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liver transplantation

liver transplantation的相关文献在2002年到2022年内共计237篇,主要集中在内科学、肿瘤学、外科学 等领域,其中期刊论文237篇、相关期刊25种,包括华中科技大学学报(医学)(英德文版)、中国高等学校学术文摘·医学、国际肝胆胰疾病杂志(英文版)等; liver transplantation的相关文献由1362位作者贡献,包括Anna Mrzljak、Li-Ying Sun、Sami Akbulut等。

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liver transplantation

-研究学者

  • Anna Mrzljak
  • Li-Ying Sun
  • Sami Akbulut
  • Ying Liu
  • Zhi-Jun Zhu
  • Georgios Tsoulfas
  • Lin Wei
  • Sezai Yilmaz
  • Wei Qu
  • Ioannis A Ziogas
  • 期刊论文

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    • Zulal Ozkurt; EsraÇınar Tanrıverdi
    • 摘要: Coronavirus disease 2019(COVID-19)has caused a pandemic that affected all countries with nearly 270 million patients and 5 million deaths,as of as of December,2021.The severe acute respiratory syndrome coronavirus 2 virus targets the receptor,angiotensin-converting enzyme 2,which is frequently found in human intestinal epithelial cells,bile duct epithelial cells,and liver cells,and all gastrointestinal system organs are affected by COVID-19 infection.The aim of this study is to review the gastrointestinal manifestations and liver damage of COVID-19 infection and investigate the severe COVID-19 infection risk in patients that have chronic gastrointestinal disease,along with current treatment guidelines.A literature search was conducted on electronic databases of PubMed,Scopus,and Cochran Library,consisting of COVID-19,liver injury,gastrointestinal system findings,and treatment.Liver and intestinal involvements are the most common manifestations.Diarrhea,anorexia,nausea/vomiting,abdominal pain are the most frequent symptoms seen in intestinal involvement.Mild hepatitis occurs with elevated levels of transaminases.Gastrointestinal involvement is associated with long hospital stay,severity of the disease,and intensive care unit necessity.Treatments and follow-up of patients with inflammatory bowel diseases,cirrhosis,hepatocellular carcinoma,or liver transplant have been negatively affected during the pandemic.Patients with cirrhosis,hepatocellular carcinoma,auto-immune diseases,or liver transplantation may have a greater risk for severe COVID-19.Diagnostic or therapeutic procedures should be restricted with specific conditions.Telemedicine should be used in non-urgent periodic patient follow up.COVID-19 treatment should not be delayed in patients at the risk group.COVID-19 vaccination should be prioritized in this group.
    • Palittiya Sintusek; Kessarin Thanapirom; Piyawat Komolmit; Yong Poovorawan
    • 摘要: Viral hepatitis infections are a great burden in children who have received liver transplant.Hepatotropic viruses can cause liver inflammation that can develop into liver graft fibrosis and cirrhosis over the long term.Immunological reactions due to viral hepatitis infections are associated with or can mimic graft rejection,rendering the condition difficult to manage.Prevention strategies using vaccinations are agreeable to patients,safe,cost-effective and practical.Hence,strategies to eliminate viral hepatitis A and B focus mainly on immunization programmes for children who have received a liver transplant.Although a vaccine has been developed to prevent hepatitis C and E viruses,its use is not licensed worldwide.Consequently,eliminating hepatitis C and E viruses mainly involves early detection in children with suspected cases and effective treatment with antiviral therapy.Good hygiene and sanitation are also important to prevent hepatitis A and E infections.Donor blood products and liver grafts should be screened for hepatitis B,C and E in children who are undergoing liver transplantation.Future research on early detection of viral hepatitis infections should include molecular techniques for detecting hepatitis B and E.Moreover,novel antiviral drugs for eradicating viral hepatitis that are highly effective and safe are needed for children who have undergone liver transplantation.
    • Seema Alam; Bikrant Bihari Lal
    • 摘要: Recent evidence points towards the role of genotype to understand the phenotype,predict the natural course and long term outcome of patients with progressive familial intrahepatic cholestasis(PFIC).Expanded role of the heterozygous transporter defects presenting late needs to be suspected and identified.Treatment of pruritus,nutritional rehabilitation,prevention of fibrosis progression and liver transplantation(LT)in those with end stage liver disease form the crux of the treatment.LT in PFIC has its own unique issues like high rates of intractable diarrhoea,growth failure;steatohepatitis and graft failure in PFIC1 and antibody-mediated bile salt export pump deficiency in PFIC2.Drugs inhibiting apical sodium-dependent bile transporter and adenovirus-associated vector mediated gene therapy hold promise for future.
    • Chiyoe Shirota; Akinari Hinoki; Takahisa Tainaka; Wataru Sumida; Fumie Kinoshita; Kazuki Yokota; Satoshi Makita; Hizuru Amano; Yoichi Nakagawa; Hiroo Uchida
    • 摘要: BACKGROUND Biliary atresia(BA)is a rare pediatric disease.AIM To compare the outcomes of laparoscopic portoenterostomy(Lap-PE)with those of laparotomy(Open-PE)at a single institution.METHODS The surgical outcomes of PE were retrospectively analyzed for patients with a non-correctable type of BA from 2003 to 2020.RESULTS Throughout the assessment period,119 patients received PE for BA treatment,including 66 Open-PE and 53 Lap-PE cases.Although the operation duration was longer(medians:for Open-PE,242 min;for Lap-PE,341 min;P80%for both groups for the first half year post surgery,followed by a gradual decrease with time;there were no statistically significant differences in the native liver survival rates for any durations assessed.CONCLUSION Lap-PE could be a standard therapy for BA.
    • Esther Platt; Enriko Klootwijk; Alan Salama; Brian Davidson; Francis Robertson
    • 摘要: People exposed to liver ischaemia reperfusion(IR)injury often develop acute kidney injury and the combination is associated with significant morbidity and mortality.Molecular mediators released by the liver in response to IR injury are the likely cause of acute kidney injury(AKI)in this setting,but the mediators have not yet been identified.Identifying the mechanism of injury will allow the identification of therapeutic targets which may modulate both liver IR injury and AKI following liver IR injury.
    • Aathira Ravindranath; Moinak Sen Sarma
    • 摘要: Fatty acid oxidation defects(FAOD)and urea cycle defects(UCD)are among the most common metabolic liver diseases.Management of these disorders is dotted with challenges as the strategies differ based on the type and severity of the defect.In those with FAOD the cornerstone of management is avoiding hypoglycemia which in turn prevents the triggering of fatty acid oxidation.In this review,we discuss the role of carnitine supplementation,dietary interventions,newer therapies like triheptanoin,long-term treatment and approach to positive newborn screening.In UCD the general goal is to avoid excessive protein intake and indigenous protein breakdown.However,one size does not fit all and striking the right balance between avoiding hyperammonemia and preventing deficiencies of essential nutrients is a formidable task.Practical issues during the acute presentation including differential diagnosis of hyperammonemia,dietary dilemmas,the role of liver transplantation,management of the asymptomatic individual and monitoring are described in detail.A multi-disciplinary team consisting of hepatologists,metabolic specialists and dieticians is required for optimum management and improvement in quality of life for these patients.
    • Luis Cesar Bredt; Luis Alberto Batista Peres; Michel Risso; Leandro Cavalcanti de Albuquerque Leite Barros
    • 摘要: BACKGROUND Acute kidney injury(AKI)has serious consequences on the prognosis of patients undergoing liver transplantation.Recently,artificial neural network(ANN)was reported to have better predictive ability than the classical logistic regression(LR)for this postoperative outcome.AIM To identify the risk factors of AKI after deceased-donor liver transplantation(DDLT)and compare the prediction performance of ANN with that of LR for this complication.METHODS Adult patients with no evidence of end-stage kidney dysfunction(KD)who underwent the first DDLT according to model for end-stage liver disease(MELD)score allocation system was evaluated.AKI was defined according to the International Club of Ascites criteria,and potential predictors of postoperative AKI were identified by LR.The prediction performance of both ANN and LR was tested.RESULTS The incidence of AKI was 60.6%(n=88/145)and the following predictors were identified by LR:MELD score>25(odds ratio[OR]=1.999),preoperative kidney dysfunction(OR=1.279),extended criteria donors(OR=1.191),intraoperative arterial hypotension(OR=1.935),intraoperative massive blood transfusion(MBT)(OR=1.830),and postoperative serum lactate(SL)(OR=2.001).The area under the receiver-operating characteristic curve was best for ANN(0.81,95%confidence interval[CI]:0.75-0.83)than for LR(0.71,95%CI:0.67-0.76).The root-mean-square error and mean absolute error in the ANN model were 0.47 and 0.38,respectively.CONCLUSION The severity of liver disease,pre-existing kidney dysfunction,marginal grafts,hemodynamic instability,MBT,and SL are predictors of postoperative AKI,and ANN has better prediction performance than LR in this scenario.
    • Paul J Thuluvath; Feng Li
    • 摘要: BACKGROUND We have recently shown that the European Association for the Study of the Liver-Chronic Liver Failure Consortium(EASL-CLIF)criteria showed a better sensitivity to detect acute-on-chronic liver failure(ACLF)with a better prognostic capability than the North American Consortium for the Study of End-Stage Liver Disease criteria.AIM To simplify EASL-CLIF criteria for ease of use without sacrificing its sensitivity and prognostic capability.METHODS Using the United Network for Organ Sharing data(January 11,2016,to August 31,2020),we modified EASL-CLIF(mEACLF)criteria;the modified mEACLF criteria included six organ failures(OF)as in the original EASL-CLIF,but renal failure was defined as creatinine≥2.35 mg/dL and coagulation failure was defined as international normalized ratio(INR)≥2.0.The mEACLF grades(0,1,2,and≥3)directly reflected the number of OF.RESULTS Of the 40357 patients,14044 had one or more OF,and 9644 had ACLF grades 1-3 by EASL-CLIF criteria.By the mEACLF criteria,15574 patients had one or more OF.The area under the receiver operating characteristic(AUROC)for 30-d allcause mortality by OF was 0.842(95%CI:0.831-0.853)for mEACLF and 0.835(95%CI:0.824-0.846)for EASL-CLIF(P=0.006),and AUROC for 30-d transplantfree mortality by OF was 0.859(95%CI:0.849-0.869)for mEACLF and 0.851(95%CI:0.840-0.861)for EASL-CLIF(P=0.001).The AUROC of 30-d all-cause mortality by ACLF grades was 0.842(95%CI:0.831-0.853)for mEACLF and 0.793(95%CI:0.781-0.806)for EASL-CLIF(P<0.0001).The AUROC of 30-d transplant-free mortality by ACLF was 0.859(95%CI:0.848-0.869)for mEACLF and 0.805(95%CI:0.793-0.817)for EASL-CLIF(P<0.0001).CONCLUSION Our study showed that EASL-CLIF criteria for ACLF grades could be simplified for ease of use without losing its prognostication capability and sensitivity.
    • Sittichoke Prachuapthunyachart; Palittiya Sintusek; Chomchanat Tubjareon; Nataruks Chaijitraruch; Anapat Sanpavat; Teerasak Phewplung; Piyaporn Wanawongsawad; Ai-lada Intrarakamhang; Voranush Chongsrisawat
    • 摘要: BACKGROUND Liver transplantation(LT)has become an acceptable curative method for children with several liver diseases,especially irreversible acute liver failure and chronic liver diseases.King Chulalongkorn Memorial Hospital is one of Thailand’s largest liver transplant centers and is responsible for many pediatric cases.AIM To report the experience with pediatric LT and evaluate outcomes of livingrelated vs deceased-donor grafts.METHODS This evaluation included children who underwent LT between August 2004 and November 2019.Data were retrospectively reviewed,including demographics,diagnoses,laboratory values of donors and recipients,the pediatric end-stage liver disease(PELD)or model for end-stage liver disease(MELD)score,graft source,wait time,perioperative course,postoperative complications,and survival rates.Continuous data were reported using the median and interquartile range.The Mann–Whitney U-test was used to compare the wait time between the living-related and deceased-donor groups.The chi-square or Fisher's exact test were used to compare the frequencies of between-group complications.Survival rates were calculated using the Kaplan–Meier method.RESULTS Ninety-four operated pediatric liver transplant patients were identified(54%were females).The median age at transplantation was 1.2(0.8-3.8)years.The median PELD and MELD scores were 20(13-26.8)and 19.5(15.8-26.3),respectively.Most grafts(81.9%)were obtained from living-related donors.The median wait time for the living donors was significantly shorter compared with the deceased donors at 1.6(0.3-3.1)mo vs 11.2(2.1-33.3)mo(P=0.01).Most patients were diagnosed with biliary atresia(74.5%),and infection was the most common complication within 30 d posttransplantation(14.9%).Without a desensitization protocol,9%of transplants were ABOincompatible.Eight hepatitis B core antibodies(anti-HBc)-negative recipients received positive anti-HBc grafts without different observed complications.The overall survival rate was 93.6%and 90.3%at 1 and 5 years,respectively.No graft loss during follow-up was noted among survivors.CONCLUSION A significant number of pediatric LT cases were reported in Thailand.Based on relatively comparable outcomes,ABO-incompatible and HBc antibody-positive grafts may be considered in an organ shortage situation.
    • Irene De La Caridad Perez; Ziv J Haskal; John I Hogan; Curtis K Argo
    • 摘要: BACKGROUND Infection of a transjugular intrahepatic portosystemic shunt(TIPS)stent is a rare and serious complication that most commonly occurs during TIPS creation and revision.Patients typically present with recurrent bacteremia due to shunt occlusion or vegetation.To date there are approximately 58 cases reported.We present a patient diagnosed with late polymicrobial TIPS infection five years following TIPS creation.CASE SUMMARY A 63-year-old female status-post liver transplant with recurrent cirrhosis and portal hypertension presented with sepsis and recurrent extended-spectrum betalactamase Escherichia coli bacteremia.Computed tomography of the abdomen revealed an occluded TIPS with thrombus extension into the distal right portal vein,and focal thickening of the cecum and ascending colon.Colonoscopy revealed patchy ulcers in these areas with histopathology demonstrating ulcerated colonic mucosa with fibrinopurulent exudate.Shunt thrombectomy and revision revealed infected-appearing thrombus.Patient initially cleared her infection with antibacterial therapy and TIPS revision;however,soon after,she developed Enterobacter cloacae bacteremia and Candida glabrata and C.albicans fungemia with recurrent TIPS thrombosis.She remained on antifungal therapy indefinitely and later developed vancomycin-resistant Enterococcus faecium with recurrent TIPS thrombosis.The option of liver re-transplant for removal of the infected TIPS was not offered given her critical illness and complex shunt anatomy.The patient became intolerant to linezolid and elected hospice care.CONCLUSION Clinicians should be aware that TIPS superinfection may occur as long as five years following TIPS creation in an immunocompromised patient.
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