Increasing the Donor Pool: Consideration of Prehospital Cardiac Arrest in Controlled Donation After Circulatory Death for Liver Transplantation

Ahmed H. Elaffandi, Glenn K. Bonney, Bridget Gunson, Irene Scalera, Hynek Mergental, John R. Isaac, Simon R. Bramhall, Darius F. Mirza, M. Thamara P.R. Perera, Paolo Muiesan – 18 October 2013 – Donor warm ischemia has implications for outcomes after liver transplantation (LT) using organs from donation after circulatory death (DCD) donors. Prehospital cardiac arrest (PHCA) before donation may generate a further ischemic insult. The aim of this single‐center study of 108 consecutive DCD LT procedures was to compare the outcomes of PHCA and non‐PHCA cohorts.

Use of hepatitis B surface antigen–positive grafts in liver transplantation: A matched analysis of the US National database

Zhiwei Li, Zhenhua Hu, Jie Xiang, Jie Zhou, Sheng Yan, Jian Wu, Lin Zhou, Shusen Zheng – 18 October 2013 – The scarcity of available donor organs is the key challenge in orthotopic liver transplantation (OLT). A viable way of expanding the donor pool is the use of liver grafts from hepatitis B surface antigen (HBsAg)–positive donors.

Donor hemodynamic profile presages graft survival in donation after cardiac death liver transplantation

Peter L. Abt, Jens Praestgaard, Sharon West, Richard Hasz – 18 October 2013 – Obligatory exposure to a period of warm ischemia is the defining feature of liver allografts from donation after cardiac death (DCD) donors. We explored novel methods for characterizing the dynamic aspects of donor warm ischemia that might be useful in assessing organ quality. The hemodynamic profile during donor warm ischemia was retrospectively studied for 110 Maastricht category III DCD donors.

Multimodal therapy including liver transplantation for hepatic undifferentiated embryonal sarcoma

Ashley Walther, James Geller, Abigail Coots, Alexander Towbin, Jaimie Nathan, Maria Alonso, Rachel Sheridan, Greg Tiao – 18 October 2013 – The outcomes of hepatic undifferentiated embryonal sarcoma (HUES) have historically been limited by persistent, unresectable disease and the subsequent development of disease resistance and dissemination. We present our institutional experience with HUES and assess current treatment trends and outcomes in the era of liver transplantation. We conducted a retrospective chart review of cases presenting with HUES at our institution over the past 10 years.

Defining and characterizing severe hypoxemia after liver transplantation in hepatopulmonary syndrome

Dhruv Nayyar, H. S. Jeffrey Man, John Granton, Samir Gupta – 18 October 2013 – Hepatopulmonary syndrome is defined as a triad of liver disease, intrapulmonary vascular dilatations, and abnormal gas exchange, and it carries a poor prognosis. Liver transplantation is the only known cure for this syndrome. Severe hypoxemia in the early postoperative period has been reported to be a major complication and often leads to death in this population, but it has been poorly characterized.

Meeting report of the 19th Annual International Congress of the International Liver Transplantation Society (Sydney Convention and Exhibition Centre, Sydney, Australia, June 12‐15, 2013)

Gabriel C. Oniscu, Geraldine Diaz, Josh Levitsky – 17 October 2013 – The International Liver Transplantation Society held its annual meeting from June 12 to 15 in Sydney, Australia. More than 800 registrants attended the congress, which opened with a conference celebrating 50 years of liver transplantation (LT). The program included series of featured symposia, focused topic sessions, and oral and poster presentations. This report is by no means all‐inclusive and focuses on specific abstracts on key topics in LT.

Pediatric liver transplantation for urea cycle disorders and organic acidemias: United Network for Organ Sharing data for 2002‐2012

Emily R. Perito, Sue Rhee, John Paul Roberts, Philip Rosenthal – 17 October 2013 – Decision making concerning liver transplantation is unique for children with urea cycle disorders (UCDs) and organic acidemias (OAs) because of their immediate high priority on the waiting list, which is not related to the severity of their disease. There are limited national outcome data on which recommendations about liver transplantation for UCDs or OAs can be based.

Regional perfusion by extracorporeal membrane oxygenation of abdominal organs from donors after circulatory death: A systematic review

Iestyn M. Shapey, Paolo Muiesan – 17 October 2013 – Organs from donors after circulatory death (DCDs) are particularly susceptible to the effects of warm ischemia injury. Regional perfusion (RP) by extracorporeal membrane oxygenation (ECMO) is increasingly being advocated as a useful remedy to the effects of ischemia/reperfusion injury, and it has been reported to enable the transplantation of organs from donors previously deemed unsuitable. The MEDLINE, Embase, and Cochrane databases were searched, and articles published between 1997 and 2013 were obtained.

Aerobic capacity during cardiopulmonary exercise testing and survival with and without liver transplantation for patients with chronic liver disease

William Bernal, Rosa Martin‐Mateos, Miklós Lipcsey, Caroline Tallis, Kyne Woodsford, Mark J. Mcphail, Christopher Willars, Georg Auzinger, Elizabeth Sizer, Michael Heneghan, Simon Cottam, Nigel Heaton, Julia Wendon – 17 October 2013 – Chronic liver disease (CLD) is associated with muscle wasting, reduced exercise tolerance and aerobic capacity (AC). Measures of AC determined with cardiopulmonary exercise testing (CPET) may predict survival after liver transplantation (LT), but the relationship with nontransplant outcomes is uncertain.

Combined lung and liver transplantation: Analysis of a single‐center experience

Stephanie G. Yi, Sherilyn Gordon Burroughs, Matthias Loebe, Scott Scheinin, Harish Seethamraju, Soma Jyothula, Howard Monsour, Robert McFadden, Hemangshu Podder, Ashish Saharia, Emad H. Asham, Maha Boktour, A. Osama Gaber, R. Mark Ghobrial – 17 October 2013 – Patients with end‐stage lung disease complicated by cirrhosis are not expected to survive lung transplantation alone. Such patients are potential candidates for combined lung‐liver transplantation (CLLT), however few reports document the indications and outcomes after CLLT. This is a review of a large single‐center CLLT series.

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