Background: Living-donor liver transplantation has become a legitimate alternative to cadaveric liver transplantation. However, information on the perioperative management of donors is still scarce.
Methods: Between October 1996 and May 2001, 52 consecutive living-donor liver transplantations have been performed at the authors' institution. The preoperative and postoperative management of donors, operative technique, and complications are herein described.
Results: All donors were discharged from the hospital alive and well, and all returned to their normal lifestyle without any significant adverse sequelae after a mean hospital stay of 13 days after the operation. Overall, 24 complications occurred, all of which could be managed conservatively, except for one case of hepatic duct stricture that required a relaparotomy. A learning curve has been observed in terms of blood loss during donor hepatectomy.
Conclusions: These results indicate that our approach toward the selection and management of donors was appropriate. Because of the use of meticulous operative techniques, blood loss could also be minimized.
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http://dx.doi.org/10.1067/msy.2002.119576 | DOI Listing |
DNA is subject to continual damage, leaving each cell with thousands of individual DNA lesions at any given moment. The efficiency of DNA repair means that most known classes of lesion have a half-life of minutes to hours, but the extent to which DNA damage can persist for longer durations remains unknown. Here, using high-resolution phylogenetic trees from 89 donors, we identified mutations arising from 818 DNA lesions that persisted across multiple cell cycles in normal human stem cells from blood, liver and bronchial epithelium.
View Article and Find Full Text PDFUpdates Surg
January 2025
Department of Gastrointestinal and Transplant Surgery, Hospital São Lucas Copacabana, Hospital Adventista Silvestre and Hospital Universitário Clementino Fraga Filho-UFRJ, Rio de Janeiro, Brazil.
Although living donor liver transplantation has evolved, small-for-size syndrome remains a feared complication. Achieving optimal outflow for the graft with limited donor risk is possible with an experienced team and different techniques. Here we describe the technical aspects of living donor liver transplantation using a right lobe graft, including the different types of grafts, venous reconstructions and the importance of preoperative workup.
View Article and Find Full Text PDFAnn Hepatobiliary Pancreat Surg
January 2025
Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Backgrounds/aims: Liver transplantation (LT) is now a critical, life-saving treatment for patients with liver cirrhosis or hepatocellular carcinoma. Despite its significant benefits, biliary complications (BCs) continue to be a major cause of postoperative morbidity. This study evaluates the fluorescence intensity (FI) of the common bile duct (CBD) utilizing near-infrared indocyanine green (ICG) imaging, and examines its association with the incidence of BCs within three months post-LT.
View Article and Find Full Text PDFAnn Transplant
January 2025
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
BACKGROUND We previously reported that the Model for End-stage Liver Disease (MELD) score and donor age are risk factors for small-for-size syndrome in adult living donor liver transplantation (LDLT) involving small grafts. Since April 2021, we have performed splenectomy as a portal inflow modulation in LDLT using small grafts according to the presence of risk factors. In this study, we evaluated the validity of our splenectomy strategies for optimizing graft outcomes.
View Article and Find Full Text PDFJ Transl Med
January 2025
Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
Background: Colorectal cancer (CRC) exhibits a high incidence globally, with the liver being the most common site of distant metastasis. At the time of diagnosis, 20-30% of CRC patients already present with liver metastases. Colorectal liver metastasis (CRLM) is a major cause of mortality among CRC patients.
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