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primary graft dysfunction after liver transplantation

Hepatobiliary & Pancreatic Diseases International 2014年第2期13卷 125-137页

作者： Xiao-Bo Chen Ming-Qing Xu Department of Liver and Vascular Surgery West China Hospital Sichuan University

BACKGROUND: primary graft dysfunction (PGD) causes complications in liver transplantation, which result in poor prognosis. Recipients who develop PGD usually experience a longer intensive care unit and hospital stay and have higher mortality and graft loss rates compared with those without graft dysfunction. However, because of the lack of universally accepted definition, early diagnosis of graft dysfunction is difficult. Additionally, numerous factors affect the allograft function after transplantation, making the prediction of PGD more difficult. The present review was to analyze the literature available on PGD and to propose a *** SOURCE: A search of PubMed (up to the end of 2012) for English-language articles relevant to PGD was performed to clarify the characteristics, risk factors, and possible treatments or interventions for ***: There is no pathological diagnostic standard; many documented definitions of PGD are different. Many factors such as donor status, procurement and transplant process and recipient illness may affect the function of graft, and ischemia reperfusion injury is considered the direct cause. Potentia managements which are helpful to improve graft function were investigated. Some of them are ***: Our analyses suggested that the definition of PGD should include one or more of the following variables: (1)bilirubin ≥10 mg/dL on postoperative day 7; (2) internationa normalized ratio ≥1.6 on postoperative day 7; and (3) alanine aminotransferase or aspartate aminotransferase >2000 IU/L within 7 postoperative days. Reducing risk factors may decrease the incidence of PGD. A majority of the recipients could recover from PGD; however, when the graft progresses intoprimary non-function, the patients need to be treated with retransplantation.

关键词： graft function primary graft dysfunction initial poor function primary non-function liver transplantation

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primary graft dysfunction following lung transplantation:From pathogenesis to future frontiers

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World Journal of Transplantation 2023年第3期13卷 58-85页

作者： Sanjeet Singh Avtaar Singh Sudeep Das De Ahmed Al-Adhami Ramesh Singh Peter MA Hopkins PhilipAlan Curry Department of Cardiothoracic Surgery Royal Infirmary of EdinburghEdinburgh EH164SAUnited Kingdom Institute of Cardiovascular and Medical Sciences University of GlasgowGlasgow G128QQUnited Kingdom Heart and Lung Transplant Unit Wythenshawe HospitalManchester M239NJUnited Kingdom Department of Heart and Lung Transplant Royal Papworth HospitalCambridge CB20AYUnited Kingdom Mechanical Circulatory Support Inova Health SystemFalls ChurchVA 22042United States Queensland Lung Transplant Service Prince Charles HospitalBrisbaneQLD 4032Australia Department of Cardiothoracic Surgery Golden Jubilee National HospitalGlasgow G814DYUnited Kingdom

Lung transplantation is the treatment of choice for patients with end-stage lung ***,just under 5000 lung transplants are performed worldwide ***,a major scourge leading to 90-d and 1-year mortality remains primary graft *** is a spectrum of lung injury ranging from mild to severe depending on the level of hypoxaemia and lung injury *** review aims to provide an in-depth analysis of the epidemiology,pathophysiology,risk factors,outcomes,and future frontiers involved in mitigating primary graft *** current diagnostic criteria are examined alongside changes from the previous *** also highlight the issues surrounding chronic lung allograft dysfunction and identify the novel therapies available for ex-vivo lung *** primary graft dysfunction remains a significant contributor to 90-d and 1-year mortality,ongoing research and development abreast with current technological advancements have shed some light on the issue in pursuit of future diagnostic and therapeutic tools.

关键词： primary graft dysfunction Lung transplantation Pathophysiology Risk factors Extracorporeal membranous oxygenation

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Portal vein arterialization in 25 liver transplant recipients:A Latin American single-center experience

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World Journal of Transplantation 2024年第2期14卷 135-147页

作者： Nicolas Andres Cortes-Mejia Diana Fernanda Bejarano-Ramirez Juan Jose Guerra-Londono Diego Rymel Trivino-Alvarez Raquel Tabares-Mesa Alonso Vera-Torres Division of Anesthesiology Critical Care Medicineand Pain MedicineThe University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Transplant and Hepatobiliary Surgery Department Fundacion Santa Fe de BogotaBogota 110111Colombia General Surgery Department Fundacion Santa Fe de BogotaBogota 110111Colombia

BACKGROUND Portal vein arterialization(PVA)has been used in liver transplantation(LT)to maximize oxygen delivery when arterial circulation is compromised or has been used as an alternative reperfusion technique for complex portal vein thrombosis(PVT).The effect of PVA on portal perfusion and primary graft dysfunction(PGD)has not been *** patients receiving PVA and LT at the Fundacion Santa Fe de Bogota between 2011 and 2022 were *** account for the time-sensitive effects of graft perfusion,patients were classified into two groups:prereperfusion(pre-PVA),if the arterioportal anastomosis was performed before graft revascularization,and postreperfusion(post-PVA),if PVA was performed *** pre-PVA rationale contemplated poor portal hemodynamics,severe vascular steal,or ***-PVA was considered if graft hypoperfusion became *** interventions were attempted before PVA.

关键词： Liver transplantation Portal vein arterialization Arteriovenous anastomoses Portal hypertension Portal vein thrombosis Spontaneous portosystemic shunts Vascular steal phenomenon primary graft dysfunction Early allograft dysfunction

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Factors affecting complications development and mortality after single lung transplant

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World Journal of Transplantation 2021年第8期11卷 320-334页

作者： Metodija Sekulovski Bilyana Simonska Milena Peruhova Boris Krastev Monika Peshevska-Sekulovska Lubomir Spassov Tsvetelina Velikova Department of Anesthesiology and Intensive care University Hospital LozenetzSofia 1407Bulgaria Medical Faculty Sofia University St.Kliment OhridskiSofia 1407Bulgaria Department of Gastroenterology University Hospital LozenetzSofia 1407Bulgaria Department of Clinical Oncology MHAT Hospital for Women Health NadezhdaSofia 1330Bulgaria Department of Cardiothoracic Surgery University Hospital LozenetzSofia 1431Bulgaria Department of Clinical Immunology University Hospital LozenetzSofia 1407Bulgaria

Lung transplantation(LT)is a life-saving therapeutic procedure that prolongs survival in patients with end-stage lung ***,as a therapeutic option for high-risk candidates,single LT(SLT)can be feasible because the immediate morbidity and mortality after transplantation are lower compared to sequential single(double)LT(SSLTx).Still,the long-term overall survival is,in general,better for *** the great success over the years,the early post-SLT period remains a perilous time for these *** who undergo SLT are predisposed to evolving early or late postoperative *** review emphasizes factors leading to post-SLT complications in the early and late periods including primary graft dysfunction and chronic lung allograft dysfunction,native lung complications,anastomosis complications,infections,cardiovascular,gastrointestinal,renal,and metabolite complications,and their association with morbidity and mortality in these ***,we discuss the incidence of malignancy after SLT and their correlation with immunosuppression therapy.

关键词： Lung transplantation Single lung transplant primary graft dysfunction Native lung complications Technical transplant complications Vascular transplant complications graft rejection De novo malignancy

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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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