Portacaval Shunt and Inferior Vena Cava Preservation in Orthotopic Liver Transplantation

Margarit, C; Cenarruzabeitia, Íñigo López de; Lázaro, José; Cancino, J.D.; Rojas, L.H.; Escartín, Alfredo; Mora, A.; Bilbao, Itxarone

doi:10.1016/j.transproceed.2005.10.062

Cited by 25 publications

(29 citation statements)

References 6 publications

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“…A direct comparison of the operative times with and without TPCS was available in 3 studies. 9,10,14 There was no difference in 2 studies, 9,14 and 1 study found that the operative time was shorter in patients undergoing TPCS. 10 The intraoperative blood product transfusion requirement was described in 6 articles.…”

Section: Resultsmentioning

confidence: 91%

“…Results from the 8 included articles are summarized in Tables 1 and 2, including a total of 2073 patients. 1,3,[8][9][10][11][12][13] The indication for transplantation was given for 647 recipients. The majority of patients had chronic liver disease (95.51%), with the remainder (4.49%) being transplanted for acute liver failure.…”

Section: Resultsmentioning

confidence: 99%

“…Postoperative renal function was reported in 3 studies, and all showed that TPCS did not appear to have an adverse effect on postoperative serum creatinine 9,13,14 Perioperative morbidity and mortality was described in 3 studies and ranged from 2.5% to 18% 1,14 and from 10% to 12%, 1,3 respectively. No comparison was made between patients with and without a TPCS.…”

Section: Resultsmentioning

confidence: 99%

“…14 During the anhepatic phase, the decrease in cardiac output was significantly less with the use of a TPCS only in those patients with a high (Ͼ1000 mL/minute) portal blood flow. 14 Similarly, Margarit et al 9 reported a beneficial effect of a TPCS in patients with cirrhosis when the portal flow was greater than 800 mL/minute.…”

Section: Discussionmentioning

confidence: 98%

“…There were 3 articles in which a direct comparison of the operative time was possible: TPCS was associated with a shortening of the operative time in 1 article, 10 whereas in the other 2 articles, the difference was not significant. 9,14 The lowering of portal pressure leads to less bleeding during dissection and hepatectomy, translating an often difficult step into a more straightforward procedure that is less time-consuming and thus compensating for the time taken to complete the TPCS. In addition, the improvement in operative exposure gives trainees the opportunity to perform the retrohepatic dissection under controlled circumstances.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Temporary portocaval shunt in orthotopic liver transplantation: Need for a standardized approach?

2008

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Maintenance of portal and systemic venous return during the anhepatic phase of liver transplantation (LT) improves hemodynamic stability. With the piggyback technique, caval return is maintained; however, temporary clamping of the portal vein is still necessary. The use of a temporary portocaval shunt (TPCS) has been proposed to minimize the effect of portal venous interruption. The aim of this study was to perform a systematic review of the literature to determine whether there is evidence to support the routine use of a TPCS in LT. An electronic search of the literature from 1963 to 2007 was performed. A total of 4386 articles were identified, of which 8 met all the criteria and were included in the study. Because of the variability in reporting and the small number of studies, statistical comparison was not possible; however, a trend toward a shorter operative time, less blood product transfusion, and maintenance of higher mean arterial pressures during portal vein clamping was seen in patients with a TPCS. In conclusion, the available evidence, albeit scarce, supports the use of a TPCS in patients undergoing LT. A prospective randomized study of patients most likely to benefit from a TPCS is necessary to substantiate these findings.

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Section: Resultsmentioning

confidence: 91%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Temporary portocaval shunt in orthotopic liver transplantation: Need for a standardized approach?

2008

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Piggy-back graft for liver transplantation

Gurusamy

Pamecha

Davidson

2011

Cochrane Database of Systematic Reviews

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Prediction of the binding mode between GSK3β and a peptide derived from GSKIP using molecular dynamics simulation

Tang

Chuang

et al. 2011

Biopolymers

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GSK3β plays an important role in many physiological functions; dysregulated GSK3β is involved in human diseases such as diabetes, cancer, and Alzheimer's disease. This study uses MD simulations to determine the interaction between GSK3β and a peptide derived from GSKIP, a novel GSK3β interacting protein. Results show that GSKIPtide is inlaid in a binding pocket consisting of an α-helix and an extended loop near the carboxy-terminal end. This binding pocket is hydrophobic, and is responsible for the protein-protein interaction of two other GSK3β interacting proteins: FRAT and Axin. The GSKIPtide binding mode is closer to that of AxinGID (in the Axin-GSK3-interacting domain). The single-point mutations of V267G and Y288F in GSK3β differentiate the binding modes between GSK3 and GSKIPtide, AxinGID, and FRATide. The V2677G mutation of GSK3β reduces the GSKIPtide binding affinity by 70% and abolishes the binding affinity with AxinGID, but has no effect on FRATide. However, GSK3β Y288F completely abolishes the FRATide binding without affecting GSKIPtide or AxinGID binding. An analysis of the GSK3β-GSKIPtide complex structure and the X-ray crystal structures of GSK3β-FRATide and GSK3β-AxinGID complexes suggests that the hydroxyl group of Y288 is crucial to maintaining a hydrogen bond network in GSK3β-FRATide. The hydrophobic side chain of V267 maintains the integrity of helix-helix ridge-groove hydrophobic interaction for GSK3β-GSKIPtide and GSK3β-AxinGID. This study simulates these two mutant systems to provide atomic-level evidence of the aforementioned experimental results and validate the wild-type complex structure prediction.

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Portacaval Shunt and Inferior Vena Cava Preservation in Orthotopic Liver Transplantation

Cited by 25 publications

References 6 publications

Temporary portocaval shunt in orthotopic liver transplantation: Need for a standardized approach?

Temporary portocaval shunt in orthotopic liver transplantation: Need for a standardized approach?

Piggy-back graft for liver transplantation

Prediction of the binding mode between GSK3β and a peptide derived from GSKIP using molecular dynamics simulation

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