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Grade of donor liver microvesicular steatosis does not affect the postoperative outcome after liver transplantation

Hepatobiliary & Pancreatic Diseases International 2017年第6期16卷 617-623页

作者： Anne Andert Tom Florian Ulmer wenzel schoning Daniela Kroy Marc Hein Patrick Hamid Alizai Christoph Heidenhain Ulf Neumann Maximilian Schmeding Department of General Visceral and Transplant SurgeryUniklinik RWTH Aachen AachenGermany Department of Internal Medicine Uniklinik RWTH Aachen AachenGermany Department of Anaesthesiology Uniklinik RWTH Aachen AachenGermany Department of General and Visceral Surgery Sana Hospital Düsseldorf-Gerresheim Germany

BACKGROUND:The potential effect of graft steatosis on the postoperative liver function is discussed controversially. The present study aimed to evaluate the effect of the donor liver microvesicular steatosis on the postoperative outcome after liver ***:Ninety-four patients undergoing liver transplantation at the University Hospital Aachen were included in this study. The patient cohort was divided into three groups according to the grade of microvesicular steatosis(MiS):MiS 60%(n=26).The outcomes after liver transplantation were evaluated, including the 30-day and 1-year patient and graft survival rates and the incidences of early allograft dysfunction(EAD) and primary nonfunction(PNF). RESULTS:The incidences of EAD and PNF did not differ significantly between the groups. We observed 5 cases of PNF,one occurred in the MiS 60% ***:Microvesicular steatosis of donor livers has no negative effect on the postoperative outcome after liver transplantation.

关键词： liver transplantation liver steatosis microvesicular steatosis early allograft dysfunction

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Validation of the Enhanced Recovery after Surgery (ERAS) society recommendations for liver surgery: a prospective, observational study

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Hepatobiliary Surgery and Nutrition 2023年第1期12卷 20-36,I0003-I0006页

作者： Moritz Schmelzle Felix Krenzien Paul Dahlke Alina Krombholz Nora Nevermann Linda Feldbrügge Axel Winter wenzel schoning Christian Benzing Johann Pratschke Jens Neudecker Department of Surgery Campus Charite Mitte and Campus Virchow-KlinikumCharite-Universitatsmedizincorporate member of Freie Universität BerlinHumboldt-Universitat zu BerlinBerlinGermany Berlin Institute of Health(BIH) BerlinGermany

Twenty-three recommendations were summarized by the Enhanced Recovery After Surgery(ERAS)society for liver *** aim was to validate the protocol especially with regard to adherence and the impact on ***:Using the ERAS Interactive Audit System(EIAS),ERAS items were evaluated in patients undergoing liver *** a period of 26 months,304 patients were prospectively enrolled in an observational study(DRKS00017229).Of those,51 patients(non-ERAS)were enrolled before and 253 patients(ERAS)after the implementation of the ERAS *** adherence and complications were compared between the two ***:Overall adherence increased from 45.2%in the non-ERAS group to 62.7%in the ERAS group(P0.05).Overall complications decreased from 41.2%(n=21)in the non-ERAS group to 26.5%(n=67)in the ERAS group(P=0.0423),which was mainly due to the reduction of grade 1-2 complications from 17.6%(n=9)to 7.6%(n=19)(P=0.0322).As for patients undergoing open surgery,implementation of ERAS lead to a reduction of overall complications in patients scheduled for minimally invasive liver surgery(MILS)(P=0.036).Conclusions:Implementation of the ERAS protocol for liver surgery according to the ERAS guidelines of the ERAS Society reduced Clavien-Dindo grade 1-2 complications particularly in patients who underwent *** ERAS guidelines are beneficial for the outcome,while adherence to the various items has not yet been satisfactorily defined.

关键词： Enhanced Recovery After Surgery(ERAS) prehabilitation liver surger

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