Safety and efficacy of extended thrombophilia screening directed venous thromboembolic events (VTE) prophylaxis in live liver donors: do we really need extended thrombophilia screening routinely?

Background And Aims: The study aimed to determine the prevalence of hereditary thrombophilia, and stratify its severity among live liver donors in Pakistan. Also, the authors evaluated the safety and efficacy of thrombophilia profile testing directed venous thromboembolic events (VTE) prophylaxis while balancing bleeding risk and the need for routine thrombophilia testing before live liver donation among living donor candidates.

Materials And Methods: Protein S (PS), protein C (PC), anti-thrombin (AT) III, and anti-phospholipid antibody panel (APLA) levels were measured in 567 potential donor candidates.

Obstacles to the deceased donor transplantation in Pakistan.

Introduction: Transplantation in many Asian countries is moulded by socioeconomic, religious, cultural and health indicators. In most Asian countries, the living-related donation is the common most organ donation. Due to the limited deceased organ donation, live donor programmes flourished in many Asian countries.

Splenic artery transposition for hepatic arterial supply in living donor liver transplantation.

Objective: To determine the safety and outcome of splenic artery(SA) transposition in extra-anatomic hepatic arterial reconstruction (HAR) in living donor liver transplantation(LDLT).

Methods: We retrospectively compared the outcome of the ten liver recipients who underwent HAR with the transposed splenic artery (SA group) with a matched cohort of 40 recipients who underwent HAR with the standard hepatic artery (HA group) between March, 2019 and December, 2020 at liver transplantation department, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Pakistan. The comparison of recipients' and donor demographics, operative and graft characteristics, post-operative labs, Doppler ultrasound(USG) findings, and complications, along with 30-day mortality, and 1-year survival were reported for both groups.

Simultaneous Living Kidney And Liver Transplantation in a Young Male From Two Living Donors.

Simultaneous kidney and liver transplantation (SKLT) is the surgical treatment modality for combined liver and kidney failure. Although it is a challenging procedure, but has got the added advantage of a single procedure and common immunosuppression therapy. Recently, the practice of deceased donors SKLT has increased dramatically in the West.

Central Pancreatectomy for Solid Pseudopapillary Tumour of Pancreas in A 13-Year Girl.

Solid Pseudopapillary Tumour (SPT) is a very rare tumour of the pancreas. A 13-year girl presented to us with the complaint of upper abdominal pain and non-bilious vomiting for 15 days. Preoperative diagnosis of SPT involving the body of the pancreas was made by CT scan and ultrasound- guided Trucut biopsy.

Cerebral phaeohyphomycosis in liver transplant recipient: A case report.

Cerebral phaeohyphomycosis is a fungal brain infection with a high fatality rate. It is caused by dematiaceous fungi and is increasingly recognized as a cause of serious illness in both immunocompetent and immunocompromised patients. We report cerebral phaeohyphomycosis in a liver transplant recipient.

Liver Transplantation in HIV-Infected Patient.

HIV infections have always been a stigma, and the majority of transplant centres avoid liver transplantation in patients having end-stage liver disease patients with HIV coinfection. HIV patients with end-stage liver disease having undetectable HIV viral load, CD4+ cell count of >100/ml, and negative history of AIDS-specific opportunistic infections are considered suitable candidates for liver transplantation. Fulfilling the above-mentioned criteria, we performed successful living donor liver transplantation (LDLT) procedure on a 58-year-old gentleman who presented with end-stage liver disease and HIV coinfection.

The Need for a Liver Transplant Registry in Pakistan.

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Evolving liver transplantation in Pakistan: Future challenges.

Liver transplantation is a life-saving procedure that started in the early 60s. Initially, it struggled with multiple failed attempts but later it progressed and emerged as a gold standard procedure for liver failure secondary to various etiologies. In the first two decades, it faced various challenges like peri and post-operative care management, the quality of graft, optimal immunosuppressant use, and recipient selection criteria.

Is a Preservation Solution for Living Donor Liver Transplantation Needed? Adding a New Chapter in LDLT!

Unlabelled: Preservation solutions are required for organ viability in deceased donor liver transplantation (LT). However, their role in live donor LT (LDLT) has not been standardized.

Methods: Eighty adult recipients who underwent right lobe LDLT at the Department of Liver Transplantation Surgery, Gambat, Pakistan, were studied.

ABO incompatible living donor liver transplant with antibody titer of 1:4: First case report from Pakistan.

Introduction And Importance: The most common reason for live liver donor rejection is ABO incompatibility. With breaching this incompatibility barrier, probably an additional 25%-35% of liver transplantation (LT) procedures would become possible. Also, ABOi-LT can be lifesaving in acute settings.

Expanding the living liver donor pool in countries having limited deceased donor activity: Pakistani perspective.

Over the last decades, liver transplantation (LT) has evolved into a life-saving procedure. Due to limited deceased donor activities in the eastern world, living donor liver transplantation (LDLT) had flourished tremendously in most Asian countries. Yet, these LDLT activities fall short of meeting the expected demands.

An Innovation in the Technique of Recipient Hepatectomy in Living Donor Liver Transplantation.

Recipient hepatectomy is a challenging surgical procedure. Coagulopathy, multiple collaterals, and dense adhesions secondary to previous spontaneous bacterial peritonitis in cirrhotics are the major contributing factors. However, the appropriate recipient hepatectomy technique can limit the massive blood loss and minimize the operative time.

DRCNN: A deep recurrent convolutional neural network with transfer learning through pre-trained embeddings for automated ICD coding.

The International Classification of Diseases (ICD), which is endorsed by the World Health Organization, is a diagnostic classification standard. ICD codes store, retrieve, and analyze health information to make clinical decisions. Currently, ICD coding has been adopted by more than 137 countries.

Role of antibiotic prophylaxis on surgical site infection prevention in a low-risk population undergoing laparoscopic cholecystectomy: A randomized controlled study.

Objective: To compare the incidence of surgical site infections (SSIs) in low-risk patients undergoing laparoscopic cholecystectomy (LC) with pre-operative antibiotics versus no pre-operative antibiotics administration.

Study Design: Randomized controlled study.

Setting: Hepatobiliary department, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Pakistan, from Jul 1, 2018, to Jun 30, 2021.

Safety of glucose-6 phosphate dehydrogenase deficient donors in living right lobe liver donation.

Background: The literature lacks data on World Health Organization (WHO) class II and III deficient liver donors who underwent right hepatectomy during living donor liver transplantation (LDLT).

Methods: In this prospective cohort study, we compared the perioperative outcomes of 15 glucose-6 phosphate dehydrogenase (G6PD) deficient living liver donors with a matched cohort of 39 nondeficient living liver donors undergoing right lobe donation.

Results: Out of 15 G6PD deficient donors, four (26.

Small-for-Size versus Standard-Size Graft in Living Donor Liver Transplantation.

Objective: To compare the outcome of small-for-size grafts versus standard-size grafts regarding the frequency of postoperative complications, early graft dysfunction, and 1-year survival.

Study Design: Retrospective cohort study.

Place And Duration Of Study: Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences (PAQSJIMS) Hospital, Gambat, Sindh, Pakistan from March 2019 to April 2020.

Median Arcuate Ligament Compression on Celiac Trunk during Liver Transplantation Procedure.

Low insertion of median arcuate ligament (MAL) can cause compression over the celiac trunk with subsequent complications. During liver transplantation procedure, the graft artery is usually anastomosed with the hepatic artery of the recipient, which arises from the celiac trunk. MAL compression might reduce hepatic arterial blood flow to the graft, which can induce postoperative hepatic arterial thrombosis, causing graft failure.

Challenges of continuation of live liver donor programme during COVID-19 pandemic in Pakistan: outcomes and lessons learned.

Background: COVID-19 pandemic has globally affected healthcare including the transplantation programmes.

Materials And Methods: We retrospectively studied the impact of COVID-19 on live liver donor (LLD) programme at liver transplant centre in Gambat, Pakistan. Standard operative procedures (SOPs) including COVID-19 nasopharyngeal swab PCR, CT scans, personal protective equipment use, 6-feet distancing were developed for LLD and transplant team to mitigate COVID-19 exposure.

Hepatic hemangioendothelioma - A rare case report.

Introduction And Importance: Hepatic hemangioendothelioma (HHE) is a very rare mild-moderate malignant tumor of the hepatic vascular endothelium. The etiology is yet not fully understood. Patients can be asymptomatic or may present with non-specific symptoms or hepatic insufficiency.

Frequency and Outcome of Hepatic Arterial Thrombosis in Recipients of Living Donor Liver Transplantation.

Unlabelled: ABASTRACT Objective: To determine the frequency, risk factors, and management of hepatic arterial thrombosis (HAT) in recipients of living donor living transplantation.

Study Design: Cohort study.

Place And Duration Of Study: Department of Liver Transplant, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Sindh, Pakistan, from 1st January 2019 to 31st July 2020.