The evolution of liver transplantation practices

Walia, Ann; Schumann, Roman

doi:10.1097/mot.0b013e3282ffabee

Cited by 26 publications

(23 citation statements)

References 47 publications

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“…(HEPATOLOGY 2012;56:1557-1566 L iver transplantation (LT) has saved the lives of many patients with end-stage liver diseases and has become a curative procedure for certain liver diseases. 1 Similar to other types of organ transplantation, chimerism can develop after LT with the chimeric cells either circulating or integrated into the parenchyma. 2 Several types of reciprocal chimerisms after LT have been reported, including (1) recipient-derived cells in the donor organ 3,4 ; (2) hematopoietic chimerism of donor origin in the recipient blood [5][6][7] ; and (3) donor origin cells in the skin and lymph nodes.…”

Section: Cd45mentioning

confidence: 99%

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Hematopoietic chimerism in liver transplantation patients and hematopoietic stem/progenitor cells in adult human liver

Wang

Chen

et al. 2012

Hepatology

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Liver transplantation (LT) is a cure for many liver diseases. Blood chimerism of donor origin can develop after LT, which raises the possibility of the existence of hematopoietic stem/progenitor cells (HSPCs) in the liver. We characterized the blood chimerism in a large cohort of 249 LT patients and analyzed putative HSPCs in adult human livers. The overall incidence of chimerism was 6.43%, of which 11.11% was among short-term (1 day to 6 months) and 3.77% was among long-term (6 months to 8 years CD451 or CD45 1 liver cells could be engrafted into hematopoietic cells in an immunodeficient mouse model. These results are the first evidence of the presence of putative HSPC populations in the adult human liver, where the liver is a good ectopic niche. The discovery of the existence of HSPCs in the adult liver have implications for the understanding of extramarrow hematopoiesis, liver regeneration, mechanisms of tolerance in organ transplantation, and de novo cancer recurrence in LT patients. Conclusion: The human adult liver contains a small population of HSPCs. In LT patients, there are two types of chimerisms: transient chimerism, resulting from mature leucocytes, and long-term chimerism, derived from putative HSPCs in the liver graft. (HEPATOLOGY 2012;56:1557-1566

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Section: Cd45mentioning

confidence: 99%

“…See Ching Chan, 1 Sheung Tat Fan 1,2 Liver transplantation (LT) is a cure for many liver diseases. Blood chimerism of donor origin can develop after LT, which raises the possibility of the existence of hematopoietic stem/progenitor cells (HSPCs) in the liver.…”

mentioning

confidence: 99%

Hematopoietic chimerism in liver transplantation patients and hematopoietic stem/progenitor cells in adult human liver

Wang

Chen

et al. 2012

Hepatology

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“…These results may have an important influence on both referrals and considerations regarding candidacy for transplantation in patients with severe HPS. However, they are based only on the four largest series (reporting on [16][17][18][19][20][21][22][23][24] adult patients with significant HPS) (7)(8)(9)(10) and one literature review (reviewing 81 adult and pediatric reports) (11) …”

Section: Liver Transplantation Is the Only Known Effective Therapy Fomentioning

confidence: 99%

Improved Survival After Liver Transplantation in Patients with Hepatopulmonary Syndrome

Gupta

Castel

Rao

et al. 2010

American Journal of Transplantation

185

138

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Hepatopulmonary syndrome (HPS) is present in 10-32% of chronic liver disease patients, carries a poor prognosis and is treatable by liver transplantation (LT).Previous reports have shown high LT mortality in HPS and severe HPS (arterial oxygen (PaO 2 ) ≤50 mmHg). We reviewed outcomes in HPS patients who received LT between 2002 and 2008 at two transplant centers supported by a dedicated HPS clinic. We assessed mortality, complications and gas exchange in 21 HPS patients (mean age 51 years, MELD score 14), including 11/21 (52%) with severe HPS and 5/21 (24%) with living donor LT (median follow-up 20.2 months after LT). Overall mortality was 1/21 (5%); mortality in severe HPS was 1/11 (9%). Peritransplant hypoxemic respiratory failure occurred in 5/21 (24%), biliary complications in 8/21 (38%) and bleeding or vascular complications in 6/21 (29%). Oxygenation improved in all 19 patients in whom PaO 2 or SaO 2 were recorded. PaO 2 increased from 52.2 ± 13.2 to 90.3 ± 11.5 mmHg (room air) (p < 0.0001) (12 patients); a higher baseline macroaggregated albumin shunt fraction predicted a lower rate of postoperative improvement (p = 0.045) (7 patients). Liver transplant survival in HPS and severe HPS was higher than previously demonstrated. Severity of HPS should not be the basis for transplant refusal.

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“…1 Major advances in surgical techniques and immunosuppressive treatments have markedly improved the outcome of liver transplant, and current 1-year survival is > 90%. 2 There is a high demand for liver transplant in Iran. 3 Therefore, a liver transplant program was started at Imam Khomeini Hospital Complex in 2002.…”

Section: Introductionmentioning

confidence: 99%

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2014

Exp Clin Transplant

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The evolution of liver transplantation practices

Cited by 26 publications

References 47 publications

Hematopoietic chimerism in liver transplantation patients and hematopoietic stem/progenitor cells in adult human liver

Hematopoietic chimerism in liver transplantation patients and hematopoietic stem/progenitor cells in adult human liver

Improved Survival After Liver Transplantation in Patients with Hepatopulmonary Syndrome

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