Ex Situ Machine Perfusion of Human Donor Livers via the Surgically Reopened Umbilical Vein: A Proof of Concept

Conclusions. Machine perfusion with portal perfusion via the umbilical vein is feasible. Portal venous flows were similar to those obtained after cannulation of the portal vein main stem. This technique enables continuous oxygenated perfusion of liver grafts during procurement, splitting, and implantation.
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science–Liver Source Type: research

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We report a case of an intracranial hemorrhage first suspected during a trans-cranial Doppler assessment of a postorthotopic liver transplant patient. The patient was at considerable risk of bleeding, due to a primary graft nonfunction, but he had also elevated ammonium levels, justifying the comatose state, and no focal neurological deficits.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Case Report Source Type: research
Authors: Kim JS, Kim KW, Choi SH, Jeong SY, Kwon JH, Song GW, Lee SG Abstract OBJECTIVE: To investigate whether diagnostic performance of contrast-enhanced ultrasound (CEUS) could be improved with modified criteria to diagnose significant hepatic artery occlusion (HAO) and to determine the role of CEUS in patients with a tardus-parvus hepatic artery (HA) pattern on Doppler US. MATERIALS AND METHODS: Among 2679 adult liver transplantations performed over 7 years, HAO was suspected in 288 recipients, based on Doppler ultrasound. Among them, 130 patients underwent CEUS. After excluding two technical failures, 128 ...
Source: Korean Journal of Radiology - Category: Radiology Tags: Korean J Radiol Source Type: research
Purpose:Veno-occlusive disease (VOD) is a severe complication of allogenic stem cell transplantation (allo-SCT). The diagnosis of VOD is often difficult and relies on clinical assessment and clinical chemistry. B-mode ultrasound (B-US) and color doppler sonography (CDS) are only of limited additional diagnostic value. We recently observed a patient with VOD, who revealed a pathologic hepatic CEUS pattern (reduced portal venous and parenchymal enhancement). Because CEUS is a measure of perfusion, this suggested that CEUS could potentially be a novel diagnostic tool of VOD (Trenker et al. Bone Marrow Transplantation, 2018). ...
Source: Blood - Category: Hematology Authors: Tags: 721. Clinical Allogeneic Transplantation: Conditioning Regimens, Engraftment, and Acute Transplant Toxicities: Poster II Source Type: research
AbstractUltrasound is routinely used as the first imaging exam for evaluation of renal transplants and can identify most major surgical complications and evaluate vascularity with color Doppler. Ultrasound is limited, however, in the detection of parenchymal disease processes and Doppler evaluation is also prone to technical errors. Multiple new ultrasound applications have been developed and are under ongoing investigation which could add additional diagnostic capability to the routine ultrasound exam with minimal additional time, cost, and patient risk. Contrast-enhanced ultrasound (CEUS) can be used off-label in the tra...
Source: Abdominal Imaging - Category: Radiology Source Type: research
AbstractLivers removed during transplant hepatectomies could represent a useful anatomic ex vivo resource for surgical training, since they are intact and not altered by post-mortem changes yet. The aim of this study is to investigate the effectiveness of such kind of surgical training applied on some hepatic surgery techniques. In the present paper, we focused on split liver operation and middle hepatic vein (MHV) bipartition/reconstruction, since these procedures have a quite long learning curve. Seven native livers were submitted to split liver procedure by a senior resident assisted by a fully trained hepatic surgeon. ...
Source: Updates in Surgery - Category: Surgery Source Type: research
AbstractPurposeHepatopulmonary syndrome (HPS) and portopulmonary hypertension (PoPH) are extrahepatic complications of biliary atresia (BA). Their detection is sometimes delayed, which may result in missed opportunities for liver transplantation. The aim of this study was to determine the onset ages of HPS and PoPH in BA patients.MethodsBA patients followed at our institution were identified. Patients visited our clinic for routine blood work, as well as regular electrocardiography, chest X-rays, and arterial blood gas tests. Lung perfusion scintigraphy and cardiac ultrasound were performed to diagnose HPS. Cardiac cathete...
Source: Pediatric Surgery International - Category: Surgery Source Type: research
We present the case of a 47-year-old man, whose diagnosis was made with clinical and analytical data supported by ultrasound signs that showed hepatic congestion. After treatment with defibrotide the patient improved clinically and analytically. Hepatic vascularization and perfusion also improved. Therefore, abdominal doppler ultrasound is shown as a noninvasive exploration useful for the clinical management of SOS and as an early marker of good clinical evolution. PMID: 28715896 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
In this study, we performed ultrasound elastography to explore the stiffness of the right lobe liver before and after hepatectomy in donors who underwent resection of left lobe or lateral segment of liver.
Source: Transplantation Proceedings - Category: Transplant Surgery Authors: Tags: Asian Transplantation Week 2016 Source Type: research
Abstract Contrast-enhanced Ultrasound (CEUS) represents a complementary technique to grey-scale and colour Doppler ultrasonography (US) which allows for real-time visualization and characterization of tissue perfusion. Its inherent advantages in the child makes US an ideal imaging modality; repeatability and good tolerance along with the avoidance of computed tomography (CT), a source of ionizing radiation, renders US imaging desirable. Although currently paediatric CEUS is principally used in an "off-label" manner, US contrast agents have received regulatory approval for assessment of paediatric focal l...
Source: The British Journal of Radiology - Category: Radiology Authors: Tags: Br J Radiol Source Type: research
French Intensive Care Society, International congress - Réanimation 2016. Ann Intensive Care. 2016 Jun;6(Suppl 1):50 Authors: Jaillette E, Girault C, Brunin G, Zerimech F, Chiche A, Broucqsault-Dedrie C, Fayolle C, Minacori F, Alves I, Barrailler S, Robriquet L, Delaporte E, Thellier D, Delcourte C, Duhamel A, Nseir S, Valette X, Desmeulles I, Savary B, Masson R, Seguin A, Daubin C, Sauneuf B, Verrier P, Pottier V, Orabona M, Samba D, Viquesnel G, Lermuzeaux M, Hazera P, Hanouz JL, Parienti JJ, Du Cheyron D, Demoule A, Clavel M, Rolland-Debord C, Perbet S, Terzi N, Kouatchet A, Wallet F, Roze H, Vargas ...
Source: Australian Family Physician - Category: Primary Care Authors: Tags: Ann Intensive Care Source Type: research
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