Recent advances in understanding and managing liver transplantation

Russo, Francesco Paolo; Ferrarese, Alberto; Zanetto, Alberto

doi:10.12688/f1000research.8768.1

Cited by 27 publications

(23 citation statements)

References 48 publications

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“…Liver transplantation markedly improved the patient outcome and the result was compatible with other studies. [ 22 ] One hundred and five patients (105/3487; 3%) underwent liver transplantation. The benefit on the mortality of cirrhotic patients starts within the first 30 days after liver transplantation [ Figure 1 and Table 3 ].…”

Section: Discussionmentioning

confidence: 99%

The long-term outcomes of cirrhotic patients with pleural effusion

Hung

Tseng

Tsai

et al. 2018

Saudi J Gastroenterol

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Background/Aim:A pleural effusion is an abnormal collection of fluid in the pleural space and may cause related morbidity or mortality in cirrhotic patients. Currently, there are insufficient data to support the long-term prognosis for cirrhotic patients with pleural effusion. In this study, we investigated the short- and long-term effects of pleural effusion on mortality in cirrhotic patients and evaluated the benefit of liver transplantation in these patients.Patients and Methods:The National Health Insurance Database, derived from the Taiwan National Health Insurance Program, was used to identify 3,487 cirrhotic patients with pleural effusion requiring drainage between January 1, 2007 and December 31, 2010. The proportional hazards Cox regression model was used to control for possible confounding factors.Results:The 30-day, 90-day, 1-year, and 3-year mortalities were 20.1%, 40.2%, 59.1%, and 75.9%, respectively, in the cirrhotic patients with pleural effusion. After Cox proportional hazard regression analysis adjusted by patient gender, age, complications of cirrhosis and comorbid disorders, old age, esophageal variceal bleeding, hepatocellular carcinoma, hepatic encephalopathy, pneumonia, renal function impairment, and without liver transplantation conferred higher risks for 3-year mortality in the cirrhotic patients with pleura effusion. Liver transplantation is the most important factor to determine the 3-year mortalities (HR: 0.17, 95% CI 0.11- 0.26, P < 0.001). The 30-day, 30 to 90-day, 90-day to 1-year, and 1 to 3-year mortalities were 5.7%, 13.4%, 20.4%, and 21.7% respectively, in the liver transplantation group, and 20.5%, 41.0%, 61.2%, and 77.5%, respectively, in the non-liver transplantation group.Conclusion:In cirrhotic patients, the presence of pleural effusion predicts poor long-term outcomes. Liver transplantation could dramatically improve the survival and should be suggested as soon as possible.

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Section: Discussionmentioning

confidence: 99%

The long-term outcomes of cirrhotic patients with pleural effusion

Hung

Tseng

Tsai

et al. 2018

Saudi J Gastroenterol

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“…Ayrıca, en karmaşık ve teknik olarak zahmetli cerrahi prosedürlerden biridir ve genellikle yüksek morbidite ve reoperasyon oranına sahiptir (2,4). Dünyada ilk başarılı karaciğer nakli ameliyatı 1967 yılında Starzl tarafından gerçekleştirilirken, ülkemizde 1988 yılında Mehmet Haberal tarafından yapılmıştır (5).…”

Section: Discussionunclassified

“…Tzakis ve ark. (24) piggy-back tekniğinde inferior 5 yıllık sağkalım sırasıyla %90 ve %80 düzeylerindedir (2). Serimizde hasta sağkalımı %87,5'dir.…”

Section: Safra Yoluunclassified

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Our Liver Transplantation Experience: A One-Year Single Center Study

Kısaoğlu¹,

Mutlu²,

Dandin³

et al. 2017

Akd Med J

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ÖZAmaç: Kliniğimizde 2016 yılı içerisinde gerçekleştirilen canlı ve kadavra vericili karaciğer nakli tecrübemizi sunmaktır. Gereç ve Yöntemler:Akdeniz Üniversitesi Tıp Fakültesi Organ Nakli Merkezi'nde 2016 yılı içe-risinde canlı ve kadavradan karaciğer nakli yapılan yetişkin ve pediatrik toplam 48 hasta ve vericileri çalışmaya dahil edildi. Demografik veriler, nakil endikasyonları, ameliyata ait teknik bilgiler, safra anastomozu ve vasküler komplikasyonlar, hastanede yatış süresi, takip süresi, greft ve hasta sağkalımı, mortalite nedenleri geriye dönük olarak değerlendirildi. Material and Methods:A total of forty-eigtht adult and pediatric patients who had undergone cadaveric and living donor liver transplantation at our organ transplantation center in 2016 were included in our study. The patients' and donors' demographics, indications, technical data about operations, postoperative biliary anastomosis and vascular complications, the length of stay in the hospital, follow-up time and outcomes were analyzed retrospectively.Results: Mean (±standard deviation) age of patients (24 male, 24 female) was 40.6 (±20.1). The most common indications were HBV-related cirrhosis and cryptogenic cirrhosis. The number of living donor liver transplantations was 29. Mean (±SD) follow-up time and length of hospital stay were 5.4 (±3.7) months and 23.5 (±20.7) days, respectively. While no patient had a hepatic vein complication, one (2.1%) patient had portal vein thrombosis at the fourth postoperative hour and one (2.1%) patient had decreased hepatic arterial flow after the third postoperative month. Complication of bile duct anastomosis was developed in eight patients (16.6%). The rate of patient survival was 87.5%. Conclusion:According to our one-year experience, cadaveric and living donor liver transplantation are performed successfully at our transplantation center.

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“…Liver transplantation (LT) is the most effective management strategy for end-stage liver disease and hepatocellular carcinoma (1). Owing to the evolution of surgical techniques along with potent immunosuppressive agents and infection control, survival rates following LT have reached 90% and 80% at one and five years, respectively (1).…”

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confidence: 99%