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Pain management for liver transplant recipients
We present current evidence-based literature that reviews optimal pain management strategies for this challenging patient demographic.RECENT FINDINGS: Multiple studies have shown that thoracic epidurals provide superior pain control in open hepatic resections. Recent data suggests thoracic epidurals may be safely considered in select liver transplant recipients with normal preoperative coagulation status; however, this evidence is limited, and further studies are needed. When the risks of coagulopathy prohibit epidural placement, truncal blocks such as transversus abdominis plane blocks or quadratus lumborum blocks and abd...
Source: Current Opinion in Organ Transplantation - September 20, 2023 Category: Transplant Surgery Authors: Simrat Kaur Patrick Henthorn Adrian Hendrickse Source Type: research

Dysfunctional Cori and Krebs cycle and inhibition of lactate transporters constitute a mechanism of primary non-function of fatty liver allografts
Transl Res. 2023 Sep 16:S1931-5244(23)00146-9. doi: 10.1016/j.trsl.2023.09.006. Online ahead of print.ABSTRACTOrthotopic liver transplantation (OLT) is a lifesaving procedure. However, grafts may fail due to primary non-function (PNF). In the past, we demonstrated PNFs to be mainly associated with fatty allografts, and given its unpredictable nature, the development of a disease model is urgently needed. In an effort to investigate mechanism of fatty-allograft associated PNFs, we induced fatty liver disease in donor animals by feeding rats a diet deficient in methionine and choline (MCD). We performed OLT with allografts o...
Source: Translational Research : the journal of laboratory and clinical medicine - September 18, 2023 Category: Laboratory Medicine Authors: Ulf Kulik Caroline Moesta Reinhard Spanel J ürgen Borlak Source Type: research

Emerging therapeutic options for non-alcoholic fatty liver disease: A systematic review
CONCLUSION: The data analyzed in this review showed clinically significant improvement in individual histological features of NAFLD in both animal and human trials for all four classes, as well as good safety profiles (P < 0.05). We believe this compilation of information will have positive clinical implications in obtaining an FDA-approved therapy for NAFLD.PMID:37701920 | PMC:PMC10494562 | DOI:10.4254/wjh.v15.i8.1001
Source: World Journal of Hepatology - September 13, 2023 Category: Gastroenterology Authors: Jasmine Tidwell Natalie Balassiano Anjiya Shaikh Mahmoud Nassar Source Type: research

Machine perfusion in liver transplantation
CONCLUSIONS: In situations where the decision has been made to transplant a liver donated after circulatory death or donated following brain death, end-ischaemic HOPE will provide superior clinically relevant outcomes compared with SCS alone. Specifically, graft survival is improved (high-certainty evidence), serious adverse events are reduced (moderate-certainty evidence), and in donors after circulatory death, clinically relevant ischaemic biliary complications are reduced (high-certainty evidence). There is no good evidence that NMP has the same benefits over SCS in terms of these clinically relevant outcomes. NMP does ...
Source: Cochrane Database of Systematic Reviews - September 12, 2023 Category: General Medicine Authors: Samuel J Tingle Joseph J Dobbins Emily R Thompson Rodrigo S Figueiredo Balaji Mahendran Sanjay Pandanaboyana Colin Wilson Source Type: research

Outcomes of Patients With Colorectal Liver Metastasis in the Developing World: Is Liver Transplantation for Unresectable Liver Metastasis, the Next Logical Step?
CONCLUSION: Liver transplant has the potential to benefit a small but significant portion of patients with unresectable liver metastasis.PMID:37693265 | PMC:PMC10483002 | DOI:10.1016/j.jceh.2023.03.009
Source: Clinical Colorectal Cancer - September 11, 2023 Category: Cancer & Oncology Authors: Janesh M Mufaddal Kazi Shraddha Patkar Prudvi Raj S Abhiram Bhoyar Ashwin Desouza Avanish Saklani Mahesh Goel Source Type: research

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