Transplantation proceedings
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Sodium, chloride, and lactic acid load may be responsible for acidosis during surgery; complex disorders may not have a single, identifiable causative anion, with only the strong ion gap (SIG) being elevated. We studied the effects of fluids infused during various phases of liver transplant surgeries on acid-base and electrolyte changes using the Henderson-Hasselbach and Stewart equations. ⋯ Avoiding large quantities of sodium chloride-containing fluids may help to decrease the incidence of hyperchloremic acidosis among this group of patients. The changes in SIG but not in bicarbonate during liver transplant procedures were highly correlated with pH changes.
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Vascular complications (VC) after liver transplantation (OLT) are one of the most feared problems that frequently result in graft and patient loss. Herein we have reported our experience with VC after either deceased donor liver transplantation (DDLT) or living donor liver transplantation (LDLT). ⋯ In our experience, the incidence of vascular complications was significantly higher among the LDLT group compared with the DDLT group. Vascular complications were associated with poorer graft and patient survival rates in both groups.
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The shortage of organ donors along with the increased number of waiting recipients have created the need for new strategies to expand the organ pool: living donors, split livers, domino livers, and organs from donations after cardiac death (DCD). The purpose of this article was to focus upon aspects of DCD application in the religious, traditional, ethical, and legal aspects of the Arab world. ⋯ DCD in the Arab world is more complicated than in Western countries. It should be re-evaluated and thoroughly reviewed with the new criteria for DCD and its implementation in our region.