Transplantation proceedings
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Due to the lack of donor organs for orthotopic liver transplantation (OLT) in Germany, a larger proportion of patients advance to multi-organ failure (MOF) before OLT. Twenty-three patients on the waiting list for OLT were admitted to our intensive care unit (ICU) from January 2007 until September 2009. They consisted of 16 men and 7 women of median (25th-75th percentile) age of 60 years (54-65). ⋯ In conclusion, OLT may be successful treatment for cirrhotic patients with MOF. Outcomes of MOF in cirrhotic patients may improve after OLT but are generally worse than acceptable. A shorter ICU waiting time seemed to be beneficial.
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Scientific publications are valuable markers of scientific activity for countries. We performed a bibliometric study to evaluate the number of publications written by Turkish authors. The aim of this study is to evaluate Turkey's contribution in terms of number of publications included in Science Citation Index Expanded (SCI-E) in the scientific field of liver transplantation compared with other countries. To our knowledge, this is the first bibliometric study in liver transplantation research of Turkey. ⋯ Turkey showed a significant positive trend in publications in the scientific field of liver transplantation in the last 30 years, and the rank of Turkey among other countries improved in recent decades. Currently, Turkey is one of the top 17 countries in terms of number of scientific publications listed in SCI-E. This can be considered as another indicator for Turkey's progress in the field of liver transplantation.
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The experimental investigation was performed to study the effects of methylene blue (MB) on hemodynamic, biochemical, and tissue changes among rabbits undergoing liver ischemia and reperfusion (IR). Twenty-four rabbits were randomized into 5 groups: 1, SHAM, control; 2, MB infusion bolus (3 mg/kg); 3, IR, hepatic ischemia for 60 minutes followed by 120 minutes of reperfusion; 4, MB-R, undergoing ischemia that had received an MB bolus infusion (3 mg/kg) prior to reperfusion; 5, R-MB, undergoing ischemia and MB bolus infusion after hemodynamic instability caused by reperfusion. The analysis included continuous recording of vital signs. ⋯ Blood gas data revealed different patterns among the SHAM, MB, IR, MB-R, and R-MB groups, without statistical significance, except for favorable lactate results in the R-MB group (P<.01), which displayed greater survival. Biochemical tests did not show significant differences among the groups, whereas histological analysis revealed favorable appearances for the MB-R and R-MB groups. The MB effect lasted long after reperfusion, suggesting that improvement in the hemodynamic parameters was not based on liver integrity, but rather was possibly related to endothelial function.
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We present a case of long-term survival of a patient who underwent living-donor liver transplantation for unresectable liver metastases of colon cancer. Two years after left hemicolectomy and subsequent to repeated liver resections, this patient presented with unresectable metastatic disease confined to the liver. She was offered a living-donor liver transplantation, and her husband agreed to be the donor. Five years after transplant, she was alive and recurrence free.
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Comparative Study
Relationship between ischemia/reperfusion injury and the stimulus of fibrogenesis in an experimental model: comparison among different preservation solutions.
Orthotopic liver transplantation (OLT) has been the standard treatment for end-stage acute and chronic liver disease. Ischemia-reperfusion (I/R) injury is one of the major causes of poor graft function early after OLT, and adversely influencing graft and patient survivals. It is unknown whether I/R injury influences liver fibrogenesis. ⋯ In this experimental model of early reperfusion injury, preservation changes related to higher levels of renin, which suggest its role in fibrogenesis. FBP was associated with lower renin levels than other solutions including UW.