{"title":"Retraction note.","authors":"P. Małkowski, K. Zieniewicz","doi":"10.2478/njmr-2014-0013","DOIUrl":"https://doi.org/10.2478/njmr-2014-0013","url":null,"abstract":"","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"14 1 1","pages":"56"},"PeriodicalIF":1.1,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/njmr-2014-0013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43085222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jan-Paul Gundlach, F. Braun, Finn Mötter, Alexander Bernsmeier, P. Barrio, Nicola Ehmke, R. Günther, H. Hinrichsen, T. Becker, W. Weinmann, A. Schröck, M. Yegles, F. Wurst
Background Monitoring sobriety is mandatory for liver transplant (LT) candidates with alcohol-related cirrhosis in Germany. Prior to listing, abstinence of 6 months is required. However, little is known about biomarker performance in alcohol-related cirrhosis. Routine testing of ethyl glucuronide in urine (uEtG) or hair (hEtG) is prone to manipulation or is unfeasible in anuria. Phosphatidylethanol (PEth) in dried-blood spots is a promising alternative. We compared PEth with routine parameters and self-reports in alcohol-related and non-alcohol-related cirrhosis at our transplant center. Material/Methods All patients received self-report questionnaires (AUDIT & TLFB). Blood, urine and hair samples, as well as PEth dried-blood spots were drawn at baseline. In addition, survival analyses were conducted. Results Out of 66 patients, 53 were listed for LT and 13 were candidates not listed so far. An alcohol-use disorder was found in 25 patients. Positive results for uEtG, hEtG, and PEth were found in 5/65, 9/65, and 34/66 cases, respectively. PEth positivity was found in 52% of patients with alcohol-related cirrhosis, while 53% of patients with other liver diseases were positive. While uEtG, hEtG, and TLFB correlated with higher PEth values, active waiting list status was significantly correlated with negative PEth values. During the mean follow-up of 41.15 months, 23 patients were transplanted (34.9%). None of the biomarkers significantly predicted survival. Conclusions PEth can importantly assist abstinence monitoring in LT candidates due to its high validity and objectivity. The high percentage of patients with alcohol consumption in the non-alcoholic liver disease cohort underscores the importance of testing all transplant candidates.
{"title":"Phosphatidylethanol (PEth) for Monitoring Sobriety in Liver Transplant Candidates: Preliminary Results of Differences Between Alcohol-Related and Non-Alcohol-Related Cirrhosis Candidates","authors":"Jan-Paul Gundlach, F. Braun, Finn Mötter, Alexander Bernsmeier, P. Barrio, Nicola Ehmke, R. Günther, H. Hinrichsen, T. Becker, W. Weinmann, A. Schröck, M. Yegles, F. Wurst","doi":"10.12659/AOT.936293","DOIUrl":"https://doi.org/10.12659/AOT.936293","url":null,"abstract":"Background Monitoring sobriety is mandatory for liver transplant (LT) candidates with alcohol-related cirrhosis in Germany. Prior to listing, abstinence of 6 months is required. However, little is known about biomarker performance in alcohol-related cirrhosis. Routine testing of ethyl glucuronide in urine (uEtG) or hair (hEtG) is prone to manipulation or is unfeasible in anuria. Phosphatidylethanol (PEth) in dried-blood spots is a promising alternative. We compared PEth with routine parameters and self-reports in alcohol-related and non-alcohol-related cirrhosis at our transplant center. Material/Methods All patients received self-report questionnaires (AUDIT & TLFB). Blood, urine and hair samples, as well as PEth dried-blood spots were drawn at baseline. In addition, survival analyses were conducted. Results Out of 66 patients, 53 were listed for LT and 13 were candidates not listed so far. An alcohol-use disorder was found in 25 patients. Positive results for uEtG, hEtG, and PEth were found in 5/65, 9/65, and 34/66 cases, respectively. PEth positivity was found in 52% of patients with alcohol-related cirrhosis, while 53% of patients with other liver diseases were positive. While uEtG, hEtG, and TLFB correlated with higher PEth values, active waiting list status was significantly correlated with negative PEth values. During the mean follow-up of 41.15 months, 23 patients were transplanted (34.9%). None of the biomarkers significantly predicted survival. Conclusions PEth can importantly assist abstinence monitoring in LT candidates due to its high validity and objectivity. The high percentage of patients with alcohol consumption in the non-alcoholic liver disease cohort underscores the importance of testing all transplant candidates.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e936293-1 - e936293-9"},"PeriodicalIF":1.1,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46135435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Alissa, Delal Alkortas, Mohammed Alsebayel, R. Almasuood, W. Aburas, Tahani N. Altamimi, E. Devol, A. Al-jedai
Background Tacrolimus is a calcineurin inhibitor (CNI) commonly used as an immunosuppressant to prevent the rejection of organ transplants. After liver transplantation, it can cause early neurological complications, known as early calcineurin inhibitor-induced neurotoxicity (ECIIN). Its management requires CNI withdrawal, a measure that can affect post-transplant outcomes, primarily allograft rejection. In addition, it can negatively impact the quality of life. The incidence and risk factor of ECIIN has not been reported in the Saudi population. We investigated the incidence and risk factors of ECIIN after liver transplant in Saudi patients. We also looked at the length of stay in the Intensive Care Unit, hospital, and 30-day mortality as secondary endpoints. Material/Methods This was a retrospective cohort study of adult patients on tacrolimus with mild, moderate, or severe neurological events within the first month after liver transplantation at a single center of patients who meet the inclusion criteria and were over age 14 years. A total of 338 patients were included in the analysis, and the sample size was calculated based on a pilot study. Results Among 338 liver transplantation patients, 63 patients (19%) developed ECIIN. Forty-eight percent of patients had seizures, 23% had agitation, 21% had psychosis, 10% had severe tremors, 13% had confusion, and 6% developed coma. The median time of the incident to develop ECIIN was 9 (IQR: 5–13.5) days after transplant. Thirty-eight patients were managed by switching to cyclosporine, 12 required a reduction in the dose, and 3 were managed temporarily by discontinuing therapy. Autoimmune hepatitis as an underlying liver disease was one of the statistically significant risk factors (P=0.0311). The median length of hospital stay was 31 (IQR: 21–75.5) days, ICU length of stay was 10 (IQR: 5–20.5) days, and 8 patients died within 30 days after transplant. Conclusions The incidence of ECIIN in Saud Arabia was similar to that reported in other populations with similar risk factors. Electrolyte imbalance, mainly hyponatremia, was significantly associated with developing ECIIN. Therefore, ECIIN may potentially increase hospital and ICU length of stay.
{"title":"Tacrolimus-Induced Neurotoxicity in Early Post-Liver Transplant Saudi Patients: Incidence and Risk Factors","authors":"D. Alissa, Delal Alkortas, Mohammed Alsebayel, R. Almasuood, W. Aburas, Tahani N. Altamimi, E. Devol, A. Al-jedai","doi":"10.12659/AOT.935938","DOIUrl":"https://doi.org/10.12659/AOT.935938","url":null,"abstract":"Background Tacrolimus is a calcineurin inhibitor (CNI) commonly used as an immunosuppressant to prevent the rejection of organ transplants. After liver transplantation, it can cause early neurological complications, known as early calcineurin inhibitor-induced neurotoxicity (ECIIN). Its management requires CNI withdrawal, a measure that can affect post-transplant outcomes, primarily allograft rejection. In addition, it can negatively impact the quality of life. The incidence and risk factor of ECIIN has not been reported in the Saudi population. We investigated the incidence and risk factors of ECIIN after liver transplant in Saudi patients. We also looked at the length of stay in the Intensive Care Unit, hospital, and 30-day mortality as secondary endpoints. Material/Methods This was a retrospective cohort study of adult patients on tacrolimus with mild, moderate, or severe neurological events within the first month after liver transplantation at a single center of patients who meet the inclusion criteria and were over age 14 years. A total of 338 patients were included in the analysis, and the sample size was calculated based on a pilot study. Results Among 338 liver transplantation patients, 63 patients (19%) developed ECIIN. Forty-eight percent of patients had seizures, 23% had agitation, 21% had psychosis, 10% had severe tremors, 13% had confusion, and 6% developed coma. The median time of the incident to develop ECIIN was 9 (IQR: 5–13.5) days after transplant. Thirty-eight patients were managed by switching to cyclosporine, 12 required a reduction in the dose, and 3 were managed temporarily by discontinuing therapy. Autoimmune hepatitis as an underlying liver disease was one of the statistically significant risk factors (P=0.0311). The median length of hospital stay was 31 (IQR: 21–75.5) days, ICU length of stay was 10 (IQR: 5–20.5) days, and 8 patients died within 30 days after transplant. Conclusions The incidence of ECIIN in Saud Arabia was similar to that reported in other populations with similar risk factors. Electrolyte imbalance, mainly hyponatremia, was significantly associated with developing ECIIN. Therefore, ECIIN may potentially increase hospital and ICU length of stay.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e935938-1 - e935938-9"},"PeriodicalIF":1.1,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49127635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic kidney disease (CKD) is a serious comorbidity affecting liver transplant recipients (LTRs). Calcineurin inhibitor dosing minimization protocols and everolimus use purportedly increased from 2010, potentially impacting CKD development. This systematic literature review was designed to identify CKD incidence in adult LTRs, focusing on studies published from 2010 onwards. PubMed, Embase, and the Cochrane Database of Systematic Reviews were searched for papers reporting renal function (glomerular filtration rate [GFR]; estimated GFR [eGFR] or Chronic Kidney Disease Epidemiology Collaboration) for adult LTRs ≥6 months after transplantation. Primary outcome: renal function ≥6 months after transplantation, with CKD stage. Bias was assessed using the Cochrane Collaboration bias tool and by reviewing disclosures/industry funding. Of 3960 records identified, 14 publications were included. In at least 1 study arm, mean GFR/eGFR remained stable/improved temporally in 4 and decreased in 8 publications. Where GFR/eGFR decreased, mean eGFR was 71.4–119.6 mL/min/1.73 m2 (CKD stage 2-stage 1) across studies at baseline, and was 77.2 and 79.1 mL/min/1.73 m2 (stage 2) at 12 months. The proportion of patients with CKD increased between baseline and follow-up; 23.2–36.8% of patients had CKD stage 3a or higher at 12 months (2 studies). Rates ranged from 85.7–100% (6 months) for patient survival, 81.0% (12 months) to 100.0% (17 months) for graft survival, and 0–40% (12 months) for acute rejection. Most studies carried risk of bias. Evidence of temporal renal function decline highlights the need for continuous renal monitoring of LTRs, particularly regarding potential CKD development/progression.
{"title":"A Systematic Review of the Literature on Chronic Kidney Disease Following Liver Transplantation","authors":"H. Miyata, Y. Morita, Anil . Kumar","doi":"10.12659/AOT.935170","DOIUrl":"https://doi.org/10.12659/AOT.935170","url":null,"abstract":"Chronic kidney disease (CKD) is a serious comorbidity affecting liver transplant recipients (LTRs). Calcineurin inhibitor dosing minimization protocols and everolimus use purportedly increased from 2010, potentially impacting CKD development. This systematic literature review was designed to identify CKD incidence in adult LTRs, focusing on studies published from 2010 onwards. PubMed, Embase, and the Cochrane Database of Systematic Reviews were searched for papers reporting renal function (glomerular filtration rate [GFR]; estimated GFR [eGFR] or Chronic Kidney Disease Epidemiology Collaboration) for adult LTRs ≥6 months after transplantation. Primary outcome: renal function ≥6 months after transplantation, with CKD stage. Bias was assessed using the Cochrane Collaboration bias tool and by reviewing disclosures/industry funding. Of 3960 records identified, 14 publications were included. In at least 1 study arm, mean GFR/eGFR remained stable/improved temporally in 4 and decreased in 8 publications. Where GFR/eGFR decreased, mean eGFR was 71.4–119.6 mL/min/1.73 m2 (CKD stage 2-stage 1) across studies at baseline, and was 77.2 and 79.1 mL/min/1.73 m2 (stage 2) at 12 months. The proportion of patients with CKD increased between baseline and follow-up; 23.2–36.8% of patients had CKD stage 3a or higher at 12 months (2 studies). Rates ranged from 85.7–100% (6 months) for patient survival, 81.0% (12 months) to 100.0% (17 months) for graft survival, and 0–40% (12 months) for acute rejection. Most studies carried risk of bias. Evidence of temporal renal function decline highlights the need for continuous renal monitoring of LTRs, particularly regarding potential CKD development/progression.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e935170-1 - e935170-30"},"PeriodicalIF":1.1,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47768241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Roche, A. Bauhofer, M. Bravo, G. Pageaux, F. Zoulim, A. Otero, M. Prieto, C. Baliellas, D. Samuel
Background Self-administered subcutaneous hepatitis B immunoglobulin (s.c. HBIg) in combination with nucleos(t)ide analogs (NUCs) has proved to be effective and safe in preventing hepatitis B virus (HBV) reinfection after liver transplantation. Material/Methods This non-interventional, prospective, single-arm, multicenter, international study collected data on long-term effectiveness, safety, patient satisfaction (Treatment Satisfaction Questionnaire for Medication, TSQM-11), and quality of life (EQ-5D questionnaire) in routine practice over a 2-year treatment period. Data analysis was based on 195 adults (82.1% male) transplanted for HBV-related liver diseases and treated with s.c. HBIg with/without NUC(s). Results HBV recurrence (seropositivity of HBV surface antigen and/or HBV DNA) was observed in 7/195 (3.6%) patients (annual rate: 2.01%). Hepatocellular carcinoma (HCC) recurred in 4/83 (4.8%) patients transplanted for HBV-HCC (annual rate: 2.88%). Twenty-nine adverse drug reactions occurred in 16/195 (8.2%) patients. Convenience and overall satisfaction scores of the TSQM-11 were significantly (P<0.05) improved under treatment at the 3-month, 2-year, and last follow-up visits. Quality of life remained constant over the entire observation period (EQ-5D index [P≥0.075]). S.c. HBIg was mainly self-administered (6458/9021 administrations, 71.6%) at home (8514/9021 administrations, 94.4%). Conclusions The results indicate long-term effectiveness and safety of s.c. HBIg in combination with NUC therapy in preventing post-transplant HBV reinfection under real-life conditions. The convenience of the therapy contributed to the high overall treatment satisfaction and acceptance by the patients.
{"title":"Long-Term Effectiveness, Safety, and Patient-Reported Outcomes of Self-Administered Subcutaneous Hepatitis B Immunoglobulin in Liver Post-Transplant Hepatitis B Prophylaxis: A Prospective Non-Interventional Study","authors":"B. Roche, A. Bauhofer, M. Bravo, G. Pageaux, F. Zoulim, A. Otero, M. Prieto, C. Baliellas, D. Samuel","doi":"10.12659/AOT.936162","DOIUrl":"https://doi.org/10.12659/AOT.936162","url":null,"abstract":"Background Self-administered subcutaneous hepatitis B immunoglobulin (s.c. HBIg) in combination with nucleos(t)ide analogs (NUCs) has proved to be effective and safe in preventing hepatitis B virus (HBV) reinfection after liver transplantation. Material/Methods This non-interventional, prospective, single-arm, multicenter, international study collected data on long-term effectiveness, safety, patient satisfaction (Treatment Satisfaction Questionnaire for Medication, TSQM-11), and quality of life (EQ-5D questionnaire) in routine practice over a 2-year treatment period. Data analysis was based on 195 adults (82.1% male) transplanted for HBV-related liver diseases and treated with s.c. HBIg with/without NUC(s). Results HBV recurrence (seropositivity of HBV surface antigen and/or HBV DNA) was observed in 7/195 (3.6%) patients (annual rate: 2.01%). Hepatocellular carcinoma (HCC) recurred in 4/83 (4.8%) patients transplanted for HBV-HCC (annual rate: 2.88%). Twenty-nine adverse drug reactions occurred in 16/195 (8.2%) patients. Convenience and overall satisfaction scores of the TSQM-11 were significantly (P<0.05) improved under treatment at the 3-month, 2-year, and last follow-up visits. Quality of life remained constant over the entire observation period (EQ-5D index [P≥0.075]). S.c. HBIg was mainly self-administered (6458/9021 administrations, 71.6%) at home (8514/9021 administrations, 94.4%). Conclusions The results indicate long-term effectiveness and safety of s.c. HBIg in combination with NUC therapy in preventing post-transplant HBV reinfection under real-life conditions. The convenience of the therapy contributed to the high overall treatment satisfaction and acceptance by the patients.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e936162-1 - e936162-12"},"PeriodicalIF":1.1,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43064690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Yoon, Sanghee Song, Sanghoon Lee, O. Kim, S. Hong, N. Yi, J. M. Kim, Kwang-Wonng Lee, M. Kim, Y. Choi, K. Suh, S. Lee
Background The number of pediatric patients awaiting liver transplantation has decreased. Due to its increased use in Korea, split liver transplantation (SLT) may be a substitute for living donor liver transplantation (LDLT); however, the outcomes of pediatric SLT and LDLT in Korea remain unreported. Material/Methods We reviewed data of Korean patients aged <18 years who received SLT from 2005 to 2014, based on the Korea national database and compared to recipients who underwent LDLTs at Seoul National University Hospital during the same period. Results A total of 63 and 56 patients were included in SLT and LDLT, respectively. The most common indication for LT was biliary atresia (60.3% in SLT vs 67.9% in LDLT). The Pediatric End-Stage Liver Disease score did not differ between the groups (P>0.05). The 1-, 3-, and 5-year overall survival rates were 92.1%, 90.2%, and 86.6% in the SLT and 96.4%, 94.6%, and 94.6% in the LDLT groups, respectively (P=0.21); the corresponding graft survival rates were 88.9%, 87.1%, and 83.6% in the SLT and 92.9%, 91.0%, and 91.0% in the LDLT groups, respectively (P=0.31). Fulminant hepatic failure was a risk factor for graft failure [OR, 8.77 (1.08–70.92); P=0.042], but not overall survival [OR, 11.78 (0.56–247.29); P=0.11]. Conclusions The graft and overall survival rates of SLT and LDLT were not different in pediatric patients in Korea, and fulminant hepatic failure was the only risk factor affecting graft survival outcomes.
{"title":"Outcomes of Split Liver Transplantation vs Living Donor Liver Transplantation in Pediatric Patients: A 5-Year Follow-Up Study in Korea","authors":"K. Yoon, Sanghee Song, Sanghoon Lee, O. Kim, S. Hong, N. Yi, J. M. Kim, Kwang-Wonng Lee, M. Kim, Y. Choi, K. Suh, S. Lee","doi":"10.12659/AOT.935682","DOIUrl":"https://doi.org/10.12659/AOT.935682","url":null,"abstract":"Background The number of pediatric patients awaiting liver transplantation has decreased. Due to its increased use in Korea, split liver transplantation (SLT) may be a substitute for living donor liver transplantation (LDLT); however, the outcomes of pediatric SLT and LDLT in Korea remain unreported. Material/Methods We reviewed data of Korean patients aged <18 years who received SLT from 2005 to 2014, based on the Korea national database and compared to recipients who underwent LDLTs at Seoul National University Hospital during the same period. Results A total of 63 and 56 patients were included in SLT and LDLT, respectively. The most common indication for LT was biliary atresia (60.3% in SLT vs 67.9% in LDLT). The Pediatric End-Stage Liver Disease score did not differ between the groups (P>0.05). The 1-, 3-, and 5-year overall survival rates were 92.1%, 90.2%, and 86.6% in the SLT and 96.4%, 94.6%, and 94.6% in the LDLT groups, respectively (P=0.21); the corresponding graft survival rates were 88.9%, 87.1%, and 83.6% in the SLT and 92.9%, 91.0%, and 91.0% in the LDLT groups, respectively (P=0.31). Fulminant hepatic failure was a risk factor for graft failure [OR, 8.77 (1.08–70.92); P=0.042], but not overall survival [OR, 11.78 (0.56–247.29); P=0.11]. Conclusions The graft and overall survival rates of SLT and LDLT were not different in pediatric patients in Korea, and fulminant hepatic failure was the only risk factor affecting graft survival outcomes.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e935682-1 - e935682-10"},"PeriodicalIF":1.1,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48379213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Cho, G. Choi, J. M. Kim, J. Rhu, C. Kwon, J. Joh
Background Laparoscopic donor hepatectomy (LDH) for living donor liver transplantation has been performed in several specialized institutes. Surgical outcomes of LDH have shown comparable results to open donor hepatectomy (ODH), but the quality of life (QOL) after LDH is not known. This prospective questionnaire-based study was performed to assess health status and QOL of live liver donors before and after donor hepatectomy (DH). Material/Methods From May 2017 to February 2020, questionnaire items such as the Enhanced Recovery after Surgery mobility scale (EMS), Body Image Questionnaire, and EQ-5D-3L were examined up to 1 year after DH to respectively evaluate postoperative recovery, body image satisfaction, and health status. Results During the study period, 45 laparoscopic DH (LDH) donors and 2 open DH (ODH) donors were finally fully evaluated. The LDH group had a significantly higher mean EMS than ODH on postoperative day (POD) 5, and 7 (P=0.011, and P=0.004, respectively). Body image scores of the LDH group were significantly higher than that of the ODH group at 1 month after DH (17.8 vs 15.0, P=0.017). There were 45 LDH donors who recovered to preoperative values at 6 months and 1 month after DH, with no statistically significant difference in EQ-5D-3L index value and visual analogue scale (P=0.059 and P=0.217, respectively). Conclusions Within 1 month after DH, LDH donors showed faster mobility recovery and body image satisfaction to the level of preoperative status than ODH. LDH donors recovered to preoperative health status within 6 months, in accordance with previous studies of ODH donors.
背景腹腔镜供肝切除术(LDH)用于活体肝移植已在一些专业机构进行。LDH的手术结果已经显示出与开放式供肝切除术(ODH)相当的结果,但LDH后的生活质量(QOL)尚不清楚。本前瞻性研究以问卷为基础,评估活体肝供者在供肝切除术(DH)前后的健康状况和生活质量。材料/方法于2017年5月至2020年2月期间,对术后1年的增强术后恢复活动能力量表(EMS)、身体形象问卷(Body Image questionnaire)和EQ-5D-3L进行问卷调查,分别评估术后恢复情况、身体形象满意度和健康状况。结果在研究期间,对45例腹腔镜DH (LDH)供体和2例开放式DH (ODH)供体进行了全面评估。LDH组术后第5、7天平均EMS显著高于ODH组(P=0.011、P=0.004)。LDH组身体形象评分在DH后1个月显著高于ODH组(17.8 vs 15.0, P=0.017)。有45例LDH供体在DH后6个月和1个月恢复到术前值,EQ-5D-3L指数值和视觉模拟评分差异无统计学意义(P=0.059和P=0.217)。结论DH后1个月内,LDH供者的活动能力恢复速度和身体形象满意度均高于ODH。根据以往对脱氢酶供者的研究,脱氢酶供者在6个月内恢复到术前健康状态。
{"title":"Postoperative Health Status and Quality of Life After Pure Laparoscopic Donor Hepatectomy for Living Donor Liver Transplantation","authors":"C. Cho, G. Choi, J. M. Kim, J. Rhu, C. Kwon, J. Joh","doi":"10.12659/AOT.935611","DOIUrl":"https://doi.org/10.12659/AOT.935611","url":null,"abstract":"Background Laparoscopic donor hepatectomy (LDH) for living donor liver transplantation has been performed in several specialized institutes. Surgical outcomes of LDH have shown comparable results to open donor hepatectomy (ODH), but the quality of life (QOL) after LDH is not known. This prospective questionnaire-based study was performed to assess health status and QOL of live liver donors before and after donor hepatectomy (DH). Material/Methods From May 2017 to February 2020, questionnaire items such as the Enhanced Recovery after Surgery mobility scale (EMS), Body Image Questionnaire, and EQ-5D-3L were examined up to 1 year after DH to respectively evaluate postoperative recovery, body image satisfaction, and health status. Results During the study period, 45 laparoscopic DH (LDH) donors and 2 open DH (ODH) donors were finally fully evaluated. The LDH group had a significantly higher mean EMS than ODH on postoperative day (POD) 5, and 7 (P=0.011, and P=0.004, respectively). Body image scores of the LDH group were significantly higher than that of the ODH group at 1 month after DH (17.8 vs 15.0, P=0.017). There were 45 LDH donors who recovered to preoperative values at 6 months and 1 month after DH, with no statistically significant difference in EQ-5D-3L index value and visual analogue scale (P=0.059 and P=0.217, respectively). Conclusions Within 1 month after DH, LDH donors showed faster mobility recovery and body image satisfaction to the level of preoperative status than ODH. LDH donors recovered to preoperative health status within 6 months, in accordance with previous studies of ODH donors.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e935611-1 - e935611-9"},"PeriodicalIF":1.1,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46434679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Although the International Society for Islamic Legal Studies and the Islamic Organization for Medical Sciences have officially approved of transplantations, Muslims’ opinions on this issue are not uniform. The aim of this study was to assess the general knowledge, attitudes, and opinions concerning organ transplantation among Muslim Tatars living in North-East Poland. Material/Methods The study included 78 Muslim Tatars and was carried out at the Center of Muslim Culture using the diagnostic poll method. Results Transplantation from living donors was accepted by 96.1% of respondents, and from dead donors by 88.8% of respondents. Consent to the removal of organs after the death of a close relative was approved of by 57.7%, and 1/5 of respondents objected to it. Removal of their organs after death was approved of by 70.5% of respondents, more often by persons with higher education and vocational education than among those with only elementary education. Only 2.2% of respondents had reported their objection to the Central Objection Register. Almost 40% of men and women informed their family members about their willingness to be an organ donor. Most (71.8%) respondents had a positive attitude to transplantation, 25.6% had a negative attitude, and 2.6% were neutral. Approximately 72% of respondents believed that the final decision concerning the removal of organs from dead donors should be made by the family, and according to 8.9%, it should be prescribed by the law. Conclusions Muslim Tatars living in Poland mostly accept the removal of organs both from live donors and from dead bodies. Gender and education level had a considerable impact on the decision concerning organ donation.
{"title":"Do Muslims Living in Poland Approve of Organ Transplantation?","authors":"G. Kobus, H. Bachórzewska-Gajewska, J. Małyszko","doi":"10.12659/AOT.934494","DOIUrl":"https://doi.org/10.12659/AOT.934494","url":null,"abstract":"Background Although the International Society for Islamic Legal Studies and the Islamic Organization for Medical Sciences have officially approved of transplantations, Muslims’ opinions on this issue are not uniform. The aim of this study was to assess the general knowledge, attitudes, and opinions concerning organ transplantation among Muslim Tatars living in North-East Poland. Material/Methods The study included 78 Muslim Tatars and was carried out at the Center of Muslim Culture using the diagnostic poll method. Results Transplantation from living donors was accepted by 96.1% of respondents, and from dead donors by 88.8% of respondents. Consent to the removal of organs after the death of a close relative was approved of by 57.7%, and 1/5 of respondents objected to it. Removal of their organs after death was approved of by 70.5% of respondents, more often by persons with higher education and vocational education than among those with only elementary education. Only 2.2% of respondents had reported their objection to the Central Objection Register. Almost 40% of men and women informed their family members about their willingness to be an organ donor. Most (71.8%) respondents had a positive attitude to transplantation, 25.6% had a negative attitude, and 2.6% were neutral. Approximately 72% of respondents believed that the final decision concerning the removal of organs from dead donors should be made by the family, and according to 8.9%, it should be prescribed by the law. Conclusions Muslim Tatars living in Poland mostly accept the removal of organs both from live donors and from dead bodies. Gender and education level had a considerable impact on the decision concerning organ donation.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e934494-1 - e934494-7"},"PeriodicalIF":1.1,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43600820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Kędzierska-Kapuza, Grzegorz Witkowski, K. Baumgart-Gryn, M. Durlik
Arterial and venous thrombosis of pancreatic allografts is a rare complication in the late post-transplantation period. In addition to traditional thrombosis risk factors, SARS-CoV-2 infection predisposes patients to thrombotic diseases in both arterial and venous vessels. Transplant patients with a history of COVID-19 should be carefully monitored for arterial embolism and graft vein thrombosis. Early detection of this complication in patients after transplantation allows a chance to save the organ. Thromboprophylaxis with low molecular weight heparin is of great importance.
{"title":"Pancreas Allograft Thrombosis as a Post-COVID-19 Complication in a Diabetic Patient After Pancreas Transplantation","authors":"K. Kędzierska-Kapuza, Grzegorz Witkowski, K. Baumgart-Gryn, M. Durlik","doi":"10.12659/AOT.935863","DOIUrl":"https://doi.org/10.12659/AOT.935863","url":null,"abstract":"Arterial and venous thrombosis of pancreatic allografts is a rare complication in the late post-transplantation period. In addition to traditional thrombosis risk factors, SARS-CoV-2 infection predisposes patients to thrombotic diseases in both arterial and venous vessels. Transplant patients with a history of COVID-19 should be carefully monitored for arterial embolism and graft vein thrombosis. Early detection of this complication in patients after transplantation allows a chance to save the organ. Thromboprophylaxis with low molecular weight heparin is of great importance.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e935863-1 - e935863-3"},"PeriodicalIF":1.1,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42891464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Allana C Fortunato, Rafael S Pinheiro, Cal S Matsumoto, Rubens M Arantes, Vinicius Rocha-Santos, Lucas S Nacif, Daniel R Waisberg, Liliana Ducatti, Rodrigo B Martino, Luiz Carneiro-D'Albuquerque, Wellington Andraus
Short bowel syndrome is the most common etiology of intestinal failure, resulting from either resections of different intestinal segments or a congenital condition. Due to the absence or considerable reduction of intestinal loops in the abdominal cavity, patients with short bowel syndrome present with atrophy and muscle retraction of the abdominal wall, which leads to loss of abdominal domain and elasticity. This complication is an aggravating factor of intestinal transplantation since it can prevent the primary closure of the abdominal wall. A vast array of surgical techniques to overcome the challenges of the complexity of the abdominal wall have been described in the literature. The aim of our study was to review the modalities of abdominal wall closure in intestinal/multivisceral transplantation. Our study consisted of a systematic review following the methodological instructions described in the PRISMA guidelines. Duplicate studies and studies that did not meet the criteria for the systematic review were excluded, especially those without relevance and an explicit relationship with the investigated theme. After this step, 63 articles were included in our study. The results obtained with these techniques have been encouraging, but a high incidence of wound complications in some reports has raised concerns. There is no consensus among transplantation centers regarding which technique would be ideal and with higher success rates and lower rates of complications.
{"title":"Techniques for Closing the Abdominal Wall in Intestinal and Multivisceral Transplantation: A Systematic Review.","authors":"Allana C Fortunato, Rafael S Pinheiro, Cal S Matsumoto, Rubens M Arantes, Vinicius Rocha-Santos, Lucas S Nacif, Daniel R Waisberg, Liliana Ducatti, Rodrigo B Martino, Luiz Carneiro-D'Albuquerque, Wellington Andraus","doi":"10.12659/AOT.934595","DOIUrl":"10.12659/AOT.934595","url":null,"abstract":"<p><p>Short bowel syndrome is the most common etiology of intestinal failure, resulting from either resections of different intestinal segments or a congenital condition. Due to the absence or considerable reduction of intestinal loops in the abdominal cavity, patients with short bowel syndrome present with atrophy and muscle retraction of the abdominal wall, which leads to loss of abdominal domain and elasticity. This complication is an aggravating factor of intestinal transplantation since it can prevent the primary closure of the abdominal wall. A vast array of surgical techniques to overcome the challenges of the complexity of the abdominal wall have been described in the literature. The aim of our study was to review the modalities of abdominal wall closure in intestinal/multivisceral transplantation. Our study consisted of a systematic review following the methodological instructions described in the PRISMA guidelines. Duplicate studies and studies that did not meet the criteria for the systematic review were excluded, especially those without relevance and an explicit relationship with the investigated theme. After this step, 63 articles were included in our study. The results obtained with these techniques have been encouraging, but a high incidence of wound complications in some reports has raised concerns. There is no consensus among transplantation centers regarding which technique would be ideal and with higher success rates and lower rates of complications.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e934595"},"PeriodicalIF":1.1,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8897964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48091649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}