Dual graft living donor liver transplantation – a case report

Nikam, Vinayak; Mohanka, Ravi; Golhar, Ankush; Bhade, Rashmi; Prashantha, Rao; Gadre, Parul; Shrimal, Anurag

doi:10.1186/s12893-019-0606-5

Cited by 13 publications

(4 citation statements)

References 18 publications

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“…The operation is also complicated, and it is difficult to popularize this model for the study of liver transplantation. In addition, although some patients have unilateral graft atrophy after DGLT, the survival rate of most patients is tremendously good and no uncurable complications can be pinpointed ( 37 , 38 ), similar to the rat model’s survival rate in our experiment. This “extra” or atrophic graft, although it failed to regenerate well eventually, seems to support patients as a transition through the period of greatest need for liver ( 14 , 19 ).…”

Section: Discussionsupporting

confidence: 81%

Preliminary study of donor volume changes after dual-graft liver transplantation in rats

Wang,

Ma,

et al. 2023

Front. Immunol.

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Dual-graft liver transplantation (DGLT) expands the pool of donors, ensures the safety of the donors, and treats a potential small for size syndrome (SFSS). However, some of the recipient graft showed atrophy. The cause and mechanism of the unbalanced proliferation and atrophy of dual grafts after clinical DGLT have not been clarified. We established and optimized the rat model of DGLT to explore the causes of growth unbalance. Continuously and dynamically observed bilateral graft volume and portal vein blood flow change by magnetic resonance imaging (MRI) and ultrasound (US). We detected liver function indexes: alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL). Liver samples from receptors were obtained for morphology, and apoptosis was measured by RT-PCR and western blot. Optimization of the model improved the 7-day survival rate from former 58.3% to 87.5%, and the 30-day survival rate was 68.8%. The volume of the right graft gradually increased, and the left graft atrophied during the 30-day observation period. The portal blood flow of the left graft gradually decreased until the 30th day (0.13 ± 0.01 ml/s) compared with the sham group (0.63 ± 0.05 ml/s), and the right graft significantly increased on the 30th day (0.75 ± 0.11ml/s). The liver function initially increased and then recovered. The total volume (12.52 ± 1.60 ml vs 4.47 ± 0.08 ml) and weight (12.09 ± 1 g vs 4.91 ± 0.18 g) of the graft increased significantly compared to pre-transplantation and reached the level of the sham operation group on the 30th day. The volume and weight of the right graft increased more than those of the left graft (P < 0.05). There was more inflammatory cell infiltration in the left graft, and the right graft had obvious proliferation of hepatocytes and mature bile duct cells. Left grafts were more prone to apoptosis than right grafts (P < 0.05). In conclusion, growth of the right graft is superior to the left; after double liver transplantation, perfusion blood flow and apoptosis may be the reason contributing to the volume differences in dual grafts.

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Section: Discussionsupporting

confidence: 81%

Preliminary study of donor volume changes after dual-graft liver transplantation in rats

Wang,

Ma,

et al. 2023

Front. Immunol.

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“…Such results are meaningful to the transplant community, given that there are over 11,000 patients waiting for a liver transplant in the United States in 2022 (https://optn.transplant.hrsa.gov/data/) and a transplant is the only current remedy for these patients. For lung and liver transplants, dual‐donor organ exchange is a promising mechanism that would help reduce the number of patients currently on organ waiting lists and reduce the risks of undesirable health outcomes associated with donors after transplant (Luo & Tang, 2015; Vinayak et al., 2019; Xu et al., 2015).…”

Section: Literature Reviewmentioning

confidence: 99%

“…hrsa.gov/data/) and a transplant is the only current remedy for these patients. For lung and liver transplants, dual-donor organ exchange is a promising mechanism that would help reduce the number of patients currently on organ waiting lists and reduce the risks of undesirable health outcomes associated with donors after transplant (Luo & Tang, 2015;Vinayak et al, 2019;Xu et al, 2015). Luo and Tang (2015) formally develop a mathematical model for lung exchange that employs dual-donor transplants.…”

Section: Dual-donor Organ Exchangementioning

confidence: 99%

An optimization framework for analyzing dual‐donor organ exchange

Stauffer

Shetty

et al. 2023

Production and Operations Management

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We study an optimal matching problem in the context of dual-donor organ exchange, where a portion of two living donors' organs are transplanted to a single patient. This dual-donor transplant technique is becoming more widespread for lung and liver transplants. However, multiple medical compatibility criteria pose a serious challenge for matching a patient with two compatible donors. In the United States and many other countries, laws prohibit commercial (for-profit) deals for human organs, so donor exchanges are run by nonprofit organizations connecting donors with people in need of organs, with the goal of increasing transplant matches. We propose a simple chain mechanism in dual-donor organ exchange to increase the number of patient-dual-donor matches, which would maximize the number of patients receiving transplants. Based on this objective, we propose a general simple chain optimization framework for finding the maximum patient matching, taking into account multiple compatibility criteria (e.g., blood type and weight), and determine the complexity status of the problem. We provide theoretical results on the structures of simple chains, as well as a polynomial time algorithm to obtain the maximum patient matching simple chain with blood type compatibility. Through a numerical study for multiple compatibility criteria, we show that in many scenarios, a simple chain substantially increases the number of patients matched with dual donors for transplants, as opposed to exchange cycles. We also address the problem of maximizing the number of patients matched for dual-donor organ transplants via two-way and three-way exchange cycles, subject to donors' and recipients' medical compatibility criteria, along with a discussion of their computational complexity. Finally, we characterize the general configurations of large n-way exchange cycles and provide theoretical insights for their structural properties. Our findings provide general optimization models for dual-donor organ exchange operators to increase the number of patients matched for transplant, given multiple compatibility criteria. In addition, we show how exchange operators, using simple chains, can increase patient matches and reduce simultaneous surgical resource requirements over exchange cycles. K E Y W O R D Schain matching, dual-donor organ exchange, exchange cycles, mathematical programming, maximum independent set, nonprofit operations, NP-complete

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“…Также в мировой практике описаны способы трансплантации и других фрагментов печени живого донора, в том числе трансплантации двух левых латеральных секторов от разных живых доноров и др., однако эти методы ограничиваются опытом нескольких клиник и не могут быть рекомендованы для широкой практики [45].…”

Section: таблица 4 соответствие по размеру трансплантата печениunclassified

Этапы Подготовки И Обследования Родственных Доноров Печени И Их Периоперационное Ведение

Сёмаш,

Джанбеков,

Акбаров

et al. 2023

coloproc

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Отбор, подготовка и периоперационное ведение прижизненных родственных доноров печени – сложный и ответственный вид медицинской помощи, требующий от врачей максимального вовлечения на всех этапах. В данной статье подробно описана селекция и подготовка донора к резекции печени, основные принципы донорской резекционной хирургии. Также подробно описано послеоперационное ведение доноров и их реабилитация.

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Dual graft living donor liver transplantation – a case report

Cited by 13 publications

References 18 publications

Preliminary study of donor volume changes after dual-graft liver transplantation in rats

Preliminary study of donor volume changes after dual-graft liver transplantation in rats

An optimization framework for analyzing dual‐donor organ exchange

Этапы Подготовки И Обследования Родственных Доноров Печени И Их Периоперационное Ведение

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