Transplantation proceedings
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Morphologic characteristics of the graft have been proposed as a major contributor to the long-term outcomes in orthotopic liver transplantation (OLT). Our objective was to determine the impact of donor variables, including donor age, donor-recipient HLA match, and type of donation (DCD vs donation after brain death [DBD]), on the outcome of OLT in 192 patients with hepatitis C virus (HCV). Fourteen patients underwent OLT from donation after cardiac death (DCD) donors and 188 from DBD donors. ⋯ Donor- recipient HLA matching did not appear to correlate with OLT outcome in patients with HCV. DCD donors and donors older than 60 years of age significantly impact patient and graft survival. Lower graft and patient survival in recipients from DCD donors does not appear to be related to early disease recurrence.
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The gap between cadaver organ donation and waiting list forces us to develop new strategies. Many institutions have turned to emergency departments (ED). ⋯ Educational support and proper management from OPO-like organizations to emergency medical staff will provide better outcomes.
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Anatomical landmark technique for central venous catheter insertion preoperatively during renal transplantation may result in serious complications. In this prospective study, we sought to evaluate the results of ultrasonography-guided central venous catheter insertion before renal transplantation. ⋯ Ultrasonography-guided jugular venous catheter insertion is a successful safe method. Routine ultrasonography-guided procedures before renal transplantation avoided the complications related to catheter insertion.
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The aim of this study was to investigate the usefulness of hepatobiliary scintigraphy for the evaluation of liver grafts in the early postoperative period in patients receiving liver transplants from living related donors. ⋯ Hepatobiliary scintigraphy, which is a noninvasive and objective method, is useful to assess grafts in the early postoperative period among patients who received liver transplants from living related donors.
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The aim of this study was to evaluate the safety and effectiveness of a restrictive fluid management strategy and acute normovolemic intraoperative hemodilution (ANIH) to decrease transfusion requirements among living-donors for liver transplantation (LDLT). We retrospectively reviewed the data of 114 consecutive LDLT donors. The patients were divided into 2 groups based on whether (Group I; n = 73) or not (Group II; n = 41) a restrictive fluid management strategy with ANIH was used during the procedure. ⋯ Patients in Group I had a shorter hospital stay than those in Group II (8.2 +/- 4.6 days vs 10.1 +/- 4.9 days; P = .03). In conclusion, a restrictive fluid management strategy with ANIH was a safe blood-salvage technique for LDLT. This approach was also associated with decreased length of hospital stay and a trend toward decreased transfusion requirements.