scholarly journals Liver transplant recipients infected with SARS‐CoV‐2 in the early postoperative period: Lessons from a single center in the epicenter of the pandemic

2020 ◽  
Author(s):  
Daniel Reis Waisberg ◽  
Edson Abdala ◽  
Lucas Souto Nacif ◽  
Luciana Bertocco Haddad ◽  
Liliana Ducatti ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Transplant Recipients ◽  
Single Center ◽  
Liver Transplant Recipients

scholarly journals The Benefit of Sirolimus Maintenance Immunosuppression and Rabbit Antithymocyte Globulin Induction in Liver Transplant Recipients That Develop Acute Kidney Injury in the Early Postoperative Period

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Benjamin T. Duhart ◽  
Winston A. Ally ◽  
Amy G. Krauss ◽  
Joanna Q. Hudson ◽  
James D. Eason ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Liver Transplant ◽  
Postoperative Period ◽  
Antithymocyte Globulin ◽  
Kidney Injury ◽  
Early Postoperative Period ◽  
Transplant Recipients ◽  
Maintenance Immunosuppression ◽  
Rabbit Antithymocyte Globulin ◽  
Liver Transplant Recipients

Published data are limited describing renal outcomes in orthotopic liver transplant (OLT) recipients prescribed sirolimus (SRL) maintenance immunosuppression (MIS) and rabbit antithymocyte globulin (rATG) induction. We investigated whether SRL MIS and rATG induction facilitated recovery of acute kidney injury in the early postoperative period. This retrospective descriptive study screened 308 consecutive OLTs performed between 2006 and 2009. All patients received rATG induction with steroid avoidance. MIS consisted of SRL or TAC with mycophenolate mofetil. A total of 197 patients were included: 168 (85%) received TAC and 29 (15%) received SRL for a median of 365 days. Demographics were similar between groups except for a higher incidence of pretransplant renal dysfunction in the SRL recipients (SRL 59% versus TAC 21%;P<0.05). The eGFR was significantly (P<0.05) higher for all time points in the TAC group with the exception of month 2. However, improvement in eGFR was significantly (P<0.05) greater in the SRL group postoperatively. Our study suggests that rATG induction and SRL maintenance immunosuppression facilitate renal recovery for liver transplant recipients that develop acute kidney injury in the early postoperative period.

scholarly journals Interest in Immunosuppression Withdrawal among Liver Transplant and Autoimmune Hepatitis Patients

2021 ◽  
Vol 12 (2) ◽  
pp. 147-154
Author(s):  
Eden Sharabi ◽  
Allison Carroll ◽  
Peter Cummings ◽  
Josh Levitsky
Keyword(s):  
Decision Making ◽  
Liver Transplant ◽  
Autoimmune Hepatitis ◽  
Immunological Tolerance ◽  
Side Effect Profile ◽  
Transplant Recipients ◽  
Single Center ◽  
Patient Reported ◽  
Liver Transplant Recipients ◽  
Mean Time

Immunosuppression withdrawal (ISW) is considered in liver transplant recipients (LTRs) and autoimmune hepatitis patients (AIHPs). Immunosuppressive therapy (IST) can be burdensome both financially and due to its side effect profile, making ISW an important intervention to consider. Data on patient interest in ISW would be helpful to providers in ISW decision-making. We conducted independent single-center surveys of LTR and AIHP attitudes on IST and withdrawal interest. Of 325 LTRs screened, 120 completed the survey (50% female, mean age 58 ± 14 years, mean time since transplant 8 ± 10.5 years and 79.5% Caucasian). Of 100 AIHPs screened, 45 completed the survey (77.8% female, mean age 54 ± 2 and 82.2% Caucasian). A higher percentage of AIHPs expressed concern with their IST and were interested in ISW compared with LTRs. However, over a third of LTRs were interested in ISW, particularly those with knowledge of this potential intervention. LTRs who discussed ISW with a physician were more likely to desire withdrawal (p = 0.02; OR = 2.781 (95% CI = 1.125, 6.872)). As patient interest in ISW is of growing interest, investigators should continue to assess patient-reported desires and outcomes and pursue strategies to achieve immunological tolerance.

The Impact of Marijuana Use on Liver Transplant Recipients: A 900 Patient Single Center Experience

2021 ◽  
Author(s):  
Jacob Guorgui ◽  
Takahiro Ito ◽  
Daniela Markovic ◽  
Antony Aziz ◽  
Stephanie Younan ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Marijuana Use ◽  
Transplant Recipients ◽  
Single Center ◽  
Single Center Experience ◽  
Liver Transplant Recipients ◽  
The Impact

Sirolimus in Liver Transplant Recipients: A Large Single-Center Experience

2010 ◽  
Vol 42 (7) ◽  
pp. 2579-2584 ◽  
Author(s):  
M. Vivarelli ◽  
A. Dazzi ◽  
A. Cucchetti ◽  
A. Gasbarrini ◽  
M. Zanello ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Transplant Recipients ◽  
Single Center ◽  
Single Center Experience ◽  
Liver Transplant Recipients

Pleural Effusions Following Liver Transplantation: A Single-Center Experience

2020 ◽  
pp. 088506662093244
Author(s):  
Justin K. Lui ◽  
Lidia Spaho ◽  
Shahrad Hakimian ◽  
Michael Devine ◽  
Rosa Bui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Hospital Length Of Stay ◽  
Transplant Recipients ◽  
Single Center ◽  
Pleural Effusions ◽  
Post Transplantation ◽  
Significant Difference ◽  
Liver Transplant Recipients

Introduction: This was a single-center retrospective study to evaluate incidence, prognosis, and risk factors in patients with postoperative pleural effusions, a common pulmonary complication following liver transplantation. Methods: A retrospective review was performed on 374 liver transplantation cases through a database within the timeframe of January 1, 2009 through December 31, 2015. Demographics, pulmonary and cardiac function testing, laboratory studies, intraoperative transfusion/infusion volumes, postoperative management, and outcomes were analyzed. Results: In the immediate postoperative period, 189 (50.5%) developed pleural effusions following liver transplantation of which 145 (76.7%) resolved within 3 months. Those who developed pleural effusions demonstrated a lower fibrinogen (149.6 ± 66.3 mg/dL vs 178.4 ± 87.3 mg/dL; P = .009), total protein (5.8 ± 1.0 mg/dL vs 6.1 ± 1.2 mg/dL; P = .04), and hemoglobin (9.8 ± 1.8 mg/dL vs 10.3 ± 1.9 mg/dL; P = .004). There was not a statistically significant difference in 1-year all-cause mortality and in-hospital mortality between liver transplant recipients with and without pleural effusions. Liver transplant recipients who developed pleural effusions had a longer hospital length of stay (16.4 ± 10.9 days vs 14.0 ± 16.5 days; P = .1), but the differences were not statistically significant. However, there was a significant difference in tracheostomy rates (11.6% vs 5.4%; P = .03) in recipients who developed pleural effusions compared to recipients who did not. Conclusions: In summary, pleural effusions are common after liver transplantation and are associated with increased morbidity. Pre- and intraoperative risk factors can offer both predictive and prognostic value for post-transplantation pleural effusions. Further prospective studies will be needed to further evaluate the relevance of these findings to limit instances of postoperative pleural effusions.

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