Antegrade Arterial and Portal Flushing Versus Portal Flushing Only for Right Lobe Live Donor Liver Transplantation-A Randomized Control Trial.

Abstract:

BACKGROUND:In live donor liver transplantation portal flush only of the graft is done on the bench. There are no data on antegrade arterial flush along with portal flush of the graft. METHODS:Consecutive patients undergoing elective right lobe live donor liver transplantation were block-randomized to receive either portal flush only or both portal and antegrade arterial flush. The primary objectives were safety, rate of early allograft dysfunction (EAD), and impact on vascular and biliary complications. RESULTS:After randomization, there were 40 patients in each group. Both groups had comparable preoperative, intraoperative, and donor variables. There were no adverse events related to arterial flushing. The portal and antegrade arterial flush group had significantly lower postoperative bilirubin on days 7, 14, and 21 (all P < 0.05), EAD (P = 0.005), intensive care unit/high dependency unit (P = 0.01), and hospital stay (P = 0.05). This group also had lower peak aspartate aminotransferase (P = 0.07), alanine aminotransferase (P = 0.06) and lower rates of sepsis (P = 0.08) trending toward statistical significance. Portal and antegrade arterial flush groups had lower ascitic fluid drainage and in-hospital mortality. Arterial and biliary complications were not statistically different in the 2 groups. Multivariate analysis of EAD showed portal with antegrade arterial flush was associated with lower rate (P = 0.007), whereas model for end-stage liver disease Na (P = 0.01) and donor age (P = 0.03) were associated with a higher rate of EAD. CONCLUSIONS:Portal with antegrade arterial flushing of right lobe live liver grafts is safe, significantly decreases postoperative cholestasis, EAD, intensive care unit/high dependency unit, and hospital stay and is associated with lower rates of sepsis, ascitic drainage and inhospital mortality in comparison to portal flush only.

journal_name

Transplantation

journal_title

Transplantation

authors

Pamecha V,Sandhyav R,Sinha PK,Bharathy KGS,Sasturkar S

doi

10.1097/TP.0000000000002088

subject

Has Abstract

pub_date

2018-04-01 00:00:00

pages

e155-e162

issue

4

eissn

0041-1337

issn

1534-6080

journal_volume

102

pub_type

杂志文章,随机对照试验
  • Stage I adenocarcinoma presenting in the pneumonectomy specimen at the time of single lung transplantation.

    abstract::Two patients at our institution underwent single lung transplantation. The procedure and the patient's postoperative course were uncomplicated in each case. Pathological examination of each pneumonectomy specimen revealed a well-differentiated adenocarcinoma; both were less than 1 cm in size. The remainder of each lun...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199810270-00024

    authors: Svendsen CA,Bengtson RB,Park SJ,Shumway SJ

    更新日期:1998-10-27 00:00:00

  • Evidence that portal tract microvascular destruction precedes bile duct loss in human liver allograft rejection.

    abstract::In liver allograft rejection, interlobular bile ducts are thought to be the main target of rejection. In contrast, in other organ allografts the capillary bed of the graft appears to be the primary target. To determine whether portal tract microvasculature is destroyed in liver allografts during rejection, we have ide...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199307000-00012

    authors: Matsumoto Y,McCaughan GW,Painter DM,Bishop GA

    更新日期:1993-07-01 00:00:00

  • Comparison of clinicopathologic characteristics of urothelial carcinoma between patients after renal transplantation and on dialysis.

    abstract:BACKGROUND:Urothelial carcinoma (UC) is a common complication after renal replacement therapy (RRT) among Chinese end-stage renal disease (ESRD) patients. It is unclear whether there are any differences in the clinicopathologic characteristics of UC between renal transplantation (RT) and dialysis patients; such differe...

    journal_title:Transplantation

    pub_type: 杂志文章,收录出版

    doi:10.1097/TP.0000000000000112

    authors: Zhang B,Shen C,Han WK,Yu W

    更新日期:2014-09-15 00:00:00

  • Inhibition of leukocyte chemotaxis by immunosuppressive agents. Specific inhibition of lymphocyte chemotaxis by cyclosporine.

    abstract::Since chemotaxis is an important mechanism by which leukocytes are recruited to allografts during rejection, the effect of immunosuppressant agents on in vitro chemotactic responses of neutrophils, monocytes, and lymphocytes was studied. Cyclosporine caused profound inhibition of lymphocyte chemotaxis to three differe...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199011000-00020

    authors: Adams DH,Wang LF,Neuberger JM,Elias E

    更新日期:1990-11-01 00:00:00

  • Pediatric kidney transplantation using a novel protocol of rapid (6-day) discontinuation of prednisone: 2-year results.

    abstract:BACKGROUND:There are few prospective studies of prednisone-free immunosuppression (IS) in pediatric kidney transplant (KTx) recipients. We studied the outcomes of a protocol using rapid discontinuation of prednisone (RDP, <1 week) and thymoglobulin induction. METHODS:Twenty-one RDP recipients (mean age 14+/-3 years) r...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181ac6833

    authors: Chavers BM,Chang YC,Gillingham KJ,Matas A

    更新日期:2009-07-27 00:00:00

  • Endovascular treatment of hepatic venous outflow obstruction after piggyback technique liver transplantation.

    abstract:BACKGROUND:The piggyback technique of orthotopic liver transplantation is an attractive alternative that preserves the recipient inferior vena cava and allows uninterrupted venous blood return during the anhepatic phase. As with other transplantation techniques, the vascular anastomoses required by the piggyback techni...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199908150-00018

    authors: Sze DY,Semba CP,Razavi MK,Kee ST,Dake MD

    更新日期:1999-08-15 00:00:00

  • Deoxyspergualin in lethal murine graft-versus-host disease.

    abstract::The beneficial effect of deoxyspergualin (DSG, NKT-01) on lethal graft-versus-host disease in mice has been studied in a major histoincompatible donor-recipient combination. Suppression of the effector mechanisms responsible for the lethal outcome in this GVHD model is also noted. This study reveals: (1) DSG has a mar...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199103000-00032

    authors: Nemoto K,Hayashi M,Ito J,Sugawara Y,Mae T,Fujii H,Abe F,Fujii A,Takeuchi T

    更新日期:1991-03-01 00:00:00

  • Allotransplantation of rat islets into the cisterna magna of streptozotocin-induced diabetic rats.

    abstract::Islets were isolated from the pancreata of Sprague-Dawley rats and transplanted into streptozotocin-induced diabetic outbred Wistar rats. The effect of transplantation of islets into the cisterna magna on the diabetic state of the recipients was compared with that of the conventional transplantation of islets into liv...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199203000-00003

    authors: Lee HC,Ahn KJ,Lim SK,Kim KR,Ahn YS,Lee KE,Huh KB

    更新日期:1992-03-01 00:00:00

  • mTOR Inhibition Role in Cellular Mechanisms.

    abstract::The mammalian target of rapamycin inhibitors (mTOR-I), drugs widely used in transplant medicine and oncology, exert their function by inhibiting a serine/threonine kinase with a pivotal role in cellular metabolism and in a wide range of eukaryotic biological/cellular functions and signaling networks. Additionally, as ...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/TP.0000000000001806

    authors: Zaza G,Granata S,Caletti C,Signorini L,Stallone G,Lupo A

    更新日期:2018-02-01 00:00:00

  • Morphometric analysis of neointimal formation in murine cardiac grafts: III. Dissociation of intestitial fibrosis from neointimal formation.

    abstract:BACKGROUND:This study examined the relationship between transplant vascular sclerosis (TVS) and tissue fibrosis, features of chronic rejection that can develop rapidly in accepted heterotopic murine cardiac allografts. METHODS:The rate of development of interstitial fibrosis or TVS development was determined by comput...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199710270-00020

    authors: Armstrong AT,Strauch AR,Starling RC,Sedmak DD,Orosz CG

    更新日期:1997-10-27 00:00:00

  • Interleukin-8, neutropenia, and graft failure in human stem cell transplantation.

    abstract::We studied the role of interleukin (IL)-8 during engraftment after hematopoietic stem cell transplantation. In 40 consecutive patients undergoing either allogeneic marrow (n=32) or autologous peripheral blood stem cell transplantation (n=8), IL-8 plasma levels were serially determined. Median IL-8 concentrations peake...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000135564.82707.f0

    authors: Schwabe M,Hartert AM,Bertz H,Finke J

    更新日期:2004-10-15 00:00:00

  • Retinal complications in patients with solid organ or bone marrow transplantations.

    abstract:BACKGROUND:The administration of systemic immunosuppressive agents to recipients of solid organ or bone marrow transplants results in an immunocompromised status. As the number of organ recipients and their life span increase with recent progress in organ transplantation, ocular complications tend to become more divers...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000259386.59375.8a

    authors: Chung H,Kim KH,Kim JG,Lee SY,Yoon YH

    更新日期:2007-03-27 00:00:00

  • Outcome, incidence, and timing of infectious complications in small bowel and multivisceral organ transplantation patients.

    abstract:BACKGROUND:Infectious complications still represent a major cause of morbidity and mortality in patients with organ transplantation. In particular, small bowel or multivisceral transplantation is complicated to a greater extent than other grafts as a consequence of infectious complications including sepsis. METHODS:Th...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000185622.91708.57

    authors: Guaraldi G,Cocchi S,Codeluppi M,Di Benedetto F,De Ruvo N,Masetti M,Venturelli C,Pecorari M,Pinna AD,Esposito R

    更新日期:2005-12-27 00:00:00

  • Respiratory tract viral infections in bone marrow transplant patients.

    abstract:BACKGROUND:Community respiratory viruses such as respiratory syncytial virus (RSV), adenovirus, influenza A, influenza B, and the parainfluenza group are frequent causes of respiratory disease in bone marrow transplant (BMT) patients. MATERIAL AND METHODS:During the period from March 1993 to August 1999, 810 samples o...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.TP.0000072012.26176.58

    authors: Raboni SM,Nogueira MB,Tsuchiya LR,Takahashi GA,Pereira LA,Pasquini R,Siqueira MM

    更新日期:2003-07-15 00:00:00

  • Gene therapy-mediated CD40L and CD28 co-stimulatory signaling blockade plus transient anti-xenograft antibody suppression induces long-term acceptance of cardiac xenografts.

    abstract:BACKGROUND:The authors have previously demonstrated that inhibition of CD28 and CD40 ligand (CD40L) co-stimulatory signals by adenovirus-mediated cytotoxic T-lymphocyte-associated (CTL) antigen 4 (A4) immunoglobulin (Ig) and CD40Ig gene therapies induces tolerance or long-term acceptance in rat liver and heart allograf...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000144324.83846.a9

    authors: Hua N,Yamashita K,Hashimoto T,Masunaga T,Fujita M,Furukawa H,Uede T,Todo S

    更新日期:2004-11-27 00:00:00

  • Dallas UtErus Transplant Study: Early Outcomes and Complications of Robot-assisted Hysterectomy for Living Uterus Donors.

    abstract:BACKGROUND:Uterus transplantation is a treatment for absolute uterine infertility and can be performed with living and deceased donors. Given the safety and increased utilization of robotic assistance with other gynecologic and transplant donor operations, we adopted a robot-assisted approach to donor hysterectomy. Thi...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000003211

    authors: Johannesson L,Koon EC,Bayer J,McKenna GJ,Wall A,Fernandez H,Martinez EJ,Gupta A,Ruiz R,Onaca N,Testa G

    更新日期:2021-01-01 00:00:00

  • 3-[(dodecylthiocarbonyl)methyl]-glutarimide attenuates graft arterial disease by suppressing alloimmune responses and vascular smooth muscle cell proliferation.

    abstract:BACKGROUND:Graft arterial disease (GAD) is a major cause of late graft loss after organ transplantation. Alloimmune responses and vascular remodeling eventually cause the transplant organ to develop GAD. In this study, we aimed to limit the development of GAD by inhibiting alloimmune responses and vascular smooth muscl...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000000576

    authors: Zaitsu M,Yamashita K,Shibasaki S,Tsunetoshi Y,Fukai M,Ogura M,Yoshida T,Igarashi R,Kobayashi N,Umezawa K,Todo S

    更新日期:2015-05-01 00:00:00

  • Induction of kidney allograft tolerance by soluble CD83 associated with prevalence of tolerogenic dendritic cells and indoleamine 2,3-dioxygenase.

    abstract:BACKGROUND:Tolerogenic dendritic cells (Tol-DCs) play a critical role in inducing and maintaining tolerance. Recognizing that both T-cell inactivation and activation are contingent on signals provided by DCs and that graft-specific activated T cells are major mediators of transplant rejection, we aimed to create an env...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3182007bbf

    authors: Lan Z,Ge W,Arp J,Jiang J,Liu W,Gordon D,Healey D,DeBenedette M,Nicolette C,Garcia B,Wang H

    更新日期:2010-12-27 00:00:00

  • Increased incidence of acute myeloid leukemia after liver transplantation? Description of three new cases and review of the literature.

    abstract:BACKGROUND:Acute myeloid leukemia (AML) after solid organ transplantation is rare, with only six AML cases after liver transplantation (LT) being reported. METHODS:Characteristics of three AML cases observed among 799 recipients of LT in the authors' institution and estimation of the standardized incidence ratio (SIR)...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/01.TP.0000102549.40531.13

    authors: Camós M,Esteve J,Rimola A,Grande L,Rozman M,Colomer D,Villamor N,Costa D,Montserrat E

    更新日期:2004-01-27 00:00:00

  • The impact of transforming growth factor-beta1 gene polymorphism on end-stage renal failure after heart transplantation.

    abstract:BACKGROUND:Nephrotoxicity is a major side effect of calcineurin inhibitors (CNI). Earlier we reported 8% of our heart transplant recipients reaching end-stage renal failure (ESRF). Now, with an extended follow up of 20 years, we re-evaluated the development of ESRF and studied its influence on survival and the impact o...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000250360.78553.5e

    authors: van de Wetering J,Weimar CH,Balk AH,Roodnat JI,Holweg CT,Baan CC,van Domburg RT,Weimar W

    更新日期:2006-12-27 00:00:00

  • Effects of tacrolimus on hyperlipidemia after successful renal transplantation: a Southeastern Organ Procurement Foundation multicenter clinical study.

    abstract:BACKGROUND:Tacrolimus has been shown to have a less adverse effect on the lipid profiles of transplant patients when the drug is started as induction therapy. In order to determine the effect tacrolimus has on lipid profiles in stable cyclosporine-treated renal transplant patients with established hyperlipidemia, a ran...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1097/00007890-199801150-00017

    authors: McCune TR,Thacker LR II,Peters TG,Mulloy L,Rohr MS,Adams PA,Yium J,Light JA,Pruett T,Gaber AO,Selman SH,Jonsson J,Hayes JM,Wright FH Jr,Armata T,Blanton J,Burdick JF

    更新日期:1998-01-15 00:00:00

  • Resolution and relapse of osteopetrosis in mice transplanted with myeloid tissue of variable histocompatibility.

    abstract::Osteopetrotic microphthalmic mice (mi/mi) were treated by injections of suspensions of myeloid tissue, newborns i.p., and weanlings i.v. Donated syngeneic material effected permanent cure of oteopetrosis provided that the dose was large enough (10(8) cells of bone marrow). H-2-compatible allogeneic bone marrow was ini...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-197910000-00004

    authors: Nisbet NW,Menage J,Loutit JF

    更新日期:1979-10-01 00:00:00

  • Increased rejection in living unrelated versus living related kidney transplants does not affect short-term function and survival.

    abstract:BACKGROUND:At our institution, increased kidney donation from unrelated donors accounts for a steady rise in live donor kidney transplantation rates. We compared outcomes of living related (LRT) versus living unrelated kidney transplants (LURT) and analyzed the effect of early rejection upon graft survival. METHODS:A ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000135464.11616.5a

    authors: Fuller TF,Feng S,Brennan TV,Tomlanovich S,Bostrom A,Freise CE

    更新日期:2004-10-15 00:00:00

  • Renal allograft survival in patients with oxalosis.

    abstract:BACKGROUND:Primary hyperoxaluria is a rare autosomal recessive metabolic disease that often progresses to end-stage renal disease (ESRD). Liver transplantation is curative for patients with the alanine: glyoxylate aminotransferase deficiency. For oxalosis patients with minor enzyme deficiencies, renal transplantation m...

    journal_title:Transplantation

    pub_type: 杂志文章,多中心研究

    doi:10.1097/00007890-200209150-00020

    authors: Cibrik DM,Kaplan B,Arndorfer JA,Meier-Kriesche HU

    更新日期:2002-09-15 00:00:00

  • Antibodies to hepatitis C virus envelope proteins correlate with hepatitis C viraemia after liver transplantation.

    abstract:BACKGROUND:Liver transplant recipients for hepatitis C virus (HCV)-related cirrhosis usually remain anti-HCV-seropositive after transplantation. The aim of this study was to characterize, longitudinally, the profile of HCV-specific antibodies and cryoglobulins in liver transplant recipients with recurrent HCV infection...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199901150-00013

    authors: Gane EJ,Maertens G,Ducatteeuw A,Qian KP,Lau JY,Jones H,Davies E,Naoumov NV,Williams R

    更新日期:1999-01-15 00:00:00

  • Relationship between CD8+ T-cell phenotype and function, Epstein-Barr virus load, and clinical outcome in pediatric renal transplant recipients: a prospective study.

    abstract:BACKGROUND:The authors studied the relationship between the dynamics of Epstein-Barr virus (EBV) load, CD8 T-cell activation and differentiation, and EBV-associated symptoms in 25 children after kidney transplantation (Tx). METHODS:Twenty-two patients were enrolled at the time of Tx and three at diagnosis of EBV-induc...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000131168.21930.5c

    authors: Baudouin V,Dehée A,Pédron-Grossetete B,Ansart-Pirenne H,Haddad E,Maisin A,Loirat C,Sterkers G

    更新日期:2004-06-15 00:00:00

  • Control of cyclosporine A-induced tumor progression using 15-deoxyspergualin for rat cardiac transplantation.

    abstract::Immunosuppressive therapy increases the risk of recurrence of initial cancers in organ transplant patients, and compelling therapeutic protocols are needed to suppress the malignancy and protect the allograft. We examined the potential use of 15-deoxyspergualin (DSG) in relation to organ transplantation and cancer. Th...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000271496.75233.f6

    authors: Ohsawa I,Uemoto S,Kobayashi E,Murakami T

    更新日期:2007-08-15 00:00:00

  • Donor-recipient microchimerism is not required for tolerance induction following recipient pretreatment with donor-specific transfusion and anti-CD4 antibody. Evidence of a clear role for short-term antigen persistence.

    abstract::There is considerable current interest in the possibility that long-term graft acceptance in clinical solid-organ transplantation might be dependent upon the development of a microchimeric state between the donor and recipient. This possibility has been prompted by the observation that in some transplant patients cell...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199505270-00001

    authors: Bushell A,Pearson TC,Morris PJ,Wood KJ

    更新日期:1995-05-27 00:00:00

  • Innominate artery interposition graft simplifies the portal venous drainage method of pancreas transplantation.

    abstract::Pancreas transplantation utilizing portal venous and enteric exocrine drainage has potential benefits over the standard systemic venous and bladder exocrine drainage method. Unfortunately, technical difficulties are often experienced with the arterial anastomosis after the portal venous anastomosis is completed. We ha...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199907270-00029

    authors: Bigam DL,Hemming AW,Sanabria JR,Cattral MS

    更新日期:1999-07-27 00:00:00

  • FDA perspective: enrolment of elderly transplant recipients in clinical trials.

    abstract::Since 1989, the U.S. Food and Drug Administration (FDA) has encouraged the study of new drug and therapeutic products in elderly patients. However, despite the aging population in the United States, elderly patients continue to be underrepresented in clinical trials across a variety of therapeutic areas, including tra...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31828279d9

    authors: Meyer JM,Archdeacon P,Albrecht R

    更新日期:2013-04-15 00:00:00