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1. The Rochester Protocol for Living Donor Liver Transplantation of Unresectable Colorectal Liver Metastasis: A 5-Year Report on Selection, Approval, and Outcomes

Author

Byrne, Matthew M., Chávez-Villa, Mariana, Ruffolo, Luis I., Loria, Anthony, Endo, Yutaka, Niewiemski, Amber, Jimenez-Soto, Cristina, Melaragno, Jennifer I., Ramaraju, Gopal A., Farooq, Priya D., Dunne, Richard F., Pineda-Solis, Karen, Nair, Amit, Orloff, Mark, Tomiyama, Koji, and Hernandez-Alejandro, Roberto

Published
2024
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2. A case of 18 years disease-free survival after combined pancreatoduodenectomy and hemicolectomy for carcinosarcoma of the transverse colon

Author

Susumu Ohwada, Amika Moro, Nair Amit, Kazunari Sasaki, Shinji Sakurai, Atsuko Takada-Owada, Masaru Izumi, Yuhei Nakano, Yasushige Kashima, and Hideki Matsuyama

Subjects
Carcinosarcoma, Region of pancreas head, Pancreatoduodenectomy with hemicolectomy, Surgery, RD1-811
Abstract

Abstract Background Ascertaining the origin of large tumors located in the region of the pancreas head and adjacent mesocolon can pose a challenge preoperatively. En bloc pancreatoduodenectomy with hemicolectomy is often required towards curative tumor resection (R0) of malignant tumors in this region. Case presentation Herein we report a case of a 48-year-old man with two contiguous masses each 5 cm in size, located in the pancreatic head. The masses were detected incidentally by abdominal ultrasonography at an annual health check. Endoscopic biopsies revealed inflammation with no malignancy. Cross-sectional imaging showed the tumor direct invasion of the uncinate process of the pancreas, and the third portion of the duodenum. Based on imaging, a malignant submucosal tumor originating from mesenchymal cells in the mesentery of the transverse colon was made preoperatively. The mass required en bloc pancreatoduodenectomy, right hemicolectomy, and resection of the superior mesenteric vein. The final pathology was carcinosarcoma of the transverse colon. The patient survived 18 years after surgery without recurrence. Conclusions Malignant tumors located in the region of the pancreas head should be considered for an en bloc curative tumor resection and adjuvant chemotherapy treatments offered that might be beneficial for carcinosarcoma.

Published
2021
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3. Development of a targeted diagnostic and therapeutic delivery system for cholangiocarcinoma

Author

Nair, Amit, Coletta, Louise P., Prasad, Rajendra K., Evans, Stephen, and Critchley, Kevin

Subjects
616.99
Abstract

The current outcomes of peri-hilar cholangiocarcinoma (PH-CCA) are in general poor with no proven roles for any treatment modalities in improving survival apart from complete surgical extirpation. The dismal prognosis observed is contributed to by both delays in diagnosis and aggressive tumour biology. The advent of molecular targeting of solid cancers allows harnessing this property on microbubble and nanotechnology based platforms. Such a system provides for concurrent diagnosis and therapeutic effect (theragnosis), the feasibility of which is explored in this work. The expression of two candidate biomarkers with established roles in cancer progression, namely Neutrophil Gelatinase-Associated Lipocalin (NGAL) and Matrix Metalloproteinase-9 (MMP9) were examined by Immunohistochemistry in 54 human samples of resected PH-CCA. These markers were then evaluated for their potential as molecular targets in theragnostic platforms in cholangiocarcinoma. Both NGAL and MMP9 were found to be abundantly expressed in both tumour tissue and control liver. Although higher NGAL expression was associated with nodal metastases, no prognostic impact was seen for either marker. NGAL expression was further interrogated in six cholangiocarcinoma cell lines by Western blotting, Immunofluorescence and ELISA techniques, which revealed localisation of NGAL to the cell membrane and its secretion, both indicating its suitability to a targeting platform. Nonetheless, its expression in normal liver tissue could lead to off-target effects. Concurrently, the expression of vascular ligands CD31, CD105 and Vascular Endothelial Growth Factor Receptor-2 were each assessed in the same cohort of tissue samples. CD105 expression was found to be independently predictive of poorer overall survival. Subsequent in vitro flow assay experiments using CD105 antibody conjugated microbubbles showed it bound murine SVR endothelial cells significantly more in comparison to isotype control microbubbles. Furthermore, evaluation of in vivo targeting with the aid of high frequency ultrasound demonstrated CD105-microbubbles bound to tumour endothelium significantly more than control microbubbles in a subcutaneous murine xenograft model of cholangiocarcinoma. This work therefore indicates NGAL is suited to a theragnostic approach in cholangiocarcinoma although larger data sets are required to explore its prognostic impact. CD105-microbubbles could be utilised in the delivery of such theragnostic particles to cholangiocarcinoma tissue, whilst in themselves providing a non-invasive index of tumour vascularity when imaged with ultrasound.

Published
2016

6. Robotic Assisted Transplant Nephrectomy: Case Series and Training Model for Improving Adoption

Author

McCabe, Michael, primary, Osinski, Thomas, additional, Kashyap, Randeep, additional, Taylor, Jeremy, additional, Schuler, Nathan, additional, Shepard, Lauren, additional, Ghazi, Ahmed, additional, Helbig, Katie, additional, Dokus, M. Katherine, additional, Nair, Amit, additional, Pineda-Solis, Karen, additional, Orloff, Mark, additional, and Wu, Guan, additional

Published
2023
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7. Novel Benchmark Values for Redo Liver Transplantation. Does the Outcome Justify the Effort?: Does the Outcome Justify the Effort?

Author

Abbassi, Fariba, Gero, Daniel, Muller, Xavier, Bueno, Alba, Figiel, Wojciech, Robin, Fabien, Laroche, Sophie, Picard, Benjamin, Shankar, Sadhana, Ivanics, Tommy, van Reeven, Marjolein, van Leeuwen, Otto B, Braun, Hillary J, Monbaliu, Diethard, Breton, Antoine, Vachharajani, Neeta, Bonaccorsi Riani, Eliano, Nowak, Greg, McMillan, Robert R, Abu-Gazala, Samir, Nair, Amit, Bruballa, Rocio, Paterno, Flavio, Weppler Sears, Deborah, Pinna, Antonio D, Guarrera, James V, de Santibañes, Eduardo, de Santibañes, Martin, Hernandez-Alejandro, Roberto, Olthoff, Kim, Ghobrial, R Mark, Ericzon, Bo-Göran, Ciccarelli, Olga, Chapman, William C, Mabrut, Jean-Yves, Pirenne, Jacques, Müllhaupt, Beat, Ascher, Nancy L, Porte, Robert J, de Meijer, Vincent E, Polak, Wojciech G, Sapisochin, Gonzalo, Attia, Magdy, Weiss, Emmanuel, Adam, René A, Cherqui, Daniel, Boudjema, Karim, Zienewicz, Krzysztof, Jassem, Wayel, Dutkowski, Philipp, Clavien, Pierre-Alain, Groningen Institute for Organ Transplantation (GIOT), and Center for Liver, Digestive and Metabolic Diseases (CLDM)

Subjects
retransplantation, benchmark, redo liver transplantation
Abstract

OBJECTIVE: To define benchmark cutoffs for redo liver transplantation (redo-LT). BACKGROUND: In the era of organ shortage, redo-LT is frequently discussed in terms of expected poor outcome and wasteful resources. However, there is a lack of benchmark data to reliably evaluate outcomes after redo-LT. METHODS: We collected data on redo-LT between January 2010 and December 2018 from 22 high-volume transplant centers. Benchmark cases were defined as recipients with MELD score ≤25, absence of portal vein thrombosis, no mechanical ventilation at the time of surgery, receiving a graft from a donor after brain death. Also, high-urgent priority and early redo-LT including those for primary non-function (PNF) or hepatic artery thrombosis were excluded. Benchmark cutoffs were derived from the 75th percentile of the medians of all benchmark centers. RESULTS: Out of 1110 redo-LT, 373 (34%) cases qualified as benchmark cases. Among these cases, the rate of postoperative complications until discharge was 76%, and increased up to 87% at 1-year, respectively. One-year overall survival rate was excellent with 90%. Benchmark cutoffs included Comprehensive Complication Index (CCI®) at 1-year of ≤72, and in-hospital and 1-year mortality rates of ≤13% and ≤15%, respectively. In contrast, patients who received a redo-LT for PNF showed worse outcomes with some values dramatically outside the redo-LT benchmarks. CONCLUSION: This study shows that redo-LT achieves good outcome when looking at benchmark scenarios. However, this figure changes in high-risk redo-LT, as for example in PNF. This major analysis objectifies for the first-time results and efforts for redo-LT and can serve as a basis for discussion about the use of scarce resources.

Published
2022

10. Novel Benchmark Values for Redo Liver Transplantation. Does the Outcome Justify the Effort?

Author

UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de chirurgie et transplantation abdominale, Abbassi, Fariba, Gero, Daniel, Muller, Xavier, Bueno, Alba, Figiel, Wojciech, Robin, Fabien, Laroche, Sophie, Picard, Benjamin, Shankar, Sadhana, Ivanics, Tommy, van Reeven, Marjolein, van Leeuwen, Otto B, Braun, Hillary J, Monbaliu, Diethard, Breton, Antoine, Vachharajani, Neeta, Bonaccorsi Riani, Eliano, Nowak, Greg, McMillan, Robert R, Abu-Gazala, Samir, Nair, Amit, Bruballa, Rocio, Paterno, Flavio, Weppler Sears, Deborah, Pinna, Antonio D, Guarrera, James V, de Santibañes, Eduardo, de Santibañes, Martin, Hernandez-Alejandro, Roberto, Olthoff, Kim, Ghobrial, R Mark, Ericzon, Bo-Göran, Ciccarelli, Olga, Chapman, William C, Mabrut, Jean-Yves, Pirenne, Jacques, Müllhaupt, Beat, Ascher, Nancy L, Porte, Robert J, de Meijer, Vincent E, Polak, Wojciech G, Sapisochin, Gonzalo, Attia, Magdy, Weiss, Emmanuel, Adam, René A, Cherqui, Daniel, Boudjema, Karim, Zienewicz, Krzysztof, Jassem, Wayel, Dutkowski, Philipp, Clavien, Pierre-Alain, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de chirurgie et transplantation abdominale, Abbassi, Fariba, Gero, Daniel, Muller, Xavier, Bueno, Alba, Figiel, Wojciech, Robin, Fabien, Laroche, Sophie, Picard, Benjamin, Shankar, Sadhana, Ivanics, Tommy, van Reeven, Marjolein, van Leeuwen, Otto B, Braun, Hillary J, Monbaliu, Diethard, Breton, Antoine, Vachharajani, Neeta, Bonaccorsi Riani, Eliano, Nowak, Greg, McMillan, Robert R, Abu-Gazala, Samir, Nair, Amit, Bruballa, Rocio, Paterno, Flavio, Weppler Sears, Deborah, Pinna, Antonio D, Guarrera, James V, de Santibañes, Eduardo, de Santibañes, Martin, Hernandez-Alejandro, Roberto, Olthoff, Kim, Ghobrial, R Mark, Ericzon, Bo-Göran, Ciccarelli, Olga, Chapman, William C, Mabrut, Jean-Yves, Pirenne, Jacques, Müllhaupt, Beat, Ascher, Nancy L, Porte, Robert J, de Meijer, Vincent E, Polak, Wojciech G, Sapisochin, Gonzalo, Attia, Magdy, Weiss, Emmanuel, Adam, René A, Cherqui, Daniel, Boudjema, Karim, Zienewicz, Krzysztof, Jassem, Wayel, Dutkowski, Philipp, and Clavien, Pierre-Alain

Abstract

To define benchmark cutoffs for redo liver transplantation (redo-LT). In the era of organ shortage, redo-LT is frequently discussed in terms of expected poor outcome and wasteful resources. However, there is a lack of benchmark data to reliably evaluate outcomes after redo-LT. We collected data on redo-LT between January 2010 and December 2018 from 22 high-volume transplant centers. Benchmark cases were defined as recipients with MELD score ≤25, absence of portal vein thrombosis, no mechanical ventilation at the time of surgery, receiving a graft from a donor after brain death. Also, high-urgent priority and early redo-LT including those for primary non-function (PNF) or hepatic artery thrombosis were excluded. Benchmark cutoffs were derived from the 75th percentile of the medians of all benchmark centers. Out of 1110 redo-LT, 373 (34%) cases qualified as benchmark cases. Among these cases, the rate of postoperative complications until discharge was 76%, and increased up to 87% at 1-year, respectively. One-year overall survival rate was excellent with 90%. Benchmark cutoffs included Comprehensive Complication Index (CCI®) at 1-year of ≤72, and in-hospital and 1-year mortality rates of ≤13% and ≤15%, respectively. In contrast, patients who received a redo-LT for PNF showed worse outcomes with some values dramatically outside the redo-LT benchmarks. This study shows that redo-LT achieves good outcome when looking at benchmark scenarios. However, this figure changes in high-risk redo-LT, as for example in PNF. This major analysis objectifies for the first-time results and efforts for redo-LT and can serve as a basis for discussion about the use of scarce resources.

Published
2022

11. Novel Benchmark Values for Redo Liver Transplantation Does the Outcome Justify the Effort?

Author

Abbassi, Fariba, Gero, Daniel, Muller, Xavier, Bueno, Alba, Figiel, Wojciech, Robin, Fabien, Laroche, Sophie, Picard, Benjamin, Shankar, Sadhana, Ivanics, Tommy, van Reeven, Marjolein, van Leeuwen, Otto B., Braun, Hillary J., Monbaliu, Diethard, Breton, Antoine, Vachharajani, Neeta, Bonaccorsi Riani, Eliano, Nowak, Greg, McMillan, Robert R., Abu-Gazala, Samir, Nair, Amit, Bruballa, Rocio, Paterno, Flavio, Weppler Sears, Deborah, Pinna, Antonio D., Guarrera, James V., de Santibanes, Eduardo, de Santibanes, Martin, Hernandez-Alejandro, Roberto, Olthoff, Kim, Ghobrial, R. Mark, Ericzon, Bo-Goran, Ciccarelli, Olga, Chapman, William C., Mabrut, Jean-Yves, Pirenne, Jacques, Mullhaupt, Beat, Ascher, Nancy L., Porte, Robert J., de Meijer, Vincent E., Polak, Wojciech G., Sapisochin, Gonzalo, Attia, Magdy, Soubrane, Olivier, Weiss, Emmanuel, Adam, Rene A., Cherqui, Daniel, Boudjema, Karim, Zieniewicz, Krzysztof, Jassem, Wayel, Dutkowski, Philipp, Clavien, Pierre-Alain, Abbassi, Fariba, Gero, Daniel, Muller, Xavier, Bueno, Alba, Figiel, Wojciech, Robin, Fabien, Laroche, Sophie, Picard, Benjamin, Shankar, Sadhana, Ivanics, Tommy, van Reeven, Marjolein, van Leeuwen, Otto B., Braun, Hillary J., Monbaliu, Diethard, Breton, Antoine, Vachharajani, Neeta, Bonaccorsi Riani, Eliano, Nowak, Greg, McMillan, Robert R., Abu-Gazala, Samir, Nair, Amit, Bruballa, Rocio, Paterno, Flavio, Weppler Sears, Deborah, Pinna, Antonio D., Guarrera, James V., de Santibanes, Eduardo, de Santibanes, Martin, Hernandez-Alejandro, Roberto, Olthoff, Kim, Ghobrial, R. Mark, Ericzon, Bo-Goran, Ciccarelli, Olga, Chapman, William C., Mabrut, Jean-Yves, Pirenne, Jacques, Mullhaupt, Beat, Ascher, Nancy L., Porte, Robert J., de Meijer, Vincent E., Polak, Wojciech G., Sapisochin, Gonzalo, Attia, Magdy, Soubrane, Olivier, Weiss, Emmanuel, Adam, Rene A., Cherqui, Daniel, Boudjema, Karim, Zieniewicz, Krzysztof, Jassem, Wayel, Dutkowski, Philipp, and Clavien, Pierre-Alain

Abstract

Objective: To define benchmark cutoffs for redo liver transplantation (redo-LT). Background: In the era of organ shortage, redo-LT is frequently discussed in terms of expected poor outcome and wasteful resources. However, there is a lack of benchmark data to reliably evaluate outcomes after redo-LT. Methods: We collected data on redo-LT between January 2010 and December 2018 from 22 high-volume transplant centers. Benchmark cases were defined as recipients with model of end stage liver disease (MELD) score <= 25, absence of portal vein thrombosis, no mechanical ventilation at the time of surgery, receiving a graft from a donor after brain death. Also, high-urgent priority and early redo-LT including those for primary nonfunction (PNF) or hepatic artery thrombosis were excluded. Benchmark cutoffs were derived from the 75th percentile of the medians of all benchmark centers. Results: Of 1110 redo-LT, 373 (34%) cases qualified as benchmark cases. Among these cases, the rate of postoperative complications until discharge was 76%, and increased up to 87% at 1-year, respectively. One-year overall survival rate was excellent with 90%. Benchmark cutoffs included Comprehensive Complication Index CCI (R) at 1-year of <= 72, and in-hospital and 1-year mortality rates of <= 13% and <= 15%, respectively. In contrast, patients who received a redo-LT for PNF showed worse outcomes with some values dramatically outside the redoLT benchmarks. Conclusion: This study shows that redo-LT achieves good outcome when looking at benchmark scenarios. However, this figure changes in high-risk redo-LT, as for example in PNF. This analysis objectifies for the first-time results and efforts for redo-LT and can serve as a basis for discussion about the use of scarce resources.

Published
2022
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12. A multicentre outcome analysis to define global benchmarks for donation after circulatory death liver transplantation

Author

Schlegel, Andrea, van Reeven, Marjolein, Croome, Kristopher, Parente, Alessandro, Dolcet, Annalisa, Widmer, Jeannette, Meurisse, Nicolas, De Carlis, Riccardo, Hessheimer, Amelia, Jochmans, Ina, Mueller, Matteo, van Leeuwen, Otto B., Nair, Amit, Tomiyama, Koji, Sherif, Ahmed, Elsharif, Mohamed, Kron, Philipp, van der Helm, Danny, Borja-Cacho, Daniel, Bohorquez, Humberto, Germanova, Desislava, Dondossola, Daniele, Olivieri, Tiziana, Camagni, Stefania, Gorgen, Andre, Patrono, Damiano, Cescon, Matteo, Croome, Sarah, Panconesi, Rebecca, Carvalho, Mauricio Flores, Ravaioli, Matteo, Caicedo, Juan Carlos, Loss, George, Lucidi, Valerio, Sapisochin, Gonzalo, Romagnoli, Renato, Jassem, Wayel, Colledan, Michele, De Carlis, Luciano, Rossi, Giorgio, Di Benedetto, Fabrizio, Miller, Charles M., van Hoek, Bart, Attia, Magdy, Lodge, Peter, IJzermans, Jan N.M., Polak, Wojciech G., Claasen, Marco, de Meijer, Vincent E., Metselaar, Herold J., Schlegel, Andrea, van Reeven, Marjolein, Croome, Kristopher, Parente, Alessandro, Dolcet, Annalisa, Widmer, Jeannette, Meurisse, Nicolas, De Carlis, Riccardo, Hessheimer, Amelia, Jochmans, Ina, Mueller, Matteo, van Leeuwen, Otto B., Nair, Amit, Tomiyama, Koji, Sherif, Ahmed, Elsharif, Mohamed, Kron, Philipp, van der Helm, Danny, Borja-Cacho, Daniel, Bohorquez, Humberto, Germanova, Desislava, Dondossola, Daniele, Olivieri, Tiziana, Camagni, Stefania, Gorgen, Andre, Patrono, Damiano, Cescon, Matteo, Croome, Sarah, Panconesi, Rebecca, Carvalho, Mauricio Flores, Ravaioli, Matteo, Caicedo, Juan Carlos, Loss, George, Lucidi, Valerio, Sapisochin, Gonzalo, Romagnoli, Renato, Jassem, Wayel, Colledan, Michele, De Carlis, Luciano, Rossi, Giorgio, Di Benedetto, Fabrizio, Miller, Charles M., van Hoek, Bart, Attia, Magdy, Lodge, Peter, IJzermans, Jan N.M., Polak, Wojciech G., Claasen, Marco, de Meijer, Vincent E., and Metselaar, Herold J.

Abstract

Background & Aims: The concept of benchmarking is established in the field of transplant surgery; however, benchmark values for donation after circulatory death (DCD) liver transplantation are not available. Thus, we aimed to identify the best possible outcomes in DCD liver transplantation and to propose outcome reference values. Methods: Based on 2,219 controlled DCD liver transplantations, collected from 17 centres in North America and Europe, we identified 1,012 low-risk, primary, adult liver transplantations with a laboratory MELD score of ≤20 points, receiving a DCD liver with a total donor warm ischemia time of ≤30 minutes and asystolic donor warm ischemia time of ≤15 minutes. Clinically relevant outcomes were selected and complications were reported according to the Clavien-Dindo-Grading and the comprehensive complication index (CCI). Corresponding benchmark cut-offs were based on median values of each centre, where the 75th-percentile was considered. Results: Benchmark cases represented between 19.7% and 75% of DCD transplantations in participating centres. The 1-year retransplant and mortality rates were 4.5% and 8.4% in the benchmark group, respectively. Within the first year of follow-up, 51.1% of recipients developed at least 1 major complication (≥Clavien-Dindo-Grade III). Benchmark cut-offs were ≤3 days and ≤16 days for ICU and hospital stay, ≤66% for severe recipient complications (≥Grade III), ≤16.8% for ischemic cholangiopathy, and ≤38.9 CCI points 1 year after transplant. Comparisons with higher risk groups showed more complications and impaired graft survival outside the benchmark cut-offs. Organ perfusion techniques reduced the complications to values below benchmark cut-offs, despite higher graft risk. Conclusions: Despite excellent 1-year survival, morbidity in benchmark cases remains high. Benchmark cut-offs targeting morbidity parameters offer a valid tool to assess the protective value of new preservation technologies in hi

Published
2022

13. Recipient and Donor Outcomes after Living-Donor Liver Transplant for Unresectable Colorectal Liver Metastases

Author

Hernandez-Alejandro, Roberto, Ruffolo, Luis I., Sasaki, Kazunari, Tomiyama, Koji, Orloff, Mark S., Pineda-Solis, Karen, Nair, Amit, Errigo, Jennie, Dokus, M. Katherine, Cattral, Mark, McGilvray, Ian D., Ghanekar, Anand, Gallinger, Steven, Selzner, Nazia, Claasen, Marco P.A.W., Burkes, Ron, Hashimoto, Koji, Fujiki, Masato, Quintini, Cristiano, Estfan, Bassam N., Kwon, Choon Hyuck David, Menon, K. V.Narayanan, Aucejo, Federico, Sapisochin, Gonzalo, Hernandez-Alejandro, Roberto, Ruffolo, Luis I., Sasaki, Kazunari, Tomiyama, Koji, Orloff, Mark S., Pineda-Solis, Karen, Nair, Amit, Errigo, Jennie, Dokus, M. Katherine, Cattral, Mark, McGilvray, Ian D., Ghanekar, Anand, Gallinger, Steven, Selzner, Nazia, Claasen, Marco P.A.W., Burkes, Ron, Hashimoto, Koji, Fujiki, Masato, Quintini, Cristiano, Estfan, Bassam N., Kwon, Choon Hyuck David, Menon, K. V.Narayanan, Aucejo, Federico, and Sapisochin, Gonzalo

Abstract

Importance: Colorectal cancer is a leading cause of cancer-related death, and nearly 70% of patients with this cancer have unresectable colorectal cancer liver metastases (CRLMs). Compared with chemotherapy, liver transplant has been reported to improve survival in patients with CRLMs, but in North America, liver allograft shortages make the use of deceased-donor allografts for this indication problematic. Objective: To examine survival outcomes of living-donor liver transplant (LDLT) for unresectable, liver-confined CRLMs. Design, Setting, and Participants: This prospective cohort study included patients at 3 North American liver transplant centers with established LDLT programs, 2 in the US and 1 in Canada. Patients with liver-confined, unresectable CRLMs who had demonstrated sustained disease control on oncologic therapy met the inclusion criteria for LDLT. Patients included in this study underwent an LDLT between July 2017 and October 2020 and were followed up until May 1, 2021. Exposures: Living-donor liver transplant. Main Outcomes and Measures: Perioperative morbidity and mortality of treated patients and donors, assessed by univariate statistics, and 1.5-year Kaplan-Meier estimates of recurrence-free and overall survival for transplant recipients. Results: Of 91 evaluated patients, 10 (11%) underwent LDLT (6 [60%] male; median age, 45 years [range, 35-58 years]). Among the 10 living donors, 7 (70%) were male, and the median age was 40.5 years (range, 27-50 years). Kaplan-Meier estimates for recurrence-free and overall survival at 1.5 years after LDLT were 62% and 100%, respectively. Perioperative morbidity for both donors and recipients was consistent with established standards (Clavien-Dindo complications among recipients: 3 [10%] had none, 3 [30%] had grade II, and 4 [40%] had grade III; donors: 5 [50%] had none, 4 [40%] had grade I, and 1 had grade III). Conclusions and Relevance: This study's findings of recurrence-free and overall survival rates sugg

Published
2022

14. A multicentre outcome analysis to define global benchmarks for donation after circulatory death liver transplantation

Author

Schlegel, A, van Reeven, M, Croome, K, Parente, A, Dolcet, A, Widmer, J, Meurisse, N, De Carlis, R, Hessheimer, A, Jochmans, I, Mueller, M, van Leeuwen, O, Nair, A, Tomiyama, K, Sherif, A, Elsharif, M, Kron, P, van der Helm, D, Borja-Cacho, D, Bohorquez, H, Germanova, D, Dondossola, D, Olivieri, T, Camagni, S, Gorgen, A, Patrono, D, Cescon, M, Croome, S, Panconesi, R, Flores Carvalho, M, Ravaioli, M, Caicedo, J, Loss, G, Lucidi, V, Sapisochin, G, Romagnoli, R, Jassem, W, Colledan, M, De Carlis, L, Rossi, G, Di Benedetto, F, Miller, C, van Hoek, B, Attia, M, Lodge, P, Hernandez-Alejandro, R, Detry, O, Quintini, C, Oniscu, G, Fondevila, C, Malagó, M, Pirenne, J, Ijzermans, J, Porte, R, Dutkowski, P, Taner, C, Heaton, N, Clavien, P, Polak, W, Muiesan, P, Schlegel, Andrea, van Reeven, Marjolein, Croome, Kristopher, Parente, Alessandro, Dolcet, Annalisa, Widmer, Jeannette, Meurisse, Nicolas, De Carlis, Riccardo, Hessheimer, Amelia, Jochmans, Ina, Mueller, Matteo, van Leeuwen, Otto B, Nair, Amit, Tomiyama, Koji, Sherif, Ahmed, Elsharif, Mohamed, Kron, Philipp, van der Helm, Danny, Borja-Cacho, Daniel, Bohorquez, Humberto, Germanova, Desislava, Dondossola, Daniele, Olivieri, Tiziana, Camagni, Stefania, Gorgen, Andre, Patrono, Damiano, Cescon, Matteo, Croome, Sarah, Panconesi, Rebecca, Flores Carvalho, Mauricio, Ravaioli, Matteo, Caicedo, Juan Carlos, Loss, George, Lucidi, Valerio, Sapisochin, Gonzalo, Romagnoli, Renato, Jassem, Wayel, Colledan, Michele, De Carlis, Luciano, Rossi, Giorgio, Di Benedetto, Fabrizio, Miller, Charles M, van Hoek, Bart, Attia, Magdy, Lodge, Peter, Hernandez-Alejandro, Roberto, Detry, Olivier, Quintini, Cristiano, Oniscu, Gabriel C, Fondevila, Constantino, Malagó, Massimo, Pirenne, Jacques, IJzermans, Jan Nm, Porte, Robert J, Dutkowski, Philipp, Taner, C Burcin, Heaton, Nigel, Clavien, Pierre-Alain, Polak, Wojciech G, Muiesan, Paolo, Schlegel, A, van Reeven, M, Croome, K, Parente, A, Dolcet, A, Widmer, J, Meurisse, N, De Carlis, R, Hessheimer, A, Jochmans, I, Mueller, M, van Leeuwen, O, Nair, A, Tomiyama, K, Sherif, A, Elsharif, M, Kron, P, van der Helm, D, Borja-Cacho, D, Bohorquez, H, Germanova, D, Dondossola, D, Olivieri, T, Camagni, S, Gorgen, A, Patrono, D, Cescon, M, Croome, S, Panconesi, R, Flores Carvalho, M, Ravaioli, M, Caicedo, J, Loss, G, Lucidi, V, Sapisochin, G, Romagnoli, R, Jassem, W, Colledan, M, De Carlis, L, Rossi, G, Di Benedetto, F, Miller, C, van Hoek, B, Attia, M, Lodge, P, Hernandez-Alejandro, R, Detry, O, Quintini, C, Oniscu, G, Fondevila, C, Malagó, M, Pirenne, J, Ijzermans, J, Porte, R, Dutkowski, P, Taner, C, Heaton, N, Clavien, P, Polak, W, Muiesan, P, Schlegel, Andrea, van Reeven, Marjolein, Croome, Kristopher, Parente, Alessandro, Dolcet, Annalisa, Widmer, Jeannette, Meurisse, Nicolas, De Carlis, Riccardo, Hessheimer, Amelia, Jochmans, Ina, Mueller, Matteo, van Leeuwen, Otto B, Nair, Amit, Tomiyama, Koji, Sherif, Ahmed, Elsharif, Mohamed, Kron, Philipp, van der Helm, Danny, Borja-Cacho, Daniel, Bohorquez, Humberto, Germanova, Desislava, Dondossola, Daniele, Olivieri, Tiziana, Camagni, Stefania, Gorgen, Andre, Patrono, Damiano, Cescon, Matteo, Croome, Sarah, Panconesi, Rebecca, Flores Carvalho, Mauricio, Ravaioli, Matteo, Caicedo, Juan Carlos, Loss, George, Lucidi, Valerio, Sapisochin, Gonzalo, Romagnoli, Renato, Jassem, Wayel, Colledan, Michele, De Carlis, Luciano, Rossi, Giorgio, Di Benedetto, Fabrizio, Miller, Charles M, van Hoek, Bart, Attia, Magdy, Lodge, Peter, Hernandez-Alejandro, Roberto, Detry, Olivier, Quintini, Cristiano, Oniscu, Gabriel C, Fondevila, Constantino, Malagó, Massimo, Pirenne, Jacques, IJzermans, Jan Nm, Porte, Robert J, Dutkowski, Philipp, Taner, C Burcin, Heaton, Nigel, Clavien, Pierre-Alain, Polak, Wojciech G, and Muiesan, Paolo

Abstract

Background & Aims: The concept of benchmarking is established in the field of transplant surgery; however, benchmark values for donation after circulatory death (DCD) liver transplantation are not available. Thus, we aimed to identify the best possible outcomes in DCD liver transplantation and to propose outcome reference values. Methods: Based on 2,219 controlled DCD liver transplantations, collected from 17 centres in North America and Europe, we identified 1,012 low-risk, primary, adult liver transplantations with a laboratory MELD score of ≤20 points, receiving a DCD liver with a total donor warm ischemia time of ≤30 minutes and asystolic donor warm ischemia time of ≤15 minutes. Clinically relevant outcomes were selected and complications were reported according to the Clavien-Dindo-Grading and the comprehensive complication index (CCI). Corresponding benchmark cut-offs were based on median values of each centre, where the 75th-percentile was considered. Results: Benchmark cases represented between 19.7% and 75% of DCD transplantations in participating centres. The 1-year retransplant and mortality rates were 4.5% and 8.4% in the benchmark group, respectively. Within the first year of follow-up, 51.1% of recipients developed at least 1 major complication (≥Clavien-Dindo-Grade III). Benchmark cut-offs were ≤3 days and ≤16 days for ICU and hospital stay, ≤66% for severe recipient complications (≥Grade III), ≤16.8% for ischemic cholangiopathy, and ≤38.9 CCI points 1 year after transplant. Comparisons with higher risk groups showed more complications and impaired graft survival outside the benchmark cut-offs. Organ perfusion techniques reduced the complications to values below benchmark cut-offs, despite higher graft risk. Conclusions: Despite excellent 1-year survival, morbidity in benchmark cases remains high. Benchmark cut-offs targeting morbidity parameters offer a valid tool to assess the protective value of new preservation technologies in higher risk grou

Published
2022

16. Conditional probability of graft survival in liver transplantation using donation after circulatory death grafts – a retrospective study

Author

Sasaki, Kazunari, primary, Nair, Amit, additional, Firl, Daniel J., additional, McVey, John C., additional, Moro, Amika, additional, Diago Uso, Teresa, additional, Fujiki, Masato, additional, Aucejo, Federico N., additional, Quintini, Cristiano, additional, Kwon, Choon‐Hyuck D., additional, Eghtesad, Bijan, additional, Miller, Charles M., additional, and Hashimoto, Koji, additional

Published
2021
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20. Induction Therapy With Antithymocyte Globulin and Delayed Calcineurin Inhibitor Initiation for Renal Protection in Liver Transplantation: A Multicenter Randomized Controlled Phase II-B Trial.

Author

Nair, Amit, Coromina Hernandez, Laia, Shah, Shimul, Zervos, Xaralambos, Zimmerman, Michael, Sasaki, Kazunari, Diago, Teresa, Hashimoto, Koji, Fujiki, Masato, Aucejo, Federico, Bollinger, Jessica, Kaiser, Tiffany L., Miller, Charles M., Quintini, Cristiano, Fung, John J., and Eghtesad, Bijan

Published
2022
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22. Characterization of voltage-gated ionic currents in a peripheral sensory neuron in larval Drosophila

Author

Bate Michael, Nair Amit, and Pulver Stefan R

Subjects
Medicine, Biology (General), QH301-705.5, Science (General), Q1-390
Abstract

Abstract Background The development, morphology and genetics of sensory neurons have been extensively studied in Drosophila. Sensory neurons in the body wall of larval Drosophila in particular have been the subject of numerous anatomical studies, however, little is known about the intrinsic electrical properties of larval sensory cells. Findings We performed whole cell patch recordings from an identified peripheral sensory cell, the dorsal bipolar sensory neuron (dbd) and measured voltage-gated ionic currents in 1st instar larvae. Voltage clamp analysis revealed that dbds have a TEA sensitive, non-inactivating IK type potassium current as well as a 4-AP sensitive, inactivating IA type potassium current. dbds also show a voltage-gated calcium current (ICa) and a voltage-gated sodium current (INa). Conclusions This work provides a first characterization of voltage-activated ionic currents in an identified body-wall sensory neuron in larval Drosophila. Overall, we establish baseline physiology data for future studies aimed at understanding the ionic and genetic basis of sensory neuron function in fruit flies and other model organisms.

Published
2010
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26. Water Safety Plans for Rural Water Supply in India : Policy Issues and Institutional Arrangements

Author

Rouse, Michael, Pilgrim, Nicholas, and Nair, Amit

Subjects
OPERATIONAL PERFORMANCE, SURFACE DRAINAGE, COST RECOVERY POLICIES, SPRING, PROGRAMS, DRINKING WATER GUIDELINES, WATER SOURCES, RURAL WATER SUPPLY, PERFORMANCE IMPROVEMENTS, WATER_SANITATION, WATER SCHEMES, EFFLUENT, RURAL DRINKING WATER, DISTRIBUTION SYSTEMS, WATER TANKER, PERFORMANCE INDICATORS, WATER SOURCE, WATER TREATMENT, TRAINING PROGRAM, CONTAMINATED WATER, TRANSPARENCY, PIPELINE, WELLS, PIPELINES, RESPONSIBILITY FOR SERVICE DELIVERY, SERVICE STANDARDS, QUALITY STANDARDS, POLLUTION, QUALITY OF WATER, PUBLIC UTILITIES, SURFACE WATER, QUANTITY OF WATER, DISTRICT AUTHORITIES, PATHOGENS, WATER SERVICES, WATER SYSTEM, WATER SUPPLIES, WATER · SAMPLING, DRINKING WATER, WATER SAMPLING, WATER TANKERS, EFFLUENTS, MANAGEMENT OF WATER, FOOD PRODUCTION, COST RECOVERY, SAND, TURBIDITY, WATER TESTING LABORATORIES, SERVICE AGREEMENTS, WATER SCARCITY, RECHARGE, DRINKING WATER SUPPLY, WATER SUPPLY SYSTEM, OPEN DEFECATION, BULK SUPPLY, LOCAL OPERATORS, REGULATORY COMMISSION, DISTRIBUTION SYSTEM, GROUNDWATER, SANITATION FACILITIES, WATER CONSERVATION, SERVICE IMPROVEMENT, NUTRIENTS, WATER ASSOCIATION, RAINWATER, WATER TESTING, SALINITY, CONJUNCTIVE USE, CUSTOMER SERVICE, CONTAMINANTS, SANITATION SERVICES, MAINTENANCE REQUIREMENTS, MONITORING DATA, SAFE WATER, IRON, WATER QUALITY MANAGEMENT, OPERATION OF WATER SUPPLY, DRINKING WATER QUALITY, MANAGEMENT OF WATER SUPPLY, DRINKING WATER SAFETY, URBAN CENTERS, INVESTMENT DECISIONS, SAFETY OF DRINKING WATER, ANNUAL BUDGETS, WATER SYSTEMS, SUPPLY CHAIN, HOUSEHOLDS, SAFE DRINKING WATER, PUBLIC HEALTH, MANAGEMENT OF WATER SUPPLY SYSTEMS, MAINTENANCE COSTS, POTABLE WATER, OPERATIONAL MANAGEMENT, SANITATION COMMITTEE, WATER QUALITY STANDARDS, RURAL WATER, LEGAL STATUS, WATER DISTRIBUTION, INCENTIVE SCHEMES, SANITATION DEVELOPMENT, PIPED WATER, RAINWATER HARVESTING, FORESTRY, LOCAL SERVICE PROVIDERS, DECISION­MAKING, WATER QUALITY, WATER SUPPLY SYSTEMS, SERVICE IMPROVEMENTS, MONITORING REQUIREMENTS, INVESTMENT PROPOSALS, HAND WASHING, MANAGEMENT OF DRINKING WATER, WATER QUALITY TESTING, CAPACITY BUILDING, PERFORMANCE TARGETS, WATER QUALITY MONITORING, LAUNDRY, OPERATING COSTS
Abstract

This report outlines the key principles of water safety planning for rural water supply in India. Water safety planning represents a change of emphasis from end-of-pipe testing to the management of risks of contamination from source to mouth. End-of-pipe testing is still necessary to verify that safe drinking water is being delivered. The focus of the report is on the policy issues concerning the adoption of water safety planning and the institutional arrangements (roles and responsibilities) needed to operationalize the approach. Recommendations are provided on demonstrating and implementing the approach to establish a full program. There are three objectives of this study: 1) to consider policies for the delivery of safe drinking water quality in rural areas; 2) to provide a framework in which the various functions associated with a change of emphasis towards managing risks to the safety of drinking water can be incorporated into existing institutional frameworks, in particular building on the initiatives already taken in India to improve monitoring and surveillance of drinking water quality; and 3) to suggest an approach to demonstrate and implement such a framework.

Published
2010

27. Alveolar Soft Part Sarcoma: a unique tumor with disputed histogenesis

Author

Nair, Amit, Pai, Dinker R., Jagdish, S., and Krishnan, R.

Abstract

Sir, We wish to bring to your kind attention a case of Alveolar Soft Part Sarcoma (ASPS) managed in our institute. A 32-year-old male presented with history of rapidly increasing [...]

Published
2003

31. A dPIP5K Dependent Pool of Phosphatidylinositol 4,5 Bisphosphate (PIP2) Is Required for G-Protein Coupled Signal Transduction in Drosophila Photoreceptors.

Author

Chakrabarti, Purbani, Kolay, Sourav, Yadav, Shweta, Kumari, Kamalesh, Nair, Amit, Trivedi, Deepti, and Raghu, Padinjat

Subjects
DROSOPHILA genetics, PHOTORECEPTORS, PHOSPHOLIPASE C genetics, CELL membranes, CELLULAR signal transduction
Abstract

Multiple PIP2 dependent molecular processes including receptor activated phospholipase C activity occur at the neuronal plasma membranes, yet levels of this lipid at the plasma membrane are remarkably stable. Although the existence of unique pools of PIP2 supporting these events has been proposed, the mechanism by which they are generated is unclear. In Drosophila photoreceptors, the hydrolysis of PIP2 by G-protein coupled phospholipase C activity is essential for sensory transduction of photons. We identify dPIP5K as an enzyme essential for PIP2 re-synthesis in photoreceptors. Loss of dPIP5K causes profound defects in the electrical response to light and light-induced PIP2 dynamics at the photoreceptor membrane. Overexpression of dPIP5K was able to accelerate the rate of PIP2 synthesis following light induced PIP2 depletion. Other PIP2 dependent processes such as endocytosis and cytoskeletal function were unaffected in photoreceptors lacking dPIP5K function. These results provide evidence for the existence of a unique dPIP5K dependent pool of PIP2 required for normal Drosophila phototransduction. Our results define the existence of multiple pools of PIP2 in photoreceptors generated by distinct lipid kinases and supporting specific molecular processes at neuronal membranes. [ABSTRACT FROM AUTHOR]

Published
2015
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32. A rare case of S treptococcus sanguinis mycotic popliteal aneurysm.

Author

Jolly K, Barratt R, and Nair A

Abstract

Introduction: Mycotic popliteal aneurysms are not a common phenomenon. They can initially be easily confused with other more trivial conditions such as a Baker's cyst. We present a case of a patient presenting with a progressively worsening leg swelling which was initially misdiagnosed. Only until symptoms rapidly progressed was a popliteal aneurysm diagnosed. To our knowledge this is the only identified case of a Streptococcus sanguinis mycotic popliteal aneurysm., Case Presentation: An 81-year-old gentleman presented to the surgical assessment unit with a six-week history of a painful, diffuse swelling in the left popliteal fossa. Initially, when symptoms developed a provisional diagnosis of a Baker's cyst was made. When the symptoms progressed to involve swelling of the entire lower limb, an ultrasound was arranged. Detailed Imaging revealed a popliteal aneurysm with signs of rupture. Urgent repair was performed, with high suspicion of a mycotic aneurysm intra-operatively. Cultures confirmed this, isolating Streptococcus sanguinis . Multiple investigations failed to isolate an acute infective source of this infection. The patient recovered promptly with a long course of intravenous antibiotics, being able to mobilize normally., Conclusion: Mycotic popliteal aneurysms are not very common and can easily be confused with other benign lesions. The key to diagnosis is the presence of a pulsatile mass and further detailed imaging. This case was unique in that Streptococcus sanguinis has not been isolated from such an aneurysm until now. The most likely explanation of this case was that the aneurysm was secondary to transient bacteraemia of this organism through the oral cavity, in the absence of any cardiac involvement.

Published
2014
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