Bile Spillage as a Prognostic Factor for Gall Bladder Cancer: A Systematic Review and Meta-Analysis.

Introduction: Biliary spillage (BS) is a common complication following initial cholecystectomy for gall bladder cancer (GBC). Few studies have explored the importance of BS as a long-term prognostic factor. We perform a meta-analysis of the association between BS and survival in GBC.

Collaborative Approach Toward Transplant Candidacy for Obese Patients with End-Stage Renal Disease.

Background: An elevated BMI is a major cause of transplant preclusion for patients with end-stage renal disease (ESRD). This phenomenon exacerbates existing socioeconomic and racial disparities and increases the economic burden of maintaining patients on dialysis. Metabolic bariatric surgery (MBS) in such patients is not widely available.

Balancing Waitlist Dropout in Pancreas Transplantation.

Background: The time a patient spends on the waiting list for a Simultaneous Pancreas-Kidney (SPK) transplant depends on several donor and recipient-specific factors. The average wait-list time for SPK in the United States has been about 1 to 3 years, significantly shorter than the average wait time for kidney-only transplantation. A single-center retrospective analysis of SPK waitlisted candidates was performed to determine the implication of wait-list time on dropout from the wait-list due to death or poor health.

Laparoscopic Living Donor Nephrectomy: A Single Center Comparison of Three Different Techniques.

Background And Objectives: In this study, we compare three different surgical approaches at a single institution. Pure laparoscopic donor nephrectomy with Pfannenstiel incision (PLDN) was compared with hand-assisted laparoscopic donor nephrectomy via midline hand port (HALDNM) and hand-assisted laparoscopic donor nephrectomy via left iliac hand port (HALDNL).

Methods: This study included all laparoscopic left donor nephrectomies performed at our institution between January 1, 2020 and December 31, 2021.

Kidney Transplant Outcomes in Recipients Over the Age of 70.

Background: Patients older than 70 years are the fastest-growing age group of patients requiring renal replacement therapy. This has resulted in a corresponding increase in the number of elderly transplant recipients. We hypothesized that graft survival in this population would be comparable to that seen in the literature on kidney transplant recipients under 70 years of age.

Short and Long-Term Outcomes of Kidney Transplant Recipients Diagnosed With COVID-19 Infection: A Single-Center Observational Study.

Purpose: Kidney transplant recipients (KTRs) are at an increased risk of severe disease and death caused by coronavirus disease 2019 (COVID-19) infection. There is a paucity of information on the evolution of graft function among hospitalized KTRs who overcome the infection.

Methods: The study included adult KTRs at a single transplant institute who were diagnosed with COVID-19 and needed hospitalization between March 15, 2020, and January 15, 2021.

Resolution of Disseminated Angiosarcoma in a Kidney Transplant Recipient After Treatment With Sirolimus: A Case Report.

Angiosarcoma is a rare, almost universally fatal malignant neoplasm in kidney transplant recipients. No evidence-based guidelines are available for disseminated disease. Here, we report a case of a 66-year-old woman who developed disseminated angiosarcoma 4 months after living nonrelated kidney transplant.

Littoral cell angiomas: Benign lesion with a penchant for visceral malignancies.

Littoral cell angiomas are rare vascular tumors of the spleen. Because of their rarity, unclear etiopathogenesis, and association with other malignancies, these tumors can pose diagnostic and therapeutic challenges. Due to paucity of published literature on this entity often limited to case reports, relevant data on this topic were procured and synthesized with the aid of a comprehensive Medline search in addition to oncologic, pathologic, radiologic, and surgical literature review on littoral cell angiomas.

Observational Study of the Clinical Characteristics and Short-Term Outcomes of Kidney Transplant Recipients Diagnosed With COVID-19 Infection (SARS-CoV-2) Requiring Hospitalization in New Orleans.

Kidney transplant recipients are at increased risk of severe disease and death caused by coronavirus disease 2019 (COVID-19) infection. The role of immunosuppressive medications in the clinical presentation, disease course, and outcomes is not well understood. We analyzed kidney transplant recipients diagnosed with COVID-19 and requiring hospitalization during the initial infection surge at 2 large transplant centers in New Orleans, Louisiana, between February 1, 2020 and April 30, 2020.

Recipient risk factors for acute cellular rejection after orthotopic liver transplant - a single-center, retrospective study.

The use of model for end-stage liver disease (MELD) score for liver allocation has resulted in transplanting sicker patients. As such, it is unclear whether the risk factors and severity of acute cellular rejection (ACR) have changed. To identify ACR characteristics where average MELD score at transplant is higher than previously published studies.

Robotic Assisted Living Donor Nephrectomies: A Safe Alternative to Laparoscopic Technique for Kidney Transplant Donation.

Objective: To review outcomes after laparoscopic, robotic-assisted living donor nephrectomy (RLDN) in the first, and largest series reported to date.

Summary Of Background Data: Introduction of minimal invasive, laparoscopic donor nephrectomy has increased live kidney donation, paving the way for further innovation to expand the donor pool with RLDN.

Methods: Retrospective chart review of 1084 consecutive RLDNs performed between 2000 and 2017.

Robotic kidney transplantation in the obese patient: 10-year experience from a single center.

Despite increasing obesity rates in the dialysis population, obese kidney transplant candidates are still denied transplantation by many centers. We performed a single-center retrospective analysis of a robotic-assisted kidney transplant (RAKT) cohort from January 2009 to December 2018. A total of 239 patients were included in this analysis.

Real-Time Intraoperative Assessment of Microcirculation in Living-Donor Small Bowel Transplant: A Case Report.

Living-donor small bowel transplant has emerged as a modality to transplant patients with short bowel syndrome without prolonged wait time, albeit at the cost of technical challenges associated with vascular anastomosis due to the small size of vessels. Suboptimal perfusion in a transplanted bowel can lead to a devastating outcome, and clinical judgment alone is not completely reliable for assessment of bowel microcirculation. Here, we report a 55-year-old female patient who underwent flow cytometric cross-match-positive living-donor bowel transplant from her daughter.

Living Donor Liver Transplantation: Technical Innovations.

Living donor liver transplantation (LDLT) has found a place to serve the end-stage liver disease community as the donor safety and recipient suitability has been elucidated. Donor safety is of paramount importance and transplant programs must continue endeavors to maintain the highest possible standards. At the same time, adequacy of grafts based on recipient clinical status via their model for end-stage liver disease (MELD) score and volumetric studies to achieve a GRBWR >0.

The use of bovine pericardial patch for vascular reconstruction in infected fields for transplant recipients.

Infectious vascular complications affecting transplant recipients may lead to severe morbidity and graft loss. This is a retrospective review of vascular repair with bovine pericardial patch (BPP) in infected fields for immunosuppressed patients. BPP was used as either a patch or an interposition graft.

Pancreas Transplantation From Pediatric Donors: A United Network for Organ Sharing Registry Analysis.

Background: Pancreas grafts from pediatric donors are still considered "not ideal." Perceived concerns are related to low islet mass and potential for graft thrombosis.

Methods: The study evaluated all pancreas transplants from January 2000 to May 2015 using the Organ Procurement and Transplant Network database.

Long-term outcomes of living-related small intestinal transplantation in children: A single-center experience.

Pediatric patients with irreversible intestinal failure present a significant challenge to meet the nutritional needs that promote growth. From 2002 to 2013, 13 living-related small intestinal transplantations were performed in 10 children, with a median age of 18 months. Grafts included isolated living-related intestinal transplantation (n=7), and living-related liver and small intestine (n=6).

Obesity Increases the Risk of Primary Nonfunction and Early Access Loss, and Decreases Overall Patency in Patients Who Underwent Hemodialysis Reliable Outflow Device Placement.

Background: Hemodialysis reliable outflow (HeRO) catheters were introduced in 2008, and have been since providing a reliable alternative for hemodialysis patients who are deemed "access challenged." However, its outcomes have not been extensively investigated due to its relatively young age. Here, we report our 6-year single institution experience, and demonstrate the significant impact of obesity on HeRO graft outcomes, an aspect not previously studied in the literature.

Single Center Experience With Robotic Kidney Transplantation for Recipients With BMI of 40 kg/m2 Or Greater: A Comparison With the UNOS Registry.

Background: Obesity represents a barrier to kidney transplantation, but the increasing prevalence among renal failure patients has forced some centers to carefully consider such candidates. Morbidly obese patients may be at increased risk of delayed graft function, higher postoperative complications, and inferior graft outcomes. Nevertheless, mortality on the waiting list remains significantly higher than after transplant.

Successful living donor intestinal transplantation in cross-match positive recipients: Initial experience.

Sensitized patients tend to have longer waiting times on the deceased donor list and are at increased risk of graft loss from acute or chronic rejection compared to non-sensitized candidates. Desensitization protocols are utilized to decrease the levels of alloantibodies and to convert an initial positive cross-match to prospective donors into a negative crossmatch. These procedures are mostly available in the setting of living donation.

Renofemoral shunt for protection of abdominal allografts during emergency abdominal aortic surgery.

Emergency aortic surgery can be a daunting task in patients with functioning kidney and pancreas allografts because it poses the risk of allograft loss due to prolonged warm ischemia created by aortic cross-clamping. We present a case in which dual allografts, both originating from the right iliac arterial system, were protected from warm ischemia during aortic cross-clamping by creation of a temporary renofemoral shunt between the native left renal artery and right femoral artery. This simple technique maintained pulsatile allograft perfusion during aortic reconstruction for treatment of a ruptured mycotic aortic aneurysm complicated by an aortocolonic fistula.

Concurrent hepatic artery and portal vein thrombosis after orthotopic liver transplantation with preserved allografts.

In contrast to early HAT, late HAT has an insidious clinical presentation. Nevertheless, biliary and vascular reconstructions in this late setting are unlikely to improve outcome. Patent portal flow makes an important contribution to the viability of liver in case of late HAT while the allograft reconstitutes intrahepatic arterial flow through neovascularization.

Robotic-assisted kidney transplantation.

Robotic-assisted surgery has enabled organ transplantation in a minimally invasive fashion. Kidney transplantation is the best treatment of patients with chronic renal failure. Robotic surgery has reduced the difficulties associated with kidney transplantation for obese patients.