First report of full colon transplantation as part of a visceral allograft.

Background: The inclusion of the colon as part of intestinal and multivisceral allografts has increased in the last decade.

Methods: We describe for the first time in the literature a full colon transplantation as a part of a visceral allograft. The new approach involves modifications of the procurement technique with preservation of all three visceral aortic branches and incorporation of the descending and sigmoid colon as a part of the allograft.

Current perspectives on living donor selection in liver transplantation.

The careful selection of donors is crucial to achieving a successful outcome in living donor liver transplantation. The evaluation process involves obtaining a comprehensive medical history and pertinent laboratory testing, evaluating surgical anatomy using cross-sectional radiologic imaging and understanding donor motivation and psycho social considerations. This review outlines the evaluation of a potential living liver donor and discussed frequently encountered special considerations that may need to be addressed by the transplant team.

Survival benefit associated with liver transplantation for hepatocellular carcinoma based on tumor burden scores at listing.

Introduction: Liver transplantation (LT) provides significant survival benefits to patients with unresectable HCC. In the United States, organ allocation policies for HCCs within the United Network for Organ Sharing criteria do not prioritize patients based on their differences in oncological characteristics. This study assessed whether transplant-associated survival benefits (TASBs) vary among patients with different tumor burden scores (TBS) measured at the time of listing.

Evolving Impact of COVID-19 on Intestinal Transplant Recipients: A Single-Center Experience.

Background: There has been significant concern about coronavirus disease 2019 (COVID-19) among transplant recipients, particularly those who are highly immunosuppressed. Several studies have analyzed the impact of COVID-19 on different solid organ transplant patients. However, few isolated case reports of COVID-19 in intestinal and multivisceral transplant (ITx and MVTx) recipients are available in the literature.

Post-Liver Transplant Outcomes: A Comparative Study of 6 Predictive Models.

Background: We compared the performance of the Liver Transplant Risk Score (LTRS) with the survival outcomes following liver transplantation (SOFT), pretransplant SOFT (P-SOFT), Balance of Risk Score (BAR), donor-age and model for end-stage liver disease (D-MELD), and Organ Procurement and Transplantation Network Risk Prediction Score (ORPS) for the prediction of 90-d mortality, 1-y mortality, and 5-y survival after first-time liver transplantation (LT).

Methods: A retrospective analysis of the Scientific Registry of Transplant Recipients was conducted using data collected between 2002 and 2021.

Results: A total of 82 696 adult LT recipients with a median age of 56 y were included.

Survival after live donor versus deceased donor liver transplantation: propensity score-matched study.

Background: For individuals with advanced liver disease, equipoise in outcomes between live donor liver transplant (LDLT) and deceased donor liver transplant (DDLT) is uncertain.

Methods: A retrospective cohort study was performed using data extracted from the Scientific Registry of Transplant Recipients. Adults who underwent first-time DDLT or LTDL in the United States between 2002 and 2020 were paired using propensity-score matching with 1:10 ratio without replacement.

Donor-recipient race-ethnicity concordance and patient survival after liver transplantation.

Introduction: We assessed the association between patient survival after liver transplantation (LT) and donor-recipient race-ethnicity (R/E) concordance.

Methods: The Scientific Registry of Transplant Recipients (SRTR) was retrospectively analyzed using data collected between 2002 and 2019. Only adults without history of prior organ transplant and recipients of LT alone were included.

Interaction between cold ischemia time and Kidney Donor Profile Index on postrenal transplant outcomes.

We analyzed whether there is an interaction between the Kidney Donor Profile Index (KDPI) and cold ischemia time (CIT) in recipients of deceased donor kidney transplant (KTs). Adults who underwent KTs in the United States between 2014 and 2020 were included and divided into 3 KDPI groups (≤20%, 21%-85%, >85%) and 4 CIT strata (<12, 12-17.9, 18-23.

Safety of Patients with Renal Artery Aneurysm to Proceed with Living Donation.

Background: Renal artery aneurysm (RAA) is a rare condition that involves dilation of all layers of the arterial wall of the renal artery. The risk of rupture is rare, but intervention is recommended for larger aneurysms. Surgical decision-making regarding live donor renal transplantation (LDRT) centers around safety for the living donor, and laterality of the donated kidney is based on providing the donor with the best longevity pertaining to the remaining kidney.

Multiple infusions of ex vivo-expanded regulatory T cells promote CD163 myeloid cells and kidney allograft survival in non-lymphodepleted non-human primates.

Clinical verification of adoptively transferred regulatory T cell (Treg) efficacy in transplantation remains challenging. Here, we examined the influence of autologous ex vivo-expanded polyclonal Tregs on kidney graft survival in a clinically relevant non-human primate model. Peripheral blood Tregs were isolated and expanded using artificial antigen presenting cells.

Liver retransplants using living donors: An approach for management.

Background And Aims: Many centers do not offer living donor transplants for patients in need of a liver retransplant. We aimed to study our liver retransplant outcomes using living donors and compared them with those of retransplants performed using deceased donors.

Methods: This study retrospectively analyzed all retransplants performed at our center between 2009 and 2023, and outcomes of living donor retransplants were compared with deceased donor retransplants using standard statistical tests.

Virtual crossmatch for deceased donor kidney transplantation in the United States: A survey of histocompatibility lab directors and transplant surgeons.

Virtual crossmatch (VXM) is used as an alternative to or in conjunction with a cell-based physical crossmatch (PXM) for assessing HLA (human leukocyte antigen) compatibility prior to deceased donor kidney transplantation (DDKT). Data on practice patterns and perceptions regarding VXM use in the US are limited. We performed a survey of US HLA directors and transplant surgeons regarding HLA testing and crossmatch strategies.

Back Table Preparation of the Right Lobe Live Donor Liver Allograft: A Crucial Part of the Adult Live Donor Liver Transplant Procedure.

Introduction: We aimed to describe our procedure for vascular reconstruction and back table bench preparation for the right lobe live donor allograft. Live donor liver transplantation (LDLT) remains an important option for the expansion of the donor pool. The procedure has been widely used, and its success is dependent on a technically perfect operation with appropriate inflow and outflow of the allograft.

Treatment modalities and long-term outcomes of hepatic hemangioendothelioma in the United States.

Background: We analyzed the outcomes of patients with hepatic epithelioid hemangioendothelioma (HEHE) in the United States after stratification by their most definitive treatment.

Methods: The National Cancer Data Base was used to identify patients with HEHE between 2004 and 2018. Patients were divided in four treatment groups: no surgical therapy, ablation, liver resection or liver transplantation.

Increasing Living Donor Liver Transplantation Using Liver Paired Exchange.

Background: Living donor liver transplantation (LDLT) continues to be the primary modality of liver transplantation in Asia, but it accounts for about 5% of all liver transplantations in the US. ABO incompatibility is the primary reason motivated donors are declined. Although kidney paired exchanges are common, liver paired exchange (LPE) is still evolving in the US.

Scedosporiosis in a Combined Kidney and Liver Transplant Recipient: A Case Report of Possible Transmission from a Near-Drowning Donor.

spp. are saprobic fungi that cause serious infections in immunocompromised hosts and in near-drowning victims. Solid organ transplant recipients are at increased risk of scedosporiosis as they require aggressive immunosuppression to prevent allograft rejection.

En Bloc Liver Kidney Transplantation Using Donor Splenic Artery as Inflow to the Kidney: Report of Two Cases.

The number of simultaneous liver-kidney transplants has been increasing. This surgery is associated with an increased risk of complications, longer duration of surgery and longer ischemia time for the renal allograft. Two patients listed for liver-kidney transplant at our center underwent en bloc combined liver-kidney transplantation using donor splenic artery as inflow.

Laparoscopic vertical sleeve gastrectomy after open gastric banding in a patient with situs inversus totalis.

While several equivalent alternatives are available in the bariatric algorithm, more recently the laparoscopic sleeve gastrectomy (SG) has been gaining traction as an effective means of weight loss in patients with morbid obesity. We present the case of a 39-year-old woman with situs inversus totalis, who was taken to the operating room for laparoscopic SG. The patient had previously undergone a failed open gastric banding procedure 20 months earlier.

Life-threatening postoperative hemorrhage from hepatic artery pseudoaneurysm successfully treated by transcatheter embolization in a 5-year-old.

Upper gastrointestinal bleeding caused by a pseudoaneurysm after hepatobiliary operation is well described in adults. This can be successfully treated with transcatheter embolization under angiographic guidance. We report a case of massive upper gastrointestinal bleeding in a 5-year-old boy secondary to a pseudoaneurysm of the right hepatic artery after choledochal cyst excision.

Robotic vs. laparoscopic colorectal surgery: an institutional experience.

Background: Robotic colorectal surgery is gaining interest in general and colorectal surgery. The use of the da Vinci(®) Robotic system has been postulated to improve outcomes, primarily by increasing the dexterity and facility with which complex dissections can be performed. We report a large, single institution, comparative study of laparoscopic and robotic colectomies, attempting to better elucidate the benefits of robotic surgery in patients with colorectal disease.

The effect of low body mass index on outcome in critically ill surgical patients.

Background: Body mass index (BMI) has been correlated with complications and outcome in surgical patients at the two extremes of the nutrition spectrum.

Objective: To study the relationship between BMI, outcome, hospital length of stay, and complications in patients admitted to the surgical intensive care unit (SICU).

Design: Review of prospectively acquired data in SICU patients.