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  • 1
    Language: English
    In: Transplantation Proceedings, 6/2012, Vol.44(5), pp.1460-1463
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.transproceed.2012.01.121 Byline: M.J. Zinser (a), D.W. Hanto (b) Abstract: Infrahepatic interruption of the inferior vena cava (IVC) with azygos or hemiazygos substitution has been reported frequently in children with biliary atresia where this venous abnormality is associated with other venous abnormalities such as preduodenal portal vein or congenital heart disease. It is important to recognize this anomaly pretransplant because the hepatic vein may drain directly into the right atrium rather than into the suprahepatic vena cava. We describe herein the first report of an orthotopic deceased donor liver transplant in an adult patient with an interrupted IVC and azygos continuation. We also review the embryological development of the IVC and the vascular anomalies that can occur. Author Affiliation: (a) Department of Plastic Surgery, University Witten-Herdecke, Cologne-Merheim, Germany (b) Transplant Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
    Keywords: Embryonic Development ; Genetic Disorders ; Organ Transplantation ; Liver Transplantation;
    ISSN: 00411345
    E-ISSN: 18732623
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  • 2
    Language: English
    In: Journal of Surgical Research, 2/2012, Vol.172(2), p.198
    ISSN: 00224804
    E-ISSN: 10958673
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  • 3
    Language: English
    In: American Journal of Transplantation, 04/2007, Vol.7(4), pp.1003-1009
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1600-6143.2006.01702.x Byline: S.R. Johnson (a), S. Alexopoulos (a), M. Curry (a), D.W. Hanto (a) Keywords: Graft failure; liver transplant; outcome; primary nonfunction Abstract: PNF following liver transplantation (LT) is an infrequent but life-threatening complication. Liver allocation under MELD is based upon recipient severity of illness, a known risk factor for the occurrence of PNF. The incidence of PNF since the application of MELD has not previously been reported. The SRTR database was studied since inception of MELD until September 2004 for all adult recipients of deceased donor LT. PNF was defined as graft loss or death within 14 days of LT secondary to PNF or without defined cause. A total of 10545 transplants met inclusion criteria and PNF occurred in 613 (5.81%) of recipients. Univariate analysis demonstrated donor age, serum creatinine 〉1.5 mg/mL, hypertension and CVA as risk factors for PNF. Recipient factors included life support, mechanical ventilation, use of inotropes, hemodialysis, initial status 1 and use of a shared transplant. In the multivariate model only donor age and recipient serum creatinine, bilirubin, on life support and status 1 at transplant were significant risk factors for PNF. In this analysis of PNF in the MELD era the incidence of PNF does not appear to have increased from prior reports. Risk factors for PNF are related to donor age and severity of recipient illness. Author Affiliation: (a)The Transplant Center, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts Article History: Received 12 August 2006, revised 21 November 2006 and accepted for publication 6 December 2006 Article note: (*) Corresponding author: S. R. Johnson, srjohnso@bidmc.harvard.edu
    Keywords: Databases -- Analysis ; Organ Transplantation -- Analysis;
    ISSN: 1600-6135
    E-ISSN: 1600-6143
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  • 4
    Language: English
    In: Annals of Surgical Oncology, 2005, Vol.12(5), pp.374-380
    Description: Prognosis after resection of colorectal liver metastases is influenced by various factors. A positive margin of resection (MOR) has been shown to adversely influence prognosis. Although a 1-cm MOR has been accepted as adequate, the data to support this guideline are sparse.Our hepatobiliary database was queried for patients who underwent liver resection for colorectal metastases between January 1992 and July 2003. All patients were divided into three groups: MOR 〈.5 cm (group A), .5 to 1 cm (group B), and 〉1 cm (group C). Operative reports from each hepatic resection were analyzed to determine local factors that may have contributed to a subcentimeter MOR.A total of 112 patients (67 men and 45 women) underwent liver resection for colorectal metastases with negative margins. Fifty-three patients were in group A, 26 patients were in group B, and 33 patients were in group C. Group C demonstrated decreased local recurrence (LR; P = .003), distant recurrence (DR; P = .008), and disease-free recurrence (P = .002). A significant difference in the overall time to LR (P = .003), time to DR (P = .003), and disease-free survival (P = .002) was also demonstrated. Factors associated with a subcentimeter MOR included nonanatomical resection (P = .043), proximity to a major vessel (P = .003), and central location (P = .002).A 〈1-cm resection for colorectal liver metastases is associated with increased LR and DR, as well as decreased disease-free survival. When a nonanatomical resection is performed, a MOR 〉1 cm should be attempted, because an adequate margin is often underestimated. Considerations should be made for extended resections when tumors are centrally located or near major vessels.
    Keywords: Colon cancer ; Hepatic metastases ; Resection margin ; Liver surgery
    ISSN: 1068-9265
    E-ISSN: 1534-4681
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  • 5
    Language: English
    In: American Journal of Roentgenology, 01/1984, Vol.142(1), pp.97-99
    Description: Six patients aged 33-68 years developed posttransplant lymphoma of the abdomen an average of 105 months after successful renal transplantation. On computed tomography (CT), five lymphomas presented as bulky masses in intra- (four) or retroperitoneal (one) location. Infiltrative growth into transplanted kidney (three), colon (two), and retroperitoneum (one) resulted in poorly defined margins on CT. Central areas of lower attenuation presumably reflected tumor necrosis. Metastatic deposits in liver (two) and renal transplant (one) were of a focal nature. Prompt radiologic recognition of this serious late complication of renal transplantation is crucial.
    Keywords: Kidney Transplantation ; Tomography, X-Ray Computed ; Abdominal Neoplasms -- Diagnostic Imaging ; Lymphoma -- Diagnostic Imaging;
    ISSN: 0361-803X
    E-ISSN: 1546-3141
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  • 6
    Language: English
    In: Transfusion, 09/1988, Vol.28(5), pp.474-478
    Description: Blood component use during orthotopic liver transplantation (OLT) was evaluated after an initial 23-month experience with 37 consecutive transplant procedures. Blood component support of OLTs in 24 adult and 13 pediatric patients was reviewed. Adult procedures required intraoperatively a mean of 24.5 units of red cells (RBCs), 38.7 units of fresh-frozen plasma (FFP), 26.1 random-donor platelets (RDP), and 12.2 units of cryoprecipitate (Cryo); pediatric procedures required 4.8 units of RBCs, 5.8 of FFP, 3.9 of RDP, and 1.2 of Cryo. RBC salvage constituted 17 percent of the RBCs transfused intraoperatively. Intraoperative support in adult and pediatric OLT patients accounted for the majority of the total components required for the entire hospital stay. OLT blood component use constituted 1.3, 7.0, 3.6, and 8.1 percent of hospital-wide use of RBC, FFP, RDP, and Cryo, respectively, during the period of the study.
    Keywords: Blood Transfusion ; Liver Transplantation;
    ISSN: 0041-1132
    E-ISSN: 1537-2995
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  • 7
    Language: English
    In: Hepatology, 1993, Vol.18(3), pp.747-747
    Keywords: Medicine
    ISSN: 0270-9139
    E-ISSN: 1527-3350
    Source: ScienceDirect Journals (Elsevier)
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  • 8
    Language: English
    In: Liver Transplantation, November 1997, Vol.3(6), pp.563-570
    Description: The present study examines the incidence, risk factors, bacteriology, and mortality of infectious episodes and the role of antimicrobial prophylactic regimens after OKT3 induction in liver transplantation. Infections occurring in the first 6 months were evaluated according to the Centers for Disease...
    Keywords: Medicine
    ISSN: 1527-6465
    ISSN: 10743022
    E-ISSN: 1527-6473
    E-ISSN: 23313293
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  • 9
    Language: English
    In: Liver Transplantation, September 1997, Vol.3(5), pp.513-517
    Description: Approximately 6,000 to 7,000 orthotopic liver transplantation (OLT) procedures are performed annually, which require the administration of large volumes of blood products. Thus liver transplantation can significantly strain local and regional blood resources at a time when transfusion practices are changing dramatically, in large part because of anxiety caused by the human immunodeficiency virus. Intraoperative autologous transfusion has been proposed as a means of both reducing transfusion demands and lessening the hazards of allogeneic transfusion. However, the cost effectiveness of intraoperative blood salvage has not been unequivocally determined. We retrospectively examined the cost of intraoperative autologous transfusion during OLT for a 2-year period at the University of Cincinnati Hospital. A direct comparison was made between the charge for autologous transfusion and the calculated cost of allogeneic transfusion. Seventy OLT procedures were performed during the years 1993-1994. The average charge for autologous transfusion was $1,048.73 per case. Cell-salvage volumes for all cases were added, and the calculated conservation of allogeneic packed red blood cells totaled 359.6 units, worth $30,026.60 or $428.95 per case. The break-even point is approximately 12.6 units, and most patient do not receive this volume of salvaged blood. In fact, cell salvage reached cost equivalence in only three cases (4.8%). Moreover, the cost deficit of autologous transfusion during this 2-year period averaged $586.56 per case. (Liver Transpl Surg 1997 Sep;3(5):513-7)
    Keywords: Medicine
    ISSN: 1527-6465
    E-ISSN: 1527-6473
    Source: ScienceDirect Journals (Elsevier)
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