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Impact of Living Donor Liver Transplantation on COVID-19 Clinical Outcomes from a Quaternary Care Centre in Delhi

Journal of Clinical and Translational Hepatology 2022年第4期10卷 770-777页

作者： Imtiakum Jamir Niteen Kumar gaurav sood Ashish George Pankaj Lohia Samba Siva Rao Pasupuleti Amrish Sahney Manav Wadhawan Ajay Kumar Abhideep Chaudhary Department of HPB Surgery and Liver Transplantation BLK Super Speciality HospitalNew DelhiIndia Department of Critical Care BLK Super Speciality HospitalNew DelhiIndia Department of Statistics Mizoram University(A Central University)Pachhunga University College CampusAizawlMizoramIndia Institute of Digestive and Liver Diseases BLK Super Speciality HospitalNew DelhiIndia

Background and Aims:The anticipated fear of serious out-comes in coronavirus infected liver transplant recipients led to disruption of transplant services *** aim of our study was to analyze COVID-19 severity in transplant recipients and to compare the difference of COVID-19 clinical outcomes in early(1 year)post-transplant ***:41 post-living donor liver transplant recipients with COVID-19 infection were studied retrospectively from 1st April 2020 to 28th February ***:The median age was 49.00 years with a male preponderance(80.49%).Fif-teen patients had infection within 1 year of transplant and 26 were infected after 1 year of *** overall median interval between transplantation and COVID-19 diagnosis was 816.00 *** and malaise were the common presenting *** most common associated comorbidities were diabetes mellitus(65.85%)and hypertension(46.34%).The severity of illness was mild in 28(68.29%),moderate in 4(9.76%),severe in 6(14.63%)and critical in 3(7.32%).To identify associated risk factors,we divided our patients into less severe and more severe *** for lymphopenia,there was no worsening of total bilirubin,transaminases,al-kaline phosphatase,and gamma-glutamyl transferase in the more severe ***(19.51%)patients required inten-sive care unit admission and three(7.32%)died,while none suffered graft *** recipients with early *** post-transplant COVID-19 infection,there were similar outcomes in terms of severity of COVID-19 illness,intensive care unit care need,requirement of respiratory support,and ***:Living donor liver transplantation can be per-formed during the COVID-19 pandemic without the fear of poor recipient outcome in cases of unfortunate contraction of severe acute respiratory syndrome coronavirus-2.

关键词： COVID-19 SARS-CoV-2 Living donor liver transplantation,LDLT Mortality Perioperative

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General-motors diet: A quick fix for steatotic live liver donors

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iLIVER 2023年第3期2卷 151-155页

作者： Anish Gupta Abhideep Chaudhary gaurav sood Niteen Kumar Imtiakum Jamir Aditya Shriya Vipin Pal Singh Rekha Subramaniyam Hitesh Soni Milind Mandwar Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation BLK MAX Super Specialty HospitalNew DelhiIndia

Background and aims:GM(General-Motors)diet is a low-calorie 7-day diet plan using complex carbohydrates used for quick weight *** optimisation is known to decrease steatosis and improve outcomes in liver *** evaluated the efficacy and feasibility of using GM diet in steatotic live liver donors(LLD).Methods:LLDs who either had BMI>30 kg/m^(2),Computerised tomography liver attenuation index(CT-LAI)10%were started on GM diet for 1 *** of these LLDs and their recipients were retrieved retrospectively and ***,liver function tests(LFT),MR fat-frac-tion,CT-LAI,hospital-stay and complications were analysed in LLDs while early graft dysfunction(EGD)and complications were assessed in ***:A total of 51 LLDs with mean age of 34.6?9.5 years with baseline mean weight of 80.6±10.8 kg and BMI of 29.1±2.78 kg/m^(2) were started on GM *** a week of following the GM diet,there was an average weight loss of 3.46±2.1 kg,a decrease in fat-fraction by 3.8%±2.7,and an improvement in CT-LAI by 6.7?3.7 *** patients could successfully undergo donor hepatectomy with an average postoperative ICU stay of 2.86±0.8 days and hospital stay of 6.82?0.81 *** donor had steatosis>10% on intraoperative Tru-cut biopsy and their post-operative outcomes were similar to normal liver *** were intra-abdominal collections in 2 donors requiring drainage and one required re-exploration for intestinal *** was EGD in 8 recipients(15.6%)and mortality in 1(1.9%)***:GM diet is safe and effective regimen to reduce steatosis and increase healthy LLD pool without compromising donor or recipient safety.

关键词： Steatosis GM diet weight loss donor optimization LDLT donor hepatectomy donor outcomes

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