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Robotic liver surgery is the optimal approach as bridge to transplantation

World Journal of Hepatology 2017年第4期9卷 224-226页

作者： Paolo Magistri Giuseppe Tarantino Roberto Ballarin Andrea Coratti Fabrizio Di Benedetto Department of Medical and Surgical Sciences and Translational Medicine Sapienza - University of Rome Hepato-Pancreato-Biliary Surgery and Liver transplantation Unit University of Modena and Reggio Emilia Department of Oncology Division of Oncological and Robotic General Surgery Careggi University Hospital

The role of minimally invasive liver surgery as a bridge to transplantation is very promising but still underestimated. However, it should be noted that surgical approach for hepatocellular carcinomas(HCC) is not merely a technical or technological issue. Nowadays, the epidemiology of HCC is evolving due to the increasing role of non-alcoholic fatty-liver-disease, and the emerging concerns on direct-acting antivirals against hepatitis C virus in terms of HCC incidence. Therefore, a fully multidisciplinary study of the cirrhotic patient is currently more important than ever before, and the management of those patients should be reserved to tertiary referral hepatobiliary centers. In particular, minimally invasive approach to the liver showed several advantages compared to the classical open procedure, in terms of:(1) the small impact on abdominal wall;(2) the gentle manipulation on the liver;(3) the limited surgical trauma; and(4) the respect of venous shunts. Therefore, more direct indications should be outlined also in the Barcelona Clinic Liver Cancer model. We believe that treatment of HCC in cirrhotic patients should be reserved to tertiary referral hepatobiliary centers, that should offer patient-tailored approaches to the liver disease, in order to provide the best care for each case, according to the individual comorbidities, risk factors, and personal quality of life expectations.

关键词： Hepatocellular carcinomas Liver transplant Robotic surgery bridge to transplantation Da vinci Barcelona Clinic Liver Cancer Patient safety

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Extracorporeal membrane oxygenation in lung transplantation:Indications,techniques and results

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World Journal of transplantation 2021年第7期11卷 290-302页

作者： Eleonora Faccioli Stefano Terzi Alessandro Pangoni Ivan Lomangino Sara Rossi Andrea Lloret Giorgio Cannone Carlotta Marino Chiara Catelli Andrea Dell'Amore Thoracic Surgery Unit Department of Cardiothoracic and Vascular SciencesUniversity of PadovaPadova 35128Italy

The use of extracorporeal membrane oxygenation(ECMO)in the field of lung transplantation has rapidly expanded over the past 30 *** has become an important tool in an increasing number of specialized centers as a bridge to transplantation and in the intra-operative and/or post-operative *** is an extremely versatile tool in the field of lung transplantation as it can be used and adapted in different configurations with several potential cannulation sites according to the specific need of the *** example,patients who need to be bridged to lung transplantation often have hypercapnic respiratory failure that may preferably benefit from veno-venous(VV)ECMO or peripheral veno-arterial(VA)ECMO in the case of hemodynamic ***,in an intraoperative setting,VV ECMO can be maintained or switched to a VA *** routine use of intra-operative ECMO and its eventual prolongation in the postoperative period has been widely investigated in recent years by several important lung transplantation centers in order to assess the graft function and its potential protective role on primary graft dysfunction and on ischemia-reperfusion *** review will assess the current evidence on the role of ECMO in the different phases of lung transplantation,while analyzing different studies on pre,intra-and post-operative utilization of this extracorporeal support.

关键词： Lung transplantation Extracorporeal membrane oxygenation bridge to transplantation Support Primary graft dysfunction Ischemia-reperfusion injury

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