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Biliary complications in recipients of living donor liver transplantation:A single-centre study

World Journal of Hepatology 2021年第12期13卷 2081-2103页

作者： Reginia Nabil Guirguis Ehab Hasan Nashaat Azza Emam Yassin Wesam Ahmed Ibrahim Shereen A Saleh Mohamed Bahaa Mahmoud El-Meteini Mohamed Fathy hany mansour dabbous Iman Fawzy Montasser Manar Salah Ghada Abdelrahman Mohamed Gastroenterology and Hepatology Unit Department of Internal MedicineFaculty of MedicineAin Shams UniversityCairo 11591Egypt Department of General Surgery Faculty of MedicineAin Shams UniversityCairo 11591Egypt Department of Tropical Medicine Faculty of MedicineAin Shams UniversityCairo 11591Egypt

BACKGROUND Biliary complications(BCs)after liver transplantation(LT)remain a considerable cause of morbidity,mortality,increased cost,and graft *** To investigate the impact of BCs on chronic graft rejection,graft failure and *** From 2011 to 2016,215 adult recipients underwent right-lobe living-donor liver transplantation(RT-LDLT)at our *** excluded 46 recipients who met the exclusion criteria,and 169 recipients were included in the final ***’and recipients’demographic data,clinical data,operative details and postoperative course information were *** also reviewed the management and outcomes of *** were followed for at least 12 mo post-LT until December 2017 or graft or patient *** The overall incidence rate of BCs including biliary leakage,biliary infection and biliary stricture was 57.4%.Twenty-seven(16%)patients experienced chronic graft *** failure developed in 20(11.8%)patients.A total of 28(16.6%)deaths occurred during *** were a risk factor for the occurrence of chronic graft rejection and failure;however,mortality was determined by recurrent hepatitis C virus *** Biliary complications after RT-LDLT represent an independent risk factor for chronic graft rejection and graft failure;nonetheless,effective management of these complications can improve patient and graft survival.

关键词： Biliary complications Living donor liver transplantation Retrospective analysis Bile leak Biliary stricture Risk factors Mortality Graft rejection

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Impact of biliary complications on quality of life in live-donor liver transplant recipients

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World Journal of Hepatology 2021年第10期13卷 1405-1416页

作者： Reginia Nabil Guirguis Ehab Hasan Nashaat Azza Emam Yassin Wesam Ahmed Ibrahim Shereen A Saleh Mohamed Bahaa Mahmoud El-Meteini Mohamed Fathy hany mansour dabbous Iman Fawzy Montasser Manar Salah Ghada Abdelrahman Mohamed Department of Internal Medicine Gastroenterology and Hepatology UnitFaculty of MedicineAin Shams UniversityCairo 11591Egypt Department of General Surgery Faculty of MedicineAin Shams UniversityCairo 11591Egypt Department of Tropical Medicine Faculty of MedicineAin Shams UniversityCairo 11591Egypt

BACKGROUND Despite significant advancements in liver transplantation(LT)surgical procedures and perioperative care,post-LT biliary complications(BCs)remain a significant source of morbidity,mortality,and graft *** addition,data are conflicting regarding the health-related quality of life(HRQoL)of LT ***,the success of LT should be considered in terms of both the survival and recovery of *** To assess the impact of BCs on the HRQoL of live-donor LT recipients(LDLT-Rs).METHODS We retrospectively analysed data for 25 LDLT-Rs who developed BCs post-LT between January 2011 and December 2016 at our *** Short Form 12 version 2(SF 12v2)health survey was used to assess their *** also included 25 LDLT-Rs without any post-LT complications as a control *** The scores for HRQoL of LDLT-Rs who developed BCs were significantly higher than the norm-based scores in the domains of physical functioning(P=0.003),role-physical(P<0.001),bodily pain(P=0.003),general health(P=0.004),social functioning(P=0.005),role-emotional(P<0.001),and mental health(P<0.001).No significant difference between the two groups regarding vitality was detected(P=1.000).The LDLT-Rs with BCs had significantly lower scores than LDLT-Rs without BCs in all HRQoL domains(P<0.001)and the mental(P<0.001)and physical(P=0.0002)component summary *** The development of BCs in LDLT-Rs causes a lower range of improvement in HRQoL.

关键词： Live-donor liver transplantation Quality of life The Short Form 12 version 2 Cirrhosis Biliary complications Mental health

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Living donor liver transplantation for high model for endstage liver disease score:What have we learned?

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World Journal of Hepatology 2016年第22期8卷 942-948页

作者： hany dabbous Mohammad Sakr Sara Abdelhakam Iman Montasser Mohamed Bahaa hany Said Mahmoud El-Meteini Department of Tropical Medicine Ain Shams Center for Organ Transplant Faculty of Medicine Ain Shams University Depart-ment of Hepatobiliary Surgery Ain Shams Center for Organ Transplant Faculty of Medicine Ain Shams University

AIM: To assess the impact of model for end-stage liver disease(MELD) score on patient survival and morbidity post living donor liver transplantation(LDLT). METHODS: A retrospective study was performed on 80 adult patients who had LDLT from 2011-2013. Nine patients were excluded and 71 patients were divided into two groups; Group 1 included 38 patients with a MELD score 20. Comparison between both groups was done regarding operative time, intra-operative blood requirement, intensive care unit(ICU) and hospital stay, infection, and patient ***: Eleven patients died(15.5%); 3/38(7.9%)patients in Group 1 and 8/33(24.2%) in Group 2 with significant difference(P = 0.02). Mean operative time, duration of hospital stay, and ICU stay were similar in both groups. Mean volume of blood transfusion and cell saver re-transfusion were 8 ± 4 units and 1668 ± 202 m L, respectively, in Group 1 in comparison to 10 ± 6 units and 1910 ± 679 m L, respectively, in Group 2 with no significant difference(P = 0.09 and 0.167, respectively). The rates of infection and systemic complications(renal, respiratory, cardiovascular and neurological complications) were similar in both groups. CONCLUSION: A MELD score > 20 may predict mortality after LDLT.

关键词： Living donor liver transplantation Model for end-stage liver disease score Morbidity Mortality Infection

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Modulation of splanchnic circulation:Role in perioperativemanagement of liver transplant patients

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World Journal of Gastroenterology 2016年第4期22卷 1582-1592页

作者： Ahmed Mukhtar hany dabbous Department of Anesthesia and Critical Care Cairo UniversityCairo 11562Egypt Department of Hepatology and Gastroenterology Ain Shams UniversityCairo 11566Egypt

Splanchnic circulation is the primary mechanism thatregulates volumes of circulating blood and systemic blood pressure in patients with cirrhosis accompanied by portal hypertension. Recently, interest has been expressed in modulating splanchnic circulation in patients with liver cirrhosis, because this capability might produce beneficial effects in cirrhotic patients undergoing a liver transplant. Pharmacologic modulation of splanchnic circulation by use of vasoconstrictors might minimize venous congestion, replenish central blood flow, and thus optimize management of blood volume during a liver transplant operation. Moreover, splanchnic modulation minimizes any high portal blood flow that may occur following liver resection and the subsequent liver transplant. This effect is significant, because high portal flow impairs liver regeneration, and thus adversely affects the postoperative recovery of a transplant patient. An increase in portal blood flow can be minimized by either surgical methods(e.g., splenic artery ligation, splenectomy or portocaval shunting) or administration of splanchnic vasoconstrictor drugs such as Vasopressin or terlipressin. Finally, modulation of splanchnic circulation can help maintain perioperative renal function. Splanchnic vasoconstrictors such as terlipressin may help protect against acute kidney injury in patients undergoing liver transplantation by reducing portal pressure and the severity of a hyperdynamic state. These effects are especially important in patients who receive a too small for size graft. Terlipressin selectively stimulates V1 receptors, and thus causes arteriolar vasoconstriction in the splanchnic region, with a consequent shift of blood from splanchnic to systemic circulation. As a result, terlipressin enhances renal perfusion by increasing both effective blood volume and mean arterial pressure.

关键词： Splanchnic circulation Vasopressin agonists Portal blood flow Liver transplant Perioperative renalfunction

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Obstructed infracardiac total anomalous pulmonary venous connection:The challenge of palliative stenting for the stenotic vertical vein

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Pediatric Investigation 2020年第2期4卷 141-144页

作者： mansour Al‐Mutairi Adnan Aselan Mustafa Al‐Muhaya hany Abo‐Haded Pediatric Cardiology Department Madinah Cardiac Centre(MCC)MadinahSaudi Arabia Pediatric Cardiology Team Pediatric Cardiology UnitDepartment of PediatricsMaternity and Children Hospital(MCH)Al‐Madinah Al‐MunawarahSaudi Arabia Pediatric Cardiology Unit Department of PediatricsFaculty of MedicineMansoura UniversityMansouraEgypt

Introduction Obstructed total anomalous pulmonary venous connection(TAPVC)is one of the commonest seen emergencies in pediatric cardiology *** presentation Our case was diagnosed to have this anomaly,showing early respiratory distress resulting from severe pulmonary *** stenting of the obstruction was done,which helped in stabilizing the debilitated hemodynamics of the baby before surgery,thus a good surgical outcome and prognosis are *** This intervention may be listed as a vital measurement in the preoperative cardiac stabilization plan for infants with obstructed TAPVC.

关键词： Obstruction Total anomalous pulmonary venous connection(TAPVC) Palliative stent

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Effectiveness of stenting and subsequent re-implantation of disconnected pulmonary artery to restore the pulmonary hemodynamics

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Pediatric Investigation 2021年第1期5卷 65-68页

作者： Saad Khoshhal mansour Al-Mutairi Mohamed Morsy Nasser Kreary Abdulhameed Alnajjar hany Abo-Haded Pediatric Cardiology team Pediatric DepartmentFaculty of MedicineTaibah UniversityMadinahSaudi Arabia Pediatric Cardiology Department Madinah Cardiac CenterMadinahSaudi Arabia Pediatric Department Faculty of MedicineSohag UniversitySohagEgypt Pediatric Cardiology Unit Pediatric DepartmentFaculty of MedicineMansoura UniversityMansouraEgypt

Introduction:Early intervention in patients with congenitally disconnected pulmonary artery improves long-term *** presentation:We present 3 cases of isolated disconnected pulmonary artery in the absence of associated structural heart disease during a period of 3 ***:Transcatheter stenting of the feeding ductus arteriosus re-established pulmonary artery flow and *** surgical repair was achieved,and normal perfusion and complete function of the ipsilateral lung were regained.

关键词： Pulmonary artery Cardiac catheterization Surgery

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Bacterial infections post-living-donor liver transplantation in Egyptian hepatitis C virus-cirrhotic patients: A singlecenter study

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World Journal of Hepatology 2017年第20期9卷 896-904页

作者： Mohamed F Montasser Nadia A Abdelkader Sara M Abdelhakam hany dabbous Iman F Montasser Yasmine M Massoud Waleed Abdelmoaty Shereen A Saleh Mohamed Bahaa hany Said Mahmoud El-Meteini Department of Tropical Medicine Faculty of Medicine Ain Shams University Department of Internal Medicine Faculty of Medicine Ain Shams University Department of Hepatobiliary Surgery Ain Shams Center for Organ Transplant Faculty of Medicine Ain Shams University

AIM To determine risk factors, causative organisms and antimicrobial resistance of bacterial infections following living-donor liver transplantation(LDLT) in cirrhotic *** This prospective study included 45 patients with hepatitis C virus-related end-stage liver disease who underwent LDLT at Ain Shams Center for Organ Transplant, Cairo, Egypt from January 2014 to November 2015. Patients were followed-up for the first 3 mo after LDLT for detection of bacterial infections. All patients were examined for the possible risk factors suggestive of acquiring infection pre-, intra-and post-operatively. Positive cultures based on clinical suspicion and patterns of antimicrobial resistance were identified. RESULTS Thirty-three patients(73.3%) suffered from bacterial infections; 21 of them had a single infection episode, and 12 had repeated infection episodes. Bile was the most common site for both single and repeated episodes of infection(28.6% and 27.8%, respectively). The most common isolated organisms were gramnegative bacteria. Acinetobacter baumannii was the most common organism isolated from both single and repeated infection episodes(19% and 33.3%, respectively), followed by Escherichia coli for repeated infections(11.1%), and Pseudomonas aeruginosa for single infections(19%). Levofloxacin showed high sensitivity against repeated infection episodes(P = 0.03). Klebsiella, Acinetobacter and Pseudomonas were multi-drug resistant(MDR). Pre-transplant hepatocellular carcinoma(HCC) and duration of drain insertion(in days) were independent risk factors for the occurrence of repeated infection episodes(P = 0.024).CONCLUSION MDR gram-negative bacterial infections are common post-LDLT. Pre-transplant HCC and duration of drain insertion were independent risk factors for the occurrence of repeated infection episodes.

关键词： Living-donor liver transplantation Bacterial infection Multi-drug resistance Hepatitis C virus Liver cirrhosis

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Intensive care unit readmission in adult Egyptian patients undergoing living donor liver transplant:A single-centre retrospective cohort study

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World Journal of Hepatology 2022年第6期14卷 1150-1161页

作者： Manar Salah Iman Fawzy Montasser Hanaa A El Gendy Alaa A Korraa Gamal M Elewa hany dabbous Hossam R Mahfouz Mostafa Abdelrahman Mohammed Hisham Goda Mohamed Mohamed Bahaa El-Din Mahmoud El-Meteini Heba A Labib Department of Tropical Medicine Ain Shams Center for Organ TransplantationAin Shams UniversityCairo 11566Egypt Department of Anaesthesia and Critical Care Ain Shams Centre for Organ TransplantationAin Shams UniversityCairo 11566Egypt Department of General Surgery and Liver Transplantation Ain Shams Centre for Organ TransplantationAin Shams UniversityCairo 11566Egypt

BACKGROUND Patients who undergo living donor liver transplantation(LDLT)may suffer complications that require intensive care unit(ICU)*** To identify the incidence,causes,and outcomes of ICU readmission after *** A retrospective cohort study was conducted on patients who underwent *** collected data included patient demographics,preoperative characteristics,intraoperative details;postoperative stay,complications,causes of ICU readmission,and *** were divided into two groups according to ICU readmission after hospital *** factors for ICU readmission were identified in univariate and multivariate *** The present study included 299 ***-one(10.4%)patients were readmitted to the ICU after *** who were readmitted to the ICU were older in age(53.0±5.1 vs 49.4±8.8,P=0.001)and had a significantly higher percentage of women(29%vs 13.4%,P=0.032),diabetics(41.9%vs 24.6%,P=0.039),hypertensives(22.6%vs 6.3%,P=0.006),and renal(6.5%vs 0%,P=0.010)patients as well as a significantly longer initial ICU stay(6 vs 4 d,respectively,P<0.001).Logistic regression analysis revealed that significant independent risk factors for ICU readmission included recipient age(OR=1.048,95%CI=1.005-1.094,P=0.030)and length of initial hospital stay(OR=0.836,95%CI=0.789-0.885,P<0.001).CONCLUSION The identification of high-risk patients(older age and shorter initial hospital stay)before ICU discharge may help provide optimal care and tailor follow-up to reduce the rate of ICU readmission.

关键词： Intensive care units Liver transplantation Patient readmission Risk factors

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Using Automation Controller System and Simulation Program for Testing Closed Circuits of Mini-Sprinkler Irrigation System

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Open Journal of Modelling and Simulation 2013年第2期1卷 14-23页

作者： Hani A. mansour hany M. Mehanna Mohamed E. El-Hagarey Ahmehd S. Hassan Irrigation Department Agriculture Engineering Research Institute Agricultural Research Center Cairo Egypt Soil and Water Resources Conservation Department Desert Research Center Cairo Egypt Water Relations Field Irrigation Department Agricultural and Biological Division National Research Center Cairo Egypt

The field experiments were conducted at the experimental farm of Faculty of agricultural, southern Illinois University SIUC, USA. The project makes the irrigation automated. With the use of low cost sensors and the simple circuitry makes currently project a low cost product, which can be bought even by a poor farmer. This research work is best suited for places where water is scares and has to be used in limited quantity and this proposal is a model to modernize the agriculture industries at a mass scale with optimum expenditure. In the field of agricultural engineering, use of sensor method of irrigation operation is important and it is well known that closed circuits of Mini-sprinkler irrigation system are very economical and efficient. Closed circuits are considered one of the modifications of Mini-sprinkler irrigation system, and added advantages to Mini-sprinkler irrigation system because it can relieve low operating pressures problem at the end of the lateral lines. In the conventional closed circuits of Mini-sprinkler irrigation system, the farmer has to keep watch on irrigation timetable, which is different for different crops. Using this system, one can save manpower, water to improve production and ultimately profit. The data could be summarized in following: Irrigation methods under study when using lateral length 60 mcould be ranked in the following ascending order according the values of the predicted and measured head losses CM1M-SIS *** correlation (Corr.) coefficients were used to compare the predicted and measured head losses along the lateral lines of all the closed circuits designs. Generally, the values of correlation analysis were (>0.90) were obtained with 0% field slope60 mlength (experimental conditions) for all closed *** interaction between irrigation methods: at the start there are significant differences between CM2M-SIS and CM1M-SIS.

关键词： Automation Controller Simulation Program Mini-Sprinkler Irrigation Lateral Closed Circuits

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