(D+10) MELD as a novel predictor of patient and graft survival after adult to adult living donor liver transplantation

2017 ◽  
Vol 31 (5) ◽  
pp. e12939 ◽  
Author(s):  
Arvinder Singh Soin ◽  
Sanjay Goja ◽  
Sanjay Kumar Yadav ◽  
Tseten Yonjen Tamang ◽  
Amit Rastogi ◽  
...  
2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Steffen Hartleif ◽  
Michael Schumm ◽  
Michaela Döring ◽  
Markus Mezger ◽  
Peter Lang ◽  
...  

Background. Calcineurin inhibitors (CNI) have significantly improved patient and graft survival in pediatric liver transplantation (pLT). However, CNI toxicity leads to significant morbidity. Moreover, CNIs cannot prevent long-term allograft injury. Mesenchymal stem (stromal) cells (MSC) have potent immunomodulatory properties, which may promote allograft tolerance and ameliorate toxicity of high-dose CNI. The MYSTEP1 trial aims to investigate safety and feasibility of donor-derived MSCs in pLT. Methods/Design. 7 to 10 children undergoing living-donor pLT will be included in this open-label, prospective pilot trial. A dose of 1 × 106 MSCs/kg body weight will be given at two time points: first by intraportal infusion intraoperatively and second by intravenous infusion on postoperative day 2. In addition, participants will receive standard immunosuppressive treatment. Our primary objective is to assess the safety of intraportal and intravenous MSC infusion in pLT recipients. Our secondary objective is to evaluate efficacy of MSC treatment as measured by the individual need for immunosuppression and the incidence of biopsy-proven acute rejection. We will perform detailed immune monitoring to investigate immunomodulatory effects. Discussion. Our study will provide information on the safety of donor-derived MSCs in pediatric living-donor liver transplantation and their effect on immunomodulation and graft survival.


2014 ◽  
Vol 20 (3) ◽  
pp. 323-332 ◽  
Author(s):  
Tomoharu Yoshizumi ◽  
Toru Ikegami ◽  
Yuki Bekki ◽  
Mizuki Ninomiya ◽  
Hideaki Uchiyama ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jungchan Park ◽  
Seung-Hwa Lee ◽  
Mi Sook Gwak ◽  
Justin Sangwook Ko ◽  
Sangbin Han ◽  
...  

AbstractPreoperative neutrophil–lymphocyte ratio (NLR), has shown a predictive value in living donor liver transplantation (LDLT). However, the change in the NLR during LDLT has not been fully investigated. We aimed to compare graft survival between the NLR increase and decrease during LDLT. From June 1997 to April 2019, we identified 1292 adult LDLT recipients with intraoperative NLR change. The recipients were divided according to NLR change: 103 (8.0%) in the decrease group and 1189 (92.0%) in the increase group. The primary outcome was graft failure in the first year. In addition, variables associated with NLR change during LDLT were evaluated. During 1-year follow-up, graft failure was significantly higher in the decrease group (22.3% vs. 9.1%; hazard ratio 1.87; 95% confidence interval 1.10–3.18; p = 0.02), but postoperative complications did not differ between two groups. This finding was consistent for the overall follow-up. Variables associated with NLR decrease included preoperative NLR > 4, model for end-stage liver disease score, intraoperative inotropic infusion and red blood cell transfusion, and operative duration. The least absolute shrinkage and selection operator model yielded similar results. NLR decrease during LDLT appeared to be independently associated with graft survival. Further studies are needed to confirm our findings.


PLoS ONE ◽  
2014 ◽  
Vol 9 (11) ◽  
pp. e109731 ◽  
Author(s):  
Yoshikuni Kawaguchi ◽  
Yasuhiko Sugawara ◽  
Nobuhisa Akamatsu ◽  
Junichi Kaneko ◽  
Tsuyoshi Hamada ◽  
...  

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