scholarly journals A simple clinical calculator for assessing cardiac event risk in liver transplant candidates: The cardiovascular risk in orthotopic liver transplantation score

2018 ◽  
Vol 11 (6) ◽  
pp. 145-148
Author(s):  
Lisa B. VanWagner
Keyword(s):  
Liver Transplantation ◽  
Cardiovascular Risk ◽  
Liver Transplant ◽  
Orthotopic Liver Transplantation ◽  
Cardiac Event ◽  
Event Risk ◽  
Transplant Candidates

Cholecystitis in Patients Undergoing Liver Transplantation: A Five-Year Analysis of Incidence, Causes, and Impact

2020 ◽  
Vol 86 (10) ◽  
pp. 1254-1259
Author(s):  
Danielle S. Graham ◽  
Takahiro Ito ◽  
Michelle Lu ◽  
Joseph Dinorcia ◽  
Vatche G. Agopian ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Patient Population ◽  
Patient Survival ◽  
Kaplan Meier ◽  
High Acuity ◽  
Transplant Candidates ◽  
Pathology Reports ◽  
End Stage ◽  
High Index Of Suspicion

There is a paucity of data on cholecystitis in liver transplant candidates (LTC), including the incidence of the cholecystitis and the associated outcomes in this patient population. As such, this study examines the incidence of and factors associated with cholecystitis in the high-acuity LTC population, as well as the association between cholecystitis and graft and patient survival. Liver transplant candidates undergoing orthotopic liver transplantation (OLT) at a large transplant center from January 1, 2012 to December 31, 2016 were included in the initial analysis. Surgical pathology reports were examined for the presence of cholecystitis. Univariate analyses were performed to determine the association between patient factors and cholecystitis. Kaplan-Meier analyses and multivariate Cox proportional hazard models were performed to examine the association between cholecystitis and graft and patient survival. Of the 405 patients in the final study population, 267 (65.9%) had no cholecystitis, 21 (5.2%) had acute cholecystitis, and 117 (28.9%) had chronic cholecystitis. The presence of cholecystitis was associated with preoperative WBC, sepsis within 10 days prior to transplant, location prior to transplant, and total length of stay. While this study revealed no association between cholecystitis and graft or patient survival, it also suggests that cholecystitis is under-recognized in high-model end-stage liver disease (MELD) OLT candidates. Therefore, a high index of suspicion for cholecystitis may be helpful in caring for this vulnerable patient population; however, further studies must be performed to determine the optimal management of cholecystitis in these patients.

Liver Transplant

2013 ◽  
Author(s):  
Ximena Soler ◽  
Lori A Aronson ◽  
Gillian Derrick
Keyword(s):  
Liver Transplantation ◽  
Blood Loss ◽  
Liver Failure ◽  
Liver Transplant ◽  
Orthotopic Liver Transplantation ◽  
Massive Hemorrhage ◽  
Blood Products ◽  
End Stage

Liver transplantation is an established therapy in pediatric end-stage liver failure. Blood loss during orthotopic liver transplantation (OLT) is highly variable. Massive hemorrhage and transfusion of blood products, with its related consequences, is a well-known complication of this operation.

scholarly journals Visceral Artery Aneurysms in Liver Transplant Candidates and in Patients after Liver Transplantation

PLoS ONE ◽  
2011 ◽  
Vol 6 (12) ◽  
pp. e29544 ◽  
Author(s):  
Umberto Maggi ◽  
Daniele Dondossola ◽  
Dario Consonni ◽  
Stefano Gatti ◽  
Rossella Arnoldi ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Visceral Artery ◽  
Visceral Artery Aneurysms ◽  
Transplant Candidates

scholarly journals The Impact of Cirrhosis and Prescription Medications on QTc Interval Before and After Liver Transplantation

2017 ◽  
Vol 32 (1) ◽  
pp. 48-53 ◽  
Author(s):  
Andrew D. Santeusanio ◽  
Kevin G. Dunsky ◽  
Stephanie Pan ◽  
Thomas D. Schiano
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Qtc Interval ◽  
Prescription Medications ◽  
Qtc Prolongation ◽  
Before And After ◽  
Group 2 ◽  
Transplant Candidates ◽  
The Impact ◽  
Group 1

Background: Higher rates of corrected QT (QTc) prolongation have been reported in patients with cirrhosis. The impact of liver transplantation and prescription medications on the natural history of QTc prolongation has yet to be well characterized. Methods: This was a single-center review of patients receiving (group 1) or listed for (group 2) a liver transplant during 2014. Patients in group 1 were followed prospectively from the date of transplantation to assess rates of QTc normalization posttransplant. In group 2, patients were evaluated from the date of listing up until December 2015 to assess the prevalence of QTc prolongation among liver transplant candidates. Results: In group 1, 22 (75.9%) patients with QTc intervals >460 milliseconds at the time of transplant established normal baseline QTc intervals following transplantation. The median time to this QTc normalization was 17 days. In group 2, 30 (16.9%) patients had at least 1 documented QTc interval >500 milliseconds with prevalence rates of 42.9%, 19.0%, and 10.2% in patients with natural model of end-stage liver disease scores of >30, 16 to 30, and <16, respectively ( P < .01). Overall, 49.4% of patients in group 1 and 47.5% of patients in group 2 were prescribed QTc prolonging medications. Conclusion: QTc prolongation will resolve following transplantation in the majority of patients and generally occurs within the first several weeks. Among the listed liver transplant candidates, higher rates of clinically significant QTc prolongation may be observed in patients with more severe underlying cirrhosis. QTc prolonging medications are commonly prescribed in this population and warrant monitoring following initiation.

Preoperative Trapped Lung Is Associated With Increased Mortality After Orthotopic Liver Transplantation

2020 ◽  
pp. 152692482097860
Author(s):  
Kathryn H. Melamed ◽  
David Dai ◽  
Natasha Cuk ◽  
Daniela Markovic ◽  
Robert Follett ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Liver Transplant ◽  
Orthotopic Liver Transplantation ◽  
Meld Score ◽  
Transplant Recipients ◽  
End Stage Liver Disease ◽  
Trapped Lung ◽  
End Stage ◽  
Liver Transplant Recipients

Introduction: Trapped lung, characterized by atelectatic lung unable to reexpand and fill the thoracic cavity due to a restricting fibrous visceral pleural peel, is occasionally seen in patients with end-stage liver disease complicated by hepatic hydrothorax. Limited data suggest that trapped lung prior to orthotopic liver transplantation may be associated with poor outcomes. Research Question: What is the clinical significance of trapped lung in patients receiving orthotopic liver transplantation? Design: We performed a retrospective analysis of patients who underwent liver transplantation over an 8-year period. Baseline clinical characteristics and postoperative outcomes of adult patients with trapped lung were analyzed and compared to the overall cohort of liver transplant recipients and controls matched 3:1 based on age, sex, Model for End-Stage Liver Disease (MELD) score, and presence of pleural effusion. Results: Of the 1193 patients who underwent liver transplantation, we identified 20 patients (1.68%) with trapped lung. The probability of 1 and 2-year survival were 75.0% and 57.1%, compared to 85.6% and 80.4% (p = 0.02) in all liver transplant recipients and 87.9% and 81.1% (p = 0.03) in matched controls respectively. Patients with trapped lung had a longer hospital length of stay compared to the total liver transplant population (geometric mean 54.9 ± 8.4 vs. 27.2 ± 0.7 days, p ≤ 0.001), when adjusted for age and MELD score. Discussion: Patients with trapped prior to orthotopic liver transplantation have increased probability of mortality as well as increased health care utilization. This is a small retrospective analysis, and further prospective investigation is warranted.

Orthotopic Liver Transplantation in Patients With Cystic Fibrosis

PEDIATRICS ◽  
1987 ◽  
Vol 80 (4) ◽  
pp. 571-574
Author(s):  
Kenneth L. Cox ◽  
Richard E. Ward ◽  
Terry L. Furgiuele ◽  
Robert A. Cannon ◽  
Kathleen D. Sanders ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Liver Transplantation ◽  
Intracerebral Hemorrhage ◽  
Liver Transplant ◽  
Orthotopic Liver Transplantation ◽  
Postoperative Management ◽  
Sweat Test ◽  
Transplant Recipients ◽  
Postoperative Course ◽  
Liver Transplant Recipients

An 11-year-old boy who had cystic fibrosis underwent an orthotopic liver transplantation. His immediate postoperative course was not unusually complicated when compared with other liver transplant recipients. Transplantation did not correct abnormalities in the sweat test or the respiratory disease. Cholestasis due to obstruction of the recipient duct with tenacious bile was cleared by instilling N-acetylcysteine into the duct. On the 48th day after the transplantation, he died of an intraventricular and intracerebral hemorrhage caused by an Aspergillus brain abscess. We conclude that certain patients with cystic fibrosis may be appropriate candidates for liver transplantation, but their pre- and postoperative management may need to differ from other liver transplant recipients.

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