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Introduction: Living related liver transplantation has become the treatment for many liver diseases. We present our initial analysis on 42 cases of adult-to-adult living related liver transplants (ALRLTs) performed in a single institution in Italy. Materials and methods: From January 2002 to February 2006, we performed 42 ALRLTs. The donors (age 18 to 53) all had genetic or emotional relationships; they were all ABO-identical or ABO-compatible. Recipients (age 18 to 68) suffered from cirrhosis secondary to viral etiology (n=13), hepatocellular carcinoma on viral cirrhosis (n=21), cystic fibrosis (n=2), primary biliary cirrhosis (n=2), hepatocellular carcinoma on nonviral cirrhosis (n=2), alcoholic cirrhosis (n=1), and metastatic carcinoid to the liver (n=1). Donor liver resection resulted in 40 right hepatectomies and 2 left hepatectomies. Graft body weight ratio was always above 1%; graft implantation was performed with the piggyback technique, and in 32 cases with the use of venovenous bypass. Results: There was no donor mortality; 4 donors had biliary complications. The actuarial recipient survival rate at 3 years was 89.25% and the graft survival rate was 82.69%. Graft loss occurred in 7 patients: 5 patients underwent retransplants (4 because of hepatic artery thrombosis, 1 because of graft dysfunction), and 2 patients had 1 episode of acute cellular rejection. Conclusion: ALRLTs represent a resource to face the organ shortage in a region where the deceased donor donation rate is 7.2 donors per year per million. [ABSTRACT FROM AUTHOR]

Background: Renal cell carcinoma (RCC) with tumor thrombus extending into the inferior vena cava (IVC) occurs in 4%-10% of cases. Within this subset, pulmonary tumor embolism (PTE) appears in approximately 0.9%-2.4% of cases. We wanted to review our experience in managing patients with RCC with IVC involvement and a preoperative diagnosis of PTE., Methods: A total of seven patients presented at our center between January, 2005 and January, 2015 with RCC, IVC involvement, and PTE (diagnosed either by chest computerized tomography angiography or preoperative transesophageal echocardiogram). Each patient underwent a radical nephrectomy and tumor thrombectomy using an organ transplant-based approach., Results: Surgical removal of the PTE was performed in three patients (tumor embolectomy in two cases, right lower lobe resection in one case); the PTEs in four patients were considered to be too small to undergo surgical resection. PTE pathology found neoplastic cells in each patient that had surgical removal. No postoperative complications were observed in any of the seven patients. All four patients who were metastasis-free preoperatively (with 2/4 having tumor embolectomy performed) developed distant metastasis; median time-to-developing metastatic disease was 6.5 months. With a median follow-up of 19 months, three deaths because the disease have occurred., Conclusion: Although RCC with IVC tumor thrombus complicated by PTE may not be catastrophic in most cases, it appears to be associated with an increased risk of developing metastatic disease. In addition, as the PTEs appear to contain neoplastic cells, pulmonary artery embolectomy at the time of nephrectomy should be performed whenever possible., (© 2019 Wiley Periodicals, Inc.)