Search results for " transplantation."

Efficacy of the retreatment of hepatitis C virus infections after liver transplantation: Role of an aggressive approach

2012

A sustained virological response (SVR) is achieved by 30% of naive liver transplantation (LT) recipients treated with pegylated interferon (PEG-IFN) and ribavirin (RBV). Almost no data are available about retreatment. The aim of this study was to assess the efficacy, tolerability, and SVR predictors of retreatment. Data were collected from 4 centers on the retreatment of prior nonresponders to standard therapy or PEG-IFN (with or without RBV) and relapsers. Seventy-nine of 301 treatment-experienced LT patients (26%), who had a median age of 59 years (range = 35-77 years) and were mostly male (72%) and infected with genotype 1 (87%), were retreated with PEG-IFN and RBV at a median of 6.9 yea…

RATIONALE FOR THE USE OF ANTIOXIDANT VITAMINS IN CLINICAL ORGAN TRANSPLANTATION

1996

P0623ACUTE RENAL FAILURE IN HAPOLIDENTICAL HEMATOPOIETIC CELL TRANSPLANTATION. TWO GRAFT VS HOST DISEASE (GVHD) PROFILAXIS PROTOCOL COMPARISON

2020

Abstract Background and Aims Haplo-hematopoietic cell transplantation (Haplo-HCT) assures a valid donor in short notice in over 95% of the patients with high risk haematological neoplasia. High doses of post-transplant cyclophosphamide, in combination with other inmunosupressive drugs like calcineurin inhibitors, rapamycine and micophenolate mofetil, is safe and useful in GVHD prevention. The aim of the study was to analyze and compare acute kidney injury (AKI) in the first 100 days after transplantation, the characteristics of the patients who went on haplo-HCT, and prophylaxis for GVHD with cyclosporine (n=32) (group 1) or rapamycine (group 2), in combination with other immunossupresors. …

Anemia is not predictive of sustained virological response in liver transplant recipients with hepatitis C virus who are treated with pegylated inter…

2011

In the immunocompetent setting, antiviral therapy–related anemia has recently been shown to be associated with a sustained virological response (SVR). Our goal was to assess whether this is also true for liver transplantation (LT). We included 160 LT patients with recurrent hepatitis C virus (HCV) who were treated with pegylated interferon and ribavirin (RBV) between 2002 and 2010; 76% of the patients were men, the median age of the patients was 56 years (range = 33-75 years), 63% had advanced fibrosis, and 86% were infected with HCV genotype 1a or 1b. The baseline immunosuppression was tacrolimus in 56% of the patients. Mycophenolate mofetil (MMF) was used in 15%. Anemia was defined as a h…

Optimizing Liver Division Technique for Procuring Left Lateral Segment Grafts: New Anatomical Insights.

2021

Left liver lobe (left lateral segment) grafts (LLG) is currently the most commonly used graft to transplant children (2/3 of cases currently in Europe); it is prepared by liver division (DL) in both living (LD) and deceased donors (DD) settings. Technically speaking, classical DL is through the parenchyma of segment IV - dividing the main left glissonean pedicle left to the main biliary confluence (trans-hilar (TH) approach): historically, this technique was introduced by Bismuth and Pichlmayr in 1988 in DD setting, and applied one year later for the first successful living donor transplantations by Strong (Figure 1).

Prospective validation of a noninvasive index for predicting liver fibrosis in hepatitis C virus-infected liver transplant recipients

2009

We previously developed a mathematical model, the Hospital Universitario La Fe (HULF) index, as an alternative to protocol liver biopsy (PLB) to estimate significant fibrosis (SF) in patients who underwent liver transplantation (LT) for liver damage caused by chronic HCV infection. In the present study, we sought to validate this noninvasive index. The commonly derived clinical and laboratory data for calculating the HULF index were prospectively collected over 2.7 years from patients undergoing LT and PLB. The sensitivity, specificity, positive and negative predictive values, and diagnostic capacity were evaluated with receiver operating characteristic curve analysis. Biopsy was performed …

Liver Preservation by Aortic Perfusion Alone Compared With Preservation by Aortic Perfusion and Additional Arterial Ex Situ Back-Table Perfusion With…

2017

Background. Arterial ex situ back-table perfusion (BP) reportedly reduces ischemic-type biliary lesion after liver transplantation. We aimed to verify these findings in a prospective investigation. Methods. Our prospective, randomized, controlled, multicenter study involved livers retrieved from patients in 2 German regions, and compared the outcomes of standard aortic perfusion to those of aortic perfusion combined with arterial ex situ BP. The primary endpoint was the incidence of ischemic-type biliary lesions over a follow-up of 2 years after liver transplantation, whereas secondary endpoints included 2-year graft survival, initial graft damage as reflected by transaminase levels, and fu…

Milan-out Criteria and Worse Intention-to-Treat Outcome Postliver Transplantation

2019

Background. Milan criteria are widely used for liver transplantation selection in hepatocellular carcinoma but have been recognized to be too restrictive. Milan-out criteria are increasingly being adopted. Our aim was to analyze if liver transplantation waitlisted Milan-out hepatocellular carcinoma patients have different outcome than Milan patients. Methods. Retrospective study including all consecutive patients with hepatocellular carcinoma admitted in the waiting list for liver transplantation between January 2012 and January 2015. We included 177 patients, 146 of which eventually transplanted. Downstaging was achieved in the Milan-out cases (n = 29) before waitlisting. Results. From dia…

Cryobiopsy as a New Tool for Complications Diagnosis During Follow-up After Lung Transplantation: Single Institution Case Series

2020

ABSTRACT Background The first description of performing a new diagnostic procedure, cryobiopsy, in lung transplant recipients in Poland. Methods Three cases of patients after lung transplantation were analyzed in context of the procedure of cryobiopsy, which was performed in a hybrid room with a bronchoscopic video track and C-arm radiograph. Patients were subjected to complete anesthesia and intubated. Two or three sections with an average diameter of 5 mm were collected. Results The sections were large and fully diagnostic. In all 3 described cases they brought a decisive element into diagnosis. Conclusions Cryobiopsy is a useful tool in the differential diagnosis of lesions and complicat…

Expanded criteria for liver transplantation in patients with cirrhosis and hepatocellular carcinoma

2008

Orthotopic liver transplantation (OLT) selection for patients with hepatocellular carcinoma (HCC) is a matter of debate. The Milan criteria (MC) have been largely adopted by the international community. The main aim of this study was to evaluate the survival rates and recurrence probabilities of a new proposal for criteria (up to 3 tumors, each no larger than 5 cm, and a cumulative tumor burden </= 10 cm). Patients with cirrhosis and HCC included on the waiting list (WL) from 1991 to 2006 were retrospectively analyzed. Outcomes in patients who had tumors within and beyond the MC were compared. The survival analysis was done (1) with the intention-to-treat principle and (2) among transplante…