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Background: Iatrogenic bile duct injury (BDI) is one of the most common complications that challenge surgeons performing laparoscopic cholecystectomy (LC). As the number of LC surgeries increases, a pattern of BDI is emerging, but little is known about this matter. The purpose of this study was to assess the pattern of post-LC BDIs directed in a referral center in Iran. Methods: Post-BDI patients referred to a hepatobiliary center were studied. Demographic data, clinical status, diagnostic examinations, referral time, post-referral management, and morbidity were analyzed. Results: Nine out of 68 patients had Charcot's cholangitis triad featuring right upper quadrant abdominal pain, fever, and icter. Fever, icter, and itching were the most frequent symptoms. Increased bilirubin, leukocytosis, and abnormal liver function test (LFT) were the most common laboratory abnormalities. 30 patients experienced hepatic artery injury. Out of them, six patients experienced hepatectomy due to hepatic ischemia. Two patients were re-admitted and re-operated, and four patients died. Conclusion: Early and correct treatment by a hepatobiliary surgeon experienced in the management of these types of injuries prevents further complications in patients suffering from iatrogenic BDI. Postoperative complications of bile duct repair, such as anastomosis stricture, are possible; thus, patients need long-term and thorough postoperative observation. [ABSTRACT FROM AUTHOR]

Aim: This this study aimed to investigate the causes and prognoses of liver re-transplantation in patients referred to Imam Khomeini Hospital Liver Transplantation Center. Background: Organ shortage is a major problem in the world, a high demand for liver transplantation has exacerbated this problem. Thus, providing more information on the causes of liver re-transplantation, its prognosis, and other issues related to this procedure is of great importance. Methods: This study was conducted in 2018 as a historical cohort. In this study, the records of liver transplantation patients at Imam Khomeini Hospital Liver Transplantation Center between 2000 and 2016 were studied, and data was extracted from the records of patients undergoing liver transplantation. Patient data was entered into SPSS 20 software and analyzed. Results: In this study, 1030 patients with a mean age of 43.15 ± 14.57 years were studied. There were 426 women (41.4%) and 604 men (58.6%). The number of primary transplants was 966 with a mean age of 43.19 ± 14.72, and the number of re-transplants was 64 with a mean age of 42.56 ± 12.82. Significant differences were found between the two groups in terms of MELD and CHILD scores, cold ischemic time, total and direct bilirubin levels, liver function factors (ALT, AST, and alkaline phosphatase), hemoglobin, and WBC. There was no significant difference between the two groups in terms of age, sex, or platelets (> 0.05). The mortality rate was 241 (23.39%) in all patients and the mortality rate was 206 (21.32%) and in liver transplant patients was 35 (54.68%). The mortality rate in the transplant group was statistically higher (p<0.001). Secondary was primary non-functional graft (PNF) (37.5%) with 1-, 3, and 5-year survival rates of 82%, 81%, and 70% in primary group and 59%, 43% and 32% in re-transplantation, respectively. There was a significant difference in survival between the two groups (p <0.05). Hemoglobin and alkaline phosphatase were predictors of survival rates in transplant patients. Conclusion: The results of this study showed that the survival rate of re-transplant patients was significantly lower than that of primary transplant patients, and the mortality rate in re-transplant patients was significantly higher. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to evaluate the impact of two different reperfusion techniques on outcomes of LT patients. Background: Post-reperfusion syndrome (PRS) during liver transplantation (LT) remains a serious issue for both the surgeon and anesthetist. Methods: In this prospective study, all liver transplant recipients referred to the liver transplantation department of Imam Khomeini Hospital, Tehran, Iran, from January 2016 to June 2017 were enrolled in the study and were divided into two groups of vented (reperfusion with 300cc blood venting) and non-vented (reperfusion without blood venting) cases. Then, 30-minute intraoperative hemodynamic and biochemical changes, as well as 2-month complications and 6-month mortality, were compared between the groups. Results: 57 LT cases (31 vented and 26 non-vented) were studied (50.9% female). The two groups had a similar age (p = 0.107), sex (p = 0.885), MELD score (p = 0.61), donor warm ischemic time (p = 0.85), recipient warm ischemic time (p = 0.36), cold ischemic time (p = 0.99), comorbid disease (p = 0.502), and etiology of end-stage liver disease (p = 0.281). PRS occurred in 3 (11.5%) patients in the vented group and 4 (12.9%) in the non-vented group (p = 0.69). One (3.8%) patient in the non-vented group and 4 (12.9%) patients in vented group died (p = 0.229). Conclusion: Reperfusion with and without blood venting had the same outcome regarding intraoperative hemodynamic and biochemical changes, PRS rate, and postoperative complications, as well as 6-month survival. Thus, it seems that blood venting is not a necessary method for decreasing post-reperfusion complications following LT. [ABSTRACT FROM AUTHOR]

Background: Administration of albumin for burn patients and its effects on mortality and morbidity has been debated for along time. The aim of this study was to evaluate the effects of albumin administration on wound healing, length of hospital stay, weight change, and mortality of burn patients. Methods: Two matched groups of patients from Shiraz Burn Care Center were randomly selected. The patients in one group received parenteral albumin in addition to high protein diet and the other group received only high protein diet. The length of hospital stay, healing time, mortality, serum albumin, transferrin levels, and weight loss were compared. Results: A total of 141 patients were selected; 71 patients in control group and 70 patients in albumin group. There were no significant differences in mortality (P=0.97), length of hospital stay (P=0.45), and healing time (P=0.25) in two groups. The patients who survived had significantly higher serum transferrin level (128 mg/dL versus 102 mg/dL). Conclusion: Parenteral albumin administration did not have a significant effect on mortality, length of hospital stay, and healing time in burn patients. [ABSTRACT FROM AUTHOR]

The article describes the case of a 12-year-old boy presented with loss of consciousness and right hemiparesis four days after liver transplantation. Topics include immunosuppressive drugs received by the patient, leukocytosis, anemia, thrombocytopenia, and elevated erythrocyte sedimentation rate revealed by paraclinical evaluation, and hyaline branching hyphae revealed by the pus-like fluid cytological smear.

In 2001, a Liver Transplantation (LT) program was commenced in Imam Khomeini Hospital Complex as the first one in the capital city of Tehran which is the second liver transplantation center in Iran. This study presents the results of our 10-year experience with LT. [ABSTRACT FROM AUTHOR]