignancy [1]. Data on adult liver transplants performed in the United States showed that the number of liver transplants continued to increase over a recent decade (8082 patients in 2017, 7871 patients in 2016 and 6494 patients in 2007) [2].…”

Section: Introductionmentioning

confidence: 99%

Lateral Access Spine Surgery Following Liver Transplantation: A Report of Two Cases

Akeda

Takegami

Yamada

et al. 2020

Preprint

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Background With improving prognosis for recipients of liver transplantation, the necessity of medical care for musculoskeletal disorders, including spinal diseases, of these patients is also increasing. Only few reports are available on cases of spine surgery following liver transplantation. Furthermore, a case of lateral access surgery following liver transplantation has not thus far been reported. The purpose of this study is to present first two cases of patients treated with lateral access spine surgery following liver transplantation.Case presentation Case 1. A 49-year-old female had received living donor liver transplantation (LT) for acute-on-chronic liver failure (ACLF) ten years prior to spine surgery. The patient underwent two levels of lateral lumbar interbody fusion (LLIF) followed by posterior lumbar interbody fusion (PLIF) for degenerative lumbar disease. Although neurological symptoms in the lower extremity improved, a liver disorder resulting from acetaminophen-induced hepatotoxicity occurred at an early stage following spine surgery.Case 2. A 66-year-old female had received living donor liver transplantation for hepatocellular carcinoma (HCC) six years prior to spine surgery. She underwent posterior instrumentation surgery followed by T12 corpectomy using a wide-foot print expandable cage for T12 vertebral collapse. Following surgery, her weakened muscle strength in the lower extremities were significantly improved. Conclusions Lateral access spine surgery for lumbar and thoracolumbar lesions can be successfully performed for patients following liver transplantation. However, careful follow-up should be performed for complications related to the function of the liver graft following spine surgery.Conclusions Lateral access spine surgery for lumbar and thoracolumbar lesions can be successfully performed for patients following liver transplantation. However, careful follow-up should be performed for complications related to the function of the liver graft following spine surgery.

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2018 Clinical Update in Liver Transplantation

Cited by 16 publications

References 95 publications

Analogies and differences between cirrhotic cardiomyopathy and hepatopulmonary syndrome

Analogies and differences between cirrhotic cardiomyopathy and hepatopulmonary syndrome

Management of Patients with Liver Transplantation in ICU

Lateral Access Spine Surgery Following Liver Transplantation: A Report of Two Cases

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