Successful liver transplantation in hyperornithinemia-hyperammonemia-homocitrullinuria syndrome: Case report.

Background: HHH syndrome is a rare autosomal recessive disorder of the urea cycle, caused by a deficient mitochondrial ornithine transporter. We report the first successful liver transplantation in HHH syndrome performed in a seven-year-old boy. The patient presented at 4 weeks of age with hyperammonemic coma.

Left-liver Adult-to-Adult Living Donor Liver Transplantation: Can It Be Improved? A Retrospective Multicenter European Study.

Objective: To evaluate the European experience after Adult-to-adult living donor liver transplantation using the left liver (LL-aLDLT).

Summary Background Data: LL-aLDLT decreases donor risk but provides a smaller graft that increases recipient risk as compared with right liver (RL-aLDLT). However, there is little knowledge of results obtained after LL-aLDLT in Europe.

Liver transplantation for hepatocellular carcinoma comparing the Milan, UCSF, and Asan criteria: long-term follow-up of a Western single institutional experience.

Background: In patients with hepatocellular carcinoma (HCC), the outcome after liver transplantation (LT) is excellent if tumor characteristics are within the Milan criteria (MC). Expanded Asan criteria (AC) have not yet been validated in Western countries.

Methods: A total of 76 patients with HCC underwent LT.

Liver transplantation for alcoholic liver disease: a retrospective analysis of recidivism, survival and risk factors predisposing to alcohol relapse.

Background And Study Aims: Alcoholic liver disease (ALD) is the second most common indication for liver transplantation. The aim of this study was to evaluate the alcohol relapse rate and long-term survival after liver transplantation for ALD and to identify risk factors predisposing to alcohol relapse.

Patients And Methods: Between 2000 and 2007, 108 patients transplanted for ALD in the Ghent University Hospital were included in this retrospective analysis.

Expansion of memory-type CD8+ T cells correlates with the failure of early immunosuppression withdrawal after cadaver liver transplantation using high-dose ATG induction and rapamycin.

Background: We report on a pilot study investigating the feasibility of early immunosuppression withdrawal after liver transplantation (LT) using antithymocyte globulin (ATG) induction and rapamycin.

Methods: LT recipients received 3.75 mg/kg per day ATG from days 0 to 5 followed by rapamycin-based immunosuppression.

Risk factors and management of conversions to an open approach in laparoscopic liver resection: analysis of 265 consecutive cases.

Background: As a consequence of continuous technical developments in liver surgery, laparoscopic liver resection (LLR) is increasingly performed worldwide.

Methods: Between January 2004 and December 2011, 265 LLR were performed in 242 patients for various diseases. The experience of LLR is reported focusing on risk factors of conversion and their management.

Donor haptoglobin phenotype determines outcome following liver transplantation.

Haptoglobin (Hp) is a polymorphic plasma protein with multiple functions defined by three major phenotypes (Hp 1-1, Hp 2-1, and Hp 2-2). In this article, the effects of the donor Hp phenotype (determined by starch gel electrophoresis) on the outcome and the iron status after liver transplantation were investigated. A total of 450 liver transplant patients were enrolled in this study with a median follow-up of 37 months.

Lack of a correlation between portal vein flow and pressure: toward a shared interpretation of hemodynamic stress governing inflow modulation in liver transplantation.

The portal vein flow (PVF), portal vein pressure (PVP), and hepatic venous pressure gradient (HVPG) were prospectively assessed to explore their relationships and to better define hyperflow and portal hypertension (PHT) during liver transplantation (LT). Eighty-one LT procedures were analyzed. No correlation between PVF and PVP was observed.

Expression of placental growth factor in regenerating livers after partial hepatectomy in the rat.

Background/aims: Placental growth factor (PlGF) is known for its role in pathological conditions to protect parenchymal cells of different organs from injury, whereas its presence in the liver and its potential importance in stimulating liver regeneration has never been described. This was investigated in this study using a rat model of partial hepatectomy (PH).

Methods: The rat model of 70, 80, and 90% PH was used.

Hypomagnesemia and the risk of new-onset diabetes after liver transplantation.

New-onset diabetes after transplantation (NODAT) is a frequent complication after liver transplantation and has a negative impact on both patient and graft survival. In analogy with the previous finding of an association between posttransplant hypomagnesemia and NODAT in renal transplant recipients, the relation between both pretransplant and posttransplant hypomagnesemia and NODAT was studied in liver transplant recipients (LTRs). One hundred sixty-nine adult LTRs (>18 years old) without diabetes who underwent transplantation between 2004 and 2009 were studied (mean age = 52.

Open intraperitoneal versus retromuscular mesh repair for umbilical hernias less than 3 cm diameter.

Background: mesh techniques are the preferable methods for repair of small ventral hernias, as a primary suture repair shows high recurrence rates. The aim of this prospective study was to compare the retromuscular sublay technique with the intraperitoneal underlay technique for primary umbilical hernias.

Methods: from February 2004 to April 2007, all patients treated for umbilical hernias with maximum diameters of 3 cm were prospectively followed.

Evolution of laparoscopic left lateral sectionectomy without the Pringle maneuver: through resection of benign and malignant tumors to living liver donation.

Background: Laparoscopic left lateral sectionectomy (LLS) has gained popularity in its use for benign and malignant tumors. This report describes the evolution of the authors' experience using laparoscopic LLS for different indications including living liver donation.

Methods: Between January 2004 and January 2009, 37 consecutive patients underwent laparoscopic LLS for benign, primary, and metastatic liver diseases, and for one case of living liver donation.

Laparoscopic evaluation shows deficiencies in memory ring deployment during small ventral hernia repair.

Background: With the introduction of a self-expanding, memory-containing, circular hernia patch, surgeons have been enthusiastic about its use to repair ventral hernias smaller than 3 cm in diameter. The aim of this study was to evaluate the efficiency, reliability, and safety of the device laparoscopically with respect to adequate deployment of the patch.

Methods: During 1 year all patients with small ventral hernias were treated with this memory-containing patch and were inspected by laparoscopy.

Hemostatic efficacy of TachoSil in liver resection compared with argon beam coagulator treatment: an open, randomized, prospective, multicenter, parallel-group trial.

Background: The aim of this trial was to confirm previous results demonstrating the efficacy and safety of a fixed combination tissue sealant versus argon beam coagulation (ABC) treatment in liver resection.

Methods: This trial was designed as an international, multicenter, randomized, controlled surgical trial with 2 parallel groups. Patients were eligible for intra-operative randomization after elective resection of ≥ 1 liver segment and primary hemostasis.

Comparable results with 3-year follow-up for large-pore versus small-pore meshes in open incisional hernia repair.

Background: Decreasing the amount of polypropylene by increasing pore size produces a lighter weight mesh that may improve tissue ingrowth and, functional properties of the abdominal wall and diminish mesh-related complications. It was the aim of this prospective observational cohort study to analyze the outcome of incisional hernia repair using small-pore versus large-pore meshes and using a standardized, open, retromuscular surgical technique.

Methods: Across a 6-year period we analyzed 205 patients treated with a heavyweight mesh (group I) and 235 patients treated with a large-pore mesh (group II) for incisional hernias.

Liver transplantation from donation after cardiac death donors: initial Belgian experience 2003-2007.

The Belgian experience with donation after cardiac death (DCD) liver transplantation (LT) was retrospectively reviewed, particularly evaluating patient and graft survivals, and biliary complications. From 2003 to 2007, 58 DCD-LT were performed in Belgium. Mean procurement total warm ischemia time was 25 +/- 2 min (mean +/- SEM).

Transinguinal preperitoneal memory ring patch versus Lichtenstein repair for unilateral inguinal hernias.

Purpose: The aim of this study was to compare the transinguinal preperitoneal technique (TIPP) using a memory ring patch versus the Lichtenstein technique in relation to acute and chronic pain, post-operative complications and recurrence rates.

Methods: During an 18-month period, all adult patients that needed treatment for a unilateral inguinal or femoral hernia were treated by the TIPP repair using the Polysoft mesh. This group was retrospectively compared with a historical cohort of patients treated by the Lichtenstein technique.

Acute liver transplant rejection upon immunosuppression withdrawal in a tolerance induction trial: potential role of IFN-gamma-secreting CD8+ T cells.

We designed a pilot trial in cadaveric liver transplantation to determine whether induction with antithymocyte globulins (ATG) and sirolimus would allow immunosuppression withdrawal. Patients received ATG 3.75 mg/kg per day from day 1 to 5 after transplantation followed by sirolimus for 4 to 6 months.

Expression of SGLT1, Bcl-2 and p53 in primary pancreatic cancer related to survival.

Increased expression of glucose transporters has been reported in many cancers. It is not known whether Sodium dependent GLucose Transporter 1 (SGLT1) is up-regulated in pancreatic cancer. We studied the expression of SGLT1, Bcl-2 and p53 in primary pancreatic adenocarcinomas related to survival.

Split liver transplantation with extended right grafts under patient-oriented allocation policy. Single center matched-pair outcome analysis.

Background: Split liver transplantation (SLT) is an established technique developed to optimize the number of available grafts. Few data are available on SLT with extended right liver grafts (eRLG) in the context of patient-oriented allocation policy.

Methods: Between July 1, 2001 and December 31, 2005, 12 whole liver graft (WLG) recipients were matched with 12 eRLG recipients according to their clinical status, indication and year of liver transplantation.

The value of laparoscopic liver surgery for solid benign hepatic tumors.

Background: Laparoscopic liver resection (LLR) has gained wide acceptance for various liver resection procedures, mainly for benign diseases. However, only small series have been reported from a few selected centers.

Methods: Between January 2001 and January 2006, a total of 629 liver resections were performed at our institution.

Use of topical hemostatic agents during liver resection.

Despite all recent developments in surgical techniques during liver surgery, blood loss is still one of the main causes for postoperative morbidity and mortality. Other complications include bile leakage and fluid accumulation intraperitoneally. Fibrin sealants are able not only to enhance clot formation and wound healing but possibly work as a sealing device for postoperative leakage and fistula formation.

Rating of CCl(4)-induced rat liver fibrosis by blood serum glycomics.

Background: Non-invasive staging of human liver fibrosis is a desirable objective that remains under extensive evaluation. Animal model systems are often used for studying human liver disease and screening antifibrotic compounds. The aim of the present study was to investigate the potential use of serum N-glycan profiles to evaluate liver fibrosis in a rat model.

Early immunosuppression withdrawal after living donor liver transplantation and donor stem cell infusion.

Long-term results of organ transplantation are still limited by serious side effects of immunosuppressive drugs. A major issue, therefore, is to elaborate novel therapeutic protocols allowing withdrawal or minimization of immunosuppressive therapy after transplantation. We report on 3 patients prospectively enrolled in an original protocol designed to promote graft acceptance in living donor liver transplantation, using posttransplant conditioning with high doses of antithymocyte globulin followed by injection of donor-derived stem cells.