scholarly journals An Overview of Paediatric Liver Transplant in Hospital Selayang: 2002 to 2015

2021 ◽  
Vol 27 (2) ◽  
pp. 28-34
Author(s):  
Choy-Chen Kam ◽  
Chooi-Bee Lim
Keyword(s):  
Liver Transplant ◽  
Vascular Complications ◽  
Good Survival ◽  
Liver Transplants ◽  
Post Transplantation ◽  
Transplant Program ◽  
Common Causes ◽  
Liver Transplantations ◽  
Causes Of Mortality ◽  
Living Related

Introduction: Hospital Selayang started the liver transplant program in 2002. We report a total of 81 liver transplant cases until year 2015. Among these, paediatric cases constitute almost half. This report aims to review the demography and outcome of paediatric liver transplant cases. Methodology: Case notes of all paediatric patients underwent liver transplant from year 2002 to 2015 were retrospectively reviewed. Results: A total of 38 paediatric cases received liver transplantations from year 2002 to 2015. Age at transplantation ranged from 11 months to 16 years old (mean age 6 years) and weight ranged from 6.47 to 63 kilogram (mean 18kg). There were 20 males and 18 females, 20 of them were Malay, whereas Chinese and Indian were 13 and 4 respectively. Eighteen cases were living-related and 20 cases were cadaveric liver transplants. For recipient blood group, O+ is the commonest. Biliary atresia was the most common indication for liver transplant (22 cases; 58%), followed by intrahepatic cholestasis disorders (5 cases; 13%) and metabolic disease (4 cases; 10%).  Post transplantation, there were 6 (16%) biliary complications, 12 (32%) vascular complications, 26 (68%) developed early onset infection, 13% had acute rejection and 2 graft failure. Out of the 38 transplants, 79% of them survive after 1 year, and 69.7% survive after 5 years. The common causes of mortality were sepsis and vascular complications. Conclusion: Despite limited resources, a successful paediatric liver transplant programme has been established in Hospital Selayang with good survival rate.

Anesthetic Considerations in a Liver Transplant Recipient Presenting for Nontransplant Surgery

2018 ◽  
pp. 209-214
Author(s):  
Roshni Sreedharan ◽  
Sandeep Khanna
Keyword(s):  
Transplant Recipient ◽  
Liver Transplant ◽  
Liver Transplant Recipient ◽  
Organ Transplant ◽  
Definitive Treatment ◽  
Liver Transplants ◽  
Surgical Interventions ◽  
Liver Transplantations ◽  
Anesthetic Considerations ◽  
End Stage

Liver transplantation is the definitive treatment for end-stage liver disease. The United Network for Organ Sharing reports that there were about150,000 liver transplants done between 1988 and 2016. With increasing number of liver transplantations and improved patient survival, more of these patients will present for further surgical interventions, which may or may not be related to the initial organ transplant. These patients present with unique medical challenges associated with the transplanted organ and medications used for conferring immunosuppression. This chapter uses the case study of a 65-year-old male who had a past liver transplant who presents for nontransplant-related surgery to explore anesthetic considerations in a liver transplant recipient presenting for nontransplant surgery.

scholarly journals Disparity in Access to Care Impacts Liver Transplant Mortality

2021 ◽  
Author(s):  
Danielle Lentobarros ◽  
Sarah Karp ◽  
Gyorgy J Simon ◽  
Timothy Pruett ◽  
Jesse Schold ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Access To Care ◽  
Insurance Coverage ◽  
Geographical Location ◽  
Geographic Location ◽  
The United States ◽  
Mortality Rates ◽  
Income Level ◽  
Liver Transplants ◽  
Post Transplantation

This study aims to analyze how access to care influences patient mortality rates after liver transplants in adults by analyzing the relationships between insurance coverage, income, geographic location, and mortality rates post-transplantation. It was hypothesized that a sociodemographic variable, such as insurance type, geographical location, and income level would impact mortality rates post-liver transplant. Results showed that unknown insurance coverage increased the likelihood of mortality post-transplant, income level was not found to be a significant indicator, and patients living in the Northeast region of the United States were more likely to die post-liver transplant.

scholarly journals Treatment of the early postoperative complications following liver transplantation

2014 ◽  
Vol 2 (2) ◽  
pp. 122-126
Author(s):  
O. Rummo
Keyword(s):  
Liver Transplantation ◽  
Postoperative Complications ◽  
Effective Means ◽  
Vascular Complications ◽  
Suppressive Therapy ◽  
Post Transplantation ◽  
Early Postoperative Complications ◽  
Allograft Dysfunction ◽  
Liver Transplantations ◽  
Early Allograft Dysfunction

Despite considerable reduction of the lethality rate after ortotopic liver transplantation and owing to the achievements in modern surgery, immunology and anesthesiology, the early postoperative complications still occur in nearly 70 % and can significantly compromise patient survival.The aim of this study was to assess the frequency and causes of early post-transplantation complications and to develop effective means for their prophylaxis and treatment.Materials and methods. Within the period from 03.04.2008 to 01.07.2014, altogether 260 liver transplantations were performed in 252 recipients in the Republican Center for organ and tissue transplantation (Minsk, Belarus: of them 209 (81.2 %) according to the classic technique, 46 (17.7 %) cavaplasty and 5 portal transposition (2.4 %).Thirty-six liver transplantations (13.9 %) were performed in children before 18 years of age. The strategy of peri-operative techniques and immune-suppressive therapy were the same for all patients.Results. Vascular complications occurred in 44 cases (16.9 %), biliary complications in 46 (17.7 %), acute kidney injury in 47 (18.1 %), primary non-functioning after 3 liver transplantations (1.2 %), early allograft dysfunction in 71 (27.3 %) cases, and bacterial complications after 66 (25.4 %) liver transplantations. Predictors of early allograft dysfunction were thermal ischemia and graft steatosis. Three-year patients’ survival was 85 %.Conclusion. The main cause of death was multiple organ failure developed in a sign of bacterial complications and early allograft dysfunction. Significant role in early postoperative complications prophylaxis acts interdisciplinary prevention of nosocomial infection.

History of liver transplantation in Poland

2018 ◽  
Vol 90 (3) ◽  
pp. 60-68
Author(s):  
Marek Krawczyk
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Living Donors ◽  
Liver Transplants ◽  
Active Centers ◽  
Health Institute ◽  
Transplantation Surgery ◽  
Liver Transplantations ◽  
History Of ◽  
Medical University

Experimental research on liver transplantation was introduced in Poland by Waldemar Olszewski with his team. It was in 1972. Not until 15 years later, in 1987, did Stanisław Zieliński in Szczecin and Marian Pardela in Katowice make an attempt of transplanting liver in humans. In 1989, the attempt was made by Jacek Pawlak and Marek Krawczyk in Warsaw. The first successful liver transplantation in Poland was performed by Piotr Kaliciński at the Children’s Memorial Health Institute, Warsaw. Also, in early 1990s the attempts were made by Jerzy Polański in Warsaw and Piotr Szyber in Wrocław. In the next years, liver transplantations were connected with three centers in Szczecin and were associated with the following persons: Roman Kostryka, Maciej Wójcicki and Samir Zeaira. In Warsaw, 1994, Jacek Pawlak, Bogdan Michałowicz and Krzysztof Zieniewicz performed another successful liver transplantation. The program started to develop rapidly and is still up and running. In 2000, Wojciech Rowiński and Marek Pacholczyk created another liver transplant center in Warsaw, while in 2005 Lech Cierpka and Robert Król did the same in Katowice. In the following years, liver transplantation was initiated by Maciej Słupski in Bydgoszcz (2017) and Zbigniew Śledziński in Gdańsk (2018). In the developing liver transplant centers, an exceptional contribution was made by Paweł Nyckowski, Jacek Pawlak, Krzysztof Zieniewicz, Waldemar Patkowski, Tadeusz Wróblewski, Rafał Paluszkiewicz, Marek Pacholczyk, Andrzej Chmura, Maciej Kosieradzki and Marek Krawczyk – all employees of the Medical University of Warsaw. In Wrocław, Dariusz Patrzałek and Paweł Chudoba were very active in the field of liver transplantations. In 1996, the Organizing-Coordinating Center for Transplantation POLTRANSPLANT was brought to life. It was directed by Janusz Wałaszewski, then by Roman Danielewicz and Artur Kamiński. In 1999, Piotr Kaliciński and Marek Krawczyk started the program for liver fragment harvesting and transplantation from living donors. Until the end of 2016, 4186 liver transplantations including 314 liver transplants from living donors were performed in Poland. Currently, the active centers are three centers from Warsaw, namely Pediatric Surgery and Transplantation Surgery, Children’s Memorial Health Institute; Department of General, Transplant and Liver Surgery, Medical University of Warsaw; Department of General and Transplant Surgery, Medical University of Warsaw. Other active centers include Department of General and Transplant Surgery, Provincial Hospital in Szczecin, Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Department of Vascular, General and Transplant Surgery in Wrocław. Liver transplant programs have also been initiated at the Department of Liver and General Surgery, Bydgoszcz, and Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk.

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