Perioperative Skeletal Muscle Fluctuations in High-Acuity Liver Transplantation

2022 ◽  
Vol 270 ◽  
pp. 386-393
Author(s):  
Jazlyn Chong ◽  
Jacob Guorgui ◽  
Heidi Coy ◽  
Takahiro Ito ◽  
Michelle Lu ◽  
...  
2020 ◽  
Vol 86 (10) ◽  
pp. 1254-1259
Author(s):  
Danielle S. Graham ◽  
Takahiro Ito ◽  
Michelle Lu ◽  
Joseph Dinorcia ◽  
Vatche G. Agopian ◽  
...  

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.


Surgery ◽  
2019 ◽  
Vol 165 (2) ◽  
pp. 323-328 ◽  
Author(s):  
Joohyun Kim ◽  
Michael A Zimmerman ◽  
Stacee M Lerret ◽  
John P Scott ◽  
Stylianos Voulgarelis ◽  
...  

2017 ◽  
Vol 36 ◽  
pp. S80
Author(s):  
J. Van Vugt ◽  
S. Buettner ◽  
L. Alferink ◽  
N. Bossche ◽  
R. de Bruin ◽  
...  

2019 ◽  
Vol 8 (10) ◽  
pp. 1672
Author(s):  
Karolina Grąt ◽  
Ryszard Pacho ◽  
Michał Grąt ◽  
Marek Krawczyk ◽  
Krzysztof Zieniewicz ◽  
...  

Background: Body composition parameters are reported to influence the risk of hepatocellular carcinoma (HCC) recurrence after liver resection, yet data on patients undergoing liver transplantation are scarce. The aim of this study was to evaluate the impact of the amount of abdominal adipose tissue and skeletal muscles on the risk of HCC recurrence after liver transplantation. Methods: This was a retrospective observational study performed on 77 HCC patients after liver transplantation. Subcutaneous fat area (SFA), visceral fat area, psoas muscle area and total skeletal muscle area were assessed on computed tomography on the level of L3 vertebra and divided by square meters of patient height. The primary outcome measure was five-year recurrence-free survival. Results: Recurrence-free survival in the entire cohort was 95.7%, 90.8%, and 86.5% after one, three, and five years post-transplantation, respectively. SFA was significantly associated with the risk of HCC recurrence (p = 0.013), whereas no significant effects were found for visceral fat and skeletal muscle indices. The optimal cut-off for SFA for prediction of recurrence was 71.5 cm2/m2. Patients with SFA < 71.5 cm2/m2 and ≥71.5 cm2/m2 exhibited five-year recurrence-free survival of 96.0% and 55.4%, respectively (p = 0.001). Conclusions: Excessive amount of subcutaneous adipose tissue is a risk factor for HCC recurrence after liver transplantation and may be considered in patient selection process.


2019 ◽  
Vol 38 ◽  
pp. S320
Author(s):  
C.M. Peteiro Miranda ◽  
J.J. Ortez Toro ◽  
B. Sanz Martín ◽  
S. Roman Gimeno ◽  
J.A. Gimeno Orna ◽  
...  

2018 ◽  
Vol 50 (9) ◽  
pp. 2619-2621 ◽  
Author(s):  
M.A. Zimmerman ◽  
M. Selim ◽  
J. Kim ◽  
M. Kozeniecki ◽  
J.C. Hong

2017 ◽  
Vol 31 (2) ◽  
pp. 165-174 ◽  
Author(s):  
Jeroen L. A. van Vugt ◽  
Stefan Buettner ◽  
Louise J. M. Alferink ◽  
Niek Bossche ◽  
Ron W. F. de Bruin ◽  
...  

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