Validation of the IWATE criteria as a laparoscopic liver resection difficulty score in a single North American cohort.

Background: Laparoscopic liver resection (LLR) involves a difficult learning curve, for which multiple difficulty scores have been proposed to assist with safe adaptation. The IWATE Criteria is a 4-level difficulty score shown to correlate with conversion to open surgery, estimated blood loss (EBL), and operative time in Japanese and French cohorts. We set out to validate the IWATE Criteria in a North American cohort, describe the evolution of our LLR program, and analyze the IWATE Criteria's ability to predict conversion to open surgery.

Conditional probability of graft survival in liver transplantation using donation after circulatory death grafts - a retrospective study.

The use of livers from donation after circulatory death (DCD) is historically characterized by increased rates of biliary complications and inferior short-term graft survival (GS) compared to donation after brain death (DBD) allografts. This study aimed to evaluate the dynamic prognostic impact of DCD livers to reveal whether they remain an adverse factor even after patients survive a certain period following liver transplant (LT). This study used 74 961 LT patients including 4065 DCD LT in the scientific registry of transplant recipients from 2002-2017.

Should We Be Utilizing More Liver Grafts From Pediatric Donation After Circulatory Death Donors? A National Analysis of the SRTR from 2002 to 2017.

Background: Rates of withdrawal of life-sustaining treatment are higher among critically ill pediatric patients compared to adults. Therefore, livers from pediatric donation after circulatory death (pDCD) could improve graft organ shortage and waiting time for listed patients. As knowledge on the utilization of pDCD is limited, this study used US national registry data (2002-2017) to estimate the prognostic impact of pDCD in both adult and pediatric liver transplant (LT).

Sufficient hepatic artery flow compensates for poor portal vein flow after liver transplantation in patients with portal vein thrombosis.

Objective: Portal vein thrombosis (PVT) does not preclude liver transplantation (LT), but poor portal vein (PV) flow after LT remains a predictor of poor outcomes. Given the physiologic tendency of the hepatic artery (HA) to compensate for low PV flow via vasodilation, we investigated whether adequate HA flow would have a favorable prognostic impact among patients with low PV flow following LT.

Methods: This study included 163 patients with PVT who underwent LT between 2004 and 2015.

Risk of Post-transplant Hepatocellular Carcinoma Recurrence Is Higher in Recipients of Livers From Male Than Female Living Donors.

Objective: To evaluate the relationship between donor sex and hepatocellular carcinoma (HCC) recurrence after living donor liver transplantation.

Background: HCC shows a male predominance in incidence and recurrence after tumor resection due to sex differences in hepatic sex hormone receptors. There have been no studies evaluating the importance of donor sex on post-transplant HCC recurrence.

Laparoscopic Liver Resection of Hepatocellular Carcinoma with a Tumor Size Larger Than 5 cm: Review of 45 Cases in a Tertiary Institution.

Introduction: Although laparoscopic liver resection (LLR) has developed rapidly, its usefulness for the treatment of large tumors is less clear, due to concerns about compromising oncological principles and patient safety. The purpose of this study was to explore the feasibility and safety of LLR for the treatment of hepatocellular carcinoma (HCC) with a tumor size larger than 5 cm.

Patients And Methods: From January 2007 to December 2014, we performed LLR in 45 patients with HCC with a tumor size ≥5 cm.

Immunosuppression status of liver transplant recipients with hepatitis C affects biopsy-proven acute rejection.

Background/aims: The relationship between patient survival and biopsy-proven acute rejection (BPAR) in liver transplant recipients with hepatitis C remains unclear. The aims of this study were to compare the characteristics of patients with and without BPAR and to identify risk factors for BPAR.

Methods: We retrospectively reviewed the records of 169 HCV-RNA-positive patients who underwent LT at three centers.

Sustained linear growth and preserved renal function in 10-year survivors of pediatric liver transplantation.

The aim of this study was to characterize the clinical outcomes of children and adolescents who achieved survival of more than 10 years following liver transplantation (LT) in a single center in Korea. From June 1996 to October 2003, 57 pediatric LTs were performed. The medical records of 44 patients who had survived more than 10 years were reviewed retrospectively.

Microsteatosis may not interact with macrosteatosis in living donor liver transplantation.

Background & Aims: The insignificance of pure microsteatosis (MiS) was reported in living donor liver transplantation (LDLT). However, since steatosis is mostly found in a mixed form of microsteatosis (MiS) and macrosteatosis (MaS), we aimed to determine the importance of MiS mixed with MaS in LDLT.

Methods: Donor matching and recipient matching were independently performed with unfixed matching ratios.

Antiviral treatment for hepatitis B virus recurrence following liver transplantation.

The purpose of this study was to identify the factors associated with the recurrence of hepatitis B virus (HBV) following liver transplantation (LT) for HBV-related disease and to recognize the outcome of treatment for HBV recurrence with oral nucleos(t)ide analogues. Six hundred and sixty-seven LTs were performed for HBsAg-positive adult patients in our institute from 1996 to 2010. HBV prophylaxis was performed by hepatitis B immunoglobulin (HBIG) monotherapy or HBIG and entecavir combination therapy.

Clinical implications of quantitative real time-polymerase chain reaction of parvovirus B19 in kidney transplant recipients - a prospective study.

This prospective study was designed to investigate the clinically significant level of parvovirus B19 viral load using quantitative real-time (RT) polymerase-chain reaction (PCR) in kidney transplantation (KT) recipients. One hundred forty-three adult recipients who underwent their first KT between November 2003 and October 2005 were enrolled. Six blood samples (the first taken preoperatively, subsequent samples taken every 4 weeks for 20 weeks) were taken from each patient for parvovirus B19 DNA RT-PCR analysis.

Prolonged cold ischemic time is a risk factor for biliary strictures in duct-to-duct biliary reconstruction in living donor liver transplantation.

Background: Duct-to-duct (DD) anastomosis is an accepted procedure for biliary reconstruction in living donor liver transplantation (LDLT). However, biliary complication rates in LDLT recipients have been reported to be as high as 20% to 30% or more. In this study, we examined various potential risk factors for biliary stricture (BS) that occurs in the context of DD reconstruction in a single-active transplant center.