Abstract No. 661 Safety and efficacy of endovascular treatment of portal vein stenosis in liver transplant recipients: a systematic review

Purpose: To evaluate the efficacy of Angioplasty and Stent Placement for the treatment of Portal Vein Stenosis in Liver Transplant Recipients by performing a systematic review. Materials and Methods: The PubMed Database was extensively searched for articles describing Portal Vein Stenosis (PVS) as a complication in Liver Transplant (LT) patients. The initial database search yielded 488 unique records published in the PubMed Database, 19 of which were deemed to meet the inclusion criteria. Outcomes were separated into 2 groups (Group A included patients with primary angioplasty, Group B included patients with primary stent placement), and further subdivided into Adult and Pediatric populations. Results: Group A included a total of 282 LT patients with portal vein stenosis. The population was predominantly pediatric (n = 243). Group B included a total of 111 LT patients with portal vein stenosis. This population was predominantly adult (n = 66). Technical success was significantly higher in both Group B pediatric (100%) and adults (97%) compared to Group A (69.5%) and (66.7%) respectively. Re-stenosis rates were significantly lower in Group B pediatric group compared to Group A (2.3% vs 29.7%, χ2 = 13.9; p < 0.001). Overall major (3.1%) and minor complications rates (1.5%) were low. Conclusion: Primary stent placement appears to have higher technical success in both populations and lower re-stenosis rates for treatment of PVS in pediatric populations.

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Portal Vein Thrombosis and Renal Dysfunction: A National Comparative Study of Liver Transplant Recipients for NAFLD versus Alcoholic Cirrhosis

Transplant International ◽

10.1111/tri.13873 ◽

2021 ◽

Author(s):

Michele Molinari ◽

Carlos Fernandez Carrillo ◽

Dai Dongling ◽

Dana Jorgensen ◽

Ana Clemente‐Sanchez ◽

...

Keyword(s):

Portal Vein ◽

Comparative Study ◽

Liver Transplant ◽

Renal Dysfunction ◽

Portal Vein Thrombosis ◽

Alcoholic Cirrhosis ◽

Transplant Recipients ◽

Vein Thrombosis ◽

Liver Transplant Recipients

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Peritoneal Dialysis After Liver Transplantation: A Systematic Review

Canadian Journal of Kidney Health and Disease ◽

10.1177/20543581211029722 ◽

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.

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Endocarditis in Liver Transplant Recipients: A Systematic Review

Journal of Clinical Medicine ◽

10.3390/jcm10122660 ◽

2021 ◽

Vol 10 (12) ◽

pp. 2660

Author(s):

Petros Ioannou ◽

Konstantinos Alexakis ◽

Diamantis P. Kofteridis

Keyword(s):

Systematic Review ◽

Liver Transplant ◽

Pulmonary Valve ◽

Cochrane Library ◽

Transplant Recipients ◽

Treatment Data ◽

Liver Transplant Recipients ◽

Culture Negative ◽

Overall Mortality ◽

Significant Mortality

Infective Endocarditis (IE) is associated with significant mortality. Interestingly, IE in patients with liver transplantation has not been adequately described. The aim of this review was to systematically review all published cases of IE in liver transplant recipients and describe their epidemiology, microbiology, clinical characteristics, treatment and outcomes. A systematic review of PubMed, Scopus and Cochrane Library (through 2nd January 2021) for studies providing epidemiological, clinical, microbiological, treatment data and outcomes of IE in liver transplant recipients was conducted. A total of 39 studies, containing data for 62 patients, were included in the analysis. The most common causative pathogens were gram-positive microorganisms in 69.4%, fungi in 25.8%, and gram-negative microorganisms in 9.7% of cases, while in 9.3% IE was culture-negative. The aortic valve was the most commonly infected valve followed by mitral, tricuspid and the pulmonary valve. Aminoglycosides, vancomycin and aminopenicillins were the most commonly used antimicrobials, and surgical management was performed in half of the cases. Clinical cure was noted in 57.4%, while overall mortality was 43.5%. To conclude, this systematic review thoroughly describes IE in liver transplant recipients and provides information on epidemiology, clinical presentation, treatment and outcomes.

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