Thymoglobulin Induction Protects Liver Allografts From Ischemia/Reperfusion Injury

The Department of Surgery of the University of Illinois, published a study in August 2005 trying to asses the ability of TG to protect against ischemia/reperfusion injury in liver transplant recipients.

Twenty two cadaveric liver transplant recipients were randomized to receive either TG (1,5 mg/kg/dose) during the anhepatic period and QOD x 2 doses, or no TG. Maintenance immunosupression consisted of Tacrolimus (or Cyclosporine) and steroids in both groups. Donor byopsies were taken during the organ procurement, cold storage, and 1 hour after re-vascularization.

Patient survival at 3 months was 100%. There was no incidence of PNF and no need for re-transplantation. The incidence of acute rejection was similar in both groups. Patients with TG had significanly decreases in alanine amino transferase and total bilirubin.

The group concluded that TG allowed for more compromised liver grafts to be transplanted with less clinical evidence or ischemia/reperfusion injury and improved function. You can read the article here...

Clin Transplant 2005: 19: 507-511

Print Post

Read More......

Identifying Donors at Risk for Perioperative Complications During LDLT

The University of Rochester and Pennsilvania published a retrospective study this month, regarding the risk factors involving living donor liver transplantation.

It is no secret that this surgery poses some problems. First, the surgery, a hepatectomy is performed on a completely healthy patient, and second, this patient is not benefitted from the procedure. This makes the procedure a technical and ethical challenge.

Recently, during the ESOT Congress, Dr. Rene Adam, from the Paul Brousse Hospital, and memeber of the European Liver Transplant Registry (ELTR), commented on the statistics regarding LDLT. He made special emphasis on the 5 donor deaths to date.

The publication presented an extensive study, and identified center volume as a minor risk, and patient age > 50 years as a major risk factor.

American Journal of Transplantation 2007; 7: 2344–2349

* If you want to read the article you can download it from the "BOX" widget, in the inferior right column.

Print Post

Read More......

ESOT: Adult-To-Adult Living Donor Liver Transplantation Using Dual Grafts

Dr. Chih-Chi Wang from the Department of Surgery at Kaohsiung Hospital, Taiwan, presented at the ESOT Congress, Prague, their experience with dual grafts for living donor liver transplantation.

They presented a prospective study including 150 adult LDLT and 5 dual graft transplantations. According to their results, 2 recipients received 1 right lobe and 1 left lobe, and the other two received two left lobes.

They concluded that dual graft transplantation provides sufficient volume in the recipient without jeopardizing donor safety. They also added that it should be considered and performed by an experienced center when a single donor is rejected based on volumetry requirements.

Print Post

Read More......

Banding and Propanolol as Prophylaxis in Liver Transplant Candidates

The Department of Surgery at the Padova University, Italy, published this month an excellent paper on what should be the primary prophylactic treatment of patients with esophageal varices who are candidates for liver transplantation.

Their study included 62 patients with high risk of bleeding due to varices. Thirty one of them were treated using Propanolol and 31 using variceal banding. Three patients in the propanolol group rebled, while in the other group only 2 patients did. One fatality ocurred in the banding group due to a post banding ulcer.
They also noted that the propanlol treated patients carried less costs than their counterparts. In their conclusions, they proposed that treatment of these patients should be primarily with propanolol, due to fewer complications and cost.

Liver Transpl 13:1272-1278, 2007.

* If you want to read this article, you can download it at the "Shared Literature" widget in the lower left column.


Print Post

Read More......