Controlling Astigmatism in Corneal Marginal Grafts

Liver transplant is a life-saving treatment with 1-year and 5-year survival rates of 90% and 70%, respectively. However, organ demand continues to exceed supply, such that many patients will die waiting for an available organ. This article reviews for the general gastroenterologist the latest developments in the field to reduce waiting list mortality and maximise utilisation of available organs. The main areas covered include legislative changes in organ donation and the new ‘opt-out’ systems being rolled out in the UK, normothermic machine perfusion to optimise marginal grafts, a new national allocation system to maximise benefit from each organ and developments in patient ‘prehabilitation’ before listing. Current areas of research interest, such as immunosuppression withdrawal, are also summarised.

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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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Current Status of Liver Transplantation Using Marginal Grafts

Journal of Investigative Surgery ◽

10.1080/08941939.2018.1517197 ◽

2018 ◽

Vol 33 (6) ◽

pp. 553-564

Author(s):

Amr Badawy ◽

Toshimi Kaido ◽

Shinji Uemoto

Keyword(s):

Liver Transplantation ◽

Current Status ◽

Marginal Grafts

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The use of marginal grafts in liver transplantation

Journal of Hepato-Biliary-Pancreatic Surgery ◽

10.1007/s00534-007-1300-z ◽

2008 ◽

Vol 15 (2) ◽

pp. 92-101 ◽

Cited By ~ 39

Author(s):

Koji Hashimoto ◽

Charles Miller

Keyword(s):

Liver Transplantation ◽

Marginal Grafts

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SHOULD WE DISCHARGE CERTAIN MARGINAL GRAFTS?

Transplantation Journal ◽

10.1097/00007890-200607152-02167 ◽

2006 ◽

Vol 82 (Suppl 2) ◽

pp. 786

Author(s):

&NA;

Keyword(s):

Marginal Grafts

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Transarterial Chemoembolization (TACE) Prior to Liver Transplantation: Does it Add to Surgical Risk when Considering Marginal Grafts?

10.26226/morressier.58eb975dd462b80290b4f99d ◽

2017 ◽

Author(s):

Amanda Boteon

Keyword(s):

Liver Transplantation ◽

Transarterial Chemoembolization ◽

Surgical Risk ◽

Marginal Grafts

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Protocol for histologic evaluation of marginal grafts in kidney transplants

Transplantation Proceedings ◽

10.1016/s0041-1345(03)00050-2 ◽

2003 ◽

Vol 35 (2) ◽

pp. 695-696

Author(s):

M.J Alférez ◽

E Sola ◽

I García ◽

J Mellado ◽

M Cabello ◽

...

Keyword(s):

Kidney Transplants ◽

Histologic Evaluation ◽

Marginal Grafts

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Bypass during Liver Transplantation: Anachronism or Revival? Liver Transplantation Using a Combined Venovenous/Portal Venous Bypass—Experiences with 163 Liver Transplants in a Newly Established Liver Transplantation Program

Gastroenterology Research and Practice ◽

10.1155/2015/967951 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Anne Mossdorf ◽

Florian Ulmer ◽

Karsten Junge ◽

Christoph Heidenhain ◽

Marc Hein ◽

...

Keyword(s):

Liver Transplantation ◽

Volume Overload ◽

Median Number ◽

Liver Transplants ◽

Safety Measures ◽

Ischemic Time ◽

Venous Bypass ◽

Transplant Program ◽

Transplantation Program ◽

Marginal Grafts

Introduction. The venovenous/portal venous (VVP) bypass technique has generally become obsolete in liver transplantation (LT) today. We evaluated our experience with 163 consecutive LTs that used a VVP bypass. Patients and Methods. The liver transplant program was started in our center in 2010. LTs were performed using an extracorporal bypass device. Results. Mean operative time was 269 minutes and warm ischemic time 43 minutes. The median number of transfusion of packed cells and plasma was 7 and 14. There was no intraoperative death, and the 30-day mortality was 3%. Severe bypass-induced complications did not occur. Discussion. The introduction of a new LT program requires maximum safety measures for all of the parties involved. Both surgical and anaesthesiological management (reperfusion) can be controlled very reliably using a VVP bypass device. Particularly when using marginal grafts, this approach helps to minimise both surgical and anaesthesiological complications in terms of less volume overload, less use of vasopressive drugs, less myocardial injury, and better peripheral blood circulation. Conclusion. Based on our experiences while establishing a new liver transplantation program, we advocate the reappraisal of the extracorporeal VVP bypass.

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