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Search Results: 1 - 10 of 5933 matches for " liver transplant "
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Evaluation of the Results of Radical Management of a Cohort of 107 Patients with Hepatocellular Carcinoma in Colombia  [PDF]
Sergio Hoyos, Jaime Chávez, álvaro Duarte, Isabel Arenas
Journal of Cancer Therapy (JCT) , 2015, DOI: 10.4236/jct.2015.613123
Abstract: Introduction: Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver and usually appears as part of liver cirrhosis (LC). Its management in the presence of LC is ideally with orthotopic liver transplantation. Surgical resection is indicated only in the presence of a tumor in a patient with a very good liver function and who for medical reasons cannot be carried to transplantation. Materials and Methods: A descriptive study of a prospective and consecutive series of patients undergoing surgery (resection or liver transplantation) for HCC in a hospital in the city of Medellin was performed, from June 2004 to January 2015. A multivariate analysis was carried out of factors associated with survival during the follow-up. Results: 116 surgical interventions for the management of HCC between June 2004 and January 2015 were performed. The analysis included 107 patients, of which 73% were men. The median age of all patients was 60 years. The factors that showed better survival were: patients undergoing transplantation, the presence of cirrhosis, tumor less than 5 cm in diameter, a unique and well-differentiated tumor; however, none of these factors achieved statistical significance. Conclusion: Both resection and liver transplantation, when well indicated achieve good 5-years of survival in patients with HCC.
Cyclosporine and Hepatitis C  [PDF]
Ryan Caballes, Mark W. Russo
Open Journal of Organ Transplant Surgery (OJOTS) , 2012, DOI: 10.4236/ojots.2012.24009
Abstract: End stage liver disease from hepatitis C is a leading indication for liver transplantation. Recurrent hepatitis C after liver transplant may lead to cirrhosis and graft failure in up to 25% of recipients five years after liver transplantation. Anti-viral therapy is challenging after liver transplantation due to increased side effects including cytopenias and decreased efficacy compared to the nontransplant population. Tacrolimus and cyclosporine are the most common immunosuppressants used to prevent graft rejection. Tacrolimus is more potent than cyclosporine and may be preferred to cyclosporine. However, cyclosporine may have activity against hepatitis C and may have a theoretical advantage to tacrolimus in hepatitis liver transplant recipients. Cyclosporine may inhibit NS5B and NS5A protein complexes and increase endogenous interferon activity. Cyclophilin inhibitors without immunosuppressive properties are under development and represent a novel mechanisms for inhibiting HCV replication.
Influences of Donor and Recipient Gene Polymorphisms on Tacrolimus Dosing and Pharmacokinetics in Asian Liver Transplant Patients  [PDF]
Mei-Ling Yee, Hui-Hui Tan, Wan-Jin Sia, Wai-Ping Yau
Open Journal of Organ Transplant Surgery (OJOTS) , 2013, DOI: 10.4236/ojots.2013.33011
Abstract: Background: Tacrolimus pharmacokinetics has large inter-individual variability. Objectives: This study aimed to investigate the impact of donor and recipient gene polymorphisms on tacrolimus dosing and pharmacokinetics in Asian liver transplant patients. Methods: Steady-statetacrolimus concentrations at 0, 1, 2, 4 and 6 h were measured. Pharma- cokinetic parameters were estimated with a one-compartment linear model using WinNonlin 6.1 program. DNA from donor liver and recipient blood samples were genotyped for CYP3Aand ABCB1 polymorphisms. Results: A total of 13 donors and 17 recipients were included. Donor genotypes influenced tacrolimus trough concentration-to-dose (C0/D) ratio only at Week 1. Patients with liver grafts from CYP3A5 expressors (*1*1 and *1*3) achieved lower mean C0/D ratio than those with grafts from non-expressors (*3*3) (64.48 versus 129.21 (mcg/L)/(mg/kg/day), P = 0.040). Hence, the dose required to achieve target concentration in patients with donor genotype CYP3A5 expressors was higher than non-expressors (0.12 versus 0.08 mg/kg, P = 0.045). Recipient with ABCB1-C3435T genotype TT demonstrated higher apparent oral clearance of tacrolimus as compared to genotype CC (17.7 versus7.9 L/h, P = 0.033). Conclusions: Donor liver CYP3Apolymorphism could potentially affect tacrolimus C0/D ratio as early as the first week post liver transplant. Genotyping of liver donors may be useful to achieve the optimal drug concentration during this critical period.
Transvaginal Natural Orifice Translumenal Endoscopic Surgery (TVNOTES): Concerns of Gynaecology Outpatients in a Tertiary Care Centre  [PDF]
Renita Lobo, Kannavi Jayashree, Annamma Thomas, Santosh A. Olakkengil
Open Journal of Organ Transplant Surgery (OJOTS) , 2013, DOI: 10.4236/ojots.2013.32008
Abstract:

Objective: (TVNOTES) [1], currently the most popular of the NOTES procedures being performed, offers the safest access point while avoiding a breach in the gastrointestinal tract to gain intraperitoneal access. But are women ready to embrace TVNOTES? Although similar studies have been conducted in developed nations, the authors aimed to seek the opinions of Indian women towards TVNOTES. Design: This study presents the results of a survey on attitudes of Indian women towards TVNOTES. 300 women attending a gynaecology out patients’ clinic were administered a questionnaire which sought out the percentage of Indian women concerned with surgical scars, their preference between TVNOTES and conventional laparoscopic surgery and apprehensions towards the vagina being used as an entry site for surgery. Results: 85.67% of the participants opted for scarless intra-abdominal surgery. Upon revealing that the surgery would be performed transvaginally (TV), reservations were unveiled, with 67.33% of all respondents being either unhappy or unsure about undergoing TV surgery. Results were initially equivocal when asked to choose between TVNOTES and conventional laparoscopic surgery, but when informed that TVNOTES may be as safe and efficacious as conventional laparoscopic surgery, the scales tipped in favour of TVNOTES, with three-fourths of the respondents opting for the latter. Conclusions: Although TVNOTES has captured the imagination and attention of surgeons, existing data suggest that the

Restless Legs Syndrome in Liver Transplant Recipients  [PDF]
Rose Franco, Syed Rizvi, Jose Franco, Farhan Rizvi
International Journal of Clinical Medicine (IJCM) , 2013, DOI: 10.4236/ijcm.2013.43026
Abstract:

Background: The prevalence of restless legs syndrome (RLS) is approximately 10% in general population. This condition is more prevalent in certain diseases and we previously reported the prevalence of RLS in chronic liver disease population to be 62%. Objectives: Our aim was to assess the self-reported prevalence of RLS using an RLS symptom specific questionnaire in liver transplant patients. Methods: Subjects were a convenience sample in transplant clinic. They completed a validated survey for core RLS symptoms and if positive went on to completed a telephone survey using the validated International RLS Severity Scale Questionnaire (IRLS) and the Johns Hopkins RLS QoL survey to measure the effect of RLS symptoms on daily activities. Results: 40 patients surveyed, RLS was found in 16 subjects (40%) with moderate severity {17 (SD + 7.2, high score 31)}. Hepatitis C as indication for liver transplant was more likely associated with RLS (p = 0.05). Calcium channel blockers were protective (p = 0.032) while antidopaminergic agent use was statistically significant for RLS symptom (p = 0.005). On multiple linear regression analysis, diabetes (p = 0.024) and use of antidepressants/antihistamines (p = 0.049) were associated with RLS. Quality of Life (QoL) surveys specific to RLS suggested RLS symptoms resulted in significantly diminished QoL, with an average QoL score of 80 (SD + 11.7). Conclusion: There was a very high prevalence of RLS in our liver transplant patients with majority experiencing moderate or severe symptoms. The explanation for this higher prevalence is likely due to combination of comorbidites as well as medications that can trigger RLS.

Fulminant Hepatitis: Definitions, Causes and Management  [PDF]
Vincenzo Morabito, Danielle Adebayo
Health (Health) , 2014, DOI: 10.4236/health.2014.610130
Abstract: Fulminant hepatitis (FH) is a rare and devastating syndrome caused by a variety of hepatic insults. It characterized by severe metabolic derangements, neurologic complications and ultimately, multiorgan failure. Liver transplantation is the gold standard therapy for patients with irreversible FH. The major areas of current research in this field include the development of: hepatic support devices, strategies to accelerate hepatic regeneration and criteria for accurate prognostic classification of patients. This review aims to focus on the definitions, aetiologies and management strategies for FH.
Falla hepática fulminante en ni?os
ROQUE E,JORGE; RíOS M,GLORIA; PINOCHET V,CONSTANZA; VIGNOLO A,PAULINA; HUMERES A,ROBERTO; RíOS R,HORACIO; QUIROGA G,MARTA; RODRíGUEZ M,MARíA GABRIELA; MORA,XIMENA; RIUS A,MONTSERRAT; HEPP K,JUAN;
Revista chilena de pediatría , 2009, DOI: 10.4067/S0370-41062009000200006
Abstract: background: acute liver failure (alf) in childhood is defined as biochemical evidence of liver injury, absence of known chronic liver disease and coagulopathy not corrected by vitamin k administration, with inr greater than 1.5 if the patient has encephalopathy or greater than 2.0 if the patient does not have encephalopathy. objective: report the experience of a single liver transplant center (lt) in the treatment of 8 children with alf and review the literature. method: retrospective review of clinical charts of patients with alf. results: the median age was 8 years-old (range 0-11), three females. five patients underwent lt. two patients died, one of them lt. the etiologies were 4 undetermined, 1 autoimmune, 1 wilson disease, 1 parvo virus and 1 chronic graft rejection. all grafts were from cadáver donor, 3 of them reduced. two out of five patients with encephalopathy grade iii-iv died. the one year survival rate was 75%. conclusions: children with alf should be treated in experienced centers with facilities for liver transplant. transplantation should be offered only if the underlying disease is treatable by liver replacement and if transplant prognosis is better than that of the underlying disease.
Técnicas quirúrgicas en trasplante hepático
Chan, Carlos;Plata-Mu?oz, Juan José;Franssen, Bernardo;
Revista de investigación clínica , 2005,
Abstract: liver transplantation (lt) is probably the biggest surgical aggression that a patient can endure. it was considered only as a last option in the era of experimental lt, yet it evolved into the definitive treatment for some types of acute and chronic end stage liver disease. in terms of technique lt is the most complex of all types of transplantations. the surgical procedure in itself is well established and has changed little through time. liver transplantation owes its improvement to better and more systematic anesthetic procedures and to perioperative care more than being due to improvement of the surgical technique. the first surgical procedure was described by thomas starzl in 1969. his initial work has been strengthened with the development of venous bypass, the refinement in vascular and biliary reconstruction technique and the development of the split liver. up to date technical aspects of orthotopic liver transplantation are described in the present article.
Hemangioendotelioma epitelioide hepático primario: un simulador de metástasis
Torres Gómez,F. J.; Rivera Hueto,F.; Torres Olivera,F. J.;
Oncología (Barcelona) , 2005, DOI: 10.4321/S0378-48352005000600005
Abstract: hepatic epithelioid hemangioendothelioma is a rare vascular tumor of adults of unknown etiology, that is more common in women. it is usually asymptomatic or presents only non specific symptoms, making the diagnosis frequently casual. the lesions are usually multifocal and of variable sizes, involving both lobes. the characteristics of the lesions shown by the imaging diagnostic techniques are superposable to those of of the metastatic disease. the histologic diagnosis requires immunohistological studies and does not contribute with prognostic criteria. the course is unexpected and 50 % of the patients die of the disease. surgery and hepatic transplant are the most useful therapeutic options. we describe the clinicopathologic characteristics of this rare lesion and contribute with a case, thay was initially diagnosed as hepatic metastatic disease.
Embarazo y trasplante hepático en pacientes cubanas
Samada Suárez,Marcia; Vasallo Prieto,Raúl; Martínez Changüí,Ysis; Hernández Rivero,Hanoi; Domínguez Cordovés,Janet; Moret Vara,Sheyla;
Revista Cubana de Obstetricia y Ginecolog?-a , 2011,
Abstract: the pregnancy in women underwent liver transplant is successful in most of cases, although it is qualified as a high risk pregnancy. the objectives of present study are to describe the pregnancy evolution in women previously underwent to liver transplant and to determine the development of obstetric complications and the evolution of liver graft. a retrospective and descriptive study was conducted in 3 patients underwent liver transplant finishing pregnancy between january, 2006 and december, 2009. the variables analyzed were: interval between the transplant and the pregnancy, obstetric backgrounds, obstetric incidences, immunosuppressive treatment during pregnancy and graft evolution. in general, the evolution of the three patients during pregnancy and puerperium were satisfactory, time between the transplant and the pregnancy onset was higher than 2 years, there were slight obstetric incidences as high blood pressure in one of the patients, the end of pregnancy was at-term in the three patients with cesarean section due obstetric indications, the three babies had appropriate weight birth and apgar scores; the liver function remained normal in two patients and in one of them the liver enzymes were normal adapting the immunosuppression. the immunosuppressive treatment was applied using anticalcineurinic drugs (tracolimus or cyclosporine) in monotherapy during pregnancy. the post-transplant interval over 2 years for the onset of pregnancy and graft stability lead to a good evolution of pregnant.
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