Background: In the living donor liver transplant setting, the preoperative assessment of potential donors is important to ensure the donor safety.
Objectives: The aim of this study was to identify causes and costs of living liver-donors rejection in the donation process.
Materials And Methods: From June 2010 to June 2012, all potential living liver donors for 66 liver transplant candidates were screened at the Ain Shams Center for Organ Transplantation. Potential donors were evaluated in 3 phases, and their data were reviewed to determine the causes and at which phase the donors were rejected.
Results: One hundred and ninety two potential living liver donors, including 157 (81.7%) males, were screened for 66 potential recipients. Of these, 126 (65.6%) were disqualified for the donation. The causes of rejection were classified as surgical (9.5 %) or medical (90.5 %). Five donors (3.9 %) were rejected due to multiple causes. Factor V Leiden mutation was detected in 29 (23 %) rejected donors (P = 0.001), 25 (19.8 %) donors had positive results for hepatitis serology (P = 0.005), and 16 (12.7 %) tested positive for drug abuse. Portal vein trifurcation (n = 9, 7.1%) and small size liver graft estimated by CT volumetric analysis (n = 6, 4.8 %) were the main surgical causes which precluded the donation.
Conclusions: Among potential Egyptian living liver donors, Factor V Leiden mutation was a significant cause for live donor rejection. A stepwise approach to donor assessment was found to be cost-effective.
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http://dx.doi.org/10.5812/hepatmon.13703 | DOI Listing |
Am J Case Rep
December 2024
Department of General Medicine, Saga University Hospital, Saga, Japan.
BACKGROUND Appropriate management of patients who have fallen is crucial for reducing damage and mortality. We report the case of a patient who fell from a seated position, which caused traumatic liver injury, with gastrointestinal symptoms as the primary patient concern. CASE REPORT A woman in her 80s who was living independently fell from a seated position during the daytime.
View Article and Find Full Text PDFAnn Clin Epidemiol
October 2024
Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
The Ministry of Health, Labor, and Welfare, Japan, launched the Diagnosis Procedure Combination system in 2002. Detailed information on the Diagnosis Procedure Combination data was reported in in 2019. In this report, I provide updated information on the Diagnosis Procedure Combination.
View Article and Find Full Text PDFJ Gastroenterol Hepatol
December 2024
Department of Surgery, The Research Institute for Transplantation, College of Medicine, Yonsei University, Seoul, South Korea.
Background: Living donor liver transplantation (LDLT) offers timely curative treatment for unresectable hepatocellular carcinoma (HCC). This study aims to validate and compare previous prediction models for HCC outcomes in 488 LDLT recipients.
Methods: For 488 patients who underwent LDLT for HCC, pretransplant imaging studies assessed by modified RECSIT criteria, tumor markers such as alpha feto-protein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA II), and explant pathology were recruited.
J Clin Exp Hepatol
November 2024
Institute of Liver Disease & Transplantation, Gleneagles Health City, Chennai, India.
Small-for-size syndrome is a clinical syndrome of early allograft dysfunction usually following living donor liver transplantation due to a mismatch between recipient metabolic and functional requirements and the graft's functional capacity. While graft size relative to the recipient size is the most commonly used parameter to predict risk, small-for-size syndrome is multifactorial and its development depends on a number of inter-dependant factors only some of which are modifiable. Intra-operative monitoring of portal haemodynamics and portal flow modulation is widely recommended though there is wide variation in clinical practice.
View Article and Find Full Text PDFJ Clin Exp Hepatol
November 2024
The Institute of Liver Disease & Transplantation, Dr. Rela Institute & Medical Centre, Bharath Institute of Higher Education & Research, Chennai, India.
Living donor liver transplantation (LDLT) constitutes the majority of liver transplants in Asia and advancements in LDLT techniques have expanded the range of allografts beyond the commonly used right lobe (RL). This review provides a comprehensive overview of lesser-known variants of allografts and LDLT techniques which include right posterior sector grafts (RPSG), dual-lobe liver transplantation (DLLT), auxiliary partial orthotopic liver transplantation (APOLT), and extended left lobe grafts with caudate concentrating on the technical aspects, current evidence, and their indications in contemporary practice of LDLT. The first section examines RPSGs, focussing on their potential as an alternative to RL grafts particularly when volumetric studies indicate a larger right posterior sector in donors.
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