Higher vs standard mean arterial pressure target in the immediate postoperative period of liver transplantation to prevent acute kidney injury: A randomized clinical trial (LIVER-PAM).

Acute kidney injury (AKI) is a frequent complication after liver transplantation, with an incidence up to 81%, and is associated with impaired long-term renal function, graft survival, and increased mortality. Hypotension is a modifiable risk factor, and while maintaining a mean arterial pressure (MAP) >65 mmHg is standard practice, higher targets may improve outcomes. The LIVER-PAM trial was an open-label, single-center, randomized clinical trial including 174 adult patients treated in an intensive care unit after liver transplantation.

New Thrombectomy Technique for Total Portal Vein Thrombosis in Liver Transplantation.

Portal vein thrombosis is present in approximately 5-16% of patients with end-stage liver disease who undergo liver transplantation. In this report, we describe a new surgical approach that has been established in our center. Two patients with total thrombosis of the main trunk of the portal vein have been treated currently.

The incidence of severe complications in liver donation from living donors: Real-world data in the era of minimally invasive surgery.

Although living liver donor safety is a fundamental principle in living donor liver transplantation, the details of severe complications that require re-operation or intensive care are not well understood. Therefore, in this study, we summarize those events in liver donation and investigate the difference in complication rates between the open and laparoscopic/robotic approaches in the era of minimally invasive surgery (MIS). We collected the case report forms of donor Clavien-Dindo grade IIIb, IV, and V complications between January 2013 and December 2022 from 16 institutions in the Vanguard Multicenter Study of the International Living Donor Liver Transplantation Group.

Can elastography predict early allograft dysfunction or loss after liver transplantation? A prospective study of diagnostic accuracy.

Introduction: The imbalance between the demand for liver transplants and the shortage of donors can be addressed by expanding the donor pool, including using extended criteria donors. This strategy may reduce waiting time and list mortality but can increase poor graft function rates, affecting short-term outcomes. Tools to predict and diagnose Early Allograft Dysfunction (EAD) are crucial.

POSTOPERATIVE OUTCOME OF PATIENTS ADMITTED TO THE INTENSIVE CARE UNIT AFTER ELECTIVE AND EMERGENCY LAPAROTOMY.

Background: Surgery is associated with a high risk for morbidity and mortality, particularly when performed in critical patients requiring intensive care unit (ICU) admission.

Aim: The aim of this study was to investigate risk factors associated with adverse outcomes in a large cohort of patients admitted to a single-center ICU after abdominal surgery.

Methods: All patients admitted to a surgical ICU for postoperative care, from January 2016 to December 2022, were retrospectively evaluated.

Use of decision algorithms for viscoelastic tests and use of blood products in patients undergoing liver transplantation: A systematic review with meta-analysis.

Introduction: Viscoelastic tests (VETs), including thromboelastography (TEG) and rotational thromboelastometry (ROTEM), provide a global assessment of hemostatic function. The use of a TEG or ROTEM system to guide the administration of blood products has been shown to reduce transfusion requirements in certain types of surgeries, but the decision algorithms for Viscoelastic tests needs to be assessed. This review aimed to assess all published evidence on viscoelastic testing in the context the use of decision algorithms for VETs on liver transplantation.

Analysis of the survival of patients with hepatocellular carcinoma and indications for liver transplantation or hepatic resection.

Background: Hepatic resection (HR) and liver transplantation (LT) are potentially curative treatments for Hepatocellular carcinoma (HCC). The aim of this study was to analyze the survival of patients with HCC and indications for surgical treatment (HR or LT) in a high-volume center.

Methods: This was a retrospective cohort study of consecutive patients with HCC and indications for LT or HR from May 2006 to July 2019.

Motivations for uterus transplantation in women with absolute uterine factor infertility: A systematic review of the literature.

Introduction: Uterine transplantation is indicated for women with absolute uterine factor infertility, which is usually associated with congenital causes (the most common being Mayer-Rokitansky-Kuster-Hauser syndrome) or acquired via hysterectomy. For these women, uterus transplantation is the only possibility for them to be able to conceive and have a biological child. The aim of this study was to understand the motivations that lead women with absolute uterine factor infertility to wish to undergo a uterus transplant.

Latin American association for the study of the liver (ALEH) guidance on postoperative care after liver transplantation.

Liver transplantation (LT) is a well-established therapy for patients with decompensated cirrhosis and early-stage hepatocellular carcinoma. Liver transplantation activity varies sharply across Latin American (LATAM) countries due to differences in resources, expertise, and funding and local attitudes toward organ donation and transplantation. This current guidance of postoperative care after LT is the first position paper of the Latin American Association for the Study of the Liver (ALEH) Special Interest Group (SIG), drawing evidence-based recommendations regarding immediate and long-term postoperative care of LT recipients, taking into consideration their applicability in Latin America.

Suture versus stapler in distal pancreatectomy and its impact on postoperative pancreatic fistula.

Postoperative pancreatic fistula is a critical complication after distal pancreatectomy. The aim of this systematic review is to assess new reports on the main pancreatic stump closure techniques (stapler and hand-sewn suture) in distal pancreatectomy, to define their influence on postoperative pancreatic fistula rates. A literature review was performed following PRISMA guidelines (PROSPERO: CRD42023408181).

Predicting futile outcomes following deceased donor liver transplantation in non-HCC patients with MELD-Na score above 30: a retrospective international multicenter cohort study.

Introduction: In the current "sickest first" allocation policy for limited deceased liver grafts, identifying patients "too sick to transplant" before transplantation is crucial to optimize outcomes. This study aimed to predict futile outcomes following deceased donor liver transplantation (DDLT) in patients with model for end-stage liver disease-sodium (MELD-Na) scores ≥30.

Methods: This international multicenter study was conducted as part of the International Society of Liver Surgeons.

INTERNATIONAL NORMALIZED RATIO AND ACTIVATED PARTIAL THROMBOPLASTIN TIME DO NOT PREDICT PLASMA TRANSFUSION IN LIVER TRANSPLANTATION.

Background: Blood loss during liver transplantation (LT) remains a major concern associated with increased morbidity and reduced patient and graft survival. The high complexity of the procedure associated with the multifaceted origin of the bleeding urges early identification of high-risk patients and proper monitoring of hemostasis disorders in order to improve results. The accuracy of international normalized ratio (INR) and activated partial thromboplastin time (aPTT) to evaluate coagulation status in cirrhotic patients has been doubted.

Analysis of two reperfusion techniques in uterine transplantation in an experimental model.

Introduction: Uterine transplantation was developed for the treatment of absolute uterine factor infertility. As it is a new modality of transplantation, there is still room for technical improvement. A factor that impacts graft survival in organ transplantation is the warm ischemia time.

Survival after liver transplantation from hepatitis B-core positive donors at a quaternary care hospital in Brazil.

Background: Liver transplantation is the treatment for many end-stage liver diseases and hepatocellular carcinoma but shortage of available organs poses significant challenge. Many centers have used grafts from donors with positive anti-HBc serology but concerns about potential hepatitis B virus reactivation and de novo hepatitis B infection have raised questions about the safety of this approach. This study aimed to evaluate the survival of liver transplant recipients from anti-HBc-positive-donors and assess the risk of hepatitis B reactivation and de novo hepatitis B.

Global perspectives on donor-derived infections: Brazil and Argentina.

Brazil and Argentina are two of the South American countries that perform the highest number of solid organ transplant procedures globally each year. These procedures are not exempt from risks for the recipient, and there is a risk of donor-derived infections. Risk mitigation measures for disease transmission from donor to recipient are essential, and biovigilance systems play a crucial role to inform authorities and provide data for the definition of screening procedures and prevention of donor-derived infections.

En Bloc Simultaneous Liver-Kidney Transplantation Compared to the Traditional Technique: Results From a Single Center.

Background: Simultaneous liver-kidney transplantation is indicated for patients with concomitant end-stage liver disease and end-stage renal disease. The traditional technique involves separate implantations of the liver and the kidney. In the en bloc approach, the liver is recovered en bloc with the right kidney and the donor renal artery is anastomosed to the donor splenic artery.

Nuclear factor kappa-light-chain-enhancer of activated B cells gene expression involvement in porcine liver transplant experimental model.

Purpose: Gene expressions of vascular Endothelial Growth Factor Alpha (VEGFa), Nuclear Factor Kappa-Light-Chain-Enhancer of Activated B cells (NFkB) and cytokines could be useful for identifying potential therapeutic targets to alleviate ischemia-reperfusion injury after liver transplantation. Cytokine gene expressions, VEGFa and NFkB were investigated in a preclinical swine model of liver transplantation.

Methods: A total of 12 pigs were used as donors and recipients in liver transplantation without venovenous bypass or aortic clamping.

BLADDER TRANSPLANTATION: THE NEW FRONTIER IN ABDOMINAL ORGAN TRANSPLANTATION.

Lower urinary tract abnormalities are directly implicated in the etiology of renal dysfunction in 6 to 24% of dialytic patients. These patients require bladder capacity and compliance readjustment before being considered viable candidates for renal transplantation. Vesical augmentation surgeries often involve the use of intestinal segments.

Liver Transplantation for Adenomatosis: A Single-Center Experience.

Background: Liver adenomatosis is characterized by multiple adenomas diffusely distributed throughout the liver parenchyma. Studies addressing liver transplantation for those cases are scarce, and the criteria used to indicate transplantation are still debatable.

Objective: To report a single-center experience of liver transplantation for diffuse adenomatosis.

Retransplantation for Late Hepatic Artery Thrombosis: Results from a Single Center.

Background: Hepatic artery thrombosis is the most common vascular complication of liver transplantation. When occurring late in the postoperative course, it may have no clinical repercussions, and conservative treatment may be implemented. Some patients, however, will develop severe biliary complications due to ischemic cholangiopathy and require retransplantation.

Liver Transplantation for Benign Massive Hepatomegaly: Results From a Single Center and Contribution of the Left-to-Right Piggyback Approach.

Introduction: Polycystic liver disease and giant hepatic hemangioma may present with severe symptom burden and indicate orthotopic liver transplantation. The left-to-right piggyback approach is a useful technique for performing total hepatectomy of enlarged livers.

Objective: The purpose of this study is to analyze the results of liver transplantation in patients with benign massive hepatomegaly.

Life-Threatening Ruptured Hepatic Artery Pseudoaneurysm Post-Liver Transplant: A Case Report.

Background: Hepatic artery pseudoaneurysm after liver transplantation is a rare condition that can lead to spontaneous bleeding, depending on its extent and location. Treatment involves endovascular and surgical approaches in addition to liver retransplantation in cases of graft failure.

Case Report: A 42-year-old female underwent deceased donor liver transplantation due to cryptogenic cirrhosis and schistosomiasis with an uneventful postoperative course.

Impact of COVID-19 pandemic on surgical volume and outcomes in a terciary care center in Brazil.

Backgrounds: COVID-19 pandemic led to a sharp decline in surgical volume worldwide due to the postponement of elective procedures. This study evaluated the impact of COVID-19 pandemic in surgical volumes and outcomes of abdominal surgery in high-risk patients requiring intensive care unit admission.

Methods: patients admitted for postoperative care were retrospectively evaluated.