Search results for " liver transplantation."
showing 6 items of 66 documents
The use of normothermic machine perfusion to rescue liver allografts from expanded criteria donors
2021
The use of expanded criteria donors is one of the strategies used to overcome the gap between the demand for organs and the number of donors. Physicians debate the extent to which marginal grafts can be used. In recent years, normothermic machine perfusion (NMP) has been used to test liver viability before transplantation. Grafts underwent NMP whenever histological steatosis was > 40% or there were at least three Eurotransplant criteria for expanded criteria donor (ECD). We used NMP to test 19 grafts, 3 from donation after type 3 controlled cardiac death (DCD), and 16 from donation after brain death (DBD). Only two grafts from DBD were not transplanted, because perfusion proved they were…
The addition of simvastatin administration to cold storage solution of explanted whole liver grafts for facing ischemia/reperfusion injury in an area…
2018
Abstract Background Liver transplantation is the best treatment for end-stage liver disease. The interruption of the blood supply to the donor liver during cold storage damages the liver, affecting how well the liver will function after transplant. The drug Simvastatin may help to protect donor livers against this damage and improve outcomes for transplant recipients. The aim of this study is to evaluate the benefits of treating the donor liver with Simvastatin compared with the standard transplant procedure. Patient and methods We propose a prospective, double-blinded, randomized phase 2 study of 2 parallel groups of eligible adult patients. We will compare 3-month, 6-month, and 12-month g…
Ischemic Type Biliary Lesions nach orthotoper Lebertransplantation - ein immunologisches Problem?
2004
Ischemic type biliary lesions (ITBL) are a major complication following orthotopic liver transplantation (OLT). In many cases re-OLT is indicated. Multiple factors have been claimed to be reasonable for ITBL; here we present a new immunological risk factor: CC-Chemokines play a key role in the recruitment of leukocytes during ischemia-reperfusion damage and acute rejection. Therefore the CC-chemokine-receptor 5 (CCR5) and its functionless CCR5-delta-32-polymorphism (CCR5Δ32) might have an influence on the grafts pathology after OLT. In 146 patients after OLT the CCR5 was analyzed with regard to the CCR5Δ32 by PCR. 120 patients (82,1%) showed a normal receptor (wildtype) whereas 26 patients …
Orthotope arterialisierte Lebertransplantation bei Ratten mit Stenttechnik der supra- und infrahepatischen v. cava
2003
The aim of this study was to establish a liver transplant model with a reduced warm ischemic period between cold preservation and completed anastomosis. Male brown Norway rats were used. A cuff was fixed in the portal vein, stents were inserted in the A. hepatica, the suprahepatic and infrahepatic v. cava and in the bile duct. After cross clamping of the recipient liver, another stent, occluded by a small pin, was introduced in the recipient suprahepatic v. cava. After ligation of this recipient suprahepatic caval stent the recipient liver was removed and the cold prepared donor liver was pushed forward along the pin and both suprahepatic stents of recipient and donor were connected. Then c…
Emergency abdominal surgery after solid organ transplantation: a systematic review
2016
Aims: Due to the increasing number of solid organs transplantations, emergency abdominal surgery in transplanted patients is becoming a relevant challenge for the general surgeon. The aim of this systematic review of the literature is to analyze morbidity and mortality of emergency abdominal surgery performed in transplanted patients for graft-unrelated surgical problems. Methods: The literature search was performed on online databases with the time limit 1990–2015. Studies describing all types of emergency abdominal surgery in solid organ transplanted patients were retrieved for evaluation. Results: Thirty-nine case series published between 1996 and 2015 met the inclusion criteria and were…
Guillain-Barré syndrome after orthotopic liver transplantation: A clinical manifestation of immune reconstitution inflammatory syndrome?
2018
Guillain-Barrè Syndrome, as part of the spectrum of dysimmune neuropathies, is unexpected to occur in immunocompromised hosts. We describe a clinical case of Guillain-Barrè syndrome, occurred a few weeks after a liver transplant, and we postulate that our case would satisfy all requirements to explain this peripheral nervous system complication as a clinical manifestation of an Immune reconstitution inflammatory syndrome. In this setting of liver transplantation, complicated by potentially multiple infective triggers, reduction of immunosuppression and reversal of pathogen-induced immunosuppression, through antimicrobial therapy, may have led to pro-inflammatory response. The pro-inflammato…