scholarly journals Safety and Tolerance of Donor-Derived Mesenchymal Stem Cells in Pediatric Living-Donor Liver Transplantation: The MYSTEP1 Study

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Steffen Hartleif ◽  
Michael Schumm ◽  
Michaela Döring ◽  
Markus Mezger ◽  
Peter Lang ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Graft Survival ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Immunosuppressive Treatment ◽  
Pilot Trial ◽  
High Dose ◽  
Donor Liver ◽  
Open Label ◽  
Donor Liver Transplantation

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.

scholarly journals Re-evaluation of the predictive score for 6-month graft survival in living donor liver transplantation in the modern era

2014 ◽  
Vol 20 (3) ◽  
pp. 323-332 ◽  
Author(s):  
Tomoharu Yoshizumi ◽  
Toru Ikegami ◽  
Yuki Bekki ◽  
Mizuki Ninomiya ◽  
Hideaki Uchiyama ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Graft Survival ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Predictive Score ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Modern Era

Complications of Hepatocellular Carcinoma patients post living Donor Liver Transplantation

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ashraf Mahmoud El-Sayed ◽  
Yasmine Mahmoud Massoud ◽  
Ayat Abdallah Abd-Elkalik
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Hepatitis C ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Immunosuppressive Treatment ◽  
Vascular Complications ◽  
Biliary Complications ◽  
Donor Liver ◽  
Donor Liver Transplantation

Abstract Background Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide, accounting for about 1 million related deaths annually. An estimated 372, 000 new cases of hepatocellular carcinoma (HCC) are diagnosed each year, constituting 4.6% of all new human cancers. Objectives The aim of our study was to study the complications of Hepatocellular Carcinoma patients post living Donor Liver Transplantation at Ain Shams Center for Organ Transplantation. Patients and methods The study population underwent Living donor liver Transplanation due to hepatitis C virus related hepatocellular carcinoma during the period from January 2008 to 2019.A total number of 114 patients underwent LDLT due to HCV related hepatocellular carcinoma.Fourteen patients(12.2%) were excluded because of the intraoperative death or postoperative early death, 7 patients(6%) were excluded because of overlapping etiologies with hepatitis C (HBV,autoimmune hepatitis,BCS,…etc) and 11 patients (9.6%) were excluded due to their age.Eighty two patients fulfilling the inclusion criteria for enrollment were recruited in the study. Results The most common complications were (45.1%) neuropsychiatric side effects induced by immunosuppressive treatment, malignancy, hypertension, renal impairment, stroke, small for size disease…etc. Biliary complications (34.1%) as well as sepsis (34.1%) were the second common complications then rejection (18.3%), recurrence (12.2%), death (11%) and vascular complications (10%). Conclusion There was no statistical significance for those within or out side the Milan criteria or UCSF criteria and its impact on the occurrence of graft rejection, sepsis, vascular complications, death, HCC recurrence and biliary complications post-transplant.

scholarly journals Association between neutrophil–lymphocyte ratio change during living donor liver transplantation and graft survival

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jungchan Park ◽  
Seung-Hwa Lee ◽  
Mi Sook Gwak ◽  
Justin Sangwook Ko ◽  
Sangbin Han ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Graft Survival ◽  
Graft Failure ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

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.

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