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Can adequate hemodynamic management of brain-dead donors improve donor organ procurement?

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World Journal of Transplantation 2022年第4期12卷 79-82页

作者： Myat Soe Thet Alessandra Verzelloni Sef Davorin Sef Department of Cardiac Surgery St Bartholomew’s HospitalLondon EC1A 7BEUnited Kingdom Department of Surgery and Cancer Faculty of MedicineImperial College London&Imperial College Healthcare NHS TrustLondon W21NYUnited Kingdom Department of Anaesthesia and Critical Care Harefield HospitalRoyal Brompton and Harefield HospitalsPart of Guy’s and St Thomas’NHS Foundation TrustLondon UB96JHUnited Kingdom Department of Cardiothoracic Surgery and Transplant Unit Harefield HospitalRoyal Brompton and Harefield HospitalsPart of Guy’s and St Thomas’NHS Foundation TrustLondon UB96JHUnited Kingdom

There is increasing evidence that adequate donor management with a goal of optimization of organ function is essential to maximize the number of organs that can be ***,identification of the cause of hemodynamic instability is crucial in order to direct the right *** donor management goals for better hemodynamic management including serial echocardiography can guide hemodynamic management in potential donors to increase both number and quality of donor hearts.

关键词： Brain-dead donors Hemodynamic Management organ procurement

Details determining the success in establishing a mouse orthotopic liver transplantation model

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World Journal of Gastroenterology 2020年第27期26卷 3889-3898页

作者： Ting Li Zheng Hu Lei Wang Guo-Yue Lv Department of Hepatobiliary and Pancreatic Surgery The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Key Laboratory of organ Regeneration and Transplantation of Ministry of Education The First Hospital of Jilin UniversityChangchun 130061Jilin ProvinceChina National-Local Joint Engineering Laboratory of Animal Models for Human Diseases Changchun 130061Jilin ProvinceChina Department of Gastrointestinal Surgery The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina

Liver transplantation(LT)is currently the only effective treatment option for endstage liver *** importance of animal models in transplantation is widely recognized among *** of the well-characterized mouse genome and the greater diversity and availability of both genetically modified animals and research reagents,mouse orthotopic LT(MOLT)has become an ideal model for the investigation of liver biology,tissue injury,regulation of alloimmunity and tolerance induction,and the pathogenesis of specific liver ***,due to its complicated and technically demanding procedure,the model has merely been used by only a few research groups in the world for *** a new learner,training lasting at least a couple of months or even years is *** of the investigators have emphasized the importance of elaborate techniques and dedicated instruments in establishing a MOLT model,but some details are often *** nontechnical details are also significant,especially for researchers who have little experience in mouse ***,we review and summarize the crucial technical and nontechnical details in establishing the model of MOLT based on scientific articles and our experience in six aspects:animal selection,anesthesia,perioperative management,organ procurement,back-table preparation,and implantation *** aim to enable research groups to shorten the learning curve and implement the mouse LT procedure with high technical success.

关键词： Mouse orthotopic liver transplantation Animal selection Anesthesia Perioperative management organ procurement Back-table preparation Implantation surgery

Long term follow-up and outcome of liver transplantation from hepatitis B surface antigen positive donors

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World Journal of Gastroenterology 2017年第12期23卷 2095-2105页

作者： Roberto Ballarin Alessandro Cucchetti Francesco Paolo Russo Paolo Magistri Matteo Cescon Umberto Cillo Patrizia Burra Antonio Daniele Pinna Fabrizio Di Benedetto Hepatopancreatobiliary Surgery and Liver Transplant Unit University Hospital "Policlinico" University of Modena and Reggio Emilia Department of Medical and Surgical Sciences DIMEC S. Orsola-Malpighi Hospital Alma Mater Studiorum University of Bologna Gastroenterology/Multivisceral Transplant Unit Department of Surgery Oncology and Gastroenterology Padua University Hospital Department of Medical and Surgical Sciences and Translational Medicine Sapienza University of Rome

Liver transplant for hepatitis B virus(HBV) currently yields excellent outcomes: it allows to rescue patients with an HBV-related advanced liver disease, resulting in a demographical modification of the waiting list for liver transplant. In an age of patient-tailored treatments, in liver transplantation as well the aim is to offer the best suitable graft to the patient who can benefit from it, also expanding the criteria for organ acceptance and allocation. With the intent of developing strategies to increase the donor pool, we set-up a multicenter study involving 3 Liver Transplant Centers in Italy: patients undergoing liver transplantation between March 03, 2004, and May 21, 2010, were retrospectively evaluated. 1408 patients underwent liver transplantation during the study period, 28(2%) received the graft from hepatitis B surface antigen positive(HBs Ag)-positive deceased donors. The average follow-up after liver transplantation was 63.7 mo [range: 0.1-119.4; SD ± 35.8]. None Primary nonfunction, re-liver transplantation, early or late hepatic artery thrombosis occurred. The 1-, 3-and 5-year graft and patient survival resulted of 85.7%, 82.1%, 78.4%. Our results suggest that the use of HBs Agpositive donors liver grafts is feasible, since HBV can be controlled without affecting graft stability. However, the selection of grafts and the postoperative antiviral therapy should be managed appropriately.

关键词： Liver transplantation Hepatitis B virus Hepatitis B surface antigen Hepatocellular carcinoma organ allocation organ procurement Multicenter study

A Modified, Rapid and Safe Technique of Kidney Only procurement from Donors after Circulatory and Brain Death (DCD, DBD)

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Open Journal of organ Transplant Surgery 2016年第4期6卷 23-28页

作者： André G. Baranski Hwai-Ding Lam Department of Transplantation Surgery Leiden University Medical Center Leiden Netherlands

There is currently a lack of standard kidney-only procurement technique. Known techniques such as kidney-only procurement using the standard multi-organ procurement technique could potentially cause more iatrogenic injuries due to less adequate exposure. An alternative using the live open kidney donation technique could also be less than ideal due to prior unknown anatomical variation and potential the inability to adequately topically cool the kidneys. We describe here a novel easy kidney-only technique leading to an improved exposure, better cold perfusion and topical cooling. Herein we show how total bowel evisceration can be achieved by stapling the hepatic hilum, superior mesenteric artery and coeliac trunk. There is a need of a kidney only procurement in order to increase the quality of deceased kidney donation in our opinion. Results have to be compared in the future to determine the potential benefits.

关键词： organ procurement Kidney Transplantation Kidney Donation Surgical Technique