28 results on '"Mauricio Sainz-Barriga"'
Search Results
2. Case report: Immediate revascularization for symptomatic hepatic artery pseudoaneurysm after orthotopic liver transplantation? A case series and literature review
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An Verena Lerut, Jacques Pirenne, Mauricio Sainz-Barriga, Joris Blondeel, Geert Maleux, and Diethard Monbaliu
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case series ,hepatic artery pseudoaneurysm ,orthotopic liver transplantation ,endovascular treatment ,arterial reconstruction ,Surgery ,RD1-811 - Abstract
IntroductionHepatic artery pseudoaneurysm (HAPA), a rare vascular complication that can develop after liver transplantation, is associated with a high mortality rate and graft loss. To salvage the liver graft, immediate revascularization, either through surgical or endovascular intervention, is required. However, currently there is no consensus on the optimal strategy. Here, we report three cases of liver transplant recipients diagnosed with HAPA and treated with immediate revascularization. In addition, we present an overview of HAPA cases described in the literature and make recommendations on how to treat this rare complication.MethodsAll adults transplanted in our center between 2005 and 2021 were retrospectively reviewed. Literature search was done in PubMed for original studies between 1980 and 2021 reporting early hepatic artery (pseudo) aneurysm after liver transplantation requiring either surgical or endovascular intervention.ResultsFrom a total of 1,172, 3 liver transplant patients were identified with a symptomatic HAPA and treated with immediate revascularization. HAPA occurred 73, 27, and 8 days after liver transplantation and was treated with immediate revascularization (two surgical and one endovascular intervention). Literature review identified 127 cases of HAPA. HAPA was managed with endovascular therapy in 20 cases and by surgical intervention in 89 cases. Overall reported mortality rate was 39.6%, whereas overall graft survival was 45.2%.ConclusionImmediate surgical or radiological interventional excision and prompt revascularization to salvage liver grafts is feasible but still associated with a high mortality.
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- 2023
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3. Age Matching of Elderly Liver Grafts With Elderly Recipients Does Not Have a Synergistic Effect on Long-term Outcomes When Both Are Carefully Selected
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Nicholas Gilbo, MD, Ina Jochmans, PhD, Mauricio Sainz-Barriga, PhD, Frederik Nevens, PhD, Schalk van der Merwe, PhD, Wim Laleman, PhD, Chris Verslype, PhD, David Cassiman, PhD, Len Verbeke, PhD, Hannah van Malenstein, PhD, Tania Roskams, PhD, Jacques Pirenne, PhD, and Diethard Monbaliu, PhD
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Surgery ,RD1-811 - Abstract
Background. Older donors and recipients are increasingly considered for liver transplantation. Both donor and recipient age have a negative impact on outcomes. Large registry analyses show that older donors are frequently matched to older recipients. Whether age-related risks accumulate in a synergic negative effect on outcomes because of donor-recipient age matching is poorly understood. Methods. We investigated the impact of donor-recipient age interaction on patient and death-censored graft survival in multivariate Cox regressions in 849 transplants (January 2000 to December 2015). Results. Donors 70 years or older did not affect long-term patient or graft survival. Recipient age independently increased the risk of death (hazard ratio [HR], 1.03; 95% confidence interval [CI], 1.02-1.05, P < 0.0001), but donor-recipient age interaction was noninfluential. The negative impact of recipient age on patient survival was significant as early as 6 months after transplantation (HR, 1.06; 95% CI, 1.03-1.09; P = 0.00008). The adjusted risk of death was significant for patients aged 60 to 69 years (HR, 1.995; 95% CI, 1.40-2.85; P < 0.0001) and 70 years or older (HR, 2.001; 95% CI, 1.10-2.66; P = 0.04). In contrast, the risk of graft loss was not influenced by recipient age (HR, 1.02; 95% CI, 0.996-1.04; P = 0.11) or age interaction. Conclusions. Older livers can be safely used in older recipients without jeopardizing graft and patient survival if other risk factors are minimized.
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- 2019
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4. The inferior mesoiliacal shunt: A novel shunt for refractory rectal variceal bleeding due to splanchnic thrombosis
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Marie Cappelle, MD, Thomas Douchy, MD, Dirk Vanbeckevoort, MD, PhD, Inge Fourneau, MD, PhD, Mauricio Sainz Barriga, MD, PhD, and Jacques Pirenne, MD, PhD
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Splanchnic vein thrombosis ,Polycythemia vera ,Inferior mesoiliacal shunt ,Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Surgical shunt therapy may be required when pharmacologic, endoscopic, and radiologic treatment of chronic splanchnic vein thrombosis have failed. In this case report, we present a new interposition shunt for the treatment of refractory rectal variceal bleeding: the inferior mesoiliacal shunt between the inferior mesenteric vein and the left common iliac vein using a cryopreserved iliac venous graft. The postoperative course was complicated by shunt thrombosis at day 2, probably owing to inadvertent interruption of anticoagulation and a decrease in the shunt flow rate. Surgical thrombectomy was performed successfully. The patient presented no relapse of rectal bleeding and was asymptomatic and well at the 12-month follow-up.
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- 2020
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5. The effect of IGL-1 preservation solution on outcome after kidney transplantation: A retrospective single-center analysis
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Jacques Pirenne, Mauricio Sainz-Barriga, Julie De Beule, Ben Sprangers, Maarten Naesens, Dirk Kuypers, Ina Jochmans, Steffen Fieuws, and Diethard Monbaliu
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medicine.medical_specialty ,Adenosine ,Allopurinol ,Organ Preservation Solutions ,Urology ,Renal function ,030230 surgery ,Single Center ,Potassium Chloride ,03 medical and health sciences ,Raffinose ,0302 clinical medicine ,Humans ,Insulin ,Immunology and Allergy ,Medicine ,Mannitol ,Pharmacology (medical) ,Viaspan ,Kidney transplantation ,Retrospective Studies ,Transplantation ,Proteinuria ,business.industry ,Confounding ,IGL-1 preservation solution ,Organ Preservation ,medicine.disease ,Glutathione ,Kidney Transplantation ,Glucose ,Double robust ,medicine.symptom ,business - Abstract
Institut Georges Lopez-1 (IGL-1) solution is increasingly used for kidney preservation, although little information on outcomes is available. Outcomes of all deceased donor kidneys preserved by IGL-1, University of Wisconsin solution (UW), or histidine-tryptophan-ketoglutarate (HTK) and transplanted in our center (2000-2018) were analyzed. Multivariable analysis for delayed graft function (DGF), functional DGF, estimated glomerular filtration rate (eGFR, CKD-EPI equation), proteinuria, acute rejection, death-censored graft loss, and patient survival were performed. A double robust approach, consisting of propensity score weighting and correction for confounders, minimized the risk of bias. In total, 1943 transplants were included: 234 with IGL-1, 1046 with UW, and 663 with HTK. As IGL-1 was only introduced in 2014, a prespecified sensitivity analysis of 917 kidneys (2010-2018) was performed using the same statistical approach. After weighting, IGL-1 retained a higher proportion of kidneys donated after circulatory death (DCD). IGL-1 was not independently associated with any of the outcomes when compared to UW or HTK. Sensitivity analysis between 2010 and 2018 showed similar results. In this retrospective analysis, using robust methodology to reduce the risk of bias, IGL-1 preservation results in equal outcomes compared to UW or HTK, despite more DCD transplants in the IGL-1 group. ispartof: American Journal Of Transplantation vol:21 issue:2 pages:830-837 ispartof: location:United States status: published
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- 2021
6. The inferior mesoiliacal shunt: A novel shunt for refractory rectal variceal bleeding due to splanchnic thrombosis
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Mauricio Sainz Barriga, Marie Cappelle, Thomas Douchy, Inge Fourneau, Jacques Pirenne, and Dirk Vanbeckevoort
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lcsh:Diseases of the circulatory (Cardiovascular) system ,Innovative technique ,medicine.medical_specialty ,Variceal bleeding ,business.industry ,Splanchnic vein thrombosis ,lcsh:Surgery ,lcsh:RD1-811 ,medicine.disease ,Thrombosis ,Asymptomatic ,Polycythemia vera ,Surgery ,Shunt (medical) ,lcsh:RC666-701 ,medicine ,Inferior mesenteric vein ,Inferior mesoiliacal shunt ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Splanchnic ,business ,Venous graft - Abstract
Surgical shunt therapy may be required when pharmacologic, endoscopic, and radiologic treatment of chronic splanchnic vein thrombosis have failed. In this case report, we present a new interposition shunt for the treatment of refractory rectal variceal bleeding: the inferior mesoiliacal shunt between the inferior mesenteric vein and the left common iliac vein using a cryopreserved iliac venous graft. The postoperative course was complicated by shunt thrombosis at day 2, probably owing to inadvertent interruption of anticoagulation and a decrease in the shunt flow rate. Surgical thrombectomy was performed successfully. The patient presented no relapse of rectal bleeding and was asymptomatic and well at the 12-month follow-up. ispartof: JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES vol:6 issue:4 pages:562-565 ispartof: location:United States status: published
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- 2020
7. Donor Hepatectomy and Implantation Time Are Associated With Early Complications After Liver Transplantation: A Single-center Retrospective Study
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Diethard Monbaliu, Chris Verslype, Tania Roskams, Nicholas Gilbo, David Cassiman, Hannah van Malenstein, Wim Laleman, Schalk Van der Merwe, Steffen Fieuws, Nicolas Meurisse, Ina Jochmans, Frederik Nevens, Jacques Pirenne, and Mauricio Sainz-Barriga
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Adult ,Male ,medicine.medical_specialty ,Time Factors ,Databases, Factual ,medicine.medical_treatment ,Operative Time ,030230 surgery ,Anastomosis ,Liver transplantation ,Single Center ,Risk Assessment ,Donor Selection ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Cause of Death ,medicine ,Hepatectomy ,Humans ,Risk factor ,Retrospective Studies ,Transplantation ,Cholestasis ,business.industry ,Hazard ratio ,Retrospective cohort study ,Odds ratio ,Middle Aged ,Tissue Donors ,Surgery ,Liver Transplantation ,medicine.anatomical_structure ,Treatment Outcome ,030211 gastroenterology & hepatology ,Female ,business ,Artery - Abstract
BACKGROUND: Donor hepatectomy and liver implantation time reduce long-term graft and patient survival after liver transplantation. It is not known whether these surgical times influence early outcomes after liver transplantation. METHODS: This single-center study evaluated the effect of donor hepatectomy and implantation time on the risk of nonanastomotic biliary strictures occurring within 1 year and of early allograft dysfunction after deceased-donor solitary liver transplantation, adjusting for other donor, recipient, and surgical factors. RESULTS: Of 917 transplants performed between 1/2000 and 12/2016, 106 (11.56%) developed nonanastomotic biliary strictures and 247 (27%) developed early allograft dysfunction. Donor hepatectomy time (median 35 min, IQR: 26-46) was an independent risk factor of nonanastomotic biliary strictures (adjusted hazard ratio (HR): 1.19, 95% CI: 1.04-1.35, p=0.01). Implantation time (median 80 min, IQR: 69-95) was independently associated with early allograft dysfunction (adjusted odds ratio (OR): 1.15, 95% CI:1.07-1.23, p
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- 2020
8. The effect of organ preservation solutions on short-term outcomes after liver transplantation: a single-center retrospective study
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Mauricio Sainz-Barriga, Steffen Fieuws, Diethard Monbaliu, Ina Jochmans, Jef Van den Eynde, Nicholas Gilbo, Jannick Achtergaele, and Jacques Pirenne
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medicine.medical_specialty ,preservation solutions ,Adenosine ,medicine.medical_treatment ,Organ Preservation Solutions ,030230 surgery ,Liver transplantation ,Single Center ,Potassium Chloride ,Histidine-tryptophan-ketoglutarate ,03 medical and health sciences ,0302 clinical medicine ,Raffinose ,medicine ,Preservation solutions ,Humans ,Insulin ,Mannitol ,Retrospective Studies ,Transplantation ,liver transplantation ,business.industry ,Incidence (epidemiology) ,Confounding ,Graft Survival ,Retrospective cohort study ,Organ Preservation ,Glutathione ,UW ,Surgery ,Liver Transplantation ,HTK ,Glucose ,Liver ,030211 gastroenterology & hepatology ,business ,IGL-1 - Abstract
The effect of preservation solutions on outcomes has been subject of many debates but the relative benefits of the various solutions remain unclear. We retrospectively compared short-term outcomes of 885 liver transplantations performed between 1/2000 and 12/2017 and preserved with either Histidine-Tryptophan-Ketoglutarate (HTK, n = 190), University of Wisconsin (UW, n = 557), or Institute George Lopez 1 preservation solution (IGL-1, n = 139). Inverse probability of treatment weighting (IPTW) was performed to account for baseline differences between groups and analyses were adjusted for confounders. In the IPTW analyses, peak AST within 7 days was 44% higher (95% CI 15-81%, P
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- 2020
9. Solid organ donation after death from listeria encephalitis: A case report
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Jacques Pirenne, Mauricio Sainz Barriga, Diethard Monbaliu, Katrien Lagrou, Thomas Douchy, Yves Debaveye, and Ina Jochmans
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Transplantation ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Endoscopic dilatation ,030230 surgery ,Liver transplantation ,Listeria infection ,medicine.disease ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Infectious Diseases ,Bacteremia ,medicine ,030211 gastroenterology & hepatology ,Invasive Listeriosis ,Organ donation ,business ,Kidney transplantation - Abstract
Despite organ shortage, organs from donors with listeria infections have been discarded for transplantation. We present the first-reported case of liver transplantation following listeria encephalitis. The patient was admitted with progressing neurological symptoms after an episode of gastroenteritis. Rhombo-encephalitis was diagnosed, and Listeria monocytogenes was found to be the causative pathogen. Despite proper antibiotic treatment and rapid clearance of bacteremia, he continued to deteriorate and became brain dead, after which organ donation was performed. At procurement, he had been treated with amoxicillin for 9 days. The recipient was treated with pipercillin/tazobactam for 21 days. Besides an anastomotic biliary stricture, necessitating endoscopic dilatation and stenting, further clinical course was uneventful and she is doing well eleven months post-transplant. Our case suggests that listeria encephalitis is not an absolute contra-indication to solid organ donation. We suggest that donors should be treated with adequate antibiotics for at least 48h prior to procurement and advocate confirmation of sterile blood cultures as a prerequisite for donation. According to listeriosis guidelines, we suggest that the recipient should be treated with targeted antibiotics for at least 2 weeks. The risk of transmission should, however, always be balanced carefully against the suspected waiting list mortality.
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- 2020
10. The Histological Picture of Indication Biopsies in the First 2 Weeks after Kidney Transplantation
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Maarten Naesens, Aleksandar Senev, Dirk Kuypers, Jacques Pirenne, Katrien De Vusser, Mauricio Sainz Barriga, Ben Sprangers, Amaryllis H. Van Craenenbroeck, Evelyne Lerut, Elisabet Van Loon, Ina Jochmans, Diethard Monbaliu, Maarten Coemans, and Marie-Paule Emonds
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Graft Rejection ,Male ,Time Factors ,Epidemiology ,Biopsy ,030230 surgery ,Critical Care and Intensive Care Medicine ,Kidney ,Gastroenterology ,0302 clinical medicine ,HLA Antigens ,Risk Factors ,Autografts ,Kidney transplantation ,0303 health sciences ,medicine.diagnostic_test ,Hazard ratio ,Cold Ischemia ,Graft Survival ,Age Factors ,Middle Aged ,medicine.anatomical_structure ,Kidney Tubules ,Nephrology ,Cohort ,Female ,Adult ,medicine.medical_specialty ,Genotype ,Ischemia ,Delayed Graft Function ,Antibodies ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,030304 developmental biology ,Aged ,Proportional Hazards Models ,Inflammation ,Transplantation ,Proportional hazards model ,business.industry ,Original Articles ,medicine.disease ,Kidney Transplantation ,Microvessels ,business - Abstract
Background and objectives In preclinical studies, ischemia-reperfusion injury and older donor age are associated with graft inflammation in the early phase after transplantation. In human kidney transplantation, impaired allograft function in the first days after transplantation is often adjudicated to donor- and procedure-related characteristics, such as donor age, donor type, and ischemia times. Design, setting, participants, & measurements In a cohort of 984 kidney recipients, 329 indication biopsies were performed within the first 14 days after transplantation. The histologic picture of these biopsies and its relationship with alloimmune risk factors and donor- and procedure-related characteristics were studied, as well as the association with graft failure. Multivariable Cox models were applied to quantify the cause-specific hazard ratios for early rejection and early inflammatory scores, adjusted for potential confounders. For quantification of hazard ratios of early events for death-censored graft failure, landmark analyses starting from day 15 were used. Results Early indication biopsy specimens displayed microvascular inflammation score ≥2 in 30% and tubulointerstitial inflammation score ≥2 in 49%. Rejection was diagnosed in 186 of 329 (57%) biopsies and associated with the presence of pretransplant donor-specific HLA antibodies and the number of HLA mismatches, but not nonimmune risk factors in multivariable Cox proportional hazards analysis. In multivariable Cox proportional hazards analysis, delayed graft function, the graft dysfunction that prompted an early indication biopsy, HLA mismatches, and pretransplant donor-specific HLA antibodies were significantly associated with a higher risk for death-censored graft failure, whereas early acute rejection was not. Conclusions Indication biopsies performed early after kidney transplantation display inflammatory changes related to alloimmune risk factors. Nonimmune risk factors for ischemia-reperfusion injury, such as cold and warm ischemia time, older donor age, and donor type, were not identified as strong risk factors for early inflammation after human kidney transplantation.
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- 2020
11. Survival of PatientsWith Liver Transplants Donated After Euthanasia, Circulatory Death, or Brain Death at a Single Center in Belgium
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Daniel Jacobs-Tulleneers-Thevissen, Ina Jochmans, Mauricio Sainz-Barriga, Jacques Pirenne, Albert Wolthuis, Nicholas Gilbo, Diethard Monbaliu, Pathology/molecular and cellular medicine, Basic (bio-) Medical Sciences, Surgical clinical sciences, and Surgery
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Adult ,medicine.medical_specialty ,Brain Death ,medicine.medical_treatment ,health care facilities, manpower, and services ,animal diseases ,Liver transplants ,Liver transplantation ,Single Center ,Belgium ,Liver Transplantation/mortality ,Research Letter ,Medicine ,Humans ,Survival analysis ,Aged ,Retrospective Studies ,business.industry ,Euthanasia ,Graft Survival ,Retrospective cohort study ,General Medicine ,social sciences ,Middle Aged ,Circulatory death ,Survival Analysis ,humanities ,Tissue Donors ,Surgery ,Liver Transplantation ,Transplantation ,surgical procedures, operative ,Graft survival ,business - Abstract
This study compares graft and patient survival rates after transplantation of livers donated after euthanasia vs after circulatory death or brain death at a hospital in Belgium, where euthanasia is legalized. ispartof: JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION vol:322 issue:1 pages:78-80 ispartof: location:United States status: published
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- 2019
12. Hemodynamic changes in ALPPS influence liver regeneration and function: results from a prospective study
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Yves D'Asseler, Clarisse Lecluyse, Bieke Lambert, Federico Tomassini, Jo Van Dorpe, Mauricio Sainz-Barriga, Karen Geboes, Anne Hoorens, Roberto Troisi, Mariano Cesare Giglio, Tomassini, Federico, D'Asseler, Yve, Giglio, Mariano C, Lecluyse, Clarisse, Lambert, Bieke, Sainz-Barriga, Mauricio, Van Dorpe, Jo, Hoorens, Anne, Geboes, Karen, and Troisi, Roberto I
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Male ,medicine.medical_specialty ,RESECTION ,STAGED HEPATECTOMY ,medicine.medical_treatment ,Operative Time ,Urology ,Hemodynamics ,Portal vein ligation ,PRESSURE ,PORTAL-VEIN LIGATION ,Postoperative Complications ,Liver Function Tests ,Internal medicine ,Medicine ,Hepatectomy ,Humans ,Prospective Studies ,HEPATOBILIARY SCINTIGRAPHY ,Prospective cohort study ,Hemodynamic stress ,Aged ,MAJOR LIVER ,Science & Technology ,Gastroenterology & Hepatology ,Hepatology ,medicine.diagnostic_test ,business.industry ,Portal Vein ,PARTITION ,MORTALITY ,Liver Neoplasms ,Gastroenterology ,Middle Aged ,2-STAGE HEPATECTOMY ,Liver regeneration ,Liver Regeneration ,Liver ,Surgery ,Female ,REMNANT ,business ,Liver function tests ,Life Sciences & Biomedicine - Abstract
BACKGROUND: Excessive increase of portal flow and pressure following extended hepatectomy have been associated to insufficient growth or function of the future liver remnant (FLR), with the risk of post-hepatectomy liver failure (PHLF). We prospectively assess the influence of liver hemodynamics on FLR regeneration and function in Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS). METHODS: Twenty-three patients underwent ALPPS; liver hemodynamics were assessed throughout the procedures. Volume and function of the FLR were evaluated by angio-CT and 99mTc-Mebrofenin-scintigraphy. RESULTS: The portal vein flow at the end of stage-1 correlated with the increase of the FLR volume (p = 0.002). Patients with portal vein pressure (PVP)
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- 2018
13. Pre-operative trans-catheter arterial chemo-embolization increases hepatic artery thrombosis after liver transplantation - a retrospective study
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Laura Van Praet, Nicholas Gilbo, David Cassiman, Geert Maleux, Ina Jochmans, Frederik Nevens, Schalk Van der Merwe, Mauricio Sainz-Barriga, Diethard Monbaliu, Chris Verslype, Jacques Pirenne, and Wim Laleman
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,animal diseases ,030230 surgery ,Liver transplantation ,Gastroenterology ,environment and public health ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,Hepatic Artery ,Postoperative Complications ,Belgium ,Risk Factors ,Internal medicine ,parasitic diseases ,medicine ,Humans ,Embolization ,Chemoembolization, Therapeutic ,Retrospective Studies ,Transplantation ,business.industry ,Graft Survival ,Retrospective cohort study ,Thrombosis ,Odds ratio ,Middle Aged ,medicine.disease ,Surgery ,Liver Transplantation ,Hepatic artery thrombosis ,Catheter ,enzymes and coenzymes (carbohydrates) ,embryonic structures ,030211 gastroenterology & hepatology ,Female ,business - Abstract
Little is known about non-surgical risk factors for Hepatic Artery Thrombosis (HAT) after Liver Transplantation (LT). We determined risk factors for HAT occurring within 90 days post-LT and analyzed the effect of HAT on graft and patient survival. Donor and recipient demographics, surgery-related data, and outcome in transplants complicated by thrombosis (HAT+) and their matched controls (HAT-) were compared. Risk factors were assessed by univariate logistic regression. Median (IQR) is given. 25 HAT occurred among 1035 adult LT (1/1997-12/2014) and 50 controls were manually matched. Donor and recipient demographics were similar. Pre-LT Trans-catheter Arterial Chemo Embolization (TACE) was more frequent in HAT+ (HAT+ 20% vs HAT- 4%, p=0.037). HAT+ had longer implantation [HAT+ 88 min (76-108) vs HAT- 77 min (66-93), p=0.028] and surgery times [HAT+ 6.25 h (5.18-7.47) vs HAT- 5.25 h (4.33-6.5), p=0.001]. Early graft dysfunction and sepsis was more frequent in HAT+ and hospitalization longer. TACE had the greatest odds ratio in unadjusted analysis (OR: 6, 95%CI: 1.07-33.53, p=0.03). All but 7 grafts were lost after HAT (HAT+ 72% vs HAT- 36%, p=0.003), however, patient survival was unaffected (HAT+ 79.8% vs HAT- 76%, p=0.75). LT candidates undergoing TACE are at risk of developing HAT early after transplant. This article is protected by copyright. All rights reserved. ispartof: Transplant International vol:31 issue:1 pages:71-81 ispartof: location:Switzerland status: published
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- 2017
14. Graft inflow modulation in adult-to-adult living donor liver transplantation: A systematic review
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Roberto I. Troisi, Giammauro Berardi, Federico Tomassini, and Mauricio Sainz-Barriga
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Adult ,Graft Rejection ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Splenectomy ,Hemodynamics ,Portacaval shunt ,030230 surgery ,Cochrane Library ,Splenic artery ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Living Donors ,Medicine ,Humans ,Embolization ,Female ,Graft Survival ,Liver Circulation ,Liver Transplantation ,Portacaval Shunt, Surgical ,Prognosis ,Survival Rate ,Treatment Outcome ,Survival rate ,Transplantation ,business.industry ,medicine.disease ,Surgery ,Portal hypertension ,030211 gastroenterology & hepatology ,business - Abstract
Introduction Small-for-size syndrome (SFSS) has an incidence between 0 and 43% in small-for-size graft (SFSG) adult living donor liver transplantation (LDLT). Portal hypertension following reperfusion and the hyperdynamic splanchnic state are reported as the major triggering factors of SFSS. Intra- and postoperative strategies to prevent or to reduce its onset are still under debate. We analyzed graft inflow modulation (GIM) during adult LDLT considering the indications, efficacy of the available techniques, changes in hemodynamics and outcomes. Materials and methods A systematic literature search was performed using PubMed, EMBASE, Scopus and the Cochrane Library Central. Treatment outcomes including in-hospital mortality and morbidity, re-transplantation rate, 1-, 3-, and 5-year patient overall survival and 1-, 3-, and 5-year graft survival rates, hepatic artery and portal vein flows and pressures before and after inflow modulation were analyzed. Results From 563 articles, 12 studies dated between 2003 and 2014 fulfilled the selection criteria and were therefore included in the study. These comprised a total of 449 adult patients who underwent inflow modulation during adult-to-adult LDLT. Types of GIM described were splenic artery ligation, splenectomy, meso-caval shunt, spleno-renal shunt, portocaval shunt, and splenic artery embolization. Mortality and morbidity ranged between 0 and 33% and 17% and 70%, respectively. Re-transplantation rates ranged between 0% and 25%. GIM was associated with good survival for both graft and recipients, reaching an 84% actuarial rate at 5 years. Through the use of GIM, irrespective of the technique, a statistically significant reduction of PVF and PVP was obtained. Conclusions GIM is a safe and efficient technique to avoid or limit portal hyperperfusion, especially in cases of SFSG, decreasing overall morbidity and improving outcomes.
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- 2017
15. P1.02: Tacrolimus induced optic neuropathy after multivisceral transplantation
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Emilio Canovai, Catherine Cassiman, Laurens Ceulemans, Philippe Demaerel, Mauricio Sainz-Barriga, Ina Jochmans, Diethard Monbaliu, Jacques Pirenne, and Tim Vanuytsel
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Transplantation - Published
- 2019
16. Successful transplantation of small-for-size grafts: A reappraisal
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Mauricio Sainz-Barriga and Roberto Troisi
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Male ,Transplantation ,Small for size syndrome ,Pathology ,medicine.medical_specialty ,Hepatology ,Portal Vein ,business.industry ,medicine.medical_treatment ,Liver transplantation ,Liver Transplantation ,Somatostatin ,Living Donors ,medicine ,Humans ,Female ,Surgery ,business - Published
- 2012
17. Flow Competition between Hepatic Arterial and Portal Venous flow during Hypothermic Machine Perfusion Preservation of Porcine Livers
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Wim Laleman, Jacques Pirenne, Charlotte Debbaut, Mauricio Sainz-Barriga, Patrick Segers, Wim Hillewaert, and Diethard Monbaliu
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Technology ,Time Factors ,Swine ,Medicine (miscellaneous) ,Hemodynamics ,HEART-BEATING DONORS ,Hepatic Artery ,Engineering ,Hypothermia, Induced ,Medicine and Health Sciences ,Infusion Pumps ,Portal Vein ,Equipment Design ,Organ Preservation ,General Medicine ,Cold Temperature ,Perfusion ,medicine.anatomical_structure ,Liver ,HEMODYNAMICS ,Cardiology ,Hepatic flow ,medicine.symptom ,Life Sciences & Biomedicine ,Liver Circulation ,Blood vessel ,Artery ,medicine.medical_specialty ,animal structures ,Organ Preservation Solutions ,Organ preservation ,RAT-LIVER ,CIRCULATION ,Biomedical Engineering ,Cold storage ,Vena Cava, Inferior ,Bioengineering ,MECHANISMS ,Biomaterials ,KIDNEY ,COLD-STORAGE ,Internal medicine ,Pressure ,medicine ,Animals ,TRANSPLANTED LIVER ,Engineering, Biomedical ,Transplantation ,Machine perfusion ,Science & Technology ,BLOOD-FLOW ,business.industry ,72-HOUR PRESERVATION ,Blood flow ,Hypothermia ,Liver Transplantation ,Surgery ,Pump perfusion ,business ,Hypothermic machine perfusion - Abstract
Hypothermic machine perfusion (HMP) is regarded as a better preservation method for donor livers than cold storage. During HMP, livers are perfused through the inlet blood vessels, namely the hepatic artery (HA) and the portal vein (PV). In previous HMP feasibility studies of porcine and human livers, we observed that the PV flow decreased while the HA flow increased. This flow competition restored either spontaneously or by lowering the HA pressure (PHA). Since this phenomenon had never been observed before and because it affects the HMP stability, it is essential to gain more insight into the determinants of flow competition. To this end, we investigated the influence of the HMP boundary conditions on liver flows during controlled experiments. This paper presents the flow effects induced by increasing PHA and by obstructing the outlet blood vessel, which is the vena cava inferior (VCI). Flow competition was evoked by increasing PHA to 55-70 mmHg, as well as by obstructing the VCI. Remarkably, a severe obstruction resulted in a repetitive and alternating tradeoff between the HA and PV flows. These phenomena could be related to intra-sinusoidal pressure alterations. Consequently, a higher PHA is most likely transmitted to the sinusoidal level. This increased sinusoidal pressure reduces the pressure drop between the PV and the sinusoids, leading to a decreased PV perfusion. Flow competition has not been encountered or evoked under physiological conditions and should be taken into account for the design of liver HMP protocols. Nevertheless, more research is necessary to determine the optimal parameters for stable HMP. ispartof: International Journal of Artificial Organs vol:35 issue:2 pages:119-131 ispartof: location:United States status: published
- Published
- 2012
18. Lack of a correlation between portal vein flow and pressure: Toward a shared interpretation of hemodynamic stress governing inflow modulation in liver transplantation
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Luigia Scudeller, Bernard de Hemptinne, Maria Gabriella Costa, Mauricio Sainz-Barriga, and Roberto Troisi
- Subjects
Transplantation ,medicine.medical_specialty ,Hepatology ,business.industry ,medicine.medical_treatment ,Portal venous pressure ,Central venous pressure ,Hemodynamics ,macromolecular substances ,Liver transplantation ,Portal vein flow ,medicine.disease ,Surgery ,Internal medicine ,medicine ,Cardiology ,Portal hypertension ,Prospective cohort study ,business ,Hemodynamic stress - Abstract
The portal vein flow (PVF), portal vein pressure (PVP), and hepatic venous pressure gradient (HVPG) were prospectively assessed to explore their relationships and to better define hyperflow and portal hypertension (PHT) during liver transplantation (LT). Eighty-one LT procedures were analyzed. No correlation between PVF and PVP was observed. Increases in the central venous pressure (CVP) were transmitted to the PVP (58%, range = 25%-91%, P = 0.001). Severe PHT (HVPG ≥ 15 mm Hg) showed a significant reciprocal association with high PVF (P = 0.023) and lower graft survival (P = 0.04). According to this initial experience, an HVPG value ≥ 15 mm Hg is a promising tool for the evaluation of hemodynamic stress potentially influencing outcomes. An algorithm for graft inflow modulation based on flows, gradients, and systemic hemodynamics is provided. In conclusion, the evaluation of PHT severity with PVP could be delusive because of the influence of CVP. PVF and PVP do not correlate and should not be used individually to assess hyperflow and PHT during LT.
- Published
- 2011
19. Continuous and intermittent cardiac output measurement in hyperdynamic conditions: pulmonary artery catheter vs. lithium dilution technique
- Author
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Maria Gabriella Costa, P. Chiarandini, Paolo Pietropaoli, Livia Pompei, Maurizio Cecconi, Silvia Mattelig, Mauricio Sainz Barriga, Toby Reynolds, and Giorgio Della Rocca
- Subjects
Adult ,Male ,Cardiac output ,Critical Care ,medicine.medical_treatment ,Indicator Dilution Techniques ,Lithium ,Pulmonary Artery ,Critical Care and Intensive Care Medicine ,law.invention ,law ,Intensive care ,medicine.artery ,medicine ,Humans ,Prospective Studies ,Cardiac Output ,Aged ,business.industry ,Pulmonary artery catheter ,Middle Aged ,Intensive care unit ,Liver Transplantation ,Catheter ,medicine.anatomical_structure ,Catheterization, Swan-Ganz ,Anesthesia ,Heart Function Tests ,Pulmonary artery ,Hyperdynamic circulation ,Female ,business ,Artery - Abstract
This study aimed to assess the level of agreement of both intermittent cardiac output monitoring by the lithium dilution technique (CO(Li)) and continuous cardiac output monitoring (PulseCO(Li)) using the arterial pressure waveform with intermittent thermodilution using a pulmonary artery catheter (CO(PAC)).Prospective, single-center evaluation.University Hospital Intensive Care Unit.Patients (n=23) receiving liver transplantation.Pulmonary artery catheters were placed in all patients and CO(PAC) was determined using thermodilution. CO(Li) and PulseCO(Li) measurements were made using the LiDCO system.Data were collected after intensive care unit admission and every 8h until the 48th hour. A total of 151 CO(PAC), CO(Li) and PulseCO(Li) measurements were analysed. Bias and 95% limit of agreement were 0.11lmin(-1) and -1.84 to + 2.05 lmin(-1) for CO(PAC) vs. CO(Li) (r=0.88) resulting in an overall percentage error of 15.6%. Bias and 95% limit of agreement for CO(PAC) vs. PulseCO(Li) were 0.29 lmin(-1) and -1.87 to + 2.46 lmin(-1) (r=0.85) with a percentage error of 16.8%. Subgroup analysis revealed a percentage error of 15.7% for CO(PAC) vs. CO(Li) and 15.1% for CO(PAC) vs. PulseCO(Li) for data pairs less than 8 lmin(-1), and percentage errors of 15.5% and 18.5% respectively for data pairs higher than 8 lmin(-1).In patients with hyperdynamic circulation, intermittent and continuous CO values determined using the LiDCO system showed good agreement with those obtained by intermittent pulmonary artery thermodilution.
- Published
- 2007
20. Portal vein thrombosis after intraportal hepatocytes transplantation in a liver transplant recipient
- Author
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Domenico Montanaro, Andrea Risaliti, Claudio Avellini, Umberto Baccarani, Daniele Gasparini, Gian Luigi Adani, Fabrizio Bresadola, Annibale Donini, Mauricio Sainz-Barriga, Andrea Sanna, and Dario Lorenzin
- Subjects
Male ,Nephrology ,medicine.medical_specialty ,medicine.medical_treatment ,Liver transplantation ,cryopreservation ,hepatocyte ,liver ,portal vein thrombosis ,transplantation ,Postoperative Complications ,Internal medicine ,medicine ,Humans ,Thrombus ,Venous Thrombosis ,Transplantation ,Portal Vein ,Vascular disease ,business.industry ,Middle Aged ,medicine.disease ,Thrombosis ,Portal vein thrombosis ,Surgery ,Venous thrombosis ,Hepatocytes ,business - Abstract
Hepatocytes transplantation is viewed as a possible alternative or as a bridge therapy to liver transplantation for patients affected by acute or chronic liver disorders. Very few data regarding complications of hepatocytes transplantation is available from the literature. Herein we report for the first time a case of portal vein thrombosis after intraportal hepatocytes transplantation in a liver transplant recipient. A patient affected by acute graft dysfunction, not eligible for retransplantation, underwent intraportal infusion of 2 billion viable cryopreserved ABO identical human allogenic hepatocytes over a period of 5 h. Hepatocytes were transplanted at a concentration of 14 million/ml for a total infused volume of 280 ml. Doppler portal vein ultrasound and intraportal pressure were monitored during cell infusion. The procedure was complicated, 8 h after termination, by the development of portal vein thrombosis with liver failure and death of the patient. Autopsy showed occlusive thrombosis of the intrahepatic portal vein branches; cells or large aggregates of epithelial elements (polyclonal CEA positive), suggestive for transplanted hepatocytes, were co-localized inside the thrombus.
- Published
- 2005
21. A multicentre, randomized clinical trial comparing the Veriset haemostatic patch with fibrin sealant for the management of bleeding during hepatic surgery
- Author
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Moritz Kleine, Robert Öllinger, Florian W. R. Vondran, Sascha Weiss, Phillip Knebel, Hüseyin Bektas, Johann Pratschke, Mauricio Sainz-Barriga, André L. Mihaljevic, Christoph Schuhmacher, and Roberto Troisi
- Subjects
Male ,Time Factors ,Administration, Topical ,medicine.medical_treatment ,Blood Loss, Surgical ,Fibrin Tissue Adhesive ,Kaplan-Meier Estimate ,Hemostatics ,law.invention ,Randomized controlled trial ,LONG-TERM OUTCOMES ,law ,HEPATOCELLULAR-CARCINOMA ,Single-Blind Method ,Prospective Studies ,Prospective cohort study ,Fixation (histology) ,COMPLICATIONS ,biology ,Gastroenterology ,Hydrogels ,TachoSil ,Middle Aged ,Europe ,LIVER RESECTION ,Treatment Outcome ,SURVIVAL ,Female ,Life Sciences & Biomedicine ,medicine.medical_specialty ,HEPATECTOMY ,Fibrin ,BLOOD-LOSS ,medicine ,Hepatectomy ,Humans ,Cellulose, Oxidized ,RECURRENCE ,Aged ,Science & Technology ,Hepatology ,Gastroenterology & Hepatology ,Hemostatic Techniques ,business.industry ,Original Articles ,Surgery ,biology.protein ,business - Abstract
BACKGROUND: Bleeding during hepatic surgery is associated with prolonged hospitalization and increased morbidity and mortality. The Veriset™ haemostatic patch is a topical haemostat comprised of an absorbable backing made of oxidized cellulose and self-adhesive hydrogel components. It is designed to achieve haemostasis quickly and adhere to tissues without fixation. METHODS: A prospective, randomized, multicentre, single-blinded study (n = 50) was performed to compare the use of a Veriset™ haemostatic patch with a fibrin sealant patch (TachoSil(®) ) (control) in the management of diffuse bleeding after hepatic surgery. Patients were randomized following the confirmation of diffuse bleeding requiring the use of a topical haemostat. Time to haemostasis was assessed at preset intervals until haemostasis was achieved. RESULTS: Both groups were similar in comorbidities and procedural techniques. The median time to haemostasis in the group using the Veriset™ haemostatic patch was 1.0 min compared with 3.0 min in the control group (P < 0.001; 3-min minimum application time for the control patch). This result was independent of bleeding severity and surface area. Both products had similar safety profiles and no statistical differences were observed in the occurrence of adverse or device-related events. CONCLUSIONS: Regardless of bleeding severity or surface area, the Veriset™ haemostatic patch achieved haemostasis in this setting significantly faster than the control device in patients undergoing hepatic resection. It was safe and easy to handle in open hepatic surgery. ispartof: HPB vol:15 issue:7 pages:548-558 ispartof: location:England status: published
- Published
- 2013
22. Lack of a correlation between portal vein flow and pressure: toward a shared interpretation of hemodynamic stress governing inflow modulation in liver transplantation
- Author
-
Mauricio, Sainz-Barriga, Luigia, Scudeller, Maria Gabriella, Costa, Bernard, de Hemptinne, and Roberto Ivan, Troisi
- Subjects
Male ,Central Venous Pressure ,Portal Vein ,Hemodynamics ,Middle Aged ,Portal Pressure ,Liver Transplantation ,Treatment Outcome ,Liver ,Hypertension, Portal ,Pressure ,Humans ,Female ,Prospective Studies ,Algorithms ,Aged - Abstract
The portal vein flow (PVF), portal vein pressure (PVP), and hepatic venous pressure gradient (HVPG) were prospectively assessed to explore their relationships and to better define hyperflow and portal hypertension (PHT) during liver transplantation (LT). Eighty-one LT procedures were analyzed. No correlation between PVF and PVP was observed. Increases in the central venous pressure (CVP) were transmitted to the PVP (58%, range = 25%-91%, P = 0.001). Severe PHT (HVPG ≥ 15 mm Hg) showed a significant reciprocal association with high PVF (P = 0.023) and lower graft survival (P = 0.04). According to this initial experience, an HVPG value ≥ 15 mm Hg is a promising tool for the evaluation of hemodynamic stress potentially influencing outcomes. An algorithm for graft inflow modulation based on flows, gradients, and systemic hemodynamics is provided. In conclusion, the evaluation of PHT severity with PVP could be delusive because of the influence of CVP. PVF and PVP do not correlate and should not be used individually to assess hyperflow and PHT during LT.
- Published
- 2011
23. Evolution of laparoscopic left lateral sectionectomy without pringle maneuver: through resection of benign and malignant tumors to living liver donation
- Author
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Salvatore Ricciardi, Frederik Berrevoet, Jacques Van Huysse, Bernard de Hemptinne, Bert Vandenbossche, Roberto Troisi, Alessio Vinci, Xavier Rogiers, Tommaso Bocchetti, and Mauricio Sainz-Barriga
- Subjects
Male ,Laparoscopic surgery ,Organoplatinum Compounds ,medicine.medical_treatment ,Blood Loss, Surgical ,Leucovorin ,Liver transplantation ,Postoperative Complications ,Left lateral sectionectomy ,Antineoplastic Combined Chemotherapy Protocols ,Living Donors ,Laparoscopy ,Melanoma ,Living liver donors ,medicine.diagnostic_test ,Liver Neoplasms ,Middle Aged ,Combined Modality Therapy ,Tissue and Organ Harvesting ,Female ,Fluorouracil ,Adenoma ,Adult ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Gastrointestinal Stromal Tumors ,Adenocarcinoma ,Article ,Disease-Free Survival ,Pringle maneuver ,medicine ,Carcinoma ,Hepatectomy ,Humans ,Repeat hepatectomy ,Aged ,Retrospective Studies ,business.industry ,Length of Stay ,medicine.disease ,Liver Transplantation ,Endoscopy ,Surgery ,Transplantation ,Camptothecin ,business ,Laparoscopic liver surgery ,Follow-Up Studies - Abstract
Background Laparoscopic left lateral sectionectomy (LLS) has gained popularity in its use for benign and malignant tumors. This report describes the evolution of the authors’ experience using laparoscopic LLS for different indications including living liver donation. Methods Between January 2004 and January 2009, 37 consecutive patients underwent laparoscopic LLS for benign, primary, and metastatic liver diseases, and for one case of living liver donation. Resection of malignant tumors was indicated for 19 (51%) of the 37 patients. Results All but three patients (deceased due to metastatic cancer disease) are alive and well after a median follow-up period of 20 months (range, 8–46 months). Liver cell adenomas (72%) were the main indication among benign tumors, and colorectal liver metastases (84%) were the first indication of malignancy. One case of live liver donation was performed. Whereas 16 patients (43%) had undergone a previous abdominal surgery, 3 patients (8%) had LLS combined with bowel resection. The median operation time was of 195 min (range, 115–300 min), and the median blood loss was of 50 ml (range, 0–500 ml). Mild to severe steatosis was noted in 7 patients (19%) and aspecific portal inflammation in 11 patients (30%). A median free margin of 5 mm (range, 5–27 mm) was achieved for all cancer patients. The overall recurrence rate for colorectal liver metastases was of 44% (7 patients), but none recurred at the surgical margin. No conversion to laparotomy was recorded, and the overall morbidity rate was 8.1% (1 grade 1 and 2 grade 2 complications). The median hospital stay was 6 days (range, 2–10 days). Conclusions Laparoscopic LLS without portal clamping can be performed safely for cases of benign and malignant liver disease with minimal blood loss and overall morbidity, free resection margins, and a favorable outcome. As the ultimate step of the learning curve, laparoscopic LLS could be routinely proposed, potentially increasing the donor pool for living-related liver transplantation.
- Published
- 2011
24. Prospective evaluation of intraoperative hemodynamics in liver transplantation with whole, partial and DCD grafts
- Author
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Koen Reyntjens, Xavier Rogiers, B. de Hemptinne, Roberto Troisi, Luigia Scudeller, Patrick Wouters, Mauricio Sainz-Barriga, Maria Gabriella Costa, and Faculteit Medische Wetenschappen/UMCG
- Subjects
Adult ,Male ,Cardiac output ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Hemodynamics ,Liver transplantation ,Intraoperative Period ,Hepatic Artery ,graft inflow modulation ,Internal medicine ,medicine ,Living Donors ,Journal Article ,DCD ,Immunology and Allergy ,Humans ,Pharmacology (medical) ,Prospective Studies ,Hepatopulmonary syndrome ,Aged ,Transplantation ,Portopulmonary hypertension ,business.industry ,Portal Vein ,hepatic artery trombosis ,portal hypertension ,Blood flow ,Middle Aged ,Liver flows ,medicine.disease ,LDLT ,liver transplantation ,systemic and hepatic hemodynamics ,Surgery ,Liver Transplantation ,Death ,Cardiology ,Portal hypertension ,Female ,business ,Perfusion ,Blood Flow Velocity ,Liver Circulation - Abstract
The interaction of systemic hemodynamics with hepatic flows at the time of liver transplantation (LT) has not been studied in a prospective uniform way for different types of grafts. We prospectively evaluated intraoperative hemodynamics of 103 whole and partial LT. Liver graft hemodynamics were measured using the ultrasound transit time method to obtain portal (PVF) and arterial (HAF) hepatic flow. Measurements were recorded on the native liver, the portocaval shunt, following reperfusion and after biliary anastomosis. After LT HAF and PVF do not immediately return to normal values. Increased PVF was observed after graft implantation. Living donor LT showed the highest compliance to portal hyperperfusion. The amount of liver perfusion seemed to be related to the quality of the graft. A positive correlation for HAF, PVF and total hepatic blood flow with cardiac output was found (p = 0.001). Portal hypertension, macrosteatosis >30%, warm ischemia time and cardiac output, independently influence the hepatic flows. These results highlight the role of systemic hemodynamic management in LT to optimize hepatic perfusion, particularly in LDLT and split LT, where the highest flows were registered.
- Published
- 2010
25. Arterial pulse cardiac output agreement with thermodilution in patients in hyperdynamic conditions
- Author
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Mauricio Sainz-Barriga, Paolo Pietropaoli, Manuela Lugano, Livia Pompei, Gaia Bertossi, Cecilia Coccia, Giorgio Della Rocca, Maria Gabriella Costa, and P. Chiarandini
- Subjects
Adult ,Male ,Cardiac output ,Arterial pulse ,medicine.medical_treatment ,Thermodilution ,cardiac output ,measurement techniques ,arterial pulse contour analysis ,thermodilution ,pulmonary artery catheter ,liver transplantation ,Blood Pressure ,macromolecular substances ,law.invention ,law ,medicine.artery ,medicine ,Humans ,In patient ,Prospective Studies ,Cardiac Output ,Aged ,business.industry ,Pulmonary artery catheter ,Hemodynamics ,Middle Aged ,University hospital ,Intensive care unit ,Liver Transplantation ,Anesthesiology and Pain Medicine ,Anesthesia ,Catheterization, Swan-Ganz ,Pulmonary artery ,Transplant patient ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objective: This study aimed to compare continuous cardiac output (CCO) obtained using the arterial pulse wave (APCO) measurement with a simultaneous measurement of the intermittent cardiac output (ICO) and CCO obtained with a pulmonary artery catheter (PAC) in liver transplant patients. Design: A prospective, single-center evaluation. Setting: A university hospital intensive care unit. Patients: Eighteen patients after liver transplantation. Interventions: Pulmonary artery catheters were placed in all patients, and ICO and CCO were determined using thermodilution. APCO measurements were made with the Vigileo System (Edwards Lifesciences, Irvine, CA). Measurements and Main Results: The authors obtained 126 data pairs of ICO and APCO and 864 pairs of CCO and APCO. ICO data were collected after intensive care unit admission and every 8 hours until the 48th postoperative hour. CCO and APCO data were collected every hour from admission until the 48th postoperative hour. Bias and precision were 0.95 ± 1.41 L/min for ICO versus APCO and 1.29 ± 1.28 L/min for CCO and APCO. Bias and precision for cardiac output (CO) data pairs less than 8 L/min were 0.32 ± 1.14 L/min between ICO and APCO and 0.71 ± 0.98 L/min between CCO and APCO. For CO data pairs higher than 8 L/min, bias and precision were 1.79 ± 1.54 L/min between ICO and APCO and 2.25 ± 1.14 L/min between CCO and APCO. Conclusions: APCO enables the assessment of CO with clinically acceptable bias and precision. At higher CO levels, APCO underestimates PAC measurements and it is not as reliable as thermodilution in hyperdynamic liver transplant patients.
- Published
- 2007
26. Endovascular treatment of aortic pseudoaneurysm after liver transplantation
- Author
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Dario Lorenzin, Massimo Sponza, Pierluigi Viale, Daniele Gasparini, Andrea Risaliti, Umberto Baccarani, Gian Luigi Adani, Fabrizio Bresadola, Mauricio Sainz-Barriga, Adani GL, Baccarani U, Gasparini D, Sponza M, Sainz-Barriga M, Lorenzin D, Viale P, Risaliti A, and Bresadola F
- Subjects
Transplantation ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,pseudoaneurysm ,LIVER TRANSPLANTATION ,Liver transplantation ,medicine.disease ,Surgery ,Pseudoaneurysm ,surgical procedures, operative ,medicine ,cardiovascular system ,cardiovascular diseases ,Endovascular treatment ,business ,Aortic pseudoaneurysm - Abstract
We report herein a case of a 59-year-old Caucasian female who experienced noninfected pseudoaneurysm, of the aorto-hepatic anastomosis of the jump graft, after third liver transplantation, that was successfully treated by endovascular aortic repair
- Published
- 2005
27. Isolation of human hepatocytes from livers rejected for liver transplantation on a national basis: Results of a 2-year experience
- Author
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Lorenza Ridolfi, Alessio Cariani, Andrea Sanna, Anna Maria Zambito, Mauricio Sainz-Barriga, Giuseppe Piccolo, Alessandro Nanni-Costa, Gian Luigi Adani, Fabrizio Bresadola, Mario Scalamogna, Andrea Risaliti, U. Baccarani, and Annibale Donini
- Subjects
Liver Cirrhosis ,medicine.medical_specialty ,Tissue and Organ Procurement ,Cirrhosis ,Cell Survival ,medicine.medical_treatment ,Cell ,Cell Separation ,In Vitro Techniques ,Liver transplantation ,Gastroenterology ,law.invention ,law ,Internal medicine ,medicine ,Humans ,Transplantation ,Hepatology ,business.industry ,Liver cell ,Bioartificial liver device ,Albumin ,medicine.disease ,Liver, Artificial ,Liver Transplantation ,medicine.anatomical_structure ,Hepatocyte ,Hepatocytes ,Surgery ,business - Abstract
The offer of liver transplantation to many patients affected by liver failure is limited by organ shortage. Clinical application of human-based liver cell therapies, such as bioartificial liver and hepatocyte transplantation, might support liver transplantation, allowing more patients to be treated and decreasing mortality in the waiting list. The development of a standardized method of hepatocyte isolation is a mainstay for large-scale application of liver cell therapy. The aim of this study is to analyze retrospectively a 2-year experience of human hepatocyte isolation from livers rejected from transplantation at organ harvesting, performed on a national basis in Italy. All the livers judged unsuitable for transplantation were considered for hepatocyte isolation. Macrosteatosis greater than 60% was the most common reason of refusal, followed by nonviral cirrhosis. Fifty-four organs were used. Human hepatocyte isolation resulted in more that 7 million liver cells/g of tissue digested with 73% 14% viability. Steatotic organs gave better results in terms of cell yield than cirrhotic livers. Isolated hepatocytes were able to perform specific liver functions, and evidence of factor IX and albumin messenger RNA (mRNA) production was reported when cells were plated in culture. Modifications of the traditional method of hepatocyte isolation, aimed at reducing ischemia-reperfusion damage and improving post-isolation cell conditions, showed improvements in post-isolation viability. In conclusion, we show that it is possible to use the vast majority of livers not suitable for transplantation on a national basis for human hepatocyte isolation, obtaining a large amount of viable functioning human hepatocytes that might be used for cell transplantation and therapy. (Liver Transpl 2003;9:506-512.) B
- Published
- 2003
28. Erratum
- Author
-
Mauricio Sainz-Barriga, Maria Gabriella Costa, Roberto Troisi, Bernard de Hemptinne, Patrick Wouters, Luigia Scudeller, Koen Reyntjens, and Xavier Rogiers
- Subjects
Transplantation ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,medicine ,Immunology and Allergy ,Hemodynamics ,Pharmacology (medical) ,Liver transplantation ,business ,Prospective evaluation ,Surgery - Published
- 2010
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