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Beyond the Rex: an innovative meso-intrahepatic portal vein bypass for late-onset extrahepatic portal vein occlusion after living donor liver transplantation

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 662-668页

作者： Chee-Chien Yong Hsu-Ting Yen Yu-Fan Cheng leona bettina dungca Raymond Joseph De Vera Itsuko Chih-Yi Chen Chao-Long Chen Department of Surgery Liver Transplantation CenterKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung Department of Cardiovascular Surgery Liver Transplantation CenterKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung Department of Diagnostic Radiology Liver Transplantation CenterKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung

The Meso-Rex bypass(MRB)is recognized as an effective treatment for portal hypertension secondary to extrahepatic portal vein occlusion(EHPVO)both in the pediatric and adult population,within or outside the context of liver *** is the preferred surgical treatment in most centers because not only does it addresses the portal hypertension,but also restores physiologic portal hepatopetal ***,the Rex recess,the landmark for this technique,may not be safely accessible in some *** present a 22-year-old male who underwent living donor liver transplant(LDLT)for neonatal *** presented with variceal bleeding due to EHPVO at 13 years after *** endoscopic,radiologic,and surgical interventions were employed to address the recurrent gastrointestinal bleeding,but results have been *** performed a meso-intrahepatic portal vein bypass(MIPVB),an innovative alternative to the MRB,for this patient with extensive post-operative adhesions,perihilar collaterals,and cavernous *** creation in patients where the Rex recess is inaccessible is technically *** with a multidisciplinary team approach,meticulous preoperative planning,and close follow-up,the authors have demonstrated that it is a safe and feasible option for patients with late-onset EHPVO after liver transplantation.

关键词： Meso-Rex bypass(MRB) portal vein occlusion liver transplantation(LT)

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Peri-operative extracorporeal membrane oxygenation in adult and pediatric living donor liver transplantation:a single-center experience

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Hepatobiliary Surgery and Nutrition 2023年第6期12卷 898-908,I0011页

作者： Itsuko Chih-Yi Chen leona bettina Pdungca Chee-Chien Yong Wei Ho Jiunn-Jye Sheu Chao-Long Chen Liver Transplantation Center Department of SurgeryKaohsiung Chang Gung Memorial HospitalKaohsiung Cardiovascular Surgery Kaohsiung Chang Gung Memorial HospitalKaohsiung

Background:Extracorporeal membrane oxygenation(ECMO)is a potential rescue therapy for patients with acute cardiopulmonary dysfunction refractory to conventional *** this study,we described the clinical profiles and outcomes of adult and pediatric living donor liver transplantation(LDLT)patients who received ECMO support during the peri-operative ***:From June 1994 to December 2020,eleven out of the 1,812 LDLTs performed at Kaohsiung Chang Gung Memorial Hospital required ECMO support:six for respiratory failure,three for cardiogenic shock,and two for refractory septic *** between the survivor and non-survivor groups was ***:The survival rate for liver transplantation(LT)patients on ECMO support is 36.4%-40%in adults and 33.3%in pediatrics,while the survival rate per indication is as follows:acute respiratory distress syndrome(ARDS)(50%),cardiogenic shock(33.3%),and sepsis(0%).Shorter durations of LT-to-ECMO and pre-ECMO mechanical ventilation were observed in the survivor *** the other hand,we observed persistently elevated total bilirubin levels in non-survivors,while none of the survivors had aspartate aminotransferase(AST)/alanine aminotransferase(ALT)levels>1,000 U/L.A higher proportion of non-survivors were on concurrent continuous renal replacement therapy(CRRT).Conclusions:Our experience has proven ECMO’s utility during the peri-operative period for both adult and pediatric LDLT patients,more specifically for indications other than septic *** studies are needed to better understand the factors leading to poor outcomes in order to identify patients who will more likely benefit from ECMO.

关键词： Extracorporeal membrane oxygenation(ECMO) living donor liver transplantation(LDLT) respiratory failure cardiogenic shock septic shock

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Proton beam therapy for downstaging hepatocellular carcinoma with lobar portal vein tumor thrombosis to living donor liver transplantation

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Hepatobiliary Surgery and Nutrition 2023年第6期12卷 966-974页

作者： Chao-Long Chen leona bettina Pdungca Chee-Chien Yong Itsuko Chih-Yi Chen Yu-Fan Cheng Jen-Yu Cheng Yen-Yang Chen Liver Transplantation Center Department of SurgeryKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung Liver Transplantation Center Department of Diagnostic RadiologyKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung Liver Transplantation Center Department of Radiation OncologyKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung Liver Transplantation Center Department of Hematology-OncologyKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung

Introduction Liver transplantation(LT)is considered as the definitive standard treatment for hepatocellular carcinoma(HCC)with the advantage of addressing both malignancy and the underlying cirrhosis,thus,providing th... 详细信息

关键词： Proton beam therapy(PBT) hepatocellular carcinoma(HCC) portal vein tumor thrombosis(PVTT) living donor liver transplantation(LDLT) downstaging therapy

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