Transplantation proceedings
-
In orthotopic liver transplantation (OLT), the critical shortage of organ donors is the reason for accepting marginal donors. Although the outcome of OLT does not entirely seem to have been affected by the use of such donors identification of predictive risk factors is challenging. This study sought to identify significant risk factors associated with graft outcomes in our institute. ⋯ Although many factors including a high serum sodium level are associated with a marginal liver graft, Last donor alanine aminotransferase level was the only significant factor that predicted the PDF.
-
Comparative Study
Which score system can best predict recipient outcomes after living donor liver transplantation?
Many scoring systems have been suggested to predict the outcomes of deceased donor liver transplantations. The aims of this study were to compare the Model for End-Stage Liver Disease (MELD) score with respect to other scores among patients who underwent living donor liver transplantation (LDLT) seeking to evaluate the best system to correlate with postoperative outcomes after LDLT. ⋯ The MELD score most correlated with total bilirubin after LDLT, while the APACHE II and SOFA scores seemed to correlate with mortality after LDLT.
-
Randomized Controlled Trial
Tying a slipknot to an intubation stylet for facilitating insertion of a nasogastric tube in liver transplant recipients: a prospective, randomized study.
It is sometimes difficult and harmful to insert a nasogastric tube (NGT) into a patient with a tendency to bleed and anesthetized recipient of liver transplantation. As a "Rusch" intubation stylet tied by a slipknot, Highwayman's hitch, to the NGT, it is easy to introduce the NGT through nasal cavity and oropharyngeal space. We designed this study to evaluate the usage of this novel method in the guidance of NGT insertion in liver transplant recipients. ⋯ The intubation stylet-guided method is reliable, with high success rate of NGT insertion in patients with a tendency to bleed anesthetized recipients of liver transplantation.
-
Comparative Study
The effects of desflurane and isoflurane on hepatic and renal functions after right hepatectomy in living donors.
Considering the severe nature of living donor right hepatectomy (removal of two thirds of the original liver), identification of an anesthetic agent having a minimal impact on postoperative organ function seems important. We compared postoperative hepatic and renal functions between 2 inhalational anesthetics, desflurane (Des) and isoflurane (Iso) among living donors undergoing right hepatectomy. ⋯ The present study showed better postoperative hepatic and renal function tests with Iso than Des at an equivalent dose of 1 MAC among living donors undergoing right hepatectomy.
-
Comparative Study
Magnetic resonance cholangiography in living donor liver transplantation: comparison of preenhanced and post-gadolinium-enhanced methods.
The purpose of this study was to evaluate the image quality and diagnostic accuracy of postgadolinium complex of diethylenetriaminepentaacetic acid (GD-DTPA)-enhanced magnetic resonance cholangiography (MRC) in donor selection. ⋯ GD-DTPA, a paramagnetic metal, can shorten the T1 and T2 relaxation values of surrounding protons. This decreases the signal of the liver parenchyma and brightens the biliary anatomy. It can improve the image quality of MRC and increase the diagnostic accuracy of the biliary tract classification. It is mandatory in the "donor and recipient surgery during the LDLT".