Transplantation proceedings
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Adequate nutritional support for patients undergoing major surgery significantly affects postoperative recovery. Data on enteral feeding after liver transplantation (LT) are scarce. The aim of this work was to determine the efficacy and complications of feeding tubes inserted with the use of fluoroscopic assistance, endoscopic assistance, or transperitoneal jejunostomy in patients who underwent LT. ⋯ Enteral feeding tube insertion in patients who can not maintain a nasogastric tube or start oral intake for a long time is important for nutritional support after LT. Proper feeding method selection according to patient condition can help patients by improving nutritional support after major operations such as LT.
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Randomized Controlled Trial Comparative Study
Comparison of antioxidant effects of isoflurane and propofol in patients undergoing donor hepatectomy.
The safety of healthy volunteer donors is one of the most important issues in living-donor liver transplantation. Use of the Pringle maneuver during donor hepatectomy can result in liver ischemia-reperfusion (IR) injury. The objective of this study was to examine the effects of isoflurane and propofol on IR injury caused by the Pringle maneuver during donor hepatectomy. ⋯ Propofol may have protective effects against IR injury caused by the Pringle maneuver during donor hepatectomy in living-donor transplantations. However, the effectiveness of propofol for clinical use needs to be investigated further.
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Lung size matching is important in lung transplantation (LT). With advances in computed tomography (CT) technology, multidetector row CT can accurately measure the thoracic cage and lung volumes. The objective of this study was to generate a new regression equation using demographic data based on the measured CT lung volume in a healthy population to predict the CT lung volume of the donor in LT size matching. ⋯ These equations could predict the CT lung volume of healthy subjects using demographic data. Using these equations, the predicted CT lung volume of donors could be matched to the measured CT lung volume of recipients in lung transplantation.
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The inflammatory response plays an important role in liver dysfunction after hepatic ischemia/reperfusion (I/R), which is tightly regulated by the Toll-like receptor 2 (TLR2)/nuclear factor (NF)-κB pathway; suppression of TLR2/NF-κB signaling has therefore become a promising target for anti-inflammatory treatment in hepatic I/R injury. Erythropoietin (EPO) is a glycoprotein cytokine produced primarily by the kidney that has anti-inflammatory activities. The purpose of the present study was to investigate the effect of EPO preconditioning, if any, against hepatic I/R injury in rats and its underlying mechanisms. ⋯ These results suggest that EPO pretreatment ameliorates hepatic I/R injury, which is involved in suppressing TLR2/NF-κB-mediated inflammation.
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Extracorporeal membrane oxygenation (ECMO) is a method of enabling gas exchange through an external membrane used to treat respiratory failure in critically ill patients. ECMO as a bridge to lung transplantation has been investigated as a potential method of reducing lung transplantation waitlist mortality. Herein we describe a case of ECMO as a bridge-to-lung transplantation for the duration of 35 days, which is the longest documented length of ECMO support before successful transplantation in Canada. ⋯ Our case provides hope that in the future we may be able to expand the population of recipients who may be candidates for lung transplantation. This case adds to the growing literature on the role of ECMO as a bridge-to-lung transplantation with the potential to reduce patient deaths while wait-listed for lung transplantation as well as increase the number of transplantations being performed.