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Day-of-surgery rejection of donors in living donor liver transplantation

World Journal of Hepatology 2012年第11期4卷 299-304页

作者： Bassem Hegab Mohamed Rabei Abdelfattah Ayman Azzam Hazem Mohamed Waleed Al Hamoudi Faisal Aba Alkhail Hamad Al Bahili hatem khalaf Mohammed Al Sofayan Mohammed Al Sebayel Department of Liver Trans-plantation and Hepatobiliary-Pancreatic Surgery King Faisal Specialist Hospital and Research Center Riyadh 11211 Saudi Arabia Department of Hepato-Biliary-Pancreatic Surgery and Liver Transplantation National Liver Institute University of Menoufiya Menoufiya 32714 Egypt Department of Hepato-Biliary and Pancreatic Surgery University of Alexan-dria Alexandria 21131 Egypt

AIM: To study diagnostic laparoscopy as a tool for excluding donors on the day of surgery in living donor liver transplantation (LDLT).METHODS: This study analyzed prospectively collected data from all potential donors for LDLT. All of the donors were subjected to a three-step donor evaluation protocol at our institution. Step one consisted of a clinical and social evaluation, including a liver profile, hepatitis markers, a renal profile, a complete blood count, and an abdominal ultrasound with Doppler. Step two involved tests to exclude liver diseases and to evaluate the donor’s serological status. This step also included a radiological evaluation of the biliary anatomy and liver vascular anatomy using magnetic resonance cholan-giopanc reatography and a computed tomography (CT) angiogram, respectively. A CT volumetric study was used to calculate the volume of the liver parenchyma. Step three included an ultrasound-guided liver biopsy. Between November 2002 and May 2009, sixty-nine potential living donors were assessed by open exploration prior to harvesting the planned part of the liver. Between the end of May 2009 and October 2010, 30 potential living donors were assessed laparoscopically to determine whether to proceed with the abdominal incision to harvest part of the liver for donation. RESULTS: Ninety-nine living donor liver transplants were attempted at our center between November 2002 and October 2010. Twelve of these procedures were aborted on the day of surgery (12.1%) due to donor findings, and eighty-seven were completed (87.9%). These 87 liver transplants were divided into the following groups: Group A, which included 65 transplants that were performed between November 2002 and May 2009, and Group B, which included 22 transplants that were performed between the end of May 2009 and October 2010. The demographic data for the two groups of donors were found to match; moreover, no significant difference was observed between the two groups of donors with res

关键词： Live donor Laparoscopic assessment Re-jected donors Day of surgery Fatty liver

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Hepatocellular adenoma: An update

引用

World Journal of Hepatology 2015年第25期7卷 2603-2609页

作者： Adarsh Vijay Ahmed Elaffandi hatem khalaf Hamad Medical Corporation National Cancer Institute Cairo University

Hepatocellular adenomas(HCA) are rare benign liver *** technological advancements have helped in the early identification of such ***,precise diagnosis of hepatocellular incidentalomas remains *** at the molecular level have provided new insights into the genetics and pathophysiology of these *** in turn have raised questions over their existing management ***,the rarity of the tumor still restricts the quality of evidence available for current recommendations and *** article provides a comprehensive review on the etiology,molecular biology,pathophysiology,clinical manifestations,and complications associated with *** also elaborates on the genetic advancements,existing diagnostic tools and current guidelines for management for such lesions.

关键词： Liver adenoma Focal liver lesion Benignliver lesion

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