Aim: To establish the impact of portal hypertension (PH) on wait-list/post-transplant outcomes in patients with polycystic liver disease (PCLD) listed for liver transplantation.
Methods: A retrospective single-centre case controlled study of consecutive patients listed for liver transplantation over 12 years was performed from our centre. PH in the PCLD cohort was defined by the one or more of following parameters: (1) presence of radiological or endoscopic documented varices from our own centre or the referral centre; (2) splenomegaly (> 11 cm) on radiology in absence of splenic cysts accounting for increased imaging size; (3) thrombocytopenia (platelets < 150 × 10/L); or (4) ascites without radiological evidence of hepatic venous outflow obstruction from a single cyst.
Results: Forty-seven PCLD patients (F: M = 42: 5) were listed for liver transplantation (LT) (single organ, = 35; combined liver-kidney transplantation, = 12) with 19 patients (40.4%) having PH. When comparing the PH group with non-PH group, the mean listing age (PH group, 50.6 (6.4); non-PH group, 47.1 (7.4) years; = 0.101), median listing MELD (PH group, 12; non-PH group, 11; = 0.422) median listing UKELD score (PH group, 48; non-PH group, 46; = 0.344) and need for renal replacement therapy ( = 0.317) were similar. In the patients who underwent LT alone, there was no difference in the duration of ICU stay (PH, 3 d; non-PH, 2 d; = 0.188), hospital stay length (PH, 9 d; non-PH, 10 d; = 0.973), or frequency of renal replacement therapy (PH, 2/8; non-PH, 1/14; = 0.121) in the immediate post-transplantation period.
Conclusion: Clinically apparent portal hypertension in patients with PCLD listed for liver transplantation does not appear to have a major impact on wait-list or peri-transplant morbidity.
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http://dx.doi.org/10.3748/wjg.v22.i45.9966 | DOI Listing |
Cureus
December 2024
Medicine/Cardiology, Rutgers University New Jersey Medical School, Newark, USA.
Coronary artery disease (CAD) is associated with poor outcomes after orthotopic liver transplantation (OLT). We report on six high-risk end-stage liver disease (ESLD) patients who underwent percutaneous coronary intervention (PCI) with bare metal stents during the preoperative evaluation process. There was no mortality or major adverse cardiac event (MACE) within 90 days of OLT.
View Article and Find Full Text PDFAustralas J Ultrasound Med
February 2025
Te Whatu Ora Southern, New Zealand 201 Great King Street, Central Dunedin Dunedin 9016 New Zealand.
Introduction: This case examines the sonographic and clinical challenge of diagnosing a pyogenic liver abscess with systemic metastatic infection.
Case Description: The patient in this case study is an 81-year-old man who presented with intermittent rigors. Following radiological and clinical assessments, a pyogenic liver abscess, with evidence of systemic metastatic infection, was diagnosed.
Ann Transplant
January 2025
Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
BACKGROUND Acute liver failure (ALF) remains a critical concern, accounting for about 8% of all liver transplants, with acetaminophen overdose contributing to nearly half of these cases. Besides synthetic toxins, natural toxins such as phallotoxin from Amanita phalloides mushrooms also lead to severe hepatocyte damage. This study investigates the outcomes of liver transplantation (LT) as a life-saving intervention in patients suffering from ALF due to acetaminophen and Amanita phalloides poisoning.
View Article and Find Full Text PDFJ Cardiothorac Surg
January 2025
Department of Surgery, Division of Cardiac Surgery, Jefferson-Einstein Medical Center Philadelphia, Philadelphia, PA, USA.
Background: End-Stage Renal Disease (ESRD) is an independent risk factor in outcomes for traditional coronary artery bypass grafting (TRAD-CAB) utilizing aortic cross-clamping and cardioplegic arrest. In order to determine if Beating-Heart CABG (BH-CABG) techniques offer benefit in patients with ESRD, an analysis of the Society of Thoracic Surgeons (STS) predicted risk versus the actual outcomes was performed.
Methods: Between March 2017 - October 2023, all ESRD patients underwent BH-CABG by a single surgeon at a single institution.
Transplant Direct
February 2025
Division of Transplantation, Department of Surgery, University of Iowa School of Medicine, Iowa City, IA.
Background: In 2020, liver allocation policy in the United States was changed to allow for broader organ sharing, which was hypothesized to reduce patient incentives to travel for transplant. Our objective was to describe patterns of travel for domestic liver transplant pre- and post-acuity circle (AC) implementation.
Methods: Incident adult liver transplant listings between August 16, 2016, and February 3, 2020 (pre-AC) or June 13, 2020, and December 3, 2023 (post-AC) were obtained from the Scientific Registry of Transplant Recipients.
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