Abdominal Organ Transplantation: Noteworthy Literature in 2018

Abstract

A PubMed search revealed 1382 articles on pancreatic transplantation, 781 on intestinal transplantation, more than 7200 on kidney transplantation, and more than 5500 on liver transplantation published between January 1, 2018, and December 31, 2018. After narrowing the list down to human studies, 436 pancreatic, 302 intestinal, 1920 liver, and more than 2000 kidney transplantation studies were screened for inclusion in this review.

Preoperative cardiac assessment in liver transplant candidates

“…Further prospective studies are needed to define features (if any) mandatory for an appropriate preoperative risk assessment and the exact role that ECG should have in the preoperative LT assessment. In case of CCM, the recommendations for prolonged QT (> 450 msec in males or > 470 msec in females) recently endorsed by ATS are to treat reversible causes and to avoid medications able to prolong QT (GRADE recommendation 1C) [9] 2.2 Biomarkers -Biomarkers may have an interesting role as non-invasive diagnostic and prognostic tools in the preoperative period [31,33,34]. Some Authors suggest the preoperative use of cardiac Troponin I (cTn I) level, now used for the general surgical population, as a marker of subclinical myocardial damage [25,35].…”

“…Precise assessment of valvular heart disease, its severity and the impact on cardiorespiratory function are relevant part of the preoperative evaluation. The role of TTE is prominent (GRADE recommendation 1C) [9], while transesophageal echocardiography (TEE) might ease the intraoperative management [33]. Mild to moderate valvular heart diseases are usually well tolerated during the surgical procedure and do not constitute a contraindication to LT [9,25].…”

Abdominal Organ Transplantation: Noteworthy Literature in 2019

“…Only a single center reported a renal transplant-specific ERAS program for cadaveric organ recipients. 15 In our 2018 review, 16 we cited an initial implementation of an ERAS protocol for renal transplant recipients, which included 286 recipients in the ERAS group and 151 in the traditional recovery group, and showed significantly better pain control, decreased length of stay, and cost savings. 17 In 2019, Dias et al published the results of their standardized ERAS protocol with prospective data from July 2017 to December 2018 (N ¼ 100) and compared it with data from prior to ERAS implementation (N ¼ 100).…”

The international experience of in-situ recovery of the DCD heart: a multicentre retrospective observational study

“…However, in the Royal Papworth Hospital, DCD transplantation makes up 30% of the total number of heart transplants. 4 Similarly, data from the US shows that in 20/21, DCD made up 5.4% of transplants, 5 however it has been estimated that DCD could increase the donor pool by up to 30% if widely adopted. 6 Therefore DCD transplantation and specifically taNRP have great potential in decreasing waiting list mortality.…”