Piggy-back graft for liver transplantation

Gurusamy, Kurinchi Selvan; Pamecha, Viniyendra; Davidson, Brian R

doi:10.1002/14651858.cd008258.pub2

Cited by 41 publications

(20 citation statements)

References 41 publications

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“…Moreover, renal insufficiency may be a problem because of clamping of the IVC causing reduced perfusion of the kidneys. Recently, in a Cochrane database analysis, the piggyback technique versus standard technique was reviewed, and they found two randomized trials with a total of 106 patients (Gurusamy et al 2011b). Warm ischemic time was shorter in the piggyback method because only one caval anastomosis had to be performed.…”

Section: Liver Transplantation-techniquesmentioning

confidence: 99%

Overview of the Indications and Contraindications for Liver Transplantation

Farkas

Hackl

Schlitt

2014

Cold Spring Harbor Perspectives in Medicine

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Liver transplantation is the only definitive treatment option for patients with irrevocable acute or chronic liver failure. In the last four decades, liver transplantation has developed from an experimental approach with a very high mortality to an almost routine procedure with good short-and long-term survival rates. Here, we present an up-to-date overview of the indications and contraindications for liver transplantation. It is shown how the evaluation of a candidate and finally listing for transplantation has to be performed in a multidisciplinary setting. Meticulous listing, timing, and organ allocation are the crucial factors to achieve an optimal outcome for the individual patient on the one hand, and reasonably using the limited deceased donor pool on the other hand. Living-donor liver transplantation is demanding but necessarily increasing. Because patients after liver transplantation need lifelong aftercare, it is important for primary care clinicians to understand the basic medical problems and risks.

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Section: Liver Transplantation-techniquesmentioning

confidence: 99%

Overview of the Indications and Contraindications for Liver Transplantation

Farkas

Hackl

Schlitt

2014

Cold Spring Harbor Perspectives in Medicine

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“…Strong vasopressors with an alpha-agonist action such as norepinephrine may be required (Ramsay et al, 1992). These changes related to reperfusion may be decreased by using the piggy back technique contributing to a side-bite of IVC allowing the venous return to continue (Findlay, 2002;Gurusamy et al, 2011). Initial arterial reperfusion may be preferable only in patients with poor cardiac reserve (Moreno et al, 2006).…”

Section: The Neohepatic Phasementioning

confidence: 99%

Anesthesia in Liver Transplantation

Kanbak¹,

Karagöz²,

Üzümcügil³

2012

Liver Transplantation - Basic Issues

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“…Moreover, some of others donor-, In randomized Brazilian reports, the piggy-back approach was related to higher rate of pulmonary infiltrates 38 , but not to bacterial translocation 39 or stimuli for the production of inflammatory molecules 40 , when compared to the conventional method. However, until publication of this study, there were no trials comparing piggy-back with conventional method without veno-venous bypass 37 . In our Department, our learning curve evolved initially with this last, which is performed with recognized swiftness and has been preferred whenever technical difficulty arose during performance of the hepatectomy 41 .…”

Section: Introductionmentioning

confidence: 98%

Non-cancerous prognostic factors of hepatocellular carcinoma after liver transplantation

Batista¹,

Miranda²,

Sabat³

et al. 2012

Acta Cir. Bras.

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PURPOSE:To explore non-cancerous factors that may be related with medium-term survival (24 months) after liver transplantation (LT) in this data from northeast Brazil. METHODS:A cross-sectional study was carried out in patients who underwent deceased-donor orthotopic LT because hepatocellular carcinoma (HCC) at the University of Pernambuco, Brazil. Non-cancerous factors (i.e.: donor-, receptor-, surgery-and center-related variables) were explored as prognostic factors of medium-term survival using univariate and multivariate approachs. RESULTS:Sixty-one patients were included for analysis. Their three, six, 12 and 24-month overall cumulative survivals were 88.5%, 80.3%, 73.8% and 65.6%, respectively. Our univariate analysis identified red blood cell transfusion (Exp[b]=1.26; p<0.01) and hepatovenous reconstruction technique (84.6% vs. 51.4%, p<0.01; respectively for piggyback and conventional approaches) as significantly related to post-LT survival. The multivariate analysis confirmed the hepato-venous reconstruction technique was an independent prognostic factor. CONCLUSION:The piggyback technique was related to improved medium-term survival of hepatocellular carcinoma patients after liver transplantation in this northeast Brazilian sample.Key words: Organ Transplantation. Liver Neoplasms. Carcinoma, Hepatocellular. Survival Analysis. Prognosis. RESUMO OBJETIVO:Explorar fatores prognósticos não oncológicos para a sobrevivência de médio prazo (24 meses) de portadores de carcinoma hepatocelular tratados com transplante hepático. MÉTODOS: Estudo de corte incluindo pacientes submetidos a transplante ortotópico de fígado (doador-cadáver) pelo Serviço deCirurgia Geral e Transplante Hepático da Universidade de Pernambuco, UPE. Exploraram-se variáveis relacionadas ao doador, receptor, procedimento cirúrgico e serviço transplantador, como potenciais fatores prognósticos para a sobrevivência de médio prazo dos transplantados, aplicando-se análise uni e multivariada. Non-cancerous prognostic factors of hepatocellular carcinoma after liver transplantationActa Cirúrgica Brasileira -Vol. 27 (6) 2012 -397 RESULTADOS: Sessenta e um pacientes foram incluídos para análise. A sobrevivência cumulativa de três, seis, 12 e 24 meses observada foi de 88,5%, 80,3%, 73,8% e 65,6%, respectivamente. Por análise univariada, identificou-se a transfusão de hemácias (Exp[b]=1,26; p<0,01) e técnica cirúrgica empregada (84,6% vs. 51,4%, p<0,01; respectivamente, piggyback vs. convencional) como estatisticamente relacionadas à sobrevivência dos pacientes estudados. Por análise multivariada, confirmou-se a técnica empregada como fator prognóstico independente. CONCLUSÃO:A técnica cirúrgica piggyback se relacionou a melhor sobrevivência de médio prazo de pacientes com carcinoma hepatocelular após transplante de fígado nesta casuística do nordeste Brasileiro.

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Piggy-back graft for liver transplantation

Cited by 41 publications

References 41 publications

Overview of the Indications and Contraindications for Liver Transplantation

Overview of the Indications and Contraindications for Liver Transplantation

Anesthesia in Liver Transplantation

Non-cancerous prognostic factors of hepatocellular carcinoma after liver transplantation

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