November 25, 2010

The ministransplant procedure in liver transplantation

Acta Gastroenterol Belg. 2010 Jul-Sep;73(3):367-9.

Donataccio M, Dalle Ore G, Donataccio D.

Liver Transplantation Unit, Ospedale Civile Maggiore, Verona, Italy. matteodonataccio@yahoo.it

Abstract

In order to ameliorate early recovery after liver transplantation a reduction of invasiveness of the abdominal incision has been tested and compared with more extended incisions. This approach named "minitransplant procedure" resulted in better early and late outcome results irrespective of preoperative patients' risk factors as previous upper abdominal surgery, Body Mass Index and Model of End Stage Liver Disease score.

PMID: 21086940 [PubMed - in process]

Source
Clin Transplant. 2010 Nov 16. doi: 10.1111/j.1399-0012.2010.01350.x. [Epub ahead of print]

Moini M, Hoseini-Asl MK, Taghavi SA, Sagheb MM, Nikeghbalian S, Salahi H, Bahador A, Motazedian M, Jafari P, Malek-Hosseini SA.

Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences Shiraz Organ Transplant Center, School of Medicine, Shiraz University of Medical Sciences Department of Surgery, School of Medicine, Shiraz University of Medical Sciences School of Medicine, Shiraz University of Medical Sciences Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Abstract

Moini M, Hoseini-Asl MK, Taghavi SA, Sagheb MM, Nikeghbalian S, Salahi H, Bahador A, Motazedian M, Jafari P, Malek-Hosseini SA. Hyponatremia a valuable predictor of early mortality in patients with cirrhosis listed for liver transplantation.
Clin Transplant 2010 DOI: 10.1111/j.1399-0012.2010.01350.x.
© 2010 John Wiley & Sons A/S. Abstract:  The current policy for organ allocation in liver transplantation is to give priority to the sickest patients mostly using model for end-stage liver disease (MELD) score in ranking. However, other factors as serum sodium may be of value in predicting early mortality. In this single-center study, patients with cirrhosis over age 14 on the liver transplant wait-list from September 1998 to June 2007 were followed for six months from the time of listing to evaluate the value of hyponatremia on mortality. Of 612 listed patients, 51 were transplanted who were excluded from survival analysis and 55 died without transplantation within the first three months. The numbers of transplanted and dead patients during months 3-6 were 29 and 24, respectively. Both MELD score and serum sodium at the time of listing were independent predictors of early mortality. On bivariate analysis, serum sodium of <130 mEq/L beside MELD was a significant predictor of mortality within 90 and 180 d. Serum sodium level <135 mEq/L masked the difference in mortality between patients with refractory and non-refractory ascites. Serum sodium level of <130 mEq/L and an increased MELD score are significant predictors of early mortality in patients listed for liver transplantation.

© 2010 John Wiley & Sons A/S.

PMID: 21077951 [PubMed - as supplied by publisher]

Source
Acta Gastroenterol Belg. 2010 Jul-Sep;73(3):380-2.

Duclos-Vallée JC.

AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, 94800 Villejuif, France. jean-charles.duclos-vallee@pbr.aphp.fr

Abstract

Liver transplantation (LT) is now feasible in HIV infected patients. To date, criteria of liver transplantation are no different from the other indications of liver transplantation; however an undetectable HIV viral load at the time of liver transplantation is desirable goal. History of opportunistic infections and CD4+ count < 100/mL do not constitute exclusion criteria. Long-term outcomes for HBV/HIV are excellent. Outcomes for HCV/HIV coinfected patients are more variable because of potentially severe recurrence on the liver graft. More effective antiviral therapy at an early stage post LT is required.

PMID: 21086943 [PubMed - in process]

Source