[Surgical treatment of liver cancer: experience of the A Coruña UHC (Spain)].

Introduction: Liver cancer (LC) is one of the most frequent tumours, in which the potentially curative treatment is surgery: partial surgical resection or liver transplant.

Objectives: To determine the morbidity and mortality, survival, and their associated factors in patients with LC, according to the type of surgical treatment: partial surgical resection or liver transplant.

Material And Methods: A retrospective, observational follow-up study of LC patients diagnosed and treated from June 1994 to December 2007.

Prognostic and developmental factors in patients receiving liver transplant due to hepatocellular carcinoma: one center's experience in the north of Spain.

Background: Hepatocellular carcinoma (HCC) is one of the most frequent types of tumor. The aim of this study was to determine the survival of patients who had received liver transplants as a result of the disease.

Methods: This observational follow-up study included 150 patients who received liver transplantations from June 1994 to December 2007.

Portal and systemic venous drainage in pancreas and kidney-pancreas transplantation: early surgical complications and outcomes.

Objective: The objective of this study was to perform a retrospective analysis of the clinical evolution and surgical complications comparing pancreas transplantation with systemic-enteric (SE) drainage versus portal-enteric (PE) drainage.

Methods: This review of 48 consecutive pancreas transplantation includes 39 simultaneous kidney and pancreas (SKP) and 9 pancreas after kidney (PAK) grafts as well as 2 retransplantations. Venous drainage was systemic (n = 29) or portal (n = 19).

Early venous outflow obstruction after liver transplantation and treatment with cavo-cavostomy.

Objective: The objective of this study was to describe by a retrospective analysis the evolution of patients who needed an end-to side cavo-cavostomy in addition to a previous cavo-caval anastomosis, during orthotopic liver transplantation (OLT), caused by hepatic venous outflow obstruction.

Methods: We reviewed 673 consecutive OLT and the treatment and evolution of technique-related complications.

Results: This study of 673 consecutive OLT, all with the piggyback modality included 23 cases (22 patients and 23 grafts) who underwent an additional cavo-caval anastomosis for venous outflow problems either perioperatively or during the immediate postoperative period.

Interventional radiologist treatment for inferior vena caval thrombosis in a liver transplant recipient.

Vascular complications remain an important cause of postoperative morbidity and mortality in liver transplant patients. There is no elective treatment and the need for retransplantation is common. Herein, we have reported an unusual case of nonanastomotic inferior vena cava thrombosis in a patient with a piggyback caval anastomosis.

Effects of portal versus systemic venous drainage in pancreas and kidney-pancreas transplantation.

Unlabelled: We performed a retrospective analysis to compare pancreas transplantation with systemic-enteric drainage (SE) or portal-enteric drainage (PE).

Methods: We reviewed 38 consecutive pancreas transplants including 31 simultaneous kidney-pancreas (SKP) and 7 pancreas after kidney (PAK), using either systemic (n = 18) or portal (n = 20) venous drainage. Demographic, clinical, and immunologic variables were similar for both groups.

The anteromedial thigh flap as a training model of a perforator flap in rat.

Background: Perforator flap surgery is a complex surgery that is based on the use of a highly precise microsurgical technique that differs slightly from a conventional free flap, especially the intramuscular dissection of the pedicle. Herein, we report a new model of a perforator flap in rat, the anteromedial thigh flap, as a teaching model of a perforator flap. It is based on a constant musculocutaneous perforator that arises from the muscular vessels for the gracilis muscle.

Steroid-free immunosuppression for pancreas-after-liver transplantation.

Simultaneous pancreas-kidney transplantation is presently a well-accepted procedure for patients with type 1 diabetes mellitus and renal failure. However, experiences with combined pancreas and liver transplantation are scarce, a few data are available about the best immunosuppression for these patients. We report our experience with two patients who received a pancreas after liver transplantation for long-standing insulin-dependent diabetes mellitus, with steroid-free immunosuppression based on daclizumab, tacrolimus, and mycophenolate mofetil.

Benefits of recombinant activated factor VII in complicated liver transplantation.

Introduction: Recombinant activated factor VII (rFVIIa, NovoSeven, NovoNordiskA/S, Bagsvaerd, Denmark) has shown benefits in hemophilic patients and recently in transplant recipients. This study presents our experiences with rFVIIa in complicated liver transplant recipients.

Methods: From May 2001 to August 2004, rFVIIa was administered to 7 patients undergoing liver transplantation.

Portal vein thrombosis in patients undergoing orthotopic liver transplantation: intraoperative endovascular radiological procedures.

Purpose: To evaluate the usefulness of endovascular procedures for portal vein complications during orthotopic liver transplantation (OLT).

Materials And Methods: Between May 1994 and November 2004, we performed 504 OLTs in 464 adults. Seventy-eight patients (16.

Long-term results for liver transplantation from non-heart-beating donors maintained with chest and abdominal compression-decompression.

Introduction: The aim of this study was to evaluate long-term results after liver transplantation from non-heart-beating donors (NHBD) using the method of chest and abdominal compression-decompression to maintain donors.

Methods: From December 1995 to November 2004, 10 NHBD were identified and maintained by means of the method of chest and abdominal compression-decompression until family and judicial permission were granted. Nine donors were Maastricht type II and one was type IV.

Endovascular treatment of splenomesenteric-portal vein thromboses during orthotopic liver transplantation.

Extensive splanchnic venous thrombosis in patients undergoing orthotopic liver transplantation (OLT) continues to have a substantial impact on surgical complexity and perioperative morbidity and mortality rates. This report presents an experience in eight patients with splanchnic venous thrombosis treated by means of splanchnic vessel recanalization, primary stent placement, and closure of spontaneous competitive shunts during OLT. In all cases, portal perfusion in the allograft was adequate, portal hypertension was solved, and no complications were observed.

Kidney-pancreas transplants: is it so difficult to start a program?

Background: For selected patients with type 1 diabetes mellitus and end-stage renal failure, simultaneous kidney-pancreas (SKP) or pancreas after kidney (PAK) transplantation is the treatment of choice. However, it is frequently difficult to start a program for fear of serious intraabdominal complications in an immunosuppressed patient. We review our initial experience with these transplantations.

Liver transplantation from maastricht category 2 non-heart-beating donors: a source to increase the donor pool?

Introduction: The demand for liver transplantation has increasingly exceeded the supply of cadaver donor organs. Non-heart-beating donors (NHBDs) may be an alternative to increase the cadaver donor pool. The outcome of 20 liver transplants from Maastricht category 2 NHBD was compared with that of 40 liver transplants from heart-beating donors (HBDs).

Liver transplantation from Maastricht category 2 non-heart-beating donors.

Background: The demand for liver transplantation has increasingly exceeded the supply of cadaver donor organs. Non-heart-beating donors (NHBDs) may be an alternative to increase the cadaver donor pool.

Methods: The outcome of 20 liver transplants from Maastricht category 2 NHBDs is compared with 40 liver transplants from heart-beating donors (HBDs).

Renal transplantation with venous drainage through the superior mesenteric vein in cases of thrombosis of the inferior vena cava.

Renal transplantation usually is performed by placing the graft in the iliac fossa, anastomosing the renal vein to the iliac vein or, when this is not possible, to the vena cava. When vascular complications occur, particularly on the venous side, the position of the graft may have to be changed. This report describes orthotopic renal grafts and positioning of the organ with anastomosis to the splenic vessels.

Auxiliary liver transplantation with portal arterialization in the rat: description of a new model.

In recent years, portal arterialization has been used in liver transplantation to increase the portal flow, as a solution for singular technical problems. We have developed a new auxiliary liver transplantation model in the rat with portal arterialization, so the native hepatic hilium remains untouched, consisting on a graft with a previous 70% hepatectomy. It is sited on the right renal bed, joining the infrahepatic inferior vena cava (IVC) of the graft with the recipient IVC.