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.

scholarly journals Liver Transplantation and Quality of Life

2000 ◽  
Vol 14 (8) ◽  
pp. 693-699 ◽  
Author(s):  
J Rodés ◽  
M Navasa
Keyword(s):  
Quality Of Life ◽  
Liver Transplantation ◽  
Survival Rate ◽  
Late Complications ◽  
Liver Transplants ◽  
Physical Conditions ◽  
The World ◽  
Liver Transplantations ◽  
Validated Instrument

To date, more than 50,000 liver transplantations have been performed around the world; the survival rate five years after transplantation ranges from 60% to 65%. One of the fundamental objectives for liver transplantation teams is to achieve the best possible quality of life (QOL) for the patients. A concise analysis of the methodology used (15 questionnaires) to measure QOL of patients with liver transplants is described. The authors suggest that now is the time to establish a database so that a validated instrument will be available to compare QOL results from all the liver transplantation programs. Liver transplantation is believed to improve QOL, although there are several problems with some of the papers published on this subject. Some studies are retrospective, whereas in others, patients in bad physical conditions are excluded from the study; in quite a few prospective studies, deaths are not included in the data analysis. Finally, the authors provide a brief, concise analysis of late complications and of recurrence of the disease after liver transplantation, which influence QOL.

scholarly journals Endoscopic Management of Biliary Complications following Liver Transplantation after Donation from Cardiac Death Donors

2012 ◽  
Vol 26 (9) ◽  
pp. 607-610 ◽  
Author(s):  
Kris P Croome ◽  
Vivian McAlister ◽  
Paul Adams ◽  
Paul Marotta ◽  
William Wall ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Cardiac Death ◽  
Hepatic Duct ◽  
Biliary Complications ◽  
Endoscopic Management ◽  
Transplant Recipients ◽  
Biliary Strictures ◽  
Liver Transplants ◽  
Liver Transplant Recipients

BACKGROUND Previous studies have shown a higher incidence of biliary complications following donation after cardiac death (DCD) liver transplantation compared with donation after brain death (DBD) liver transplantation. The endoscopic management of ischemic type biliary strictures in patients who have undergone DCD liver transplants needs to be characterized further.METHODS: A retrospective institutional review of all patients who underwent DCD liver transplant from January 2006 to September 2011 was performed. These patients were compared with all patients who underwent DBD liver transplantation in the same time period. A descriptive analysis of all DCD patients who developed biliary complications and their subsequent endoscopic management was also performed.RESULTS: Of the 36 patients who received DCD liver transplants, 25% developed biliary complications compared with 13% of patients who received DBD liver transplants (P=0.062). All DCD allograft recipients who developed biliary complications became symptomatic within three months of transplantation. Ischemic type biliary strictures in DCD allograft recipients included disseminated biliary strictures in two patients, biliary strictures of the hepatic duct bifurcation in three patients and biliary strictures of the donor common hepatic duct in three patients.CONCLUSIONS: There was a trend toward increasing incidence of total biliary complications in recipients of DCD liver allografts compared with those receiving DBD livers, and the rate of diffuse ischemic cholangiopathy was significantly higher. Focal ischemic type biliary strictures can be treated effectively in DCD liver transplant recipients with favourable results. Diffuse ischemic type biliary strictures in DCD liver transplant recipients ultimately requires retransplantation.

scholarly journals Management of COVID-19 in Liver Transplant Recipients with Immunosuppressant Therapy: Experiences of an Iranian Transplant Registry

2020 ◽  
Author(s):  
Zahra Sheikhalipour ◽  
Touraj Asvadi kermani ◽  
Farzad Kakaei ◽  
Azizeh Farshbaf Khalili ◽  
Leila Vahedi
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Organ Transplant ◽  
Immunosuppressive Drugs ◽  
Personal Hygiene ◽  
Transplant Recipients ◽  
Liver Transplants ◽  
Transplant Registry ◽  
Use Of Medical Services ◽  
Liver Transplant Recipients

Abstract Background: Following the pandemic of COVID-19 and the increased COVID-19 risk in transplant patient receptions, the authors assessed the prevalence, clinical course, and the outcome of the COVID-19 infection among liver transplant receptions. Methods: By designing and the use of researcher made questionnaire and the use of medical services, liver transplantation recipients under our center surveyed in terms of COVID-19 infection.Results: Seven patients infected with COVID-19 were identified from 265 liver transplantation recipients. The majority of patients were male and had COVID-19 despite being in-home quarantine. All patients received immunosuppressive drugs during infection with COVID-19 with no change in the routine immunosuppressive therapy. Among the identified patients, 5 recovered and 2 died. One of the dead patients, in addition to having a liver transplant, suffered brain cancer with metastasis to the lungs. Conclusion: It seems that the in liver transplants infected with COVID-19, the immunosuppressive drugs causes mild to moderate illness, and even recover from the disease.However, more evidence is needed to prove this hypothesis. It is also recommended that transplant recipients should be warned about personal hygiene and closely be monitored by organ transplant centers.

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.

Living Donor Liver Transplantation for Acute Liver Failure

2021 ◽  
pp. 241-258
Author(s):  
Lainie Friedman ◽  
J. Richard Thistlethwaite, Jr
Keyword(s):  
Liver Transplantation ◽  
Liver Failure ◽  
Liver Transplant ◽  
Acute Liver Failure ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Living Donors ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Poor Outcomes

Acute liver failure (ALF), or fulminant hepatic failure, affects approximately two to three thousand patients (adults and children) annually in the United States and accounts for approximately eight percent of all liver transplants. Liver transplant for ALF is complicated by the fact that many patients who present with ALF spontaneously recover; however, the severe time constraints that ALF poses means that patients with ALF are usually listed for deceased donor liver transplant, and potential living donors begin donor evaluations even before it is known whether a transplant will be necessary. ALF was initially a contraindication to living donor liver transplantation (LDLT) both because of poor outcomes and because of concerns that the living donors did not have adequate time to give an informed and voluntary consent. Results have improved and ALF in now an accepted indication for LDLT. This chapter examines the ethical issues raised by LDLT in the setting of ALF.

COVID-19 AND LIVER TRANSPLANTS ARE MUTUALLY EXCLUSIVE – FACT OR FICTION?

2021 ◽  
Author(s):  
Alexander Ng
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Clinical Outcomes ◽  
Severe Disease ◽  
Future Research ◽  
Clinical Practices ◽  
Liver Transplants ◽  
Future Research Directions ◽  
The Uk ◽  
Validation Of Results

COVID-19 has fundamentally altered clinical practices and guidelines. This also applies to liver transplantation. In the UK, liver transplant activity has dramatically decreased during the early months of the pandemic. The traditional logic dictates that transplantation-related immunosuppression increases the risk of COVID-19 infection and entails sub-par clinical outcomes. However, theories remain theories without clinical evidence. This article examines whether such concerns justify reducing liver transplant activity. It first gives a global picture of liver transplantation during the pandemic. It then discusses whether COVID-19 in patients having received liver transplantation contributes to sub-par clinical outcomes in four aspects: (a) mortality rates, (b) likelihood of contracting more severe disease, (c) graft efficacy and need for re-transplantation, and (d) change in immunosuppression regimen. The article argues that preliminary data positively support up-regulating liver transplant activity to pre-pandemic levels, subjected to issues in healthcare resource allocation. It also proffers future research directions, including validation of results in non-white cohorts and correlations between COVID-19 and acute complications of liver transplantation.

scholarly journals Kepenų transplantacijos raida pasaulyje ir Lietuvoje

2007 ◽  
Vol 5 (1) ◽  
pp. 0-0 ◽  
Author(s):  
Marius Paškonis ◽  
Jonas Jurgaitis ◽  
Vitalijus Sokolovas ◽  
Tatjana Rainienė ◽  
Balys Dainys ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Survival Rate ◽  
Vascular Surgery ◽  
Human Liver ◽  
University Hospital ◽  
Organ Shortage ◽  
Split Liver ◽  
Liver Transplantations ◽  
Vilnius University ◽  
Medical University

Marius Paškonis1, Jonas Jurgaitis1, Vitalijus Sokolovas1, Tatjana Rainienė2, Balys Dainys1, Kęstutis Strupas11 Vilniaus universiteto ligoninės Santariškių klinikų Gastroenterologijos,urologijos ir abdominalinės chirurgijos klinika, Santariškių g. 2, LT-08661 Vilnius2 Vilniaus universiteto ligoninės Santariškių klinikų Laboratorinės diagnostikos centroKlinikinės imunologijos laboratorija, Santariškių g. 2, LT-08661 VilniusEl paštas: [email protected] 1955–1967 metais klinikinės kepenų transplantacijos pagrindai buvo kuriami tik keliose Europos, Didžiosios Britanijos bei Jungtinių Amerikos Valstijų klinikose ir eksperimentinėse laboratorijose. 1967 metais Kolorado universitete Thomas Starzl atliko pirmą sėkmingą kepenų transplantaciją žmogui. 1968 metais Roy Calne Kembridžo universitete atliko pirmą sėkmingą kepenų transplantaciją Europoje. Tačiau tuo metu penkerius metus išgyvendavo tik apie 20% recipientų. Padėtis pasikeitė, kai 1979 metais klinikinėje organų transplantacijoje pradėtas vartoti ciklosporinas A. Recipientų penkerių metų išgyvenamumas vartojant šį imunosupresantą pasiekė 70%. Gerėjant kepenų transplantacijų rezultatams ėmė stigti donorinių organų. Atliekant sumažinto dydžio donorinių kepenų transplantaciją, vienų donorinių kepenų transplantaciją dviem recipientams, kepenų transplantaciją iš gyvo donoro, buvo stengiamasi sumažinti donorinių organų trūkumą. Šiuo metu vis daugiau dėmesio skiriama ksenotransplantacijai. Ksenotransplantacija – pažeistų žmogaus organų pakeitimas gyvūnais audiniais ar organais. Lietuvoje sėkmingos kepenų persodinimo operacijos žengia tik pirmus žingsnius. 1962 metais Vilniuje buvo įkurta Vilniaus universiteto širdies ir kraujagyslių chirurgijos laboratorija, kurioje aktyviai vyko eksperimentinė širdies, inkstų ir kepenų transplantacija. Buvo sukurtas ir kliniškai pritaikytas originalus tuo laikotarpiu ūminio kepenų funkcijos nepakankamumo gydymo metodas. Ruošiantis klinikinei kepenų transplantacijai atliktos 68 ortotopinės kepenų transplantacijos su gyvūnais. 1969 metais Širdies ir kraujagyslių chirurgijos laboratorijoje sukuriamas imunologijos sektorius. Lietuvoje pirmosios kepenų transplantacijos žmogui atliktos 2000 metais Vilniaus universiteto ligoninėje Santariškių klinikose ir Kauno medicinos universiteto klinikose. Nors šios operacijos buvo nesėkmingos, ir toliau aktyviai tobulintasi šioje chirurgijos srityje. 2002 metais Kauno medicinos universiteto klinikose prof. J. Pundziaus, o 2005 metais Vilniaus universiteto ligoninėje Santariškių klinikose prof. K. Strupo vadovaujamos specialistų brigados atliko pirmąsias sėkmingas ortotopines kepenų transplantacijas Lietuvoje. Pagrindiniai žodžiai: ortotopinė kepenų transplantacija, hetertotopinė kepenų transplantacija, transplantacinė imunologija, ksenotransplantacija, kepenų transplantacijos istorija Developement of liver transplantation in the world and in Lithuania Marius Paškonis1, Jonas Jurgaitis1, Vitalijus Sokolovas1, Tatjana Rainienė2, Balys Dainys1, Kęstutis Strupas11 Vilnius University Hospital Santariškių Klinikos, Department of Gastroenterology,Urology and Abdominal Surgery, Santariškių 2, LT-08661 Vilnius, Lithuania2 Vilnius University Hospital Santariškių Klinikos, Centre of Laboratory Diagnostics,Laboratory of Clinical Immunology, Santariškių 2, LT-08661 Vilnius, LithuaniaE-mail: [email protected] In 1955–1967, the basics of clinical liver transplantation were generated only in several experimental laboratories in Europe, Great Britain and United States. In 1967, the first successful human liver transplantation was performed by Thomas Starzl at University of Colorado. A year later, Roy Calne from University of Cambridge performed the first successful liver transplantation in Europe. The five-year survival rate was only 20% at that time. The situation changed in 1979 when the immunosuppressive agent cyclosporine A was introduced into clinical practice. The five-year survival rate reached 70%. The improved results of liver transplantation created a new problem – shortage of available organs. Reduced size liver transplantation, split liver transplantation, living donor liver transplantation were the methods to reduce organ shortage. Nowadays much attention is paid to xenotransplantation. Xenotransplantation is the transplantation of tissues or organs from one species to another. Liver transplantation in Lithuania makes only its first steps. In 1962, Laboratory of Heart and Vascular Surgery of Vilnius University was introduced, in which experimental works in the field of heart, kidney and liver transplantation were performed. At that time, the original method of treatment of acute liver insufficiency was introduced and clinically adapted. 68 experimental liver transplantations on laboratory animals were performed. In 1969, in the Laboratory of Heart and Vascular Surgery, the sector of immunology was established. The first attempts to perform human liver transplantation in Lithuania were made in 2000 at Vilnius University Hospital Santariškiu Klinikos and Kaunas Medical University Hospital. These operations were unsuccessful. Nevertheless the transplant teams continued to improve knowledge in this field of surgery. In 2002, the first successful human liver transplantations was performed at Kaunas Medical University Hospital under the guidance of Prof. J. Pundzius, and in 2005 at Vilnius University Hospital Santariškiu Klinikos under the guidance of Prof. K. Strupas. Keywords: orthotopic liver transplantation, heterotopic liver transplantation, transplant immunology, xenotransplantation, history of liver transplantation

scholarly journals Early Experience in the Queensland Orthotopic Liver Transplantation Programme

1987 ◽  
Vol 15 (3) ◽  
pp. 269-277
Author(s):  
B. J. Burrow ◽  
A. J. Board ◽  
J. E. Taske ◽  
R. Young
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Orthotopic Liver Transplantation ◽  
Early Experience ◽  
Anaesthetic Technique ◽  
Liver Transplants ◽  
To Receive

The cases of the first nine patients to receive orthotopic liver transplants in the Queensland Liver Transplant Programme are reported. Problems peculiar to this type of operation are discussed generally and in the light of this experience. The anaesthetic technique employed is described. There were no deaths attributable to anaesthesia.

Responsibility and Priority in Liver Transplantation

2009 ◽  
Vol 18 (1) ◽  
pp. 23-35 ◽  
Author(s):  
WALTER GLANNON
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Liver Failure ◽  
Liver Transplant ◽  
End Stage Renal Disease ◽  
Liver Transplants ◽  
Lower Priority ◽  
End Stage Liver Disease ◽  
Stage Renal Disease ◽  
End Stage

In a provocative 1991 paper, Alvin Moss and Mark Siegler argued that it may be fair to give individuals with alcohol-related end-stage liver disease (ARESLD) lower priority for a liver transplant than those who develop end-stage liver disease (ESLD) from other factors. Like other organs, there is a substantial gap between the available livers for transplantation and the number of people who need liver transplants. Yet, unlike those with end-stage renal disease, who can survive for some time on dialysis before receiving a kidney transplant, those with liver failure will die without a liver transplant.

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