Search results for " Liver transplant"

Management of liver disease in Italy after one year of the SARS-CoV-2 pandemic: a web-based survey

2021

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)pandemic has severely limited the clinical activity of most hospitals around the world. A previous survey of the Italian Association for the Study of the Liver (AISF) has demonstrated a negative impact of the first pandemic wave on all inpatient and outpatient hepatologyactivities. Like other countries, Italy has subsequently experienced a second and third wave, which occurred in November 2020 and in March 2021 respectively. During the second and third wave many hospitals had already developed emergency management plans and improved knowledge on the management of mild-moderate COVID19 disease was available. However, it is unknown w…

The Intention-to-Treat Effect of Bridging Treatments in the Setting of Milan Criteria–In Patients Waiting for Liver Transplantation

2019

In patients with hepatocellular carcinoma (HCC) meeting the Milan criteria (MC), the benefit of locoregional therapies (LRTs) in the context of liver transplantation (LT) is still debated. Initial biases in the selection between treated and untreated patients have yielded conflicting reported results. The study aimed to identify, using a competing risk analysis, risk factors for HCC-dependent LT failure, defined as pretransplant tumor-related delisting or posttransplant recurrence. The study was registered at www.clinicaltrials.gov (identification number NCT03723304). In order to offset the initial limitations of the investigated population, an inverse probability of treatment weighting (IP…

Chemokines: reliable markers for diagnosis of rejection and inflammation following orthotopic liver transplantation.

2001

The role of monocyte chemoattractant protein-1 in orthotopic liver transplantation.

2003

Hepatic ischemia reperfusion injury as well as acute graft rejection (RE) after orthotopic liver transplantation (OLT) are associated with leukocyte invasion of the graft. Local synthesis of chemokines is a key reaction in the recruitment and activation of inflammatory leukocytes and consequent liver damage. In this paper we describe the role of monocyte chemoattractant protein (MCP)-1 (CCL2) in human OLT. We investigated the serum CC-chemokine levels for MCP-1 by specific ELISAs after OLT in 105 human liver allografts between September 1997 and January 2001. One hour after reperfusion we saw a significant (t test) increase of MCP-1 in peripheral blood (92.5 +/- 85.8 pg/mL to 774.2 +/- 319.…

Liver Perfusate Natural Killer Cells from Deceased Brain Donors and Association with Acute Cellular Rejection after Liver Transplantation: A Time-to-…

2019

Background The ability to predict which recipients will successfully complete their posttransplant clinical course, which is crucial for liver transplant (LT) programs. The assessment of natural killer (NK) cell subset determined by flow cytometry from a monocentric series of consecutive liver perfusates could help identify risk factors portending adverse LT outcomes. Methods Liver perfusates were collected during the back-table surgical time after the procurement procedures for donors after brain death. Lymphocytic concentrations and phenotypes were matched with donors after brain death characteristics and indications, timing, surgical techniques, outcomes, and biopsy-proven acute cellular…

Prevention of ischemic-type biliary lesions by arterial back-table pressure perfusion

2003

Abstract Ischemic-type biliary lesions (ITBLs) lead to considerable morbidity after orthotopic liver transplantation (OLT). The exact pathogenesis is unknown. We tested the hypothesis that insufficient perfusion of biliary arterial vessels might be responsible for ITBLs. This could be prevented by improved perfusion techniques. Since February 2000, we performed a controlled study using arterial back-table pressure perfusion (AP) to achieve reliable perfusion of the biliary-tract capillary system, which may be impaired by the high viscosity of University of Wisconsin solution. We retrospectively analyzed 190 OLTs performed between September 1997 and July 2002 with regard to ITBLs. One hundre…

Computer-assisted image analysis of liver collagen: relationship to Ishak scoring and hepatic venous pressure gradient.

2009

Histopathological scoring of disease stage uses descriptive categories without measuring the amount of fibrosis. Collagen, the major component of fibrous tissue, can be quantified by computer-assisted digital image analysis (DIA) using histological sections. We determined relationships between DIA, Ishak stage, and hepatic venous pressure gradient (HVPG) reflecting severity of fibrosis. One hundred fifteen patients with hepatitis C virus (HCV) who had undergone transplantation had 250 consecutive transjugular liver biopsies combined with HVPG (median length, 22 mm; median total portal tracts, 12), evaluated using the Ishak system and stained with Sirus red for DIA. Liver collagen was expres…

Mortality risk according to different clinical characteristics of first episode of liver decompensation in cirrhotic patients: a nationwide, prospect…

2013

Abstract OBJECTIVES: The occurrence of decompensation marks a crucial turning point in the course of cirrhosis. The purpose of this study was to assess the risk of mortality according to the clinical characteristics of first decompensation, considering also the impact of acute-on-chronic liver failure (AoCLF). METHODS: We conducted a prospective nationwide inception cohort study in Italy. Decompensation was defined by the presence of ascites, either overt or detected by ultrasonography (UD), gastroesophageal variceal bleeding (GEVB), and hepatic encephalopathy (HE). AoCLF was defined according to the Asian Pacific Association for the Study of the Liver criteria. Multivariable Cox proportion…

“Anatomical” versus “Territorial” Belonging of the Middle Hepatic Vein: Virtual Imaging and Clinical Repercussions

2011

Background Venous drainage patterns are of vital importance in live donor liver transplantation. The purpose of this study was to delineate “anatomical-topographical” and “territorial-physiologic” patterns of the middle hepatic vein (MHV) in a 3-D liver model as determined by the Pringle line and its drainage volume of the right and left hemilivers. Methods One hundred thirty-seven consecutive live donor candidates were evaluated by 3-D CT reconstructions and virtual hepatectomies. Based on right (R) and left (L), anatomical (A) and territorial (T) belonging patterns of the MHV, each individual was assigned to one of four possible types: type I:AR–TR; type II:AL–TL; type III:AR–TL; type IV:…

Brain-core temperature of patients before and after orthotopic liver transplantation assessed by DWI thermometry

2018

To assess brain-core temperature of end-stage liver disease patients undergoing orthotopic liver transplantation (OLT) using a temperature measurement technique based on the apparent diffusion coefficient of the cerebrospinal fluid in the lateral ventricles. The study group was composed of 19 patients with a model for end-stage liver disease (MELD) score of 23.7 who underwent MR imaging before and after OLT. MR imaging studies were performed with a 1.5T MR scanner. Brain-core temperature (T: °C) was calculated using the following equation from the apparent diffusion coefficient (D) of the cerebrospinal fluid in the lateral ventricles: $$T = {{2256.74} \mathord{\left/ {\vphantom {{2256.74} {…