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56 records – page 1 of 6.

ABO-incompatible liver transplantation for critically ill adult patients.

https://arctichealth.org/en/permalink/ahliterature163388
Source
Transpl Int. 2007 Aug;20(8):675-81
Publication Type
Article
Date
Aug-2007
Author
Christian Toso
Mohammed Al-Qahtani
Faisal A Alsaif
David L Bigam
Glenda A Meeberg
A M James Shapiro
Vincent G Bain
Norman M Kneteman
Author Affiliation
Department of Surgery, Section of Hepatobiliary, Pancreatic and Transplant Surgery, University of Alberta, Edmonton, Canada.
Source
Transpl Int. 2007 Aug;20(8):675-81
Date
Aug-2007
Language
English
Publication Type
Article
Keywords
ABO Blood-Group System - immunology
Adolescent
Adult
Aged
Alberta - epidemiology
Critical Illness
Female
Follow-Up Studies
Graft Rejection - blood - epidemiology - prevention & control
Graft Survival
Humans
Immunosuppressive Agents - therapeutic use
Incidence
Liver Failure - blood - surgery
Liver Transplantation - adverse effects
Male
Middle Aged
Prognosis
Retrospective Studies
Survival Rate
Abstract
ABO incompatible (ABO-In) liver transplant remains a controversial solution to acute liver failure in adults. Adult liver recipients with acute liver failure or severely decompensated end-stage disease, intubated and/or in the intensive care unit, were grouped as ABO-In (n = 14), ABO-compatible (n = 29, ABO-C) and ABO-identical (n = 65, ABO-Id). ABO-In received quadruple immunosuppression with antibody-depleting induction agents (except two), calcineurin inhibitors, antimetabolites and steroids. No significant difference of patient and graft survivals was observed among ABO-In, ABO-C and ABO-Id: graft survivals were 64%, 62% and 67%, respectively, in 1 year and 56%, 54% and 60%, respectively, in 5 years; patient survivals 86%, 69% and 67%, respectively, in 1 year and 77%, 61% and 62%, respectively, in 5 years. Three ABO-In grafts were lost (one hyper-acute rejection and two hepatic artery thrombosis). Surgical and infectious complications were similarly distributed between groups, except the hepatic artery thrombosis, more frequent in ABO-In (2, 14%) than ABO-I (1, 1.5%, P
PubMed ID
17521384 View in PubMed
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[Advisability of biliary drainage in liver fragments reconstruction].

https://arctichealth.org/en/permalink/ahliterature279323
Source
Khirurgiia (Mosk). 2016;(9):4-12
Publication Type
Article
Author
A V Semenkov
E F Kim
A V Filin
D S Burmistrov
A V Metelin
Yu R Kamalov
T N Galyan
A V Goncharova
Source
Khirurgiia (Mosk). 2016;(9):4-12
Language
Russian
Publication Type
Article
Keywords
Anastomosis, Surgical - adverse effects - instrumentation - methods
Anastomotic Leak - epidemiology - prevention & control
Biliary Tract Diseases - epidemiology - etiology - prevention & control
Biliary Tract Surgical Procedures - adverse effects - methods
Decompression, Surgical - methods
Drainage - methods
Female
Humans
Incidence
Liver Transplantation - adverse effects - methods
Male
Middle Aged
Moscow - epidemiology
Outcome and Process Assessment (Health Care)
Retrospective Studies
Stents
Abstract
to estimate the effect of decompressive stented drainage of biliary anastomosis on incidence of biliary complications.
294 patients aged from 5 months to 61 years (mean 13.8±0.81) were enrolled. They underwent liver fragments transplantation in the Department of Liver Transplantation of Petrovsky Russian Research Center of Surgery for the period from March 1997 to January 2016. Decompressive stented drainage tubes were used in 28 (9.5%) patients. Reconstruction without drainage was applied in 266 (90.5%) cases. In the group of biliobiliary reconstruction drainage was used in 18 out of 89 cases (20.2%), in the group of biliodigestive reconstruction - in 10 out of 202 cases (4.9%). Incidence of specific biliary complications was assessed.
There was significant direct correlation of stented drainage of biliodigestive anastomosis with various biliary complications including bile leakage (r= -0,1253; p=0.06), obturation of anastomosis (r=0.045; p=0.501), stricture of anastomosis (r= -0.0665; p=0.320), other strictures of intrahepatic bile ducts (r= -0.0291; p=0.664), hepatolithiasis (r=0.0857; p=0.199). However significant direct correation was observed between stented drainage and incidence of intrahepatic bile ducts strictures (r=0.2117; p=0.046) and anastomosis obturation (r=0.2330; p=0.028) in case of biliobiliary reconstruction. Significant correation with other biliary complications was absent (p>0.05).
Unconstrained stented drainage during primary biliary reconstruction is associated with increased incidence of biliary complications and should not be indicated routinely. Clear need for drainage should be determined in further investigations.
PubMed ID
27723689 View in PubMed
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Blockade of 4-1BB/4-1BB ligand interactions prevents acute rejection in rat liver transplantation.

https://arctichealth.org/en/permalink/ahliterature98132
Source
Chin Med J (Engl). 2010 Jan 20;123(2):212-5
Publication Type
Article
Date
Jan-20-2010
Author
Lei Qin
Hong-geng Guan
Xiao-jun Zhou
Jun Yin
Jing Lan
Hai-xin Qian
Author Affiliation
Department of General Surgery, the First Affiliated Hospital of Suzhou University, Suzhou, Jiangsu 215006, China.
Source
Chin Med J (Engl). 2010 Jan 20;123(2):212-5
Date
Jan-20-2010
Language
English
Publication Type
Article
Keywords
4-1BB Ligand - immunology
Alanine Transaminase - metabolism
Animals
Antibodies, Monoclonal - pharmacology - therapeutic use
Aspartate Aminotransferases - metabolism
Bilirubin - metabolism
Enzyme-Linked Immunosorbent Assay
Graft Rejection - immunology - prevention & control
Graft Survival - drug effects
Interferon-gamma - blood
Interleukin-10 - blood
Interleukin-2 - blood
Liver Transplantation - adverse effects
Male
Rats
Rats, Inbred Lew
Abstract
BACKGROUND: Blocking the 4-1BB/4-1BB ligand (4-1BBL) signal may modulate the secretion of Th1/Th2 cytokines and prolong the survival of the grafts, which play a key role in organ transplantation tolerance. The aim of this study was to investigate the role of blockade of the 4-1BB/4-1BBL co-stimulatory pathway with 4-1BBL monoclonal antibody (mAB) in acute rejection of rat orthotopic liver transplantation. METHODS: The orthotopic liver transplantation model was set up, while male Lewis rats were used as liver donors and Brown-Norway rats as recipients. The recipient rats were intravenously injected with anti 4-1BBL mAB or isotype control antibody. Groups were monitored for graft survival after transplantation. Plasma chemistry, including aspartate transaminase (AST), alanine aminotransferase (ALT), and bilirubin (BIL), was assayed. The concentrations of interleukin (IL)-2, IL-10 and interferon (IFN)-gamma in plasma were also measured by enzyme-linked immunosorbent assay. Allograft histology images were collected under light microscope and electron microscope. RESULTS: Isotype antibody treated recipients exhibited elevated plasma levels of liver injury markers including AST, ALT and BIL, progressive portal and venous inflammation and cellular infiltration of the liver allografts, and a mean graft survival time (MST) of 10.9 days. Administration of anti 4-1BBL mAB resulted in a decrease in plasma levels of liver injury markers and the concentrations of IL-2, IL-10 and IFN-gamma. The histological grade of rejection on day 7 decreased and MST (17.3 days) increased substantially. CONCLUSIONS: These results demonstrate that attenuation of acute rejection follows the blockade of the 4-1BB/4-1BBL co-stimulatory pathway with 4-1BBL monoclonal antibody and strongly suggest it is a promising strategy to prevent progression of graft rejection by suppressing T cell-mediated immunity.
PubMed ID
20137373 View in PubMed
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Canadian national retrospective chart review comparing the long term effect of cyclosporine vs. tacrolimus on clinical outcomes in patients with post-liver transplantation hepatitis C virus infection.

https://arctichealth.org/en/permalink/ahliterature116457
Source
Ann Hepatol. 2013 Mar-Apr;12(2):282-93
Publication Type
Article
Author
Eric M Yoshida
Leslie B Lilly
Paul J Marotta
Andrew L Mason
Marc Bilodeau
Marc Vaillancourt
Author Affiliation
Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. eric.yoshida@vch.ca
Source
Ann Hepatol. 2013 Mar-Apr;12(2):282-93
Language
English
Publication Type
Article
Keywords
Adult
Antiviral agents - therapeutic use
Biological Markers - blood
Canada
Carcinoma, Hepatocellular - immunology - virology
Chi-Square Distribution
Cyclosporine - adverse effects - therapeutic use
Diabetes Mellitus - etiology
Female
Graft Rejection - immunology - virology
Hepacivirus - genetics
Hepatitis C - complications - diagnosis - drug therapy - mortality - virology
Humans
Immunosuppressive Agents - adverse effects - therapeutic use
Kaplan-Meier Estimate
Liver Cirrhosis - immunology - virology
Liver Neoplasms - immunology - virology
Liver Transplantation - adverse effects - immunology - mortality
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
RNA, Viral - blood
Recurrence
Retrospective Studies
Risk factors
Tacrolimus - adverse effects - therapeutic use
Time Factors
Treatment Outcome
Viral Load
Abstract
The transition from regular use of cyclosporine to the newer calcineurin-inhibitors, such as tacrolimus, has been suggested as a contributing factor to the "era effect" of worsening outcomes of post-transplant HCV recurrence. This retrospective medical chart review of 458 patients was undertaken to evaluate the role of immunosuppressant choice (cyclosporine vs. tacrolimus) in determining virologic response and clinical outcomes of post-liver transplant HCV infection recurrence. Our results showed that patients undergoing interferon-based treatment taking cyclosporine have significantly better odds (OR: 2.59, P = 0.043) of presenting a sustained viral response (66.7%) compared to tacrolimus (52.8%). This did not result in a significant effect on post-liver transplantation clinical events including HCV-related deaths, graft loss, fibrosing cholestatic hepatitis, hepatocellular carcinoma or graft rejection. Other variables, which showed a significant relationship with the achievement of sustained viral response included donor age (OR 0.96, P = 0.001) and HCV genotype 1 infection (OR 0.05, P
PubMed ID
23396740 View in PubMed
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Cardiovascular risk profile of patients with acute liver failure after liver transplantation when compared with the general population.

https://arctichealth.org/en/permalink/ahliterature146176
Source
Transplantation. 2010 Jan 15;89(1):61-8
Publication Type
Article
Date
Jan-15-2010
Author
Fredrik Aberg
Antti Jula
Krister Höckerstedt
Helena Isoniemi
Author Affiliation
Transplantation and Liver Surgery Clinic, Helsinki University Hospital, Helsinki, Finland. Fredrik.Aberg@helsinki.fi
Source
Transplantation. 2010 Jan 15;89(1):61-8
Date
Jan-15-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Blood Glucose - metabolism
Cardiovascular Diseases - epidemiology
Coronary Disease - epidemiology
Diabetes Mellitus - epidemiology
Dyslipidemias - epidemiology
Female
Finland - epidemiology
Follow-Up Studies
Humans
Lipids - blood
Liver Failure, Acute - complications - epidemiology - etiology
Liver Transplantation - adverse effects
Male
Obesity - epidemiology
Overweight - epidemiology
Prevalence
Retrospective Studies
Risk assessment
Time Factors
Abstract
As opposed to most solid-organ transplant recipients, patients with acute liver failure exhibit a pretransplant health status more comparable with the general population, and any posttransplant cardiovascular risk excess should thus be more attributable to transplantation-related factors alone.
This study compared the cardiovascular risk of 77 consecutive patients with acute liver failure at 5 years after liver transplantation with that of the general population using age, sex, and residence area-standardized prevalence ratios (SPR).
At least one cardiovascular risk factor developed in 92% of patients. Treated hypertension, observed in 71% of patients at 5 years, was more common among patients than controls (SPR, 2.73; 95% confidence interval [CI], 2.06-3.55), whereas the 61% prevalence of dyslipidemia and 3% prevalence of impaired fasting glucose were significantly less frequent among patients (SPR, 0.69; 95% CI, 0.51-0.92 and SPR, 0.29; 95% CI, 0.04-1.00). The 5-year prevalence of diabetes (10%), overweight (32%), and obesity (13%) deviated nonsignificantly from controls (SPR 1.90, 0.85, and 0.58). Antibody therapy associated with a 1.49-fold increase in the risk of hypertension (95% CI, 1.15-1.94) and a 6.43-fold increase in the risk of diabetes (95% CI, 1.18-34.9). Immunosuppression-type, steroids, acute rejection, retransplantation, or graft steatosis revealed nonsignificant risk alterations.
Liver transplantation and associated immunosuppression evidently cause hypertension, and possibly elicit diabetes in susceptible individuals. Conversely, the often reported transplantation-associated increased burden of overweight/obesity and dyslipidemia might relate mostly to other factors.
PubMed ID
20061920 View in PubMed
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Continuous development of arrhythmia is observed in Swedish transplant patients with familial amyloidotic polyneuropathy (amyloidogenic transthyretin Val30Met variant).

https://arctichealth.org/en/permalink/ahliterature137473
Source
Liver Transpl. 2011 Feb;17(2):122-8
Publication Type
Article
Date
Feb-2011
Author
Sadahisa Okamoto
Rolf Hörnsten
Konen Obayashi
Priyantha Wijayatunga
Ole B Suhr
Author Affiliation
Departments of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Source
Liver Transpl. 2011 Feb;17(2):122-8
Date
Feb-2011
Language
English
Publication Type
Article
Keywords
Adult
Age of Onset
Aged
Amyloid Neuropathies, Familial - genetics - mortality - surgery
Arrhythmias, Cardiac - genetics - mortality - therapy
Cardiac Pacing, Artificial
Chi-Square Distribution
Female
Genetic Predisposition to Disease
Humans
Kaplan-Meier Estimate
Liver Transplantation - adverse effects - mortality
Male
Middle Aged
Mutation
Prealbumin - genetics
Proportional Hazards Models
Risk assessment
Risk factors
Sweden - epidemiology
Time Factors
Treatment Outcome
Young Adult
Abstract
In patients with familial amyloidotic polyneuropathy (FAP), heart complications are prognostic factors for mortality and morbidity after liver transplantation (LT). However, only a few studies have analyzed the development of arrhythmia in transplant patients with FAP. We investigated the development of arrhythmia requiring pacemaker insertion (PMI) in Swedish transplant patients with FAP, and we related the findings to gender, age at disease onset, and survival. One hundred four transplant patients with the amyloidogenic transthyretin Val30Met mutation were included in the study. Twenty-six (25%) received a pacemaker during the observation period (a median of 11 years after disease onset). This frequency was comparable to that noted in a previous study describing the natural course of FAP. No significant differences in PMI between early-onset cases (
PubMed ID
21280184 View in PubMed
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Development of cardiomyopathy after liver transplantation in Swedish hereditary transthyretin amyloidosis (ATTR) patients.

https://arctichealth.org/en/permalink/ahliterature129681
Source
Amyloid. 2011 Dec;18(4):200-5
Publication Type
Article
Date
Dec-2011
Author
Sadahisa Okamoto
Ying Zhao
Per Lindqvist
Christer Backman
Bo-Göran Ericzon
Priyantha Wijayatunga
Michael Y Henein
Ole B Suhr
Author Affiliation
Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Source
Amyloid. 2011 Dec;18(4):200-5
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Amyloidosis, Familial - complications - mortality - surgery
Blood pressure
Cardiomyopathies - etiology - pathology
Female
Humans
Liver Transplantation - adverse effects
Male
Middle Aged
Multivariate Analysis
Regression Analysis
Sweden
Ventricular Septum - pathology
Abstract
Recent studies of liver transplanted (LTx) familial amyloidotic polyneuropathy (FAP) patients have shown a progression of cardiomyopathy in some patients after LTx, but knowledge of the underlying factors remains limited.
Seventy-five patients, who had undergone LTx from 1996 to 2008, were included. They had all been examined by echocardiography 1-16 months before LTx. Fifty-four had been re-examined 7-34 months, and forty-two 36-137 months after LTx.
A significant increase in interventricular septum (IVS) thickness occurred after LTx (p
PubMed ID
22080763 View in PubMed
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Do older patients utilize excess health care resources after liver transplantation?

https://arctichealth.org/en/permalink/ahliterature131376
Source
Ann Hepatol. 2011 Oct-Dec;10(4):477-81
Publication Type
Article
Author
Neil Shankar
Mamoun AlBasheer
Paul Marotta
William Wall
Vivian McAlister
Natasha Chandok
Author Affiliation
Division of Gastroenterology, University of Western Ontario, London, Ontario, Canada.
Source
Ann Hepatol. 2011 Oct-Dec;10(4):477-81
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Chi-Square Distribution
Delivery of Health Care - economics - utilization
Female
Health Resources - economics - utilization
Humans
Intensive Care - utilization
Length of Stay
Liver Transplantation - adverse effects - economics
Male
Middle Aged
Odds Ratio
Ontario
Patient Readmission
Referral and Consultation - utilization
Regression Analysis
Reoperation
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Abstract
Liver transplantation is a highly effective treatment for end-stage liver disease. However, there is debate over the practice of liver transplantation in older recipients (age = 60 years) given the relative shortage of donor grafts, worse post-transplantation survival, and concern that that older patients may utilize excess resources postoperatively, thus threatening the economic feasibility of the procedure.
To determine if patients = 60 years of age utilize more health resources following liver transplantation compared with younger patients.
Consecutive adult patients who underwent primary liver transplantation (n = 208) at a single center were studied over a 2.5-year period. Data were collected on clinico-demographic characteristics and resource utilization. Descriptive statistics, including means, standard deviations, or frequencies were obtained for baseline variables. Patients were stratified into 2 groups: age = 60 years (n = 51) and
PubMed ID
21911888 View in PubMed
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Early Predictors of Long-term Outcomes of HCV-negative Liver Transplant Recipients Having Survived the First Postoperative Year.

https://arctichealth.org/en/permalink/ahliterature273856
Source
Transplantation. 2016 Feb;100(2):382-90
Publication Type
Article
Date
Feb-2016
Author
Fredrik Åberg
Arno Nordin
Leena Toivonen
Helena Isoniemi
Source
Transplantation. 2016 Feb;100(2):382-90
Date
Feb-2016
Language
English
Publication Type
Article
Keywords
Adult
Alkaline Phosphatase - blood
Biomarkers - blood
Communicable Diseases - etiology
Comorbidity
Decision Support Techniques
Female
Finland
Graft Rejection - etiology
Graft Survival
Humans
Immunosuppressive Agents - therapeutic use
Kaplan-Meier Estimate
Liver Transplantation - adverse effects - mortality
Male
Middle Aged
Multivariate Analysis
Neoplasms - etiology
Proportional Hazards Models
Registries
Risk assessment
Risk factors
Sex Factors
Survivors
Time Factors
Transplant Recipients
Treatment Outcome
Up-Regulation
Abstract
The non-improvement in >1-year post-liver transplant (LT) survival and diminishing importance of hepatitis C (HCV) with modern antivirals justify identification of early factors predictive of long-term outcome post-LT in HCV-negative recipients.
This nationwide study included all 631 HCV-negative adult patients transplanted in Finland 1982-2013 with at least 1-year graft survival (6311 person-year follow-up). We tested 37 variables, including immunosuppression, for their association with >1-year combined graft loss/mortality, late rejection, cancer, or infections.
Significant multivariate predictors of graft loss/mortality were male gender (HR 2.40, P = 0.001), pretransplant hepatocellular (HR 2.92, P = 0.001) or biliary cancer (HR 12.7, P
PubMed ID
26683515 View in PubMed
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Effect of operator experience and frequency of procedure performance on complication rate after ultrasound-guided percutaneous liver biopsies.

https://arctichealth.org/en/permalink/ahliterature106394
Source
J Pediatr Gastroenterol Nutr. 2013 Nov;57(5):638-43
Publication Type
Article
Date
Nov-2013
Author
Birgitte H Westheim
Ingegerd Aagenæs
Anniken B Østensen
Truls Sanengen
Runar Almaas
Author Affiliation
*Department of Pediatric Research, Women and Children's Division †Department of Radiology, Rikshospitalet, Oslo University Hospital ‡Department of Paediatric Medicine, Women and Children's Division, Oslo University Hospital, Oslo, Norway.
Source
J Pediatr Gastroenterol Nutr. 2013 Nov;57(5):638-43
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Abdominal Pain - epidemiology - prevention & control
Adolescent
Biopsy, Needle - adverse effects
Child
Child, Preschool
Clinical Competence
Endoscopy, Digestive System - adverse effects
Hospitals, University
Humans
Image-Guided Biopsy - adverse effects
Incidence
Infant
Liver - pathology - ultrasonography
Liver Transplantation - adverse effects
Norway - epidemiology
Pain, Postoperative - epidemiology - prevention & control
Postoperative Complications - epidemiology - physiopathology - prevention & control - ultrasonography
Postoperative Hemorrhage - epidemiology - physiopathology - prevention & control - ultrasonography
Radiology, Interventional - manpower
Retrospective Studies
Severity of Illness Index
Time Factors
Abstract
The aim of the present study was to assess whether the complication rate after ultrasound-guided percutaneous liver biopsies in children is affected by how frequently the procedure is performed by the operator.
Medical charts and ultrasound descriptions of 311 ultrasound-guided percutaneous liver biopsy procedures performed by 18 radiologists at a single center from 2000 to 2011 were reviewed. Postbiopsy ultrasound the following day was performed after 97% of the procedures.
There were no differences in the procedure-associated rate of major bleeding incidents (2.2% vs 0.8%, P = 0.38), minor bleeding incidents (15.2% vs 10.2%, P = 0.31), or abdominal pain (13.0% vs 10.6%, P = 0.61) among operators who performed =10 procedures and those who performed >10 procedures during the study period. A higher rate of minor bleeding incidents were recorded after liver biopsy when operators had performed 20 pediatric liver biopsies during the study period (odds ratio 3.4 [1.3-9.1], P = 0.02). No association between the number of biopsies performed by the operator during the 2 years preceding the date of the biopsy and complications was found.
Major complications are infrequent after pediatric liver biopsies and no relation between operator experience and major complications was found. We found a significant, but minor, effect of operator procedure frequency on the rate of minor bleeding incidents after ultrasound-guided pediatric liver biopsies.
PubMed ID
24177785 View in PubMed
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56 records – page 1 of 6.