Early Progression of Coronary Atherosclerosis in Patients Following Liver Transplantation: Results From the Coronary Atherosclerosis Following Liver Transplant (CALT) Study

2021 ◽  
Vol 30 ◽  
pp. S187
Author(s):  
T. Sampaio Rodrigues ◽  
N. Nerlekar ◽  
P. Gow ◽  
R. Lim ◽  
T. Sampaio Rodrigues ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Coronary Atherosclerosis ◽  
Early Progression

scholarly journals Peritoneal Dialysis After Liver Transplantation: A Systematic Review

2021 ◽  
Vol 8 ◽  
pp. 205435812110297
Author(s):  
Jean Maxime Côté ◽  
Isabelle Ethier ◽  
Héloïse Cardinal ◽  
Marie-Noëlle Pépin
Keyword(s):  
Systematic Review ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Kidney Failure ◽  
Liver Graft ◽  
Transplant Recipients ◽  
Technique Survival ◽  
Liver Transplant Recipients

Background: Chronic kidney disease following liver transplantation is a major long-term complication. Most liver transplant recipients with kidney failure will be treated with dialysis instead of kidney transplantation due to noneligibility and shortage in organ availability. In this population, the role of peritoneal dialysis (PD) as a modality of kidney replacement therapy (KRT) remains unclear. Objective: To determine the feasibility regarding safety, technique survival, and dialysis efficiency of PD in liver transplant recipients requiring KRT for maintenance dialysis. Design: Systematic review. Setting: Interventional and observational studies reporting the use of PD after liver transplantation. Patients: Adult liver transplant recipients with kidney failure treated with maintenance KRT. Measurements: Extracted data included eligibility criteria, study design, demographics, and PD modality. The following outcomes of interest were extracted: rate of peritonitis and microorganisms involved, noninfectious peritoneal complications, technique survival, and kidney transplantation-censored technique survival. Non-PD complications included overall survival, liver graft dysfunction, and hospitalization rate. Methods: The following databases were searched until July 2020: MedLine/PubMed, EMBASE, CINAHL, and Cochrane Library. Two reviewers independently screening all titles and abstracts of all identified articles. Due to the limited sample size, observational designs and study heterogeneity expected, no meta-analysis was pre-planned. Descriptive statistics were used to report all results. Results: From the 5263 identified studies, 4 were included in the analysis as they reported at least 1 outcome of interest on a total of 21 liver transplant recipients, with an overall follow-up duration on PD of 19.0 (Interquartile range [IQR]: 9.5-29.5) months. Fifteen episodes of peritonitis occurred in a total cumulative PD follow-up of 514 patient-months, representing an incidence rate of 0.35 per year. These episodes did not result in PD technique failure, mortality, or impairment of liver graft function. Limitations: Limitations include the paucity of studies in the field and the small number of patients included in each report, a risk of publication bias and the impossibility to directly compare hemodialysis to PD in this population. These results, therefore, must be interpreted with caution. Conclusions: Based on limited data reporting the feasibility of PD in liver transplant recipients with kidney failure, no signal was associated with an increased risk of infectious complications. Long-term studies evaluating this modality need to be performed. Registration (PROSPERO): CRD42020218374.

scholarly journals Risk factors predicting Cytomegalovirus infection in post liver transplant recipients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M G Abdelrahman ◽  
H A Mahmoud ◽  
M K Mohsen ◽  
M O Ali ◽  
A M N Mohamed
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Organ Transplantation ◽  
Chronic Rejection ◽  
Cytomegalovirus Infection ◽  
Transplant Recipients ◽  
Cmv Infection ◽  
Donor Liver Transplantation ◽  
Liver Transplant Recipients

Abstract Background Liver transplantation is considered to be the only curative treatment for patients with end stage liver disease. Postoperative infection remains to be one of the most common causes of morbidity and mortality throughout the past years. Cytomegalovirus (CMV) infection although considered to be a weak viral infection that usually passes asymptomatic in immunocompetent patients, however, it is considered one of the most common pathogens causing morbidities and mortality in liver transplant recipients. Multiple studies have been done to assess the risk factors for developing CMV infection. Objective Identification of risk factors predicting Cytomegalovirus infection in liver transplant recipients following transplantation. Methods This retrospective study was conducted on 194 patients and their donors who underwent living donor liver transplantation operation at Ain Shams centre for organ transplantation (ASCOT) at Ain Shams specialized hospital in the period between January 2010 and December 2016 with at least one year follow up period after operation for the recipient group. Results In our study, 194 patients undergoing liver transplantation at Ain shams centre for organ transplantation over seven years from January 2010 to December 2016 have been followed to assess risk factors affecting CMV infection development. Chronic rejection was found to be the most common factor associated with CMV infection followed by Cyclosporin (Neoral) as main postoperative immunosuppressant following liver transplantation. Other factors that were found to carry risk for CMV infection included younger age, advanced MELD score, positive CMV IgM status of the donors and recipients. Conclusion Differentiation of Cytomegalovirus disease from Cytomegalovirus infection isn’t always available as it requires tissue invasive techniques. Multiple risk factors have been attributed to cause Cytomegalovirus infection (viremia) . In our study, rejection (chronic rejection) was the factor that carries highest risk for Cytomegalovirus infection development followed by Cyclosporin .

scholarly journals HIV and Liver transplantation: The British Columbia Experience, 2004 to 2013

2014 ◽  
Vol 25 (3) ◽  
pp. 159-162 ◽  
Author(s):  
Clara Tan-Tam ◽  
Pamela Liao ◽  
Julio S Montaner ◽  
Mark W Hull ◽  
Charles H Scudamore ◽  
...  
Keyword(s):  
British Columbia ◽  
Liver Transplantation ◽  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Liver Transplant ◽  
Clinical Outcomes ◽  
Disease Status ◽  
Transplant Program ◽  
End Stage

BACKGROUND: The demand for definitive management of end-stage organ disease in HIV-infected Canadians is growing. Until recently, despite international evidence of good clinical outcomes, HIV-infected Canadians with end-stage liver disease were ineligible for transplantation, except in British Columbia (BC), where the liver transplant program of BC Transplant has accepted these patients for referral, assessment, listing and provision of liver allograft. There is a need to evaluate the experience in BC to determine the issues surrounding liver transplantation in HIV-infected patients.METHODS: The present study was a chart review of 28 HIV-infected patients who were referred to BC Transplant for liver transplantation between 2004 and 2013. Data regarding HIV and liver disease status, initial transplant assessment and clinical outcomes were collected.RESULTS: Most patients were BC residents and were assessed by the multidisciplinary team at the BC clinic. The majority had undetectable HIV viral loads, were receiving antiretroviral treatments and were infected with hepatitis C virus (n=16). The most common comorbidities were anxiety and mood disorders (n=4), and hemophilia (n=4). Of the patients eligible for transplantation, four were transplanted for autoimmune hepatitis (5.67 years post-transplant), nonalcoholic steatohepatitis (2.33 years), hepatitis C virus (2.25 years) and hepatitis B-delta virus coinfection (recent transplant). One patient died from acute renal failure while waiting for transplantation. Ten patients died during preassessment and 10 were unsuitable transplant candidates. The most common reason for unsuitability was stable disease not requiring transplantation (n=4).CONCLUSIONS: To date, interdisciplinary care and careful selection of patients have resulted in successful outcomes including the longest living HIV-infected post-liver transplant recipient in Canada.

Normalised intrinsic mortality risk in liver transplantation: European Liver Transplant Registry study

The Lancet ◽  
2000 ◽  
Vol 356 (9230) ◽  
pp. 621-627 ◽  
Author(s):  
René Adam ◽  
Valérie Cailliez ◽  
Pietro Majno ◽  
Vincent Karam ◽  
Paul McMaster ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Mortality Risk ◽  
Registry Study ◽  
Transplant Registry ◽  
Intrinsic Mortality

What Happens When Adequate Vascular Access Cannot Be Provided for Major Surgery (Liver Transplantation)?

2019 ◽  
Vol 24 (1) ◽  
pp. 52-54 ◽  
Author(s):  
Zoka Milan ◽  
Sanjay Agrawal ◽  
Katyayani Katyayani ◽  
Nikhil Sharma
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Vascular Access ◽  
Early Stage ◽  
Major Surgery ◽  
Early Age ◽  
Large Vein ◽  
Central Access

Highlights Although not traditionally accepted as a viable central access during liver transplant, this case illustrates that in certain situations femoral central access can be successful When dealing with patients who require constant vascular access from a very early age, potential large vein thromboses should be considered Thromboprophylaxis initiation should be considered at a very early stage

scholarly journals Th1/Th2cytokines and ICAM–1 levels post-liver transplant do not predict early rejection

2000 ◽  
Vol 9 (1) ◽  
pp. 35-38 ◽  
Author(s):  
E. Granot ◽  
A. Tarcsafalvi ◽  
S. Emre ◽  
P. Sheiner ◽  
S. Guy ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Immunosuppressive Therapy ◽  
Allograft Rejection ◽  
Liver Perfusion ◽  
Percentage Increase ◽  
Plasma Samples ◽  
Liver Allograft ◽  
Predominant Factor ◽  
Ifn Γ

Th1derived cytokines IFN-γ and IL–2, Th2cytokine IL–4, and ICAM–1 have been implicated in liver allograft rejection. In order to determine whether monitoring of cytokine profiles during the first days post-liver transplant can predict early rejection we measured IFN-gg, IL–2, sIL–2 receptor, IL–4 and ICAM–1 in 22 patients, in plasma samples obtained within 4h after liver perfusion (baseline) and between postoperative days (POD) 3–6. ICAM–1 and sIL–2R levels at POD 3–6 were significantly higher than at baseline but did not differ in presence or absence of rejection. Mean percentage increase of ICAM–1 levels was significantly lower in patients with Muromonab-C3Orthoclone OKT3(J.C. Health Care) (OKT3) whereas percentage increase of sIL–2R levels was higher in OKT3-treated patients. IFN-γ levels at POD 3–6 increased from baseline while IL–4 levels were unchanged. Levels of IFN-γ, IL–4 and their ratios did not correlate with rejection or immunosuppressive therapy. Thus, Th1/Th2cytokine monitoring during the first week post-transplant does not predict early rejection and immunosuppressive therapy is the predominant factor affecting ICAM and sIL–2R levels after liver transplantation.

scholarly journals Association of Hematuria with Renal Progression and Survival in Patients Who Underwent Living Donor Liver Transplant

2021 ◽  
Vol 10 (19) ◽  
pp. 4345
Author(s):  
Kai-Chieh Chang ◽  
Yao-Peng Hsieh ◽  
Huan-Nung Chao ◽  
Chien-Ming Lin ◽  
Kuo-Hua Lin ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Living Donor ◽  
Donor Liver ◽  
Living Donor Liver Transplant ◽  
Group A ◽  
Renal Progression ◽  
Group B ◽  
Donor Liver Transplant

Background: This study aimed to determine the association between episodic or persistent hematuria after liver transplantation and long-term renal outcomes. Methods: Patients who underwent living donor liver transplantation between July 2005 and June 2019 were recruited and divided into two groups based on the finding of microscopic or gross hematuria after transplantation. All patients were followed up from the index date until the end date in May 2020. The risks of chronic kidney disease, death, and 30% and 50% declines in estimated glomerular filtration rate (eGFR) were compared between groups. Results: A total of 295 patients underwent urinalysis for various reasons after undergoing transplantation. Hematuria was detected in 100 patients (group A) but was not present in 195 patients (group B). Compared with group B, group A had a higher risk of renal progression, including eGFR decline >50% [aHR = 3.447 (95%CI: 2.24~5.30), p < 0.001] and worse survival. In addition, patients who took non-steroidal anti-inflammatory drugs (NSAIDs) continuously for over seven days within six months before transplant surgery had high risks of rapid renal progression, including a >30% decline in eGFR [aHR = 1.572 (95%CI: 1.12~2.21), p = 0.009)]. Conclusion: Development of hematuria after surgery in patients who underwent living donor liver transplant and were exposed to NSAIDs before surgery were associated with worse long-term renal dysfunction and survival.

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