Pancreatology
1. Department of Medicine, University Medical Center Hamburg-Eppendorf, Germany; Center of Internal Medicine II, Brandenburg Medical School Theodor Fontane, Germany.
Published: July 2018
Background: Limited data exists concerning the coincidence of chronic pancreatitis (CP) and liver cirrhosis with respect to the patient outcome after liver transplantation (LT). The aim of the study was to identify risk factors for graft loss after liver transplantation and to evaluate the impact of CP on graft survival.
Methods: We analyzed the data of 421 cirrhotic patients who underwent evaluation for primary liver transplantation from January 2007 to January 2014. Diagnosis of CP based on morphologic findings which were graded according to the Cambridge and Manchester classification. (Graft) survival after LT was analyzed by Cox regression analysis. Recipient- and donor-related risk factors for graft loss were evaluated using univariate and multivariate analysis.
Results: 40/421 cirrhotic patients suffered from CP (9.5%). 250/421 (59.4%) patients underwent LT between January 2007 and January 2014. In total, 89 patients died or were in need of a re-transplantation during follow-up until August 2017. Patients with CP (N = 26) were at increased risk for graft loss after LT (hazard ratio = 2.183; 95% confidence interval = 1.232-3.868). CP (P = 0.001), a MELD score ≥24 (P = 0.021), absence of esophageal or gastrical varices (P = 0.018), the age of the donor (P = 0.008) and infections after transplantation (P = 0.030) were independent risk factors for organ loss after transplantation in the multivariate Cox regression analysis.
Conclusion: Patients with chronic pancreatitis are at increased risk for graft loss after LT. A high MELD score, the absence of esophageal or gastrical varices, an advanced donor age and post-transplant infections negatively affect graft survival, too.
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http://dx.doi.org/10.1016/j.pan.2017.09.006 | DOI Listing |
Introduction: Prior studies have demonstrated racial disparities in access to liver transplantation but determinants of these disparities remain poorly understood. We used geographic catchment areas for transplant centers (transplant referral regions, TRRs) to characterize transplant environment contributors to racial and ethnic disparities in liver transplant access.
Methods: Data were obtained from the Scientific Registry for Transplant Recipients (SRTR) and the National Center for Health Statistics (NCHS) from 2015 to 2021.
Intern Med J
January 2025
Australian National Liver Transplant Unit, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Background: Access to liver transplantation (LT) is affected by geographic disparities. Higher waitlist mortality is observed in patients residing farther from LT centres, but the impact of distance on post-LT outcomes is unclear.
Aims: To evaluate whether the distance LT recipients reside from their LT centre affects graft and patient outcomes.
Crit Care Explor
January 2025
eGenesis, Inc., Cambridge, MA.
Objectives: To systematically review the safety and efficacy of nonbiological (NBAL) or biological artificial liver support systems (BAL) and whole-organ extracorporeal liver perfusion (W-ECLP) systems, in adults with acute liver failure (ALF) and acute-on-chronic liver failure (ACLF).
Data Sources: Eligible NBAL/BAL studies from PubMed/Embase searches were randomized controlled trials (RCTs) in adult patients with ALF/ACLF, greater than or equal to ten patients per group, reporting outcomes related to survival, adverse events, transplantation rate, and hepatic encephalopathy, and published in English from January 2000 to July 2023. Separately, we searched for studies evaluating W-ECLP in adult patients with ALF or ACLF published between January1990 and July 2023.
Liver Int
February 2025
Liver Disease Research Branch, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, Bethesda, Maryland, USA.
Background And Aims: Short courses of intravenous (iv) methylprednisolone (MP) can cause drug induced liver injury (DILI). The aim of this study was to assess the clinical features and HLA associations of MP-related DILI enrolled in the US DILI Network (DILIN).
Methods: DILIN cases with MP as a suspected drug were reviewed.
Clin Transplant
January 2025
New Zealand Liver Transplant Unit, Auckland City Hospital, Te Toka Tumai, Auckland, New Zealand.
Introduction: Previous guidelines considered body mass index (BMI) over 40 kg/m a relative contra-indication to liver transplantation (LT). The aims were to examine the selection process and study outcomes of patients with Class I-III obesity.
Methods: Retrospective analysis of outcomes of obese patients assessed for LT at our center between 2010 and 2023, divided into three groups: Class I (BMI30-34.
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