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Primary liver transplantation vs transplant after Kasai portoenterostomy in children with biliary atresia: A retrospective Brazilian single-center cohort

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World Journal of Transplantation 2024年第1期14卷 112-119页

作者： Melina Utz Melere Valberto Sanha Marco Farina Carolina Soares da Silva luiza Nader Cristine Trein Angelica Maria lucchese Cristina Ferreira antonio nocchi kal.l.fl.via heinz feier Department of Hepatology and liver Transplantation Santa Casa de Porto AlegrePorto Alegre 90050170Brazil Department of Hepato-biliary-pancreatic Surgery and liver Transplantation Irmandade Santa Casa de Misericórdia de Porto AlegrePorto Alegre 90020-090Brazil Department of Surgical Oncology Santa Rita Hospital/Santa Casa de Misericórdia de Porto AlegrePorto Alegre 90050-170Rio Grande do SulBrazil

BACKGROUND Biliary atresia(BA)is the most common indication for pediatric liver transplantation,although portoenterostomy is usually performed ***,due to the high failure rate of portoenterostomy,liver transplantation has been advocated as the primary procedure for patients with *** is still unclear if a previous portoenterostomy has a negative impact on liver transplantation *** To investigate the effect of prior portoenterostomy in infants un-dergoing liver transplantation for *** This was a retrospective cohort study of 42 pediatric patients with BA who underwent primary liver transplantation from 2013 to 2023 at a single tertiary center in *** with BA were divided into two groups:Those undergoing primary liver transplantation without portoenterostomy and those undergoing liver transplantation with prior *** variables were compared using the Student’s t-test or the Kruskal-Wallis test,and categorical variables were compared using theχ2 or Fisher’s exact test,as *** Cox regression analysis was performed to determine risk factors for portal vein *** and graft survival analyses were conducted with the Kaplan–Meier product-limit estimator,and patient subgroups were compared using the two-sided log-rank *** Forty-two patients were included in the study(25[60%]girls),23 undergoing liver transplantation without prior portoenterostomy,and 19 undergoing liver transplantation with prior *** with prior portoenterostomy were older(12 vs 8 months;P=0.02)at the time of liver transplantation and had lower Pediatric End-Stage liver Disease scores(13.2 vs 21.4;P=0.01).The majority of the patients(35/42,83%)underwent livingdonor liver *** group of patients without prior portoenterostomy appeared to have a higher incidence of portal vein thrombosis(39 vs 11%),but this result did not reach statistical *** portoenterostomy

关键词： Hepatic portoenterostomy Biliary atresia liver transplantation Patient outcome assessment Portal vein Survival

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liver volumetric and anatomic assessment in living donor liver transplantation: The role of modern imaging and artificial intelligence

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World Journal of Transplantation 2023年第6期13卷 290-298页

作者： Mayara Machry luis Fernando Ferreira Angelica Maria lucchese antonio nocchi kal.l.fl.via heinz feier Department of Hepato-Biliary-Pancreatic Surgery and liver Transplantation Irmandade Santa Casa de Misericórdia de Porto AlegrePorto Alegre 90020-090Brazil Postgraduation Program in Medicine:Hepatology Federal University of Health Sciences of Porto AlegrePorto Alegre 90050-170Brazil

The shortage of deceased donor organs has prompted the development of alternative liver grafts for ***-donor liver transplantation(lDlT)has emerged as a viable option,expanding the donor pool and enabling timely transplantation with favorable graft function and improved long-term *** accurate evaluation of the donor liver’s volumetry(lV)and anatomical study is crucial to ensure adequate future liver remnant,graft volume and precise liver ***,ensuring donor safety and an appropriate graftto-recipient weight *** lV(MlV)using computed tomography has traditionally been considered the gold standard for assessing liver ***,the method has been limited by cost,subjectivity,and *** lV techniques employing advanced segmentation algorithms offer improved reproducibility,reduced variability,and enhanced efficiency compared to manual ***,the accuracy of automated lV requires further *** study provides a comprehensive review of traditional and emerging lV methods,including semi-automated image processing,automated lV techniques,and machine learning-based ***,the study discusses the respective strengths and weaknesses of each of the aforementioned *** use of artificial intelligence(AI)technologies,including machine learning and deep learning,is expected to become a routine part of surgical planning in the near *** implementation of AI is expected to enable faster and more accurate image study interpretations,improve workflow efficiency,and enhance the safety,speed,and cost-effectiveness of the *** preoperative assessment of the liver plays a crucial role in ensuring safe donor selection and improved outcomes in *** has inherent limitations that have led to the adoption of semi-automated and automated software ***,AI has tremendous potential for lV and segmentation;however,its widespread use is hindered

关键词： liver transplantation living-donor Diagnostic imaging Artificial intelligence Machine learning Deep learning

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