Background: Liver transplantation (LTX) for severe hepatic trauma and its sequelae is a rare but potentially lifesaving option at the far end of the operative spectrum.
Methods: This study analyzes 12 cases with LTX for hepatic trauma and its consequences from two transplant centers. A total of 2,701 consecutive liver transplants unrelated to trauma served as a control group. χ and Mann-Whitney U-tests, Kaplan-Meier analysis with log-rank tests, and Cox regression analysis were applied. Addressed were issues before, during, and after LTX. Major study end points were patient and graft survival.
Results: The posttrauma transplant recipients are significantly younger (p = 0.014), with a significantly shorter graft survival (p = 0.038), resulting in a significantly higher retransplantation rate (p = 0.043). Of the 12 patients, 11 underwent surgical treatment for hepatic trauma before LTX with 7 of 12 patients experiencing liver necrosis at the time of LTX. Short-term survival and long-term survival are not significantly different between trauma and nontrauma patients. Severity of liver trauma (Moore Score) and concomitant injuries (Injury Severity Score [ISS]) have no significant impact on patient and graft survival. Four patients with hepatic trauma were treated with two-stage LTX with anhepatic phases between 14 hours and 28 hours. Two of those patients reached long-term survival (20-22 years).
Conclusion: LTX for severe liver trauma and its consequences seems justified in extreme cases. The high frequency of liver necrosis at the time of LTX may indicate possible shortcomings in liver packing technique or liver resection for hemorrhage control. Thus, severe hepatic trauma requires treatment by experienced liver surgeons and emergency physicians.
Level Of Evidence: Therapeutic study, level IV.
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http://dx.doi.org/10.1097/TA.0b013e3182a8fe8a | DOI Listing |
Int J Biol Macromol
January 2025
College of Life Sciences, Shandong Agricultural University, Taian 271018, China. Electronic address:
It was imperative to discover and utilize high-efficiency, non-toxic substances for the prevention and management of type 2 diabetes mellitus (T2DM) and its associated complications, given the escalating prevalence and significant global health burden. In the present study, the acetylated Ganoderma applanatum polysaccharide (A-GAP) was successfully obtained and characterized, demonstrating excellent efficacy in ameliorating organ damage induced by T2DM through targeted modulation of the gut-liver axis. The physiological and molecular biological findings indicated that A-GAP may modulate the Nrf2/Keap1-TLR4/NFκB-Bax/Bcl-2 signaling pathway network, thereby mitigating oxidative stress and the subsequent inflammatory response, ultimately alleviating the inhibitory effects of IRS and insulin resistance.
View Article and Find Full Text PDFHPB (Oxford)
January 2025
Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, India.
Background: Our study aimed to compare the clinical presentation and outcomes of post-cholecystectomy bile duct injuries (BDI) with and without arterial injuries.
Methods: A prospective analysis of 123 patients with post-cholecystectomy BDI between July 2018 and January 2022 was performed. Multivariate logistic regression analysis was used to assess the impact of vascular injuries on perioperative complications and long-term outcomes after delayed repair.
J Surg Res
January 2025
Dean's Office, Medical College, Aga Khan University, Karachi, Pakistan; Department of Surgery, Medical College, Aga Khan University, Karachi, Pakistan; Department of Community Health Sciences, Medical College, Aga Khan University, Karachi, Pakistan.
Introduction: While various factors leading to prolonged length of stay (LOS) have been identified for emergency general surgery (EGS), there is limited literature on specific factors for individual emergent specialties. This study aimed to identify patient factors and in-hospital complications associated with prolonged LOS for gastrointestinal (GI) and non-GI-related EGS presentations in a low-resource setting.
Methods: Data from 2010 to 2019 were retrieved from one of the largest tertiary care centers in Pakistan.
Mediators Inflamm
January 2025
School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou 310053, China.
This study aims to investigate the mechanism of Diels et Gilg flavonoids (THF) on acute hepatic injury (AHI). First, high-performance liquid chromatography (HPLC) fingerprints were established to obtain the main chemical components of THF. According to the network pharmacology databases, collect active targets of AHI and potential targets.
View Article and Find Full Text PDFWorld J Gastroenterol
January 2025
School of Basic Medicine, Qilu Medical University, Zibo 255300, Shandong Province, China.
Alcohol-related liver disease (ALD), which is induced by excessive alcohol consumption, is a leading cause of liver-related morbidity and mortality. ALD patients exhibit a spectrum of liver injuries, including hepatic steatosis, inflammation, and fibrosis, similar to symptoms of nonalcohol-associated liver diseases such as primary biliary cholangitis, metabolic dysfunction-associated steatotic liver disease, and nonalcoholic steatohepatitis. Elafibranor has been approved for the treatment of primary biliary cholangitis and has been shown to improve symptoms in both animal models and cell models of metabolic dysfunction-associated steatotic liver disease and nonalcoholic steatohepatitis.
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