Publications by authors named "Rajakannu Muthukumarassamy"

Background: Derivation of hepatocytes from stem cells has been established through various protocols involving growth factor (GF) and small molecule (SM) agents, among others. However, mesenchymal stem cell-based derivation of hepatocytes still remains expensive due to the use of a cocktail of growth factors, and a long duration of differentiation is needed, thus limiting its potential clinical application.

Methods: In this study, we developed a chemically defined differentiation strategy that is exclusively based on SM and takes 14 days, while the GF-based protocol requires 23-28 days.

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Article Synopsis
  • Hepatic artery complications (HACs) after pediatric liver transplantation can lead to significant health issues, and this study aims to understand how common they are, how they are managed, and what outcomes arise from these complications.
  • The research utilizes the international HEPATIC Registry, collecting data on pediatric patients under 18 who experienced HAC within the last 20 years, focusing on survival rates and treatment success.
  • Ethical approval will be obtained from all participating sites, and findings will be shared at conferences and in academic journals, with the study registered on ClinicalTrials.gov (NCT05818644).
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Background: Paucity of deceased donor livers has resulted in a 10-fold rise in living donor liver transplantations (LDLTs) performed in India over the past decade. Nonetheless, number of deceased donor liver transplantation (DDLT) performed has improved with the establishment of simplified legal framework for certification of brain death and organ donation. In this study, we present our outcomes of DDLT performed at various centers, comparing their outcomes and provide a snapshot of the increasing number of DDLT across the state over the years.

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An aggressive Epstein-Barr virus (EBV)-associated inflammatory pseudotumor-like follicular dendritic cell (IPT-like FDC) sarcoma is reported in an adult female. The patient developed multifocal recurrence and passed away 13 months after the initial surgical resection. A bright field microscopic examination of the tumor demonstrated a classical growth pattern and the diffuse expression of Programmed death ligand 1 (PD-L1) and somatostatin receptor 2a (SSTR2a).

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Background: Postoperative complications affect the long-term survival and quality of life in patients undergoing liver resection. No model has yet been validated to predict 90-day severe morbidity and mortality.

Methods: The prospective recruitment of patients undergoing liver resection for various indications was performed.

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Background: Failure to achieve a good arterial inflow to the graft in living donor liver transplantation (LDLT) has disastrous consequences to the graft and patient survival. Standard microvascular techniques of hepatic artery (HA) anastomosis used in deceased donor liver transplantation are not applicable in LDLT. We present the results of our unique Backwall-first technique of HA anastomosis in both adult and pediatric LDLT.

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Post-coronavirus disease 2019 (COVID-19) cholangiopathy (PCC) is a new entity observed in patients recovering from severe COVID-19 pneumonia. Most patients recover with cholestasis improving over a period of time. In some patients, cholestasis is severe and persists or progresses to liver failure necessitating liver transplant.

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Background: The aim was to develop a model to predict clinically significant portal hypertension, hepatic venous pressure gradient (HVPG) ≥10 mmHg using pre-operative noninvasive makers.

Methods: Patients who have been programmed for liver resection/transplantation were enrolled prospectively. Preoperative liver stiffness measurement (LSM), liver function test (LFT), and intraoperative HVPG were assessed.

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Background: Resection is rarely indicated in giant hepatic hemangiomas (HHs) that are symptomatic. Enucleation (EN), compared with anatomical resection (AR), is considered the better technique to resect them as EN has been reported to have lower morbidity while conserving the normal liver tissue. But no study has yet clearly established the superiority of EN over AR.

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Background: The impact of incidentally detected hepatocellular carcinoma (iHCC) in explanted liver on the prognosis of the patients undergoing orthotopic liver transplantation remains controversial with several studies reporting survival worse than true non-hepatocellular carcinoma (non-HCC) recipients. Patients undergoing living donor liver transplantation (LDLT) have the benefit of a shorter waiting time to transplant which in principle should reduce the frequency of new tumors developing while waiting for transplant. We aimed to evaluate the incidence, histopathological features, and impact of iHCC on short- and long-term outcomes in adult LDLT recipients.

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Background: Postoperative hepatic decompensation is a serious complication of liver resection in patients undergoing hepatectomy for hepatocellular carcinoma. Liver fibrosis and clinical significant portal hypertension are well-known risk factors for hepatic decompensation. Liver stiffness measurement is a noninvasive method of evaluating hepatic venous pressure gradient and functional hepatic reserve by estimating hepatic fibrosis.

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Article Synopsis
  • * A review of 150 patients who underwent sequential surgery for colorectal cancer liver and lung metastases over 20 years revealed a median overall survival of 76 months, with specific factors indicating poorer survival rates.
  • * A small percentage (20%) of patients with over five years of follow-up achieved disease-free survival and were considered cured, with targeted therapy being a significant predictor of this outcome.
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Hepatic artery stenosis (HAS) is a rare complication of orthotopic liver transplantation (LT). HAS could evolve into complete thrombosis and lead to graft loss, incurring significant morbidity and mortality. Even though endovascular management by percutaneous transluminal angioplasty ± stenting (PTA) is the primary treatment of HAS, its longterm impact on hepatic artery (HA) patency and graft survival remains unclear.

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Background: After whole graft orthotopic liver transplantation (OLT), adaptation of the large grafts' volume to recipient weight is widely accepted despite the paucity of evidence on this subject.

Methods: Thirty nine patients with GRWR > 2.5% were included in this study and subsequently divided into two groups with 3 ≥ GRWR > 3%.

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Jejunogastric intussusception is a rare long term complication of Billroth II gastrectomy. The case reported here is a 50 year old man with history of a Billroth II gastrectomy and Braun's side-to-side jejunojejunal anastomosis who presented with hematemesis. On abdominal examination, there was a mass in the left iliac fossa.

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The common causes of pseudoaneurysms of internal carotid artery (ICA) in the neck are penetrating trauma, head and neck surgeries, carotid endarterectomies, infiltrating metastatic lymph nodes and neoplasms. We report a young male patient who presented with a swelling in left upper neck diagnosed as carotid body tumor with ultrasonography and magnetic resonance imaging. Subadventitial excision of the tumor was done.

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Fibromatosis is a rare, locally aggressive but non-metastasising fibrous mass often associated with familial adenomatous polyposis in Gardner's Syndrome (GS). Although sporadic cases occur, unlike in GS, they are predominantly extra-abdominal. We report the case of a 40-year-old lady who underwent laparotomy for a large isolated abdominal mass three years after a Whipple's procedure for adenocarcinoma of the distal common bile duct.

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Background And Aim: Rhinosporidiosis is a chronic granulomatous disease that commonly affects the nasal and nasopharyngeal mucosa. It rarely presents as disseminated disease.

Case Report: We describe a rare case of a patient who had undergone treatment for recurrent nasal rhinosporidiosis and who presented with multiple subcutaneous swellings and pulmonary lesions.

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Aim: Anal fissures are associated with hypertonia of the internal anal sphincter and pain. We evaluated the efficacy of local application of a combination of minoxidil and lignocaine in healing anal fissures.

Methods: In this prospective, randomized, double-blind study, 90 patients with anal fissure were recruited.

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