Abstract:
BACKGROUND:Donor hepatectomy with maximal safety while preserving graft viability is of principal concern in living donor liver transplantation. There are compelling reasons for avoiding blood transfusion, even with autologous blood, to avoid the potential risks it imposes on healthy donors. This study aims to describe the surgical technique and clinical outcomes of living donor hepatectomy with minimal blood loss requiring no blood transfusion. METHODS:Donor hepatectomy was performed in 30 living donors according to a detailed preoperative imaging study of the vascular and biliary anatomy. Liver parenchymal transection was carried out with strict adherence to a meticulous surgical technique without vascular inflow occlusion to either side of the liver. Pre-, intra-, and postoperative data were gathered, and factors related to blood loss were analyzed retrospectively. RESULTS:The intraoperative blood loss ranged from 20 to 300 ml with a mean of 72.0+/-58.9 ml (median, 55 ml), and neither homologous nor autologous blood transfusion was required in any of the donors intra- and postoperatively. All 30 donors were discharged with minimal complications, and remain well at a mean follow-up of 24 months after donation. Excellent graft viability was verified by the fact that all 30 recipients are alive and well with a few manageable complications. The actual graft and patient survival are both 100% at the time of writing. CONCLUSIONS:Regardless of the extent of donor hepatectomy, blood loss can and should be kept to a minimum, and living donor hepatectomy without blood transfusion is a realistic objective.
journal_name
Transplantationjournal_title
Transplantationauthors
Chen CL,Chen YS,de Villa VH,Wang CC,Lin CL,Goto S,Wang SH,Cheng YF,Huang TL,Jawan B,Cheung HKdoi
10.1097/00007890-200006270-00018subject
Has Abstractpub_date
2000-06-27 00:00:00pages
2580-6issue
12eissn
0041-1337issn
1534-6080journal_volume
69pub_type
杂志文章相关文献
TRANSPLANTATION文献大全abstract::The interpretation of cellular infiltrate from renal transplant recipients with borderline (BL) changes is still a challenging problem. To analyze the immune phenotype of such infiltrate, we quantified the mRNA expression of Foxp3 and interleukinL-10 and granzyme B (GB) in 15 kidney biopsies with BL changes. Controls ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000248884.71946.19
更新日期:2007-02-15 00:00:00
abstract:BACKGROUND:Bone marrow transplantation (BMT) for class 3 patients with thalassemia is challenging due to high rates of graft rejection and transplant-related mortality. Since the first studies of BMT in the late 1980s, a number of conditioning regimens have been designed to improve outcomes, but with suboptimal results...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000000928
更新日期:2016-04-01 00:00:00
abstract::This is a short review of tolerance from the point of view of the clinician. Various examples of tolerance occurring in patients and animal models that relate to the clinical experience are described. There may be different mechanisms by which tolerance is achieved, but from the patient's point of view operational tol...
journal_title:Transplantation
pub_type: 历史文章,杂志文章
doi:10.1097/01.tp.0000117776.14277.03
更新日期:2004-03-27 00:00:00
abstract:BACKGROUND:Organ transplantation has been successfully practiced for decades, but the outcome of cell transplantation remains disappointing. This is the case in animal models; liver allografts in mice are spontaneously accepted without requirement of immunosuppression, whereas hepatocyte transplants in the same combina...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e31818bfd13
更新日期:2008-12-15 00:00:00
abstract:BACKGROUND:We evaluated the importance and mechanism of graft and host accommodation in hamster-to-rat cardiac xenotransplantation models. METHODS:To evaluate graft accommodation, accommodated hamster grafts (Group 2) were transplanted to naïve host rats treated with FK506, and compared with naïve hamster grafts (Grou...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000296030.88283.92
更新日期:2008-01-15 00:00:00
abstract:BACKGROUND:Combined lung and liver transplantation (Lu-LTx) is a therapeutic option for selected patients with coexisting lung and liver disease. For several reasons, Lu-LTx is performed in few centers and information about the technical issues, posttransplant management and long-term outcomes associated with this proc...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3181636f3f
更新日期:2008-02-27 00:00:00
abstract::Heterologous anti-immunoglobulin (AI) is a potent immunosuppressive agent which compares favorably to anti-thymocyte serum (ATS) in inhibiting E and EAC-rosette formation and diminishing the secondary antibody response to sheep erythrocytes and E. coli lipopolysaccharide. AI prolongs H-2 incompatible skin allograft su...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-197609000-00003
更新日期:1976-09-01 00:00:00
abstract:BACKGROUND:We have previously shown that phosphorothioate intercellular adhesion molecule (ICAM)-1 antisense oligodeoxynucleotide (oligo) IP-9125 blocks the expression of rat ICAM-1 mRNA in rat L2 cells. A single ex situ perfusion of grafts with unformulated IP-9125, suspended in Euro-Collins solution, prolonged the su...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199909270-00022
更新日期:1999-09-27 00:00:00
abstract::During anesthesia 5 mg of muromonab CD3 (OKT3), an anti-CD3 monoclonal antibody, was administered prophylactically to twelve patients undergoing cadaveric renal transplantation. Preoperatively, all patients were at or near their dry body weights. Methylprednisolone 500 mg on call to or in the operating room, azathiopr...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199308000-00020
更新日期:1993-08-01 00:00:00
abstract:BACKGROUND:In the United States, 1 in 10 infants and 1 in 20 older children die on the liver transplant waiting list. Increasing split liver transplantation could increase organ availability for these children, without decreasing transplants in adults. METHODS:Using United Network for Organ Sharing Standard Transplant...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000002249
更新日期:2019-03-01 00:00:00
abstract::Adult bone marrow-derived mesenchymal stem cells (MSCs) are multipotential cells capable of regenerating injured tissues. In addition to their multipotency, MSCs inhibit natural killer cell cytotoxicity and T-lymphocyte alloproliferation. Several immunosuppressive mechanisms have been described, including indoleamine ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3181a2a4b3
更新日期:2009-05-15 00:00:00
abstract:BACKGROUND:Focal segmental glomerulosclerosis (FSGS), the second leading cause of end stage renal disease in children, appears to be increasing. Moreover, posttransplantation FSGS recurrence is a major problem, and there is concern that children receiving kidneys from living donors (LD) have increased recurrence risk. ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e31829c2431
更新日期:2013-09-01 00:00:00
abstract::A study was designed to determine if cold preservation induces an increase in lymphocyte adherence to liver sinusoids on reperfusion. Rat livers were stored at 1 degree C in University of Wisconsin solution for 45 min, 8 hr, or 30 hr, and then reperfused for 90 min at 37 degrees C in an isolated perfused rat liver app...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199109000-00004
更新日期:1991-09-01 00:00:00
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
更新日期:2005-12-27 00:00:00
abstract:BACKGROUND:Recipients of vascularized composite allografts require aggressive and lifelong immunosuppression, and because the surgery is usually performed in nonlife-threatening situations, the development of strategies to minimize immunosuppression is especially pertinent for this procedure. We investigated how comple...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000001625
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Skin-autofluorescence (skin-AF) noninvasively measures the tissue accumulation of advanced glycation end products (AGEs). AGEs are nephrotoxic and potential effectors of cardiovascular mortality. We investigated whether skin-AF predicted graft loss after kidney transplantation. METHODS:A total of 302 renal ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e31819d3173
更新日期:2009-04-15 00:00:00
abstract:BACKGROUND:Black American heart transplant recipients receiving cyclosporine-based primary immunoprophylaxis suffer higher rates of allograft rejection with hemodynamic compromise, infections, and posttransplant coronary artery disease. We examined the hypothesis that a combination of tacrolimus and mycophenolate mofet...
journal_title:Transplantation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00007890-200212150-00014
更新日期:2002-12-15 00:00:00
abstract::HLAs are fundamental to the adaptive immune response and play critical roles in the cellular and humoral response in solid organ transplantation. The genes encoding HLA proteins are the most polymorphic within the human genome, with thousands of different allelic variants known within the population. Application of th...
journal_title:Transplantation
pub_type: 杂志文章,评审
doi:10.1097/TP.0000000000001830
更新日期:2017-09-01 00:00:00
abstract::The use of cyclosporine has been associated with an increased incidence of thrombosis and endothelial cell perturbation. To explore possible mechanisms involved, we examined the effects of CSA on the activation of protein C by thrombomodulin. Cultured bovine aortic endothelial cell monolayers were incubated for 24 hr ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199103000-00030
更新日期:1991-03-01 00:00:00
abstract::Transplant coronary artery disease and malignancy are the major limitations to survival after heart transplantation. In a randomized trial, mycophenolate mofetil (MMF) significantly improved 3-year survival over azathioprine, but the expected reduction in intracoronary ultrasound evidence of vasculopathy was not found...
journal_title:Transplantation
pub_type: 杂志文章,评审
doi:10.1097/01.tp.0000153302.27299.16
更新日期:2005-02-15 00:00:00
abstract:BACKGROUND:Delayed graft function (DGF) after renal transplantation can be diagnosed according to several different definitions, complicating comparison between studies that use DGF as an endpoint. This is a particular problem after transplantation with kidneys from donation after circulatory death (DCD) kidneys, becau...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3182a19348
更新日期:2013-11-27 00:00:00
abstract:INTRODUCTION:We investigated the putative candidate biomarkers of graft rejection in peripheral blood of intestinal transplant patients. MATERIALS AND METHODS:Peripheral blood gene expression analysis was performed in intestinal transplant patients. The results were matched with concurrent graft biopsies using bioinfo...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3182370db1
更新日期:2011-12-27 00:00:00
abstract::For the development of liver injury during preservation for transplantation, phospholipid degradation may be of importance. We therefore measured the degradation of [3H]-arachidonic acid (20:4)- and [14C]-linoleic acid (18:2)-labeled phospholipids during cold and warm preservation of rat livers in Eurocollins, Univers...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199404270-00003
更新日期:1994-04-27 00:00:00
abstract:BACKGROUND:BK polyomavirus infection has been reported in 10% to 60% of renal transplant recipients with progression to BK nephropathy (BKN) occurring in 1% to 5% of patients. Graft loss occurs in up to 60% of renal transplant recipients with BKN. Because BK polyomavirus infection is believed, in part, to be a manifest...
journal_title:Transplantation
pub_type: 杂志文章,随机对照试验
doi:10.1097/TP.0b013e3181f2c94b
更新日期:2010-10-27 00:00:00
abstract:BACKGROUND:Allogeneic bone marrow transplantation (BMT) and donor lymphocyte infusion (DLI) provide valuable treatments for a range of diseases. However, the therapeutic utility of BMT and DLI is reduced by the high incidence of graft-versus-host disease (GvHD) mediated by activated donor T lymphocytes directed against...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000229435.58898.c5
更新日期:2006-08-27 00:00:00
abstract::While the immune privilege nature of the eye affords significant protection to corneal grafts, immunologic rejection is the leading cause of graft failure. Class II antigens are normally absent or expressed at very low levels in normal cornea. The role that class II antigens play in causing graft rejection is particul...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199102000-00049
更新日期:1991-02-01 00:00:00
abstract::The methodology of the conventional mixed lymphocyte culture test has been simplified and miniaturized by developing a micromethod employing Terasaki trays with a final culture volume of 20 mul containing between 10,000 and 20,000 responding and stimulating cells each/culture. This represents one-tenth the cell concen...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-197507000-00005
更新日期:1975-07-01 00:00:00
abstract::Increased QT dispersion (QTd), predicting patients with risk of malignant arrhythmia, have recently been reported in hemodialysis patients (HDp). In this prospective study, we aimed to investigate changes in QTd and signal averaged-ECG (SAECG) in HDp after transplantation. Twenty-seven HDp (M/F:18/9, mean age 30+/-8 y...
journal_title:Transplantation
pub_type: 临床试验,杂志文章
doi:10.1097/00007890-200111150-00009
更新日期:2001-11-15 00:00:00
abstract:BACKGROUND:Some statins have been reported to suppress the immune system and increase the expression of bone morphogenetic protein-2 gene that plays a pivotal role in bone regeneration. METHODS:The effects of cerivastatin on skeletal reconstruction by vascularized bone allograft were investigated in a rat tibia-fibula...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.TP.0000074992.49236.58
更新日期:2003-09-15 00:00:00
abstract::Immunomodulatory properties are attributed to apoptotic cells. These properties have been used to modulate allogeneic immune responses in experimental transplantation settings. In independent studies, apoptotic cell infusion has been shown to favor hematopoietic cell engraftment, to increase heart graft survival, and ...
journal_title:Transplantation
pub_type: 杂志文章,评审
doi:10.1097/01.tp.0000269113.59857.d6
更新日期:2007-07-15 00:00:00