Transgastric Endoscopic Lumen–Apposing Metal Stents for Intra‐abdominal Fluid Collections After Living Donor Liver Transplantation

Takeishi, Kazuki; Yoshizumi, Tomoharu; Ikegami, Toru; Itoh, Shinji; Harada, Noboru; Fujimori, Nao; Ohno, Takamasa; Mori, Masaki

doi:10.1002/lt.25707

Cited by 5 publications

(4 citation statements)

References 5 publications

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“…154,160 However, splenectomy as a modality for PIM has not gained universal acceptance because of the increased risk of complications such as bleeding, thrombosis of the splenic vein and portal vein, septic complications, and pancreatic leak. [161][162][163][164][165][166] It must, however, be noted that some of the large volume LDLT centers continue to perform splenectomy and consider this as the first modality in reducing portal flow. 14 In the current age of advanced surgical techniques using instrumentations such as vessel sealing devices and vascular staplers, splenectomy could be performed without significantly increased risk of technical complications in those with expertise 14,62,159,167,168 (Table S6, SDC, http://links.lww.…”

Section: Recommendationsmentioning

confidence: 99%

Preventing Small-for-size Syndrome in Living Donor Liver Transplantation: Guidelines From the ILTS-iLDLT-LTSI Consensus Conference

Hakeem,

Mathew,

Aunés

et al. 2023

Transplantation

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Small-for-size syndrome (SFSS) is a well-recognized complication following liver transplantation (LT), with up to 20% developing this following living donor LT (LDLT). Preventing SFSS involves consideration of factors before the surgical procedure, including donor and recipient selection, and factors during the surgical procedure, including adequate outflow reconstruction, graft portal inflow modulation, and management of portosystemic shunts. International Liver Transplantation Society, International Living Donor Liver Transplantation Group, and Liver Transplant Society of India Consensus Conference was convened in January 2023 to develop recommendations for the prediction and management of SFSS in LDLT. The format of the conference was based on the Grading of Recommendations, Assessment, Development, and Evaluation system. International experts in this field were allocated to 4 working groups (diagnosis, prevention, anesthesia, and critical care considerations, and management of established SFSS). The working groups prepared evidence-based recommendations to answer-specific questions considering the currently available literature. The working group members, independent panel, and conference attendees served as jury to edit and confirm the final recommendations presented at the end of the conference by each working group separately. This report presents the final statements and evidence-based recommendations provided by working group 2 that can be implemented to prevent SFSS in LDLT patients.

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Section: Recommendationsmentioning

confidence: 99%

Preventing Small-for-size Syndrome in Living Donor Liver Transplantation: Guidelines From the ILTS-iLDLT-LTSI Consensus Conference

Hakeem,

Mathew,

Aunés

et al. 2023

Transplantation

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“…52 Takeishi et al have used EUS-guided transgastric lumen apposing metal stent (LAMS) for drainage of pancreatic-associated fluid collections after LDLT in two patients. 54 However, LAMS placement should not be routinely used in drainage of posttransplant collections as most of these collections are nonpancreatic in origin (i.e., seroma, biloma) without an inflammatory wall. 62…”

Section: Endotransplant Hepatology: Expanding the Horizons Of Eus In ...mentioning

confidence: 99%

Endo-Hepatology: The Buzz Goes Much beyond Liver Biopsy—A Narrative Review

Puri,

Sharma,

Dhampalwar

et al. 2023

Journal of Digestive Endoscopy

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The word endo-hepatology evokes many perceptions. Some believe it to be the emerging new interventional branch and some believe it to be an extension of endoscopy. Nonetheless, it has continued to evolve into an exciting area of active work. With the advent of endoscopic ultrasound (EUS) based procedures, new vistas have opened up. EUS-guided liver biopsies, portal hypertension management, and multiple new procedures are being described. EUS also plays a large role in the management of patients in the peritransplant period. With this review, we present an overview of the role of EUS in the field of hepatology as well as during the peritransplant period and its applications.

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“…77,78 Thus, pancreatic leakage associated intraabdominal fluid collections are still a problematic cause of morbidity. Takeishi et al 79 reported that 2.6% of the patients undergoing simultaneous splenectomy during LDLT developed pancreatic leakage, without any mortalities. They showed that trans-gastric ultrasound-guided endoscopic drainage could be among the choices in treating it.…”

Section: Splenic Inflow Modulationmentioning

confidence: 99%

Small‐for‐size graft, small‐for‐size syndrome and inflow modulation in living donor liver transplantation

Ikegami

Onda

Furukawa

et al. 2020

J Hepato Biliary Pancreat

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The extended application of living donor liver transplantation (LDLT) has revealed the problem of graft size mismatching called "small-for-size syndrome (SFSS)." The initial trials to resolve this problem involved increasing the procured graft size, from left to right, and even extending to include a right lobe graft. Clinical cases of living right lobe donations have been reported since then, drawing attention to the risks of increasing the liver volume procured from a living donor. However, not only other modes of increasing graft volume (GV) such as auxiliary or dual liver transplantation, but also control of the increased portal pressure caused by a small-for-size graft (SFSG), such as a porto-systemic shunt or splenectomy and optimal outflow reconstruction, have been trialed with some positive results. To establish an effective strategy for transplanting SFSG and preventing SFSS, it is essential to have precise knowledge and tactics to evaluate graft quality and GV, when performing these LDLTs with portal pressure control and good venous outflow. Thus, we reviewed the updated literature on the pathogenesis of and strategies for using SFSG.

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Transgastric Endoscopic Lumen–Apposing Metal Stents for Intra‐abdominal Fluid Collections After Living Donor Liver Transplantation

Cited by 5 publications

References 5 publications

Preventing Small-for-size Syndrome in Living Donor Liver Transplantation: Guidelines From the ILTS-iLDLT-LTSI Consensus Conference

Preventing Small-for-size Syndrome in Living Donor Liver Transplantation: Guidelines From the ILTS-iLDLT-LTSI Consensus Conference

Endo-Hepatology: The Buzz Goes Much beyond Liver Biopsy—A Narrative Review

Small‐for‐size graft, small‐for‐size syndrome and inflow modulation in living donor liver transplantation

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