Transplantation proceedings
-
There is a wide interest in epidemiologic studies assessing different causes of post-kidney transplantation rehospitalization. However, there is a paucity of knowledge on the long-term survival and graft function of rehospitalized kidney transplant recipients during the first year. Knowledge of posttransplant rehospitalization causes may help guide the preventive program at the first year. In our study, we assess causes for hospitalization and investigate the long-term patient and graft survival after non-fatal rehospitalization in kidney recipients during the first year. ⋯ During the first year after kidney transplantation, rehospitalization was especially required because of infections and renal dysfunction. The risk factors of rehospitalization were cadaveric graft, use of mycophenolate mofetil, use of cyclosporine, and cytomegalovirus infection. To prevent and minimize rehospitalizations during the first year, a specific preventive program based on infection prevention and graft function monitoring should be established.
-
Cardiac dysfunction in patients with cirrhosis and potential clinical implications have long been known, but the pathophysiology and potential targets for therapeutic intervention are still under investigation and are only now becoming understood. The pathophysiological changes result in systolic dysfunction, diastolic dysfunction, and electrophysiological changes. Here, we aim to review cirrhotic cardiomyopathy from a cellular and physiological model and how these patients develop overt heart failure in the setting of stress, such as infection, ascites, and procedures including transjugular intrahepatic portosystemic shunt, portocaval shunts, and orthotopic liver transplantation. We will also review the most current, although limited, available therapeutic modalities.
-
Although stroke volume variation (SVV) is a valuable index of preload responsiveness, there is limited information about the association between low SVV and increased hepatectomy-related bleeding. We therefore evaluated whether SVV predicts blood loss during living donor hepatectomy. ⋯ SVV is a significant independent predictor of blood loss ≥ 700 mL during donor hepatectomy, suggesting that low SVV may provide useful information on intraoperative bleeding in donors undergoing right hepatectomy.
-
In recent years, the People's Republic of China has experienced advancements in organ transplant surgical techniques, growing transplant waiting lists, and stagnant organ donation rates. All of these factors have pressured China to find ways to increase brain-dead cadaveric donation rates to narrow the gap between organ supply and demand. The objective of this work was to review the factors influencing brain-dead cadaveric donation rates in China including legislation, brain-death criteria, and clinical practice as well as cultural and public attitudes toward brain death and organ donation, for comparisons with other countries.
-
This study analyzed hemodynamic recordings collected on a beat-to-beat basis during orthotopic liver transplantation (OLT). The first aim was to construct a graphic that will represent hemodynamic profile during OLT. The second aim was to compare the intraoperative hemodynamic pattern of survivors versus nonsurvivors and those who received a liver from normal versus marginal donors. ⋯ This study shows changes in the hemodynamic profile during OLT, measured on a beat-to-beat basis. Intraoperative hemodynamic changes did not predict patients who did not survive OLT. Beat-to-beat monitoring did not reveal significant hemodynamic instability following transplantation of marginal grafts.