Liver transplantation and hepatobiliary surgery in 2020

Abstract

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Low‐dose aspirin confers protection against acute cellular allograft rejection after primary liver transplantation

“…Liver transplantation (LT) has become a standard therapy for patients with end-stage liver disease and fulminant liver failure. Postoperative morbidity still remains high, [1] especially when accounting for vascular complications. [2,3] Hepatic artery thrombosis (HAT) occurs in 4%-9% of adult LT [4,5] and is one of the most serious vascular complications often resulting in liver necrosis, abscess formation, ischemic cholangiopathy, and graft loss.…”

Assessment of morbidity and mortality after liver transplantation for primary sclerosing cholangitis

“…There are significant challenges with liver transplantation in patients with PSC including (I) technical difficulties, (II) recurrent cholangitis post-liver transplantation due to an immunosuppressive state, (III) increased risk of rejection due to the autoimmune nature of the disease, (IV) recurrence of the disease post-liver transplantation, and (V) the shortage of liver allografts which necessitates the use of extended criteria and donation after circulatory death grafts. Despite these challenges, the post-liver transplant graft and patient survival in patients with PSC is similar to non-PSC patients ( 2 - 6 ).…”

“…Although the authors concluded that morbidity measured with a 1-year CCI score appeared to significantly affect the 1-year patient survival, in the long-term, morbidity measured with an overall CCI score appeared to be mainly increased by low-grade complications, such as infections and hypertension. However, we wonder if studies that span over 36 years could accurately assess and compare morbidity when the management of PSC gets better over decades by expert hepatologists, better and novel knowledge, such as the impact of gut microbiota ( 10 , 11 ), and better surgeons with improved techniques and knowledge in liver transplantation ( 6 ).…”

Deep learning for 3D biliary anatomy for living liver donor hepatectomy planning

“…Living donor liver transplantation (LDLT) and hepatobiliary surgery require advanced planning to guarantee the maximum safety of living liver donors and patients who undergo major hepatectomy and bile duct surgery 4 . Therefore, the application of deep-learning to LDLT and hepatobiliary surgery would be very helpful in order to guarantee patient safety and better outcomes following liver transplantation.…”