Can non-heart-beating donors replace cadaveric heart-beating liver donors?
|
|
- Merryl Fisher
- 6 years ago
- Views:
Transcription
1 Forum on Liver Transplantation / Journal of Hepatology 45 (2006) [12] Ryan CK, Johnson LA, Germin BI, Marcos A. One hundred consecutive hepatic biopsies in the workup of living donors for right lobe liver transplantation. Liver Transpl 2002;8:1114. [13] Tan HP, Patel-Tom K, Marcos A. Adult living donor liver transplantation: who is the ideal donor and recipient?. J Hepatol 2005;43:13. [14] Clavien PA. Third forum on liver transplantation. Living donor liver transplantation. Who needs it? How to do it? Who should do it?. J Hepatol 2005;43:11. [15] Portmann B, Wight DGD. Pathology of liver transplantation (excluding rejection). In: Calne R, editor. Liver Transplantation: The Cambridge and King s College Hospital Experience. Cambridge: Grune & Stratton; p [16] Ploeg RJ, D Alessandro AM, Knechtle SJ, Stegall MD, Pirsch JD, Hoffmann RM, et al. Risk factors for primary dysfunction after liver transplantation a multivariate analysis. Transplantation 1993;55:807. [17] Strasberg SM, Howard TK, Molmenti EP, Hertl M. Selecting the donor liver: risk factors for poor function after orthotopic liver transplantation. Hepatology 1994;20:829. [18] Fishbein TM, Fiel MI, Emre S, Cubukcu O, Guy SR, Schwartz ME, et al. Use of livers with microvesicular fat safely expands the donor pool. Transplantation 1997;64:248. [19] Hayashi M, Fujii K, Kiuchi T, Uryuhara K, Kasahara M, Takatsuki M, et al. Effects of fatty infiltration of the graft on the outcome of living-related liver transplantation. Transplant Proc 1999;31:403. [20] Briceno J, Padillo J, Rufian S, Solorzano G, Pera C. Assignment of steatotic livers by the Mayo model for end-stage liver disease. Transpl Int 2005;18:577. [21] Selzner N, Selzner M, Jochum W, Amann-Vesti B, Graf R, Clavien PA. Mouse livers with macrosteatosis are more susceptible to normothermic ischemic injury than those with microsteatosis. J Hepatol 2006;44:694. [22] Urena MA, Ruiz-Delgado FC, Gonzalez EM, Segurola CL, Romero CJ, Garcia IG, et al. Assessing risk of the use of livers with macro and microsteatosis in a liver transplant program. Transplant Proc 1998;30:3288. [23] Yoong KF, Gunson BK, Neil DA, Mirza DF, Mayer AD, Buckels JA, et al. Impact of donor liver microvesicular steatosis on the outcome of liver retransplantation. Transplant Proc 1999;31:550. [24] Cho JY, Suh KS, Kwon CH, Yi NJ, Cho SY, Jang JJ, et al. The hepatic regeneration power of mild steatotic grafts is not impaired in living-donor liver transplantation. Liver Transpl 2005;11:210. [25] Fan ST, Lo CM, Liu CL, Yong BH, Chan JK, Ng IO. Safety of donors in live donor liver transplantation using right lobe grafts. Arch Surg 2000;135:336. [26] McCormack L, Clavien PA. Understanding the meaning of fat in the liver. Liver Transpl 2005;11:137. [27] Hwang S, Lee SG, Jang SJ, Cho SH, Kim KH, Ahn CS, et al. The effect of donor weight reduction on hepatic steatosis for living donor liver transplantation. Liver Transpl 2004;10:721. [28] Selzner N, Rudiger H, Graf R, Clavien PA. Protective strategies against ischemic injury of the liver. Gastroenterology 2003;125:917. [29] Clavien PA, Selzner M, Rudiger HA, Graf R, Kadry Z, Rousson V, et al. A prospective randomized study in 100 consecutive patients undergoing major liver resection with versus without ischemic preconditioning. Ann Surg 2003;238:843. [30] Azoulay D, Del Gaudio M, Andreani P, Ichai P, Sebag M, Adam R, et al. Effects of 10 minutes of ischemic preconditioning of the cadaveric liver on the graft s preservation and function: the ying and the yang. Ann Surg 2005;242:133. [31] Kurihara T, Adachi Y, Yamagata M, Abe K, Akimoto M, Hashimoto H, et al. Role of eicosapentaenoic acid in lipid metabolism in the liver, with special reference to experimental fatty liver. Clin Ther 1994;16:830. [32] Alwayn IP, Andersson C, Zauscher B, Gura K, Nose V, Puder M. Omega-3 fatty acids improve hepatic steatosis in a murine model: potential implications for the marginal steatotic liver donor. Transplantation 2005;79:606. [33] Chui AK, Haghighi K, Painter D, Jayasundera M, Hall G, Rao AR, et al. Donor fatty (steatotic) liver allografts in orthotopic liver transplantation. Transplant Proc 1998;30:3286. [34] Canelo R, Braun F, Sattler B, Klinge B, Lorf T, Ramadori G, et al. Is a fatty liver dangerous for transplantation?. Transplant Proc 1999;31:414. [35] Verran D, Kusyk T, Painter D, Fisher J, Koorey D, Strasser S, et al. Clinical experience gained from the use of 120 steatotic donor livers for orthotopic liver transplantation. Liver Transpl 2003;9:500. doi: /j.jhep Can non-heart-beating donors replace cadaveric heart-beating liver donors? Rahul Deshpande, Nigel Heaton * Kings College London School of Medicine at Kings College Hospital, Institute of Liver Studies, Denmark Hill, Camberwell, London SE5 9RS, UK 1. Introduction * Corresponding author. Tel.: ; fax: address: nigel.heaton@kingsch.nhs.uk (N. Heaton). Abbreviations: NHBD, non-heart-beating donor; ICU, intensive care unit Recently non-heart-beating donation (or also called donation after cardiac death) has re-emerged as a major potential way of increasing the supply of organs for transplantation. The success of renal transplantation from non-heart-beating donors (NHBD) [1] has led to
2 500 Forum on Liver Transplantation / Journal of Hepatology 45 (2006) a renewed and wide interest in liver, pancreas and lung retrieval [2,3]. In the early years of transplantation, before the definition and legal acceptance of brain death, NHBD was the principal source of grafts. Following introduction of the concept of irreversible coma [4] and brain death, cadaveric donation gradually replaced NHBD due to the superior results obtained. However, with subsequent improvements in immunosuppression, organ preservation and the standardisation of surgical techniques, liver grafts from NHBD appear to be a valuable new source of organs with significant potential for expansion of the donor pool. 2. Non-heart-beating donation Non-heart-beating donors have been classified into four categories according to the Maastricht criteria (Table 1). The division into controlled and uncontrolled NHBD is helpful as it underlines differences in ethics, clinical practice, graft outcome and future potential between the two groups [5]. Controlled donation occurs in a hospital intensive care unit (ICU) setting in a controlled environment usually with a policy driven planned withdrawal of treatment. In uncontrolled donation, donor death occurs either outside the hospital or in the emergency room following unsuccessful attempts at resuscitation. Most of the current published literature relates to controlled NHBD. The ethics of controlled NHB donation are readily understood and accepted by doctors and the public. There is more time to assess the donors for co-morbidity; they tend to be haemodynamically stable, with normal liver and renal function. The donors are extubated after planned treatment withdrawal either in the ICU or in the operating room. These patients usually have brain injury incompatible with life with rapid cessation of cardiopulmonary function. Warm ischaemia can be accurately assessed and cold ischaemia minimised by prior preparation of a suitable recipient. There is adequate opportunity to counsel both the donor family and the recipient. In comparison to uncontrolled NHBD they tend to be older, have greater co-morbidity and have had organ support on the ICU. It has been estimated that controlled NHBD in its current form has the potential to increase the donor liver pool by at least 20% [6]. Table 1 First International Workshop on non-heart-beating donation, Maastricht, 1994 Categories of non-heart-beating donation (categories 1 and 2, Uncontrolled; 3 and 4, Controlled) 1. Dead on arrival 2. Unsuccessful resuscitation 3. Awaiting cardiac arrest-ventilator switch off 4. Cardiac arrest while brain-dead Uncontrolled NHBD are more likely to be younger and fitter without significant co-morbidity. However, death occurs in an uncontrolled setting, often after prolonged periods of resuscitation, which makes assessment of warm ischaemic time problematic. The legal, ethical and logistic issues that have to be overcome are considerable. However, an approximately twofold net increase in the donor pool has been successfully achieved by a Spanish group [7] and it has been speculated that there is the potential to increase the donor pool by up to 300%. The resources to be invested in such a programme are significant. 3. Reported outcomes after liver transplantation from controlled NHBD (Table 2) All techniques used to procure organs from controlled NHBD aim to keep warm ischaemia to a minimum. A variety of techniques have been utilised including cardiopulmonary bypass with or without cooling, extracorporeal membrane oxygenation and superrapid retrieval as a modification of the en bloc multiorgan harvest technique [3]. Our own technique involves rapid aortic and caval cannulation, topical cooling, aortic clamping and perfusion of the aorta with heparinised Marshall s solution followed by cannulation of the superior mesenteric vein to perfuse the liver with University of Wisconsin solution [6]. The best outcome from controlled NHBD livers has been associated with less than 30 min of warm ischaemia, cold ischaemic times of less than 8 h and donor age of less than 50 years [6,8,9]. A variety of techniques, including pulsatile and non-pulsatile machine perfusion, have been utilised experimentally to try to prolong organ preservations to allow more detailed assessment of the graft. To date there are little clinical data in liver transplantation to identify, which techniques will prevail in the longer term [10]. Early experience of NHBD was associated with inferior patient and graft survival, particularly for the uncontrolled group [3]. Casavilla et al. reported the early Table 2 Outcome after liver transplantation from NHBD Author Year N Pat. survival a Graft survival a Controlled NHBD Muiesan et al. [6] % 84% Abt et al. [12] % 70.2% Foley et al. [13] % 67% Manzarbeitia et al. [14] % Uncontrolled NHBD Otero et al. [19] % (2 yr) 55% (2 yr) Quintela et al. [20] % (57m) 80% (57m) N, number of patients. a One-year survival, unless otherwise stated.
3 Forum on Liver Transplantation / Journal of Hepatology 45 (2006) experience of Pittsburgh with poor graft survival secondary to vascular complications and primary nonfunction. D Alessandro et al. reported a significantly higher incidence of primary non-function (PNF) and worse graft and patient survival in recipients of controlled NHBD [11]. More recently, Abt et al. reported a higher incidence of PNF and retransplantation when compared to HBD [12]. A publication from our own centre reported a single case of PNF in a series of 32 consecutive liver transplants from controlled NHBD [6]. Current experience suggests that the results of controlled NHBD are now approaching those of heart-beating donation (HBD) [6]. Graft and patient survival at one year is 90% and 94%, respectively, in our own institution after 54 liver transplants from controlled NHBD. There are continuing concerns regarding reports of vascular and biliary complications in recipients of controlled NHBD livers. Foley et al. reported a 16.6% incidence of hepatic artery stenosis, 13.8% incidence of biliary stricture and 16.7% incidence of biloma and abscess [13]. There was a high rate of graft loss secondary to these complications. The majority of centres with significant experience of NHBD livers have reported a higher incidence of non-anastomotic biliary strictures. Abt et al. proposed that the increased susceptibility towards ischaemic cholangiopathy was a consequence of longer warm or cold ischaemia times and microcirculatory injury [8]. Manzarbeitia et al. have also reported a higher incidence of vascular complications when compared to brain dead heart-beating donors [14]. Attempts have been made to identify donor and recipient characteristics associated with poor outcome [11]. Prolonged cold ischaemia is associated with graft function and biliary complications. Beyond 12 h graft failure approaching 60% has been reported. Keeping the cold ischaemic time to less than 8 h reduces the graft failure to 10% [11]. Warm ischaemic periods of greater than 30 min have a high risk of graft non-function. Donor age greater than 40 years also appears to increase the risk of graft failure. The choice of recipient may also have a bearing on graft outcome with those on organ support pre-transplant doing less well [11]. It appears that NHBD livers have lower functioning hepatocyte mass and hepatocyte viability in experimental and clinical studies [6]. The development of clinical programmes and the recognition of good controlled NHBD livers has led to the use of liver reduction techniques for successful transplantation of 10 children at our centre [15]. These results suggest that these good donors should not be considered to be marginal. 4. Outcomes after liver transplantation from uncontrolled NHBDs Early results of uncontrolled NHBD were not encouraging. There was a high incidence of PNF and graft loss due to vascular complications [3]. However, studies reported excellent graft and patient survival in kidney recipients [16] and long-term renal function was reported to be better in Maastricht types 1 and 2 as compared to types 3 and 4 [17]. Alvarez et al. using well-defined criteria for accepting uncontrolled NHBD reported good graft function in both transplanted kidneys and livers [18]. Otero et al. reported significantly higher rates of PNF, biliary complications and initial organ dysfunction in 20 liver recipients from uncontrolled NHBD [19]. More recently there have been several case reports of successful uncontrolled NHBD maintained on mechanical chest and abdominal compression, cardio-pulmonary bypass or on ECMO [20]. Wider application and evaluation of these techniques and subsequent graft function are required. 5. The use of NHBD to expand the donor pool What is the potential for NHBD to expand the donor pool and how do we realise them? The results of controlled NHBD are now approaching those obtained with HBD provided that donor age is less than 50 years, warm ischaemia does not extend beyond 30 min and cold ischaemia is kept to a minimum with a cut off of 10 h being accepted as reasonable by the majority of centres. This may increase the donor pool by 20%, better than living donation (which may help 10%), but falling short of what is required. How can graft quality and early function be improved? Warm ischaemia cannot be avoided, but has to be minimised by excellent surgical technique, the use of low viscosity perfusion fluids possibly under pressure (50 mmhg) to clear the microcirculation and thorough flushing of the biliary tree. The use of heparin pre-donation (if allowed) and thrombolytic agents to maintain the microcirculation is considered to improve function and reduce vascular and possibly biliary complications. The need for cold preservation and the subsequent effects of ischaemia/reperfusion injury on the graft are important determinants of graft survival [21]. Experimental studies suggest that pre-treatment of NHBD prior to withdrawal of care may improve outcome by ameliorating ischaemia/reperfusion injuries [22]. A number of agents are being evaluated in experimental studies. The avoidance of cold ischaemia using techniques such as normothermic continuous organ perfusion could expand the safe use of more marginal donors and such models are being developed. Other techniques such as short term hypothermic oxygenated perfusion prior to implantation may also rescue NHBD grafts [23]. The choice of recipient should be restricted to avoid long difficult dissections and possibly those with severe portal hypertension or those on organ support. Techniques of implantation have not been formally evaluated in clinical trials, but clinical experience from small for
4 502 Forum on Liver Transplantation / Journal of Hepatology 45 (2006) Table 3 Prerequisites for establishing a NHBD liver transplant program Controlled NHBD (1) Ensure appropriate legal framework (2) Establish protocols for NHBD retrieval and train donor coordinators and other teams (3) Identify Intensive Care Units and agree protocols for withdrawal of treatment (4) Develop a successful NHBD kidney program followed by liver program, concentrating experience initially within a small team (5) Address consent and allocation issues for NHBD liver transplantation (6) Concentrate on busiest units first with extensive experience of use of marginal grafts and then expand the program Uncontrolled NHBD (1) Establish legal and ethical framework acceptable to the public (2) Carry out public and political consultation with consideration towards presumed consent (opt out) policy for organ donation (3) Develop a regional strategy and funding for 24-h availability of dedicated resuscitation ambulances deployed within defined territories to identify and resuscitate potential donors (4) Establish a robust protocol for cessation of resuscitation, consent issues, donor maintenance and subsequent retrieval (5) Twenty-four-hour availability of a dedicated retrieval team of surgeons, nurses and donor coordinators trained for uncontrolled NHBD (6) Develop cooperation and involvement of the hospital emergence department to establish the program (if possible, develop uncontrolled NHBD after a successful controlled NHBD program) size grafts and experimental studies suggest that alleviation of severe portal hypertension, blood flush and arterial reperfusion may be of value and may extend donor criteria for NHBD. With extended criteria for controlled NHBD it may be possible to expand the potential pool by 30 40% over the next 10 years. To successfully exploit uncontrolled NHBD a number of important obstacles need to be overcome (Table 3). The most pressing is to establish a legal framework that is acceptable to the public. At present uncontrolled NHBD is contentious and considered illegal in many countries. The point when resuscitation becomes futile and organ donation should be considered is not always clear and there are no internationally agreed guidelines. Public acceptance and changes to the law, which allow the use of continuous mechanical chest and abdominal compression, cardiopulmonary bypass techniques or extracorporeal membrane oxygenation whilst family members are consulted, are required. Presumed consent (opt out) helps to provide the appropriate legal framework for this type of donation. The logistics of establishing a programme of uncontrolled donation are also significant. To obtain organs from patients who have collapsed on the street or fail resuscitation in the emergency room requires a dedicated resuscitation ambulance team available 24 h a day able to reach the scene within a very short time [18]. Alvarez et al. reported their experience of 111 potential category 1 uncontrolled NHBD [17]. Of these, 53 were accepted as donors and resulted in the retrieval of 72 kidneys and 12 livers. Of the 12 livers retrieved eight were transplanted with good function. Of note, the median time from cardiac arrest to arrival in hospital was 68 min and to being placed on cardio-pulmonary bypass was 111 min. The assessment of the warm ischaemic time, the effectiveness of resuscitation and the suitability of the donor under these conditions is much more difficult. The initial investment in the training and provision of emergency services is high and the early return relatively low. Effective resuscitation will buy time for assessment of the donor and the potential graft. Reliable tests predicting graft function are needed. Liver biopsy is of limited value and other markers that have been used, which include Glutathione S-transferase and xanthine oxidase, are not reliable indicators of subsequent function. Could NHBD replace HBD? It has been suggested that the absence of brain stem death in NHBD categories 1 3 may be associated with less inflammatory infiltrate in the donor organs and that long-term graft survival may be better. The data are not yet available, but the incidence of acute rejection is currently about 25% (personal observation), certainly no higher than observed for HBD. Data are lacking for long-term outcome in liver recipients, but long-term graft survival in NHBD kidneys is excellent [1]. The early results of liver transplantation from controlled NHBD are approaching those obtained with HBD provided that conservative selection criteria are used. This will supplement the donor pool by 20%, but cannot replace HBD and should be viewed as complementary. Of concern, there may be a trend towards NHDB away from HBD to reduce donor hospital stay and to satisfy the wishes of donor family for cardio-pulmonary death, which may limit the overall increase in organ donation (i.e., a switch from HBD to NHBD as a mode of death). The greatest potential lies with uncontrolled NHBD, but changes are needed from Governments to provide a clear legal framework, funding and training for the infrastructure and acceptance by the public. The development of treatments to preserve, resuscitate and maintain these grafts in the medium term and tests which can accurately assess potential graft function will begin to tap this potential. If successful, NHBD could rival or surpass HBD and living donation as a source of organs for transplantation.
5 Forum on Liver Transplantation / Journal of Hepatology 45 (2006) References [1] Weber M, Dindo D, Demartines N, Ambuhl PM, Clavien PA. Kidney transplantation from donors without a heartbeat. N Engl J Med 2002;347: [2] D Alessandro AM, Hoffmann RM, Knechtle SJ, et al. Successful extra-renal transplantation from non-heart-beating donors. Transplantation 1995;59: [3] Casavilla A, Ramirez C, Shapiro R, et al. Experience with liver and kidney allografts from non-heart-beating donors. Transplantation 1995;59: [4] A definition of irreversible coma. Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death. JAMA 1968;205: [5] Kootstra G, Daemen JH, Oomen AP. Categories of non-heartbeating donors. Transplant Proc 1995;27: [6] Muiesan P, Girlanda R, Jassem W, et al. Single-centre experience with liver transplantation from controlled non-heartbeating donors: a viable source of grafts. Ann Surg 2005;242: [7] Alvarez J, del Barrio MR, Arias J, et al. Five years of experience with non-heart-beating donors coming from the streets. Transplant Proc 2002;34: [8] Abt PL, Crawford MD, Desai NM, et al. Liver transplantation from controlled non-heart-beating donors: an increased incidence of biliary complications. Transplantation 2003;75: [9] Monbaliu D, Crabbe T, Roskams T, et al. Livers from non-heartbeating donors tolerate short periods of warm ischemia. Transplantation 2005;79: [10] Uchiyama M, Matsuno K, Hama H, et al. Comparison between nonpulsatile and pulsatile machine perfusion preservation in liver transplantation from non-heart-beating donors. Transplant Proc 2001;33: [11] D Alessandro AM, Fernandez LA, Chin LT, et al. Donation after cardiac death: the University of Wisconsin experience. Ann Transplant 2004;9: [12] Abt PL, Desai NM, Crawford MD, et al. Survival following liver transplantation from non-heart-beating donors. Ann Surg 2004;239: [13] Foley DP, Fernandez LA, Leverson G, et al. Donation after cardiac death: the University of Wisconsin experience with liver transplantation. Ann Surg 2005;242: [14] Manzarbeitia CY, Ortiz JA, Jeon H, et al. Long-term outcome of controlled, non-heart-beating donor liver transplantation. Transplantation 2004;78: [15] Muiesan P, Jassem W, Girlanda R, et al. Segmental liver transplantation from non-heart beating donors an early experience with implications for the future. Am J Transplant 2006;6: [16] Nicholson ML, Metcalfe MS, White SA, et al. A comparison of the results of renal transplantation from non-heart-beating, conventional cadaveric, and living donors. Kidney Int 2000;58: [17] Sanchez-Fructuoso AI, de Miguel Marques, Prats D, et al. Nonheart-beating donors: experience from the Hospital Clinico of Madrid. J Nephrol 2003;16: [18] Alvarez J, del Barrio R, Arias J, et al. Non-heart-beating donors from the streets: an increasing donor pool source. Transplantation 2000;70: [19] Otero A, Gomez-Gutierrez M, Suarez F, et al. Liver transplantation from Maastricht category 2 non-heart-beating donors: a source to increase the donor pool?. Transplant Proc 2004;36: [20] Quintela J, Gala B, Baamonde I, et al. Long-term results for liver transplantation from non-heart-beating donors maintained with chest and abdominal compression-decompression. Transplant Proc 2005;37: [21] Reddy S, Greenwood J, Maniakin N, et al. Non-heart-beating donor porcine livers: the adverse effect of cooling. Liver Transpl 2005;11: [22] Fukunaga K, Takada Y, Taniguchi H, et al. Endothelin antagonist treatment for successful liver transplantation from non-heart-beating donors. Transplantation 1999;67: [23] Dutkowski P, Graf R, Clavien PA. Rescue of the cold preserved rat liver by hypothermic oxygenated machine perfusion. Am J Transplant 2006;6: doi: /j.jhep How can donors with a previous malignancy be evaluated? Joseph F. Buell *, Rita R. Alloway, E. Steve Woodle The University of Cincinnati, Division of Transplantation, Cincinnati, OH, USA 1. Introduction Solid organ transplantation has flourished over the last three decades with improvements in surgical technique and modern immunosuppression resulting in * Corresponding author. Tel.: ; fax: address: Joseph.buell@uc.edu (J.F. Buell). Abbreviations: OPTN, Organ Procurement and Transplantation Network; UNOS, united network for organ sharing; DCIS, ductal carcinoma in situ. improved patient outcomes. Traditionally, solid organ transplantation has been limited by organ availability. The principal source of these organs has been cadaveric donation. A steady increase in organ donation was observed in the early 1990s realized through public awareness and education programs [1]. Concurrently several surgical innovations in live donor kidney, pancreas, liver and intestinal transplantation have also contributed to an increase in transplants. However, both efforts have appeared to have achieved a plateau in the last few years.
Overview Increasing organ donation (heart-beating donation Use of marginal grafts (quality) Cadaveric non-heart-beating donation Splitting Living dona
Increasing the organ supply Mr. Nigel Heaton Overview Increasing organ donation (heart-beating donation Use of marginal grafts (quality) Cadaveric non-heart-beating donation Splitting Living donation Domino
More informationWhen is steatosis too much for transplantation?
494 Forum on Liver Transplantation / Journal of Hepatology 45 (2006) 483 513 [4] Fernandez-Esparrach G, Sanchez-Fueyo A, Gines P, et al. A prognostic model for predicting survival in cirrhosis with ascites.
More informationAnne Barkman. The University of Kansas School of Nursing
Expanding Donor Criteria: Is it Safe? Anne Barkman The University of Kansas School of Nursing About the author: Anne Barkman is from Leawood, Kansas. She was an academic honor roll recipient for Fall 2010,
More informationHypothermic or normothermic abdominal regional perfusion: strategies and selection criteria for NHBD (Systems ECMO)
Hypothermic or normothermic abdominal regional perfusion: strategies and selection criteria for NHBD (Systems ECMO) Constantino Fondevila Associate Professor of Surgery HPB & Liver Transplant Surgery Hospital
More informationThe number of liver transplantations continues to. The Optimal Number of Donor Biopsy Sites to Evaluate Liver Histology for Transplantation
The Optimal Number of Donor Biopsy Sites to Evaluate Liver Histology for Transplantation Wendy L. Frankel, * Jason G. Tranovich, * Laura Salter, Ginny Bumgardner, and Peter Baker * Macrovesicular steatosis
More informationUse of non-heart-beating donors in renal transplantation
Postgrad Med J 2001;77:681 685 681 REVIEWS Department of Surgery, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK R M Kimber M S Metcalfe S A White M L Nicholson
More informationHwm YI Yoo, * Ernest0 Molmenti, ' and PuulJ Tbuluvutb"
The Effect of Donor Body Mass Index on Primary Nonfunction, Retransplantation Rate, and Early and Patient Survival After Liver Transplantation Hwm YI Yoo, * Ernest0 Molmenti, ' and PuulJ Tbuluvutb" Previous
More informationLiver transplantation using Donation after Cardiac Death donors
Frontiers in Liver Transplantation Liver transplantation using Donation after Cardiac Death donors Diethard Monbaliu 1,, Jacques Pirenne 1,à, David Talbot 2, 1 Catholic University Leuven, Department of
More informationNon-heart beating donors
Nephrol Dial Transplant (2004) 19 [Suppl 3]: iii26 iii31 DOI: 10.1093/ndt/gfh1011 Non-heart donors Ana Sánchez-Fructuoso 1, Dolores Prats Sánchez 1, María Marqués Vidas 1, Eduardo Lo pez de Novales 2 and
More informationIn-situ v Normothermic Regional Perfusion for Abdominal Organs
In-situ v Normothermic Regional Perfusion for Abdominal Organs ANGEL RUIZ M.D. DONATION AND TRANSPLNAT COORDINATION UNIT MEDICAL DIRECTION HOSPITAL CLÍNIC DE BARCELONA Introduction Donation after circulatory
More informationUncontrolled organ donation following prehospital cardiac arrest: a potential solution to the shortage of organ donors in the United Kingdom?
Transplant International ISSN 0934-0874 ORIGINAL ARTICLE Uncontrolled organ donation following prehospital cardiac arrest: a potential solution to the shortage of organ donors in the United Kingdom? Keith
More informationIncreasing Organ availability: From Machine Perfusion to Donors after Cardiac Death. Ayyaz Ali
Increasing Organ availability: From Machine Perfusion to Donors after Cardiac Death Ayyaz Ali No relevant financial disclosures 2 Heart Transplantation - Activity 3 Donor Heart Preservation Static preservation
More informationOutcomes of Pancreas Transplantation in the United States Using Cardiac-Death Donors
American Journal of Transplantation 2006; 6: 1059 1065 Blackwell Munksgaard C 2006 The Authors Journal compilation C 2006 The American Society of Transplantation and the American Society of Transplant
More informationGabriel C. Oniscu Consultant Transplant Surgeon Honorary Clinical Senior Lecturer NRS Career Research Fellow Royal Infirmary of Edinburgh
Gabriel Oniscu Gabriel C. Oniscu Consultant Transplant Surgeon Honorary Clinical Senior Lecturer NRS Career Research Fellow Royal Infirmary of Edinburgh 50% increase Organ donation Organ retrieval Organ
More informationSpanish model of kidney transplantation and organ donation
Spanish model of kidney transplantation and organ donation JM.Campistol, Nephrology and Renal Transplant Department, Hospital Clinic, University of Barcelona, Barcelona, Spain. jmcampis@clinic.ub.es SPAIN
More informationOrgan preservation & transplantation: newest insights & perspectives. Ina Jochmans, MD, PhD Abdominal Transplant Surgery KU Leuven, Belgium
Organ preservation & transplantation: newest insights & perspectives Ina Jochmans, MD, PhD Abdominal Transplant Surgery KU Leuven, Belgium 1. Expand the donor pool 2. Optimal preservation & resuscitation
More informationThe Groningen hypothermic liver perfusion system for improved preservation in organ transplantation Plaats, Arjan van der
University of Groningen The Groningen hypothermic liver perfusion system for improved preservation in organ transplantation Plaats, Arjan van der IMPORTANT NOTE: You are advised to consult the publisher's
More informationUtility of Marginal Donors in Liver Transplantation
Utility of Marginal Donors in Liver Transplantation HwanHyo, Lee Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Contents Review of Liver Transplantation(LT)
More informationTRANSPLANTATION OF KIDNEYS FROM DONORS WHOSE HEARTS HAVE STOPPED BEATING TRANSPLANTATION OF KIDNEYS FROM DONORS WHOSE HEARTS HAVE STOPPED BEATING
TRANSPLANTATION OF KIDNEYS FROM DONORS WHOSE HEARTS HAVE STOPPED BEATING YONG W. CHO, PH.D., PAUL I. TERASAKI, PH.D., J. MICHAEL CECKA, PH.D., AND DAVID W. GJERTSON, PH.D. ABSTRACT Background Attempts
More informationDisclosures. Normothermic Machine Liver Perfusion
Disclosures Normothermic Machine Liver Perfusion I have nothing to disclose Garrett R. Roll, MD Assistant Professor of Surgery Overview Define normothermic machine liver perfusion (NMLP) Show device examples
More informationDisclosure. Organ Procurement Surgery: Technical Aspects and Implications for Post-Transplant Care. Cadaveric Organ Procurement Historical Origins
3 4 Disclosure Organ Procurement Surgery: Technical Aspects and Implications for Post-Transplant Care I have no relevant financial relationships with any companies related to the content of this course.
More informationSplit Graft Liver Transplant for Paediatric Patients in Hong Kong
HK J Paediatr (new series) 2009;14:181-185 Split Graft Liver Transplant for Paediatric Patients in Hong Kong PHY CHUNG, KKY WONG, PKH TAM, KL CHAN, KKC NG, SC CHAN, TWC HUI, BH YONG, ST FAN, CM LO Abstract
More informationThe New England Journal of Medicine KIDNEY TRANSPLANTATION FROM DONORS WITHOUT A HEARTBEAT
KIDNEY TRANSPLANTATION FROM DONORS WITHOUT A HEARTBEAT MARKUS WEBER, M.D., DANIEL DINDO, M.D., NICHOLAS DEMARTINES, M.D., PATRICE M. AMBÜHL, M.D., AND PIERRE-ALAIN CLAVIEN, PH.D. ABSTRACT Background The
More informationStrategies for Widening Liver Donor Pool
Review Article Strategies for Widening Liver Donor Pool Ho Yu Chung, See Ching Chan, Chung Mau Lo and Sheung Tat Fan, Department of Surgery, The University of Hong Kong, Hong Kong SAR, China. Liver transplantation
More informationDCD Heart Donation Understanding the Regulatory, Ethical and Clinical Issues. Valluvan Jeevanandam MD University of Chicago Medicine
DCD Heart Donation Understanding the Regulatory, Ethical and Clinical Issues Valluvan Jeevanandam MD University of Chicago Medicine Disclosure Txn None MCS Scientific Advisor Thoratec/Abbott: Chairman
More informationLiver Transplantation Using Donation After Cardiac Death Donors: Long-Term Follow-Up from a Single Center
American Journal of Transplantation 2009; 9: 773 781 Wiley Periodicals Inc. C 2009 The Authors Journal compilation C 2009 The American Society of Transplantation and the American Society of Transplant
More informationOrgan quality can be improved
Preservation methods for transplant organs Organ quality can be improved Dr. Markus Quante Prof. Stefan G. Tullius The interval between retrieval and implantation of an organ can be used not only to prevent
More information06/04/2013 ISHLT. 2 International Conference on Respiratory Physiotherapy ARIR Genova, March 21 23, 2013
LUNG TRANSPLANTS The Journal of Heart and Lung Transplantation, 2012 2 International Conference on Respiratory Physiotherapy ARIR Genova, March 21 23, 2013 LUNG TRANSPLANTATION:STATE OF THE ART L. Santambrogio
More informationHeart Transplantation & MCS in 2017 Advances & Challenges
Heart Transplantation & MCS in 2017 Advances & Challenges Steven Tsui Papworth Hospital, Cambridge, UK Papworth Hospital Heart Transplantation ADVANCES AND CHALLENGES Heart Transplants 100 75 Adult Heart
More informationThe Groningen hypothermic liver perfusion system for improved preservation in organ transplantation Plaats, Arjan van der
University of Groningen The Groningen hypothermic liver perfusion system for improved preservation in organ transplantation Plaats, Arjan van der IMPORTANT NOTE: You are advised to consult the publisher's
More informationLiving Donor Liver Transplantation for Hepatocellular Carcinoma: It Is All about Donors?
Original Article Living Donor Liver Transplantation for Hepatocellular Carcinoma: It Is All about Donors? R. F. Saidi 1 *, Y. Li 2, S. A. Shah 2, N. Jabbour 2 1 Division of Organ Transplantation, Department
More informationUtilisation of an embedded specialist nurse and collaborative care pathway increases potential organ donor referrals in the emergency department
1 Norfolk and Norwich University Hospital NHS Trust, Norwich, Norfolk, UK 2 NHS Blood and Transplant, Addenbrookes Hospital, Cambridge, UK Correspondence to Dr Julian Garside, Emergency Medicine Registrar,
More informationLiver Transplantation Following Donation After Cardiac Death: An Analysis Using Matched Pairs
LIVER TRANSPLANTATION 15:1072-1082, 2009 ORIGINAL ARTICLE Liver Transplantation Following Donation After Cardiac Death: An Analysis Using Matched Pairs James K. Pine, Amer Aldouri, Alistair L. Young, Mervyn
More informationREVIEW NON HEART-BEATING DONORS IN ENGLAND. Chaib E. Non heart-beating-donors in England. Clinics. 2008;63(1):
CLINICS 2008;63(1):121-34 REVIEW NON HEART-BEATING DONORS IN ENGLAND Eleazar Chaib. Non heart-beating-donors in England. Clinics. 2008;63(1):121-34. When transplantation started all organs were retrieved
More information32 nd Spanish Co-ordination Congress
32 nd Spanish Co-ordination Congress Santander 19 th October 2017 Stephen Large ma ms mrcp frcs(cth) frcs mba pae(rcp) conflicts of interest 1. TransMedics: halved cost of disposables in one of our experiments
More informationUniversity of Groningen. Impaired Organ Perfusion Morariu, Aurora
University of Groningen Impaired Organ Perfusion Morariu, Aurora IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document
More informationWaiting for a Kidney. Objectives
Waiting for a Kidney Department of Urologic Sciences Grand Rounds William Gourlay Christopher Nguan April 25, 2007 Objectives 1. review the waiting times for deceased-donor kidney transplants in BC and
More informationPOST TRANSPLANT OUTCOMES IN PSC
POST TRANSPLANT OUTCOMES IN PSC Kidist K. Yimam, MD Medical Director, Autoimmune Liver Disease Program Division of Hepatology and Liver Transplantation California Pacific Medical Center (CPMC) PSC Partners
More informationThe Essentials of DBD and DCD Multi-Organ Procurement. Wendy Grant, MD ASTS 8 th Annual Fellows Symposium San Diego CA (hee hee hee) 2014
The Essentials of DBD and DCD Multi-Organ Procurement Wendy Grant, MD ASTS 8 th Annual Fellows Symposium San Diego CA (hee hee hee) 2014 Disclosures I am a transplant surgeon I was well trained to do organ
More informationLiver Splitting During Normothermic Organ Preservation
LETTERS FROM THE FRONTLINE Liver Splitting During Normothermic Organ Preservation TO THE EDITOR: Although widely established as a means to increase the number of patients who can benefit from transplantation,
More informationOrgan perfusion prior to transplantation
Organ perfusion prior to transplantation Benedict Phillips SpR Transplant Surgery Research Fellow Guy s Hospital, London Introduction Organ perfusion with blood products prior to transplantation is an
More information2
Good afternoon everyone, Dr Faucher would like to apologize not to be here today due to personal medical reasons (she is actually pregnant). I have been asked to talk you about udcd. I haven t practiced
More informationStudies on bile duct Injury and the protective role of oxygenated machine perfusion in liver transplantation Karimian, Negin
University of Groningen Studies on bile duct Injury and the protective role of oxygenated machine perfusion in liver transplantation Karimian, Negin IMPORTANT NOTE: You are advised to consult the publisher's
More informationCare of the DCD in ICU: the French experience
Care of the DCD in ICU: the French experience The National Steering Committee of donors after circulatory death C. Antoine 1, M. Videcoq 2, B. Riou 3, D. Dorez 4, G. Cheisson 5, E. Savoye 1,L. Durand 1,
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,900 116,000 120M Open access books available International authors and editors Downloads Our
More informationDonation after Cardiocirculatory
Donation after Cardiocirculatory Determination of Death: A Review A Working Document Prepared for the Forum: Donation after Cardiocirculatory Determination of Death February 17-20, 2005 by Leonard Baron,
More informationUncontrolled donation after circulatory death: European practices and recommendations for the development and optimization of an effective programme
Transplant International REVIEW Uncontrolled donation after circulatory death: European practices and recommendations for the development and optimization of an effective programme Beatriz Domınguez-Gil
More informationUEMS & EBS: DIVISION OF TRANSPLANT SURGERY
CURRICULUM AND SYLLABUS TRANSPLANTATION Module 1: Multi-organ retrieval Ability to evaluate donor suitability Ability to retrieve abdominal organs for transplantation Evaluation of donor/ organs suitability
More informationSuccessful Application of Supraceliac Aortohepatic Conduit Using Saphenous Venous Graft in Right Lobe Living Donor Liver Transplantation
LETTERS FROM THE FRONTLINE Successful Application of Supraceliac Aortohepatic Conduit Using Saphenous Venous Graft in Right Lobe Living Donor Liver Transplantation TO THE EDITOR: Hepatic artery (HA) reconstruction
More informationPAPER. Liver Transplantation Using Organ Donation After Cardiac Death. A Clinical Predictive Index for Graft Failure Free Survival
PAPER Liver Transplantation Using Organ Donation After Cardiac Death A Clinical Predictive Index for Graft Failure Free Survival Johnny C. Hong, MD; Hasan Yersiz, MD; Prawat Kositamongkol, MD; Victor W.
More informationOpportunities for Scientific Expansion of the Deceased Donor Pool in Liver Transplantation
LIVER TRANSPLANTATION 20:E1 E5, 2014 SUPPLEMENT Opportunities for Scientific Expansion of the Deceased Donor Pool in Liver Transplantation Alix P.M. Matton 1,2 and Robert J. Porte 2 1 Surgical Research
More informationWelcome to Transplantation
Renal Services Welcome to Transplantation Introductory guide to kidney transplantation. Welcome to Transplantation Kidney transplantation is not a cure for your renal disease it is just another form of
More informationTime to death after withdrawal of treatment in donation after circulatory death (DCD) donors
REVIEW C URRENT OPINION Time to death after withdrawal of treatment in donation after circulatory death (DCD) donors J.A. Bradley, G.J. Pettigrew, and C.J. Watson Purpose Controlled donation after circulatory
More informationNew classification of donation after circulatory death donors definitions and terminology
Transplant International REVIEW New classification of donation after circulatory death donors definitions and terminology Marie Thuong 1, Angel Ruiz 2, Patrick Evrard 3, Michael Kuiper 4, Catherine Boffa
More informationObjectives. Nebraska Organ Recovery 2/16/2015. The Role of Hospice and Palliative Care in Organ and Tissue Donation
The Role of Hospice and Palliative Care in Organ and Tissue Donation Objectives Summarize the organ and tissue donation process. Identify the role of hospice and palliative care staff in the organ and
More informationUse of Older Donor Livers Is Associated With More Extensive Ischemic Damage on Intraoperative Biopsies During Liver Transplantation
Use of Older Donor Livers Is Associated With More Extensive Ischemic Damage on Intraoperative Biopsies During Liver Transplantation Marc Deschênes,* Clark Forbes, Jean Tchervenkov, Jeffrey Barkun, Peter
More informationTransplant in Pediatric Heart Failure
Transplant in Pediatric Heart Failure Francis Fynn-Thompson, MD Co-Director, Center for Airway Disorders Surgical Director, Pediatric Mechanical Support Program Surgical Director, Heart and Lung Transplantation
More informationSummary of Significant Changes. Policy
This Policy replaces POL186/2 Copy Number Effective 01/04/14 Summary of Significant Changes Clarification of policy approval process Paragraph 2.2.1 Clarification of Kidney Fast Track Scheme offering criteria
More informationRemoving Patients from the Liver Transplant Wait List: A Survey of US Liver Transplant Programs
LIVER TRANSPLANTATION 14:303-307, 2008 ORIGINAL ARTICLE Removing Patients from the Liver Transplant Wait List: A Survey of US Liver Transplant Programs Kevin P. Charpentier 1 and Arun Mavanur 2 1 Rhode
More informationPediatric Cardiac Transplantation Using DCD Donors. Canadian Critical Care Forum David N. Campbell, MD
Pediatric Cardiac Transplantation Using DCD Donors Canadian Critical Care Forum David N. Campbell, MD No disclosures Disclosure Statement DCD: What is Old is New Again Early solid organ recoveries were
More informationDonor Hypernatremia Influences Outcomes Following Pediatric Liver Transplantation
8 Original Article Donor Hypernatremia Influences Outcomes Following Pediatric Liver Transplantation Neema Kaseje 1 Samuel Lüthold 2 Gilles Mentha 3 Christian Toso 3 Dominique Belli 2 Valérie McLin 2 Barbara
More informationA CRITICAL ANALYSIS OF ORGAN PERFUSION SOLUTIONS IN LIVER TRANSPLANTATION
A CRITICAL ANALYSIS OF ORGAN PERFUSION SOLUTIONS IN LIVER TRANSPLANTATION John J. Fung, MD Director, Cleveland Clinic Health System Center for Transplantation Disclosure: I have been a consultant for Dupont,
More informationLiver Transplantation
1 Liver Transplantation Department of Surgery Yonsei University Wonju College of Medicine Kim Myoung Soo M.D. ysms91@wonju.yonsei.ac.kr http://gs.yonsei.ac.kr History Development of Liver transplantation
More informationThe Gift of Life. Organ Donation and its Challenges Presented by Jessica Roth, RN, BSN, CPTC
The Gift of Life Organ Donation and its Challenges Presented by Jessica Roth, RN, BSN, CPTC Nebraska Organ Recovery System (NORS) Federally designated as an organ procurement organization (OPO) Tasked
More informationWhat Is the Real Gain After Liver Transplantation?
LIVER TRANSPLANTATION 15:S1-S5, 9 AASLD/ILTS SYLLABUS What Is the Real Gain After Liver Transplantation? James Neuberger Organ Donation and Transplantation, NHS Blood and Transplant, Bristol, United Kingdom;
More informationDCD Heart Transplantation Papworth Perspective
DCD Heart Transplantation Papworth Perspective Simon Messer Stephen Large Objectives Heart transplantation in the UK DCD donation in the UK DCD impact on heart function Normothermic Regional Perfusion
More informationCandidates about. Lung Allocation Policy. for Transplant. Questions & A n s we r s TA L K I N G A B O U T T R A N S P L A N TAT I O N
TA L K I N G A B O U T T R A N S P L A N TAT I O N Questions & A n s we r s for Transplant Candidates about Lung Allocation Policy U N I T E D N E T W O R K F O R O R G A N S H A R I N G What are the OPTN
More informationReperfusion Injury Significantly Impacts Clinical Outcome After Pulmonary Transplantation
Reperfusion Injury Significantly Impacts Clinical Outcome After Pulmonary Transplantation Robert C. King, MD, Oliver A. R. Binns, MD, Filiberto Rodriguez, MD, R. Chai Kanithanon, BA, Thomas M. Daniel,
More informationMEDICAL MANAGEMENT POLICY
PAGE: 1 of 5 MEDICAL MANAGEMENT POLICY This medical policy is not a guarantee of benefits or coverage, nor should it be deemed as medical advice. In the event of any conflict concerning benefit coverage,
More informationECMO vs. CPB for Intraoperative Support: How do you Choose?
ECMO vs. CPB for Intraoperative Support: How do you Choose? Shaf Keshavjee MD MSc FRCSC FACS Director, Toronto Lung Transplant Program Surgeon-in-Chief, University Health Network James Wallace McCutcheon
More informationTHE WORLD MEDICAL ASSOCIATION, INC. WMA STATEMENT ON ORGAN AND TISSUE DONATION
THE WORLD MEDICAL ASSOCIATION, INC. WMA STATEMENT ON ORGAN AND TISSUE DONATION Adopted by the 63rd WMA General Assembly, Bangkok, Thailand, October 2012 PREAMBLE Advances in medical sciences, especially
More informationNormothermic kidney preservation Sarah A. Hosgood and Michael L. Nicholson
Normothermic kidney preservation Sarah A. Hosgood and Michael L. Nicholson Department of Infection, Immunity and Inflammation, Transplant Group, University of Leicester, Leicester General Hospital, Leicester,
More informationLiver Transplantation for Biliary Atresia: 19-Year, Single-Center Experience
Liver Transplantation for Biliary Atresia: 19-Year, Single-Center Experience L Thomas Chin 1, Anthony M D Alessandro 1, Stuart J Knechtle 1, Luis A Fernandez 1, Glen Leverson 1, Robert H Judd 2, Elizabeth
More informationNHS. Living-donor lung transplantation for end-stage lung disease. National Institute for Health and Clinical Excellence. Issue date: May 2006
NHS National Institute for Health and Clinical Excellence Issue date: May 2006 Living-donor lung transplantation for end-stage Understanding NICE guidance information for people considering the procedure,
More informationSimultaneous Liver and Kidney Transplantation Using Donation After Cardiac Death Donors: A Brief Report
LIVER TRANSPLANTATION 17:591-595, 2011 ORIGINAL ARTICLE Simultaneous Liver and Kidney Transplantation Using Donation After Cardiac Death Donors: A Brief Report John C. LaMattina, Joshua D. Mezrich, Luis
More informationOne of the most important problems for patients
Selection of Donors and Recipients for Living Donor Liver Transplantation Key Points 1. Living donor liver transplantation (LDLT) is increasingly used for adults with end-stage liver disease. 2. Standards
More informationPredictors of cardiac allograft vasculopathy in pediatric heart transplant recipients
Pediatr Transplantation 2013: 17: 436 440 2013 John Wiley & Sons A/S. Pediatric Transplantation DOI: 10.1111/petr.12095 Predictors of cardiac allograft vasculopathy in pediatric heart transplant recipients
More informationOverall Goals and Objectives for Transplant Hepatology EPAs:
Overall Goals and Objectives for Transplant Hepatology EPAs: 1. DIAGNOSTIC LIST During the one-year Advanced Pediatric Transplant Hepatology Program, fellows are expected to develop comprehensive skills
More informationThe Journal of Thoracic and Cardiovascular Surgery
Accepted Manuscript Commentary: NO FLOW? QUICK, RE-SEW Ross M. Bremner, MD, PhD PII: S0022-5223(19)30560-4 DOI: https://doi.org/10.1016/j.jtcvs.2019.02.092 Reference: YMTC 14240 To appear in: The Journal
More informationConsultation document on Organ Donation and Transplantation Response Form
Consultation document on Organ Donation and Transplantation Response Form Contact details of person and/or institution submitting comments Name of person Address e-mail address Knud Erben erben@ceapir.org
More informationFuture of liver transplantation
Future of liver transplantation Transplant Atlantic November 4, 2016 Ian Alwayn, MD, PhD The problem: Population is becoming older, more obese and more comorbid Donor population is becoming older, more
More informationRecipient Age Affects Long-Term Outcome and Hepatitis C Recurrence in Old Donor Livers Following Transplantation
LIVER TRANSPLANTATION 15:1288-1295, 2009 ORIGINAL ARTICLE Recipient Age Affects Long-Term Outcome and Hepatitis C Recurrence in Old Donor Livers Following Transplantation Markus Selzner, 1 Arash Kashfi,
More informationLiver Transplantation for Alcoholic Liver Disease in the United States: 1988 to 1995
Liver Transplantation for Alcoholic Liver Disease in the United States: 1988 to 1995 Steven H. Belle, Kimberly C. Beringer, and Katherine M. Detre T he Scientific Liver Transplant Registry (LTR) was established
More informationAdult-to-adult living donor liver transplantation Triumphs and challenges
Falk Symposium No. 163 on Chronic Inflammation of Liver and Gut Adult-to-adult living donor liver transplantation Triumphs and challenges ST Fan, MS, MD, PhD, DSc Professor Sun CY Chair of Hepatobiliary
More informationConsent and donor choice in lung and heart-lung transplantation
Consent and donor choice in lung and heart-lung transplantation A patient s guide 1 Lung transplantation is a good option for carefully selected patients with end stage lung disease but sadly there is
More informationDownloaded from:
Callaghan, CJ; Charman, SC; Muiesan, P; Powell, JJ; Gimson, AE; van der Meulen, JH; UK Liver Transplant Audit, (2013) Outcomes of transplantation of livers from donation after circulatory death donors
More informationMODERATOR Felix Rapaport, other members of this
The First Lung Transplant in Man (1963) and the First Heart Transplant in Man (1964) J.D. Hardy MODERATOR Felix Rapaport, other members of this distinguished panel, and members of the audience, I will
More informationLong-term Outcomes After Third Liver Transplant
ArtıcLe Long-term Outcomes After Third Liver Transplant C. Burcin Taner, 1 Deniz Balci, 1 Darrin L. Willingham, 1 Andrew P. Keaveny, 1 Barry G. Rosser, 1 Juan M. Canabal, 1 Timothy S. J. Shine, 2 Denise
More informationPredictive Value of Frozen-Section Analysis in the Histological Assessment of Steatosis Before Liver Transplantation
LIVER TRANSPLANTATION 15:1821-1825, 2009 ORIGINAL ARTICLE Predictive Value of Frozen-Section Analysis in the Histological Assessment of Steatosis Before Liver Transplantation Michelangelo Fiorentino, 1
More informationValue of an Individual Liver Biopsy in the Preoperative Evaluation of Apparently Healthy Potential Liver Donors
LIVER TRANSPLANTATION 14:541-546, 2008 ORIGINAL ARTICLE Value of an Individual Liver Biopsy in the Preoperative Evaluation of Apparently Healthy Potential Liver Donors Nurten Savas, 1 Mehmet Coskun, 2
More informationIGL-1. Each bag with 1 litre solution contains:
Cold storage solution for abdominal organs: liver, kidney, pancreas. 1. QUALITATIVE AND QUANTITATIVE COMPOSITION Each bag with 1 litre solution contains: Lactobionic acid 1 mmol/l 35,8 g/l Adenosine 5
More informationLong term liver transplant management
Long term liver transplant management Dr Bill Griffiths Cambridge Liver Unit Royal College of Physicians 5.7.17 Success of Liver Transplantation Current survival, 1 st elective transplant: 1 yr survival
More informationTRANSPLANT A TION OF LIVER, PANCREAS, heart, heart/
Rcpnmcd twill A:-':-'AL~ 01 ~LKlJt.K). I,lll J"~. I No.5. November 1983. Copyright. ~ 1983. by J. B. Lippincott Company. Printed in U.S.A. Principles of Multiple Organ Procurement from Cadaver Donors J.
More informationInformation for patients (and their families) waiting for liver transplantation
Information for patients (and their families) waiting for liver transplantation Waiting list? What is liver transplant? Postoperative conditions? Ver.: 5/2017 1 What is a liver transplant? Liver transplantation
More informationPAPER. Short- and Long-term Outcomes After Steatotic Liver Transplantation
PAPER Short- and Long-term Outcomes After Steatotic Liver Transplantation M. B. Majella Doyle, MD; Neeta Vachharajani, MD; Jason R. Wellen, MD; Christopher D. Anderson, MD; Jeffrey A. Lowell, MD; Surendra
More informationLiver transplantation is a gold standard of therapy. Estimation of Standard Liver Volume for Liver Transplantation in the Korean Population
Estimation of Standard Liver Volume for Liver Transplantation in the Korean Population Hee Chul Yu, 1,2 Heecheon You, 3 Ho Lee, 4 Zhe-Wu Jin, 1 Jang Il Moon, 5 and Baik Hwan Cho 1,2 The standard liver
More informationHeart transplantation is the gold standard treatment for
Organ Care System for Heart Procurement and Strategies to Reduce Primary Graft Failure After Heart Transplant Masaki Tsukashita, MD, PhD, and Yoshifumi Naka, MD, PhD Primary graft failure is a rare, but
More informationAllinaHealthSystem 1
: Definition End-organ hypoperfusion secondary to cardiac failure Venoarterial ECMO: Patient Selection Michael A. Samara, MD FACC Advanced Heart Failure, Cardiac Transplant & Mechanical Circulatory Support
More informationThe Prognostic Value of Renal Resistance During Hypothermic Machine Perfusion of Deceased Donor Kidneys
American Journal of Transplantation 2011; 11: 2214 2220 Wiley Periodicals Inc. Brief Communication C 2011 The Authors Journal compilation C 2011 The American Society of Transplantation and the American
More informationInformed Consent for Liver Transplant Patients
Informed Consent for Liver Transplant Patients Evaluation Process You will be evaluated with consultations, lab tests and various procedures to determine the medical appropriateness of liver transplant.
More information