LigaSure versus monopolar cautery for recipient hepatectomy in liver transplantation: A propensity score-matched analysis

Background. Whether routine antifungal prophylaxis decreases posttransplantation fungal infections in patients receiving orthotopic liver transplantation (OLT) remains unclear. This study aimed to determine the effectiveness of antifungal prophylaxis for patients receiving OLT.Patients and Methods. This is a retrospective analysis of a database at Chang Gung Memorial Hospital. We have been administering routine antibiotic and prophylactic antifungal regimens to recipients with high model for end-stage liver disease scores (>20) since 2009. After propensity score matching, 402 patients were enrolled. We conducted a multistate model to analyze the cumulative hazards, probability of fungal infections, and risk factors.Results. The cumulative hazards and transition probability of “transplantation to fungal infection” were lower in the prophylaxis group. The incidence rate of fungal infection after OLT decreased from 18.9% to 11.4% (p=0.052); overall mortality improved from 40.8% to 23.4% (p<0.001). In the “transplantation to fungal infection” transition, prophylaxis was significantly associated with reduced hazards for fungal infection (hazard ratio: 0.57, 95% confidence interval: 0.34–0.96,p=0.033). Massive ascites, cadaver transplantation, and older age were significantly associated with higher risks for mortality.Conclusion. Prophylactic antifungal regimens in high-risk recipients might decrease the incidence of posttransplant fungal infections.

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The impact of older age on long term survival in living donor liver transplantation: A propensity score matching analysis

Asian Journal of Surgery ◽

10.1016/j.asjsur.2021.11.061 ◽

2021 ◽

Author(s):

Ali Avanaz ◽

Volkan Doğru ◽

Abdullah Kisaoglu ◽

Vural Taner Yilmaz ◽

Demet Sarıdemir Ünal ◽

...

Keyword(s):

Liver Transplantation ◽

Propensity Score ◽

Living Donor ◽

Living Donor Liver Transplantation ◽

Donor Liver ◽

Term Survival ◽

Donor Liver Transplantation ◽

Propensity Score Matching Analysis ◽

The Impact

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Long-Term Outcomes of Hepatic Resection versus Living Donor Liver Transplantation for Hepatocellular Carcinoma: A Propensity Score-Matching Study

Disease Markers ◽

10.1155/2015/425926 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 7

Author(s):

Toshimi Kaido ◽

Satoshi Morita ◽

Sachiko Tanaka ◽

Kohei Ogawa ◽

Akira Mori ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Transplantation ◽

Propensity Score ◽

Hepatic Resection ◽

Propensity Score Matching ◽

Odds Ratio ◽

Living Donor ◽

Survival Rates ◽

Controlled Study ◽

Recurrence Rates

Hepatic resection (HR) and liver transplantation (LT) are surgical treatment options for hepatocellular carcinoma (HCC). However, it is clinically impossible to perform a randomized, controlled study to determine the usefulness of these treatments. The present study compared survival rates and recurrence rates of HR versus living donor LT (LDLT) for HCC by using the propensity score method. Between January 1999 and August 2012, 936 patients (732 HR, 204 LDLT) underwent surgical therapy for HCC in our center. Using the propensity score matching, 80 well-balanced patients were defined. The 1- and 5-year overall survival rates were 90% and 53% in the HR group and 82% and 63% in the LT group, respectively. They were not significantly different between the two groups. The odds ratio estimated using the propensity score matching analysis was 0.842 (P=0.613). The 1- and 5-year recurrence rates were significantly lower in the LT group (9% and 21%) than in the HR group (43% and 74%) (P<0.001), and the odds ratio was 0.214 (P=0.001). In conclusion, HR should be considered a valid alternative to LDLT taking into consideration the risk for the living donor based on the results of this propensity score-matching study.

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Laparoscopic Donor and Recipient Hepatectomy Followed by Robot‐assisted Liver Graft Implantation in Living Donor Liver Transplantation

American Journal of Transplantation ◽

10.1111/ajt.16943 ◽

2021 ◽

Author(s):

Kwang‐Woong Lee ◽

YoungRok Choi ◽

Suk Kyun Hong ◽

Sola Lee ◽

Su young Hong ◽

...

Keyword(s):

Liver Transplantation ◽

Living Donor ◽

Living Donor Liver Transplantation ◽

Liver Graft ◽

Donor Liver ◽

Robot Assisted ◽

Donor Liver Transplantation ◽

Recipient Hepatectomy ◽

Graft Implantation

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Safe use of Liver Grafts from Syphilis-Positive Donors in Liver Transplantation and Review of the Literature

10.21203/rs.3.rs-136016/v1 ◽

2020 ◽

Author(s):

Xin Duan ◽

Liting Yan ◽

Chao Qian ◽

Wei Zhang ◽

Yan Shen ◽

...

Keyword(s):

Liver Transplantation ◽

Propensity Score ◽

Liver Function ◽

Hospital Stay ◽

Organ Transplantation ◽

Case Reports ◽

Benzathine Penicillin ◽

Review Of The Literature ◽

Function Recovery ◽

Marginal Grafts

Abstract Background: The growing disparity between organ availability and the number of candidates for organ transplantation has urged the use of marginal grafts including grafts from syphilis-positive donors. However, few knowledges could be acknowledged about this due to the rare data from case reports. Therefor we evaluate our data and summarize our experience of the management of liver grafts from syphilis-positive donors.Methods: From January 2015 to December 2019, 22 adult patients received liver transplantation from syphilis-positive donors while 873 patients got liver transplantation from syphilis-negative donors at our center. Given the imbalance in several baseline variables, propensity score matching was used. The outcomes were compared including complications, hospital stay, recovery of liver function and survival of the two groups and the management of the recipients was reviewed.Results: There were no differences in complications and hospital stay of the recipients after transplantation. And it showed similar trends in the liver function recovery. Patient and graft survivals were comparable to that of syphilis-negative grafts. And benzathine penicillin is effective to protect the recipients from syphilis.Conclusions: The use of liver grafts from syphilis-positive donors does not to increase the morbidity and mortality of the recipients. Also, the prophylactic theory of benzathine penicillin is helpful.

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No difference in hepatocellular carcinoma risk between chronic hepatitis B patients treated with entecavir versus tenofovir

Gut ◽

10.1136/gutjnl-2019-319867 ◽

2020 ◽

pp. gutjnl-2019-319867 ◽

Cited By ~ 3

Author(s):

Feng Su ◽

Kristin Berry ◽

George N Ioannou

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Transplantation ◽

Chronic Hepatitis ◽

Propensity Score ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Competing Risks ◽

First Line ◽

Risk Of Death ◽

Competing Risks Analysis

ObjectiveEntecavir (ETV) and tenofovir disoproxil fumarate (TDF) are first-line agents for the treatment of chronic hepatitis B (CHB). Recent studies have challenged the assumption that these agents are equally effective at preventing hepatocellular carcinoma (HCC). We aimed to determine whether the risk of HCC and mortality differ in patients with CHB treated with ETV and TDF.DesignWe performed a retrospective cohort study of Veterans Affairs patients with CHB in the USA who initiated treatment with ETV or TDF between the dates of Food and Drug Administration approval of these medications and 1 January 2017. Multivariable Cox proportional hazards regression was used to determine the association between antiviral therapy and HCC risk as well as the risk of death or liver transplantation. Propensity score adjustment and competing risks analysis were performed.ResultsWe identified 2193 ETV-treated and 1094 TDF-treated patients who were followed for a mean of 5.4 years. We found no difference in the risk of HCC in ETV-treated versus TDF-treated patients (adjusted HR (aHR) 1.00, 95% CI 0.76 to 1.32). Results were similar in propensity score adjusted and competing risks analysis, and in multiple sensitivity analyses. We also found no difference in the risk of death or liver transplantation (aHR 1.16, 95% CI 0.98 to 1.39).ConclusionsWe found no difference in the risk of HCC between patients with CHB treated with ETV versus TDF. Our results support current guideline recommendations that both agents are appropriate first-line options for the treatment of CHB.

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