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We read with great interest the recent publication by La Mura et  al1 that focused on the potential beneficial role of anticoagulants in the treatment of portal vein thrombosis (PVT) in cirrhotic patients. The investigators concluded that anticoagulant therapy (VKA) is highly effective in portal recanalization, without any evidence of an increased risk of bleedi ng, compared with untreated cirrhotic patients. In addition, La Mura et al1 successfully showed that achieving a complete recanalization of PVT with VKA is associated with a significant reduction in the long-term risk of PTH-related complication and death and/or need for a liver transplant.
Source: Clinical Gastroenterology and Hepatology - Category: Gastroenterology Authors: Tags: Letter to the Editor Source Type: research

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We describe a case of HCC with vascular invasion and right atrial thrombus that was successfully down staged. Patient underwent combined right atrial thrombectomy and living donor liver transplantation (LDLT) in the same setting. Perioperative anesthesia management and perioperative concerns of two major combined procedures are discussed.
Source: Journal of Anaesthesiology Clinical Pharmacology - Category: Anesthesiology Authors: Source Type: research
Background. To analyze the risk factors affecting the development of infection in artificial vascular grafts (AVGs) used for reconstruction of middle hepatic vein (MHV) tributaries in living donor liver transplantation (LDLT). Methods. Between January 2009 and January 2018, 1253 right lobe LDLTs were performed at our Transplant Institute, and MHV tributaries of the 640 right lobe liver grafts were reconstructed with AVG. Reconstructed MHV tributaries were removed due to AVG infection in 25 of these patients (case group; n = 25). To determine risk factors for AVG infection, right lobe LDLT patients without AVG infectio...
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research
Conclusions. This study led to European clinical trial authorization for a phase II study in a homogeneous patient cohort, with repeated infusions and intermediate doses.
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research
Since a 1989 report demonstrating successful living donor liver transplantation (LDLT), living donors have been increasingly used to overcome the disparity between organ supply and demand, especially in the cases of pediatric patients. Although short-term graft outcomes after LDLT have improved significantly because of progress in surgical techniques and immunosuppression, biliary stricture (BS) remains the Achilles heel of pediatric LDLT and is the major cause of significant long-term morbidity. BS results in poor quality of life or even in graft loss after LDLT, with a reported incidence of BS after pediatric LDLT of 10%...
Source: Transplantation - Category: Transplant Surgery Tags: Commentaries Source Type: research
Abstract Hepatocellular carcinoma is one of the most frequent malignant tumors worldwide: Portal vein tumor thrombosis (PVTT) occurs in about 35%-50% of patients and represents a strong negative prognostic factor, due to the increased risk of tumor spread into the bloodstream, leading to a high recurrence risk. For this reason, it is a contraindication to liver transplantation and in several prognostic scores sorafenib represents its standard of care, due to its antiangiogenetic action, although it can grant only a poor prolongation of life expectancy. Recent scientific evidences lead to consider PVTT as a complex...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
Nontumoral PVT is present at liver transplantation in 5% to 26% of cirrhotic patients, and the prevalence of complex PVT as defined here (Grade 4 Yerdel, and Grade 3,4 Jamieson and Charco) has been reported in 0% to 2.2%.Adequate portal inflow is mandatory to ensure graft and patient survival after liver transplantation. With time, the proposed classifications of non-tumoral chronic PVT have evolved from being anatomy-based to also incorporating functional parameters. However, none of the currently proposed classifications are directed towards decision-making, as regards choice of inflow to the graft during LT and the outcomes there of.
Source: Journal of Hepatology - Category: Gastroenterology Authors: Tags: Review Source Type: research
Non-tumoral portal vein thrombosis (PVT) is present at liver transplantation in 5% to 26% of cirrhotic patients, and the prevalence of complex PVT as defined here (grade 4 Yerdel, and grade 3,4 Jamieson and Charco) has been reported in 0% to 2.2%. Adequate portal inflow is mandatory to ensure graft and patient survival after liver transplantation. With time, the proposed classifications of non-tumoral chronic PVT have evolved from being anatomy-based, to also incorporating functional parameters.
Source: Journal of Hepatology - Category: Gastroenterology Authors: Tags: Review Source Type: research
Conclusion: MSCTA detected more lesions and we believe that it should be considered as a road map for Doppler US follow-ups as well as a routine screening modality for early detection of vascular complications in symptomatic and asymptomatic liver transplantation patients that may be missed by Doppler US. PMID: 31408295 [PubMed - as supplied by publisher]
Source: Turkish Journal of Medical Sciences - Category: General Medicine Tags: Turk J Med Sci Source Type: research
AbstractClinical manifestations of liver transplantation complications can be subtle and non-specific. Medical imaging, mainly Doppler ultrasound, plays an important role to detect and grade these. Colour Doppler ultrasound exams are routinely performed at 24 –48 h, on the 7th day, the first and third month after transplantation. MDCT and MR images are acquired based on the Doppler ultrasound (DUS) findings, even in the absence of abnormal liver function. As vascular complications appear early after surgery, DUS should be performed by experience pers onnel. Diagnostic angiography is seldom performed. This pict...
Source: Insights into Imaging - Category: Radiology Source Type: research
ConclusionRetrohepatic IVC damages are not a contraindication for LDLT. The presence or absence of venous collateral circulation is an important indicator of the need for IVC interposition graft use.
Source: Journal of Gastrointestinal Surgery - Category: Surgery Source Type: research
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