scholarly journals Anesthesia for Liver Transplantation

2021 ◽  
Author(s):  
Zeynep Ersoy ◽  
Nedim Çekmen ◽  
Adnan Torgay
Keyword(s):  
Liver Transplantation ◽  
Gold Standard ◽  
Multidisciplinary Approach ◽  
Standard Treatment ◽  
Perioperative Period ◽  
Hemodynamic Instability ◽  
Anesthesia Management ◽  
End Stage Liver Disease ◽  
End Stage ◽  
Disease Understanding

Orthotopic liver transplantation (OLT) is the gold standard treatment for patients with end-stage liver disease. Understanding of the multisystem physiology of end stage liver desease (ESLD) is fundamental to the management of transplant recipient. Since OLT is a very dynamic process, a multidisciplinary approach and optimization is essential in the perioperative period. During the management anesthesiologists should focus on significant hemodynamic instability, physiology, metabolic disturbance and coagulopathy of those patients. The aim of this review was to summarize peroperative and anesthesia management in line with the guidelines.

Hemodynamic Instability During Liver Transplantation in Patients with End-Stage Liver Disease

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Dmitri Bezinover ◽  
Ahmed Mukhtar ◽  
Gebhard Wagener ◽  
Christopher Wray ◽  
Annabel Blasi ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Hemodynamic Instability ◽  
End Stage Liver Disease ◽  
End Stage

Low psoas muscle index as an unfavorable factor in children with end‐stage liver disease undergoing liver transplantation

2021 ◽  
Author(s):  
Settapong Jitwongwai ◽  
Chatmanee Lertudomphonwanit ◽  
Thitiporn Junhasavasdikul ◽  
Praman Fuangfa ◽  
Pornthep Tanpowpong ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Psoas Muscle ◽  
End Stage Liver Disease ◽  
End Stage

Alkaline phosphatase isoforms in serum after liver allograft surgery

1994 ◽  
Vol 40 (7) ◽  
pp. 1272-1277 ◽  
Author(s):  
J Randolph-Habecker ◽  
J A Lott ◽  
R J Tesi
Keyword(s):  
Liver Transplantation ◽  
Alkaline Phosphatase ◽  
Liver Function Tests ◽  
Clinical Findings ◽  
High Molecular Mass ◽  
Reference Ranges ◽  
Liver Allograft ◽  
Postoperative Course ◽  
End Stage Liver Disease ◽  
End Stage

Abstract Orthotopic liver transplantation (OLT) is now the only available treatment for end-stage liver disease; the major postoperative complications of OLT are rejection and infection. Fractionation of alkaline phosphatase (ALP) isoforms in serum by isoelectric focusing can be used to identify patients with complications. Reference ranges for liver-function tests (LFT) and liver ALP isoforms were established for post-OLT patients with stable postoperative courses and compared with those of patients with complications. We found canalicular, hepatocyte, and high-molecular-mass ALP to be statistically higher in nearly all patients with complications as compared with patients who had a stable postoperative course; these tests may identify patients requiring a liver biopsy. When used in conjunction with LFT and other clinical findings, ALP isoforms could aid in the monitoring of complications and treatment and in the adjustment of immunosuppressive therapy in stable OLT cases.

scholarly journals RIPK3-Mediated Necroptosis and Neutrophil Infiltration Are Associated with Poor Prognosis in Patients with Alcoholic Cirrhosis

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Zhenzhen Zhang ◽  
Guomin Xie ◽  
Li Liang ◽  
Hui Liu ◽  
Jing Pan ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Poor Prognosis ◽  
Alcoholic Cirrhosis ◽  
Normal Liver ◽  
Neutrophil Infiltration ◽  
Meld Score ◽  
End Stage Liver Disease ◽  
Cirrhotic Patients ◽  
End Stage

Alcoholic cirrhosis is an end-stage liver disease with impaired survival and often requires liver transplantation. Recent data suggests that receptor-interacting protein kinase-3- (RIPK3-) mediated necroptosis plays an important role in alcoholic cirrhosis. Additionally, neutrophil infiltration is the most characteristic pathologic hallmark of alcoholic hepatitis. Whether RIPK3 level is correlated with neutrophil infiltration or poor prognosis in alcoholic cirrhotic patients is still unknown. We aimed to determine the correlation of RIPK3 and neutrophil infiltration with the prognosis in the end-stage alcoholic cirrhotic patients. A total of 20 alcoholic cirrhotic patients subjected to liver transplantation and 5 normal liver samples from control patients were retrospectively enrolled in this study. Neutrophil infiltration and necroptosis were assessed by immunohistochemical staining for myeloperoxidase (MPO) and RIPK3, respectively. The noninvasive score system (model for end-stage liver disease (MELD)) and histological score systems (Ishak, Knodell, and ALD grading and ALD stage) were used to evaluate the prognosis. Neutrophil infiltration was aggravated in patients with a high MELD score (≥32) in the liver. The MPO and RIPK3 levels in the liver were positively related to the Ishak score. The RIPK3 was also significantly and positively related to the Knodell score. In conclusion, RIPK3-mediated necroptosis and neutrophil-mediated alcoholic liver inflammatory response are highly correlated with poor prognosis in patients with end-stage alcoholic cirrhosis. RIPK3 and MPO might serve as potential predictors for poor prognosis in alcoholic cirrhotic patients.

Diastolic Dysfunction in Patients with End-Stage Liver Disease Is Associated with Development of Heart Failure Early after Liver Transplantation

2011 ◽  
Vol 17 (8) ◽  
pp. S19
Author(s):  
Taylor F. Dowsley ◽  
David B. Bayne ◽  
Alan N. Langnas ◽  
Ioana Dumitru ◽  
John R. Windle ◽  
...  
Keyword(s):  
Heart Failure ◽  
Liver Transplantation ◽  
Liver Disease ◽  
Diastolic Dysfunction ◽  
End Stage Liver Disease ◽  
End Stage

Liver Transplantation for the Gastroenterologist

2015 ◽  
Author(s):  
Andreea M. Catana ◽  
Michael P. Curry
Keyword(s):  
United States ◽  
Liver Transplantation ◽  
Liver Disease ◽  
Organ Procurement ◽  
The United States ◽  
Waiting Lists ◽  
Liver Graft ◽  
Term Survival ◽  
End Stage Liver Disease ◽  
End Stage

The first liver transplantation (LT) was performed in 1963, and currently more than 65,000 people in the United States are living with a transplanted liver. In 2012, the number of adults who registered on the LT waiting list decreased for the first time since 2002; 10,143 candidates were added compared with 10,359 in 2011. LT offers long-term survival for complications of end-stage liver disease and prolongs life in properly selected patients, but problems such as donor deficit, geographic disparities, and long waiting lists remain. This overview of LT for the gastroenterologist details the indications for LT and patient selection, evaluation, liver organ allocation, prioritization for transplantation, transplantation benefit by the Model for End-Stage Liver Disease (MELD), MELD limitations, sources of liver graft, strategies employed to decrease the donor deficit, complications, and outcomes. Figures include indications for LT in Europe and the United States, Organ Procurement and Transplantation Network regions in the United States, the number of transplants and size of active waiting lists, mortality by MELD, regional disparity, patient survival rates with and without hepatitis C virus, and unadjusted patient and graft survival. Tables list LT milestones, indications for LT, contraindications for LT, minimal listing criteria for LT, criteria for LT in acute liver failure, LT evaluation process, adult recipient listing status 1A, and early posttransplantation complications. This review contains 7 highly rendered figures, 8 tables, and 46 references. 

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