Abstract:
:Portal vein thrombosis (PVT), a common complication of end stage liver disease, is no longer considered a definite contraindication for liver transplantation (LTx). The clinical decision to perform an LTx in the case of PVT depends on the degree of PVT and the experience of the surgeon. Eversion thromboendovenectomy was suggested by most authors as the surgical technique of choice for PVT grade 1, 2, and 3. If PVT obstructs more extended parts of the porto-mesenteric venous circulation, surgical options would include different types of venous jump graft reconstructions or arterialization of the portal vein. Combined liver and small bowel transplantation is another possible alternative. Cavoportal hemitransposition (CPHT) and renoportal anastomosis (RPA) were recently particularly advocated as creative surgical strategies in case of diffuse PVT. In this work, we focus on CPHT and RPA surgical techniques during LTx, which attempts to secure the portal flow to the liver graft in case of pre-existent diffuse PVT. We provide a review of all reported clinical experience at international clinical centers using these techniques. According to our meta-analysis a total of 15 studies were published on this topic between 1996 and 2005. In summary, a total of 56 orthotopic LTx have been performed in 53 patients (28 men, 25 women) combined with either CPHT or RPA, for the purpose of providing the donor graft with adequate inflow. Mean age was 44 yr including two patients who were infants, with the youngest recipient being two yr old. Main indications for LTx were liver cirrhosis caused by viral hepatitis, alcoholic cirrhosis and cryptogenic cirrhosis. CPHT was performed in 46 cases, and RPA in 10 cases. Thirty-five of 53 patients (66%) had surgery previous to LTx. Of these, 13 patients (37%) [corrected] presented with a history of other previous surgical procedures for decompression of portal hypertension or treatment of associated complications (portocaval shunts, splenectomy, etc). Ascites, renal dysfunction, lower extremity and torso edema and variceal bleeding were dominant post-operative complications after CPHT or RPA noted in 22 cases (41.5%), 18 cases (34%), 17 cases (32%) and 13 cases (24.5%) respectively. Patients' follow-up ranged from two to 48 months. Thirty nine of 53 patients [corrected] (74%) survived [corrected] and 14 patients died (26%) [corrected] during the course of observation. Based on the literature, we conclude that the ideal technique to overcome PVT during LTx is still controversial. Short-term follow-up results of both methods are promising, however, long-term results are unknown at present. Furthermore, clinical follow-up and basic experimental work is required to evaluate the influence of systemic venous inflow to the liver graft with respect to long-term liver function and liver regeneration.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Paskonis M,Jurgaitis J,Mehrabi A,Kashfi A,Fonouni H,Strupas K,Büchler MW,Kraus TWdoi
10.1111/j.1399-0012.2006.00560.xsubject
Has Abstractpub_date
2006-09-01 00:00:00pages
551-62issue
5eissn
0902-0063issn
1399-0012pii
CTR560journal_volume
20pub_type
杂志文章,评审abstract::Renal transplantation remains the definitive treatment for end-stage renal disease (ESRD). The shorter renal vein in right donor nephrectomies is associated with higher incidence of technical failure. We present here our experience with autologous internal jugular vein (IJV) conduits to facilitate living-donor transpl...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13312
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Liver ischaemia-reperfusion (I/R) occurs during resuscitation from haemorrhagic shock, hepatic transplantation and anatomic resection of the liver. This injury is associated with hepatocellular enzyme release and hepatocyte necrosis. The impact of chronic illnesses such as diabetes mellitus (DM) on hepatic I...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00210
更新日期:2004-01-01 00:00:00
abstract::Retrograde arterial flush (RGAF) of liver grafts, which prevents arterial intima injuries in living donor liver transplantation (LDLT), seemed to reduce post-transplantational cholestasis by our preliminary study. The aim of this study was to further confirm this effect of RGAF of grafts in LDLT by a prospective rando...
journal_title:Clinical transplantation
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-0012.2011.01493.x
更新日期:2012-03-01 00:00:00
abstract::There is currently an imbalance between the need for cadaveric kidneys for transplantation and the supply. The medical criteria for accepting cadaveric donors are changing and organs that were originally thought to be unacceptable have functioned well. Previous reports have discussed the problems with transplanting ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1992-12-01 00:00:00
abstract::The objective of this study was to evaluate the effects of itraconazole as a first choice drug in the treatment of pulmonary aspergillosis in heart transplant recipients. Heart transplant recipients suffering from invasive pulmonary aspergillosis were included in this study. Group 1 included 4 patients treated with i....
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1998-02-01 00:00:00
abstract::Hispanic race and low socioeconomic status are established predictors of disparity in access to kidney transplantation. This single-center retrospective review was undertaken to determine whether Hispanic race predicted kidney transplant outcomes. A total of 720 patients underwent kidney transplantation from January 1...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12662
更新日期:2016-02-01 00:00:00
abstract::In 1969, a study by Patel and Terasaki persuaded the renal transplant community that a pre-transplant cross-match should always be performed between donor and recipient to detect HLA antibodies and prevent hyperacute allograft rejection. Although the role of the cross-match among nonsensitized patients is controversia...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.16.s7.3.x
更新日期:2002-01-01 00:00:00
abstract::Donor lung allocation in the United States focuses on decreasing waitlist mortality and improving recipient outcomes. The implementation of allocation policy to match deceased donor lungs to waitlisted patients occurs through a unique partnership between government and private organizations, namely the Organ Procureme...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13873
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:There are limited published data concerning the effects of different immunosuppressive regimens on the development of polyomavirus (BKV) viremia. We examined the risk of developing BKV viremia in kidney transplant recipients receiving everolimus (EVR) or mycophenolic acid (MPA) as maintenance therapy. METHO...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.12151
更新日期:2013-07-01 00:00:00
abstract::Temporary graft dysfunction with gas exchange abnormalities is a common finding during the postoperative course of a lung transplant and is often determined by the post-reimplantation syndrome. Supportive measures including oxygen by mask, inotropes, diuretics, and pulmonary vasodilators are usually effective in non-s...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01050.x
更新日期:2009-09-01 00:00:00
abstract:INTRODUCTION:Controlled donation after circulatory death (DCD) remains ethically controversial. The authors developed a controlled DCD protocol in which comfort therapy is regularly used. The aim of this study was to determine whether this policy shortens the DCD donors' life. METHODS:The authors retrospectively analy...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12276
更新日期:2014-01-01 00:00:00
abstract::This paper describes 108 consecutively treated patients receiving 109 cadaveric (CD) and living donor (LD) renal allografts using a protocol of quadruple sequential immunosuppression with a rabbit anti-human thymocyte IgG (Thymoglobuline), azathioprine, tapering corticosteroids, and delayed introduction of cyclosporin...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1997-06-01 00:00:00
abstract::Cell-mediated responses to xenoantigens are different from those to alloantigens. CD4+ T cells are especially important in xenoresponses and depletion of CD4+ T cells can prolong survival of xenografts better than allografts in some circumstances. The difference between the two responses is due in part to the relative...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:
更新日期:1994-04-01 00:00:00
abstract::Experimental models suggest that endothelin-1 (ET-1) has a significant role in the pathogenesis of cyclosporin A (CyA)-induced hypertension. However, its serum levels evaluated in different studies, including patients who received solid organ transplants, exhibited controversial results. Our study population consisted...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-0012.2005.00357.x
更新日期:2005-08-01 00:00:00
abstract:INTRODUCTION:Alagille syndrome (AGS) is an inherited multisystem disorder, and liver transplantation (LT) may be required in pediatric patients with AGS (P-AGS). There are limited data regarding the outcomes of LT in adults with AGS (A-AGS). AIM:To determine and compare the outcomes of LT in A-AGS vs. P-AGS as well as...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2011.01574.x
更新日期:2012-03-01 00:00:00
abstract::Clinical outcomes are generally worse for black vs nonblack renal allograft recipients. In BENEFIT and BENEFIT-EXT, recipients were randomized to belatacept more intense-based, belatacept less intense-based, or cyclosporine-based immunosuppression. At year 7, belatacept was associated with superior graft survival vs c...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/ctr.13225
更新日期:2018-04-01 00:00:00
abstract::Histopathologic diagnoses in transplantation can be improved with molecular testing. Preferably, molecular diagnostics should fit into standard-of-care workflows for transplant biopsies, that is, formalin-fixed paraffin-embedded (FFPE) processing. The NanoString(®) gene expression platform has recently been shown to w...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12689
更新日期:2016-03-01 00:00:00
abstract::The use of tacrolimus (FK506) in adult kidney-transplant recipients has been the subject of a number of single- and multi-center studies. This review article focuses on those studies in which tacrolimus was used either as rescue therapy in patients who developed refractory rejection on cyclosporine (CyA)-based regimen...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:
更新日期:1998-12-01 00:00:00
abstract::Chronic lung allograft dysfunction (CLAD) reduces long-term graft survival. It is important to distinguish CLAD subtypes: bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS) as RAS has a worse prognosis and accurate subtyping could facilitate targeted treatments. However, the current diagn...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13027
更新日期:2017-08-01 00:00:00
abstract::Skin cancer is a common, potentially life-threatening malignancy in organ transplant recipients (OTR), and it is important for transplant physicians to be aware of patient history of skin cancer. Patient self-report represents a quick method of obtaining past medical history of skin cancer but no study has validated t...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2012.01601.x
更新日期:2012-03-01 00:00:00
abstract::Organ donor availability is the major limiting factor in pediatric liver transplantation, and many children succumb from their liver disease before a suitable donor can be found. In an attempt to overcome this shortage, reduced-size liver transplantation, split liver transplantation, and living-donor liver transplanta...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:
更新日期:1991-04-01 00:00:00
abstract::Post-transplant lymphoproliferative disorder (PTLD) may compromise long-term outcome of lung transplant (LTx) recipients. A case-control study was performed, comparing LTx recipients with PTLD (n=31) to matched recipients without PTLD (Controls, n=62). Risk factors for PTLD and post-transplant outcomes were assessed. ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12983
更新日期:2017-07-01 00:00:00
abstract:INTRODUCTION:In 2006, model for end-stage liver disease (MELD)-based allocation was implemented in the Eurotransplant (ET) region. Sick patients, who in general require more resources, are prioritized. In this analysis, the effect of MELD on costs for liver transplantation (LTx) was assessed. METHODS:Total costs for L...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-0012.2011.01483.x
更新日期:2011-09-01 00:00:00
abstract::Hepatitis C is the leading indication for liver transplantation in the USA and recurrence is universal. The impact of preexisting diabetes, new-onset diabetes after transplant (NODAT), and glycemic control on fibrosis progression has not been studied. This retrospective longitudinal cohort study included adult liver r...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12391
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:Urinary tract infections (UTIs) account for significant morbidity after kidney transplantation (KT). Screening for asymptomatic bacteruria (AB) has proven to be beneficial in certain population including pregnant women; however, it is not well-studied in KT population. We reviewed the incidence, clinical feat...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12954
更新日期:2017-05-01 00:00:00
abstract:BACKGROUNDS:Recurrent hepatitis C virus (HCV) infection is universal post-transplantation. Fibrosis (F) stage ≥2 at 12 months identifies patients with rapid fibrosis progression. Antiviral therapy (AVT) remains the only option to attenuate fibrosis progression. We hypothesized that CXCL10 levels can distinguish between...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12354
更新日期:2014-05-01 00:00:00
abstract::Porto-pulmonary hypertension with moderate or severe pulmonary arterial hypertension (PAH) is viewed as a contraindication to liver transplantation (LT) because of associated poor outcomes; however, patients with biliary atresia (BA) are generally good candidates for LT. Ten patients with moderate/severe PAH underwent...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12415
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Numerous studies of steroid withdrawal have been carried out in kidney and liver transplant recipients, but only a few in pancreas transplant recipients. Yet, pancreas transplant recipients could have significant long-term benefits from steroid withdrawal. METHODS:We performed a retrospective analysis to de...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2000.140114.x
更新日期:2000-02-01 00:00:00
abstract::The development of post-transplant lymphoproliferative disorders (PTLD) is a well-recognized complication of solid organ transplantation in patients receiving immunosuppressive therapy. The literature on PTLD in live renal allograft recipients is scarce and most of the data pertains to PTLD in cadaveric transplants. A...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2005.00406.x
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:The objective of this retrospective study was to characterize the neutrophil to lymphocyte ratio (NLR) on the waitlist and determine its prognostic utility in liver transplantation (LT) for hepatocellular carcinoma (HCC) with special focus on longitudinal data. Biomarkers such as pre-operative NLR have been s...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13743
更新日期:2019-12-01 00:00:00