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The Host Response to Grafts and Transplantation Immunology
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
The most serious impediment to liver transplantation is the technical complexity of the surgical procedure, rather than control of subsequent rejection. Indeed, livers are not easily rejected. The large liver mass may overwhelm or absorb the immune responses directed at it. Nonetheless, liver transplant recipients must be immunosuppressed if rejection is to be avoided.
Transplant Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
David van Dellen, Zia Moinuddin, Hussein Khambalia, Brian KP Goh
Tests results: compatible with acute-on-chronic liver disease from hepatitis B flare and started on anti-viral treatment. Scans show solitary 6.0 cm HCC in right lobe. Managing surgeons and hepatologists decide that an urgent liver transplant is his best chance of survival and to list for deceased-donor liver transplant. What are the criteria which determine the priority for listing in Singapore?Status 1/highest priority (can cross blood groups)ABO blood group compatible: based on MELD score/waiting time
Prevention of pre-eclampsia
Published in Pankaj Desai, Pre-eclampsia, 2020
On the other hand, viral hepatitis seemingly has no cure. But from medical science, it is a known viral disease. Once the viral load is overwhelmed by the body’s resistance mechanisms, the disease gets cured. Like anaemia, jaundice can also be a derangement. Types of liver derangements, which result from factors that produce a permanent dysfunction of liver function as in hepatitis C are derangements. They elude a cure. A liver transplant replaces the dead liver tissue by a healthy and functioning new hepatic tissue. But that is not a cure for the original disease. It is just a circumvention of the diseased system.
Distribution and progression of cerebral amyloid angiopathy in early-onset V30M (p.V50M) hereditary ATTR amyloidosis
Published in Amyloid, 2023
Yusuke Takahashi, Kazuhiro Oguchi, Yusuke Mochizuki, Ken Takasone, Naoki Ezawa, Akira Matsushima, Nagaaki Katoh, Masahide Yazaki, Yoshiki Sekijima
The annual SUVR increase rate in female patients (0.013/year) (Figure 2(A)) was significantly higher than in male patients (0.006/year, p = .023) (Figure 2(B) and Table 2). In addition, the annual SUVR increase rate tended to be greater in patients without disease-modifying pharmacological therapies (0.009/year) (Figure 2(C)) than in those with pharmacological therapies (0.005/year) (Figure 2(D) and Table 2), although this difference was not significant (p = .276). The 20 patients without disease-modifying pharmacological therapies included 18 post-liver transplant patients and 2 treatment naïve patients. Among the 14 pharmacological treatment patients, tafamidis was administered to 12 patients (treatment duration: 7 − 90 months, mean: 50.0 ± 27.2 months), patisiran was administered to 7 patients (treatment duration: 12 − 50 months, mean: 25.0 ± 12.4 months), diflunisal was administered to 3 patients (treatment duration: 23, 38, and 74 months, respectively) and vutrisiran was administered to 1 patient (treatment duration: 12 months).
Growth through adversity: posttraumatic growth in anonymous living liver donors
Published in Disability and Rehabilitation, 2022
Sandra Krause, Cheryl Pritlove, Susan Abbey, Judy Jung
Approximately 5–25% of those waiting to receive a liver transplant die while on the transplant waiting list [1–4]. Living liver donation – a surgical procedure wherein a healthy individual donates a portion of their liver to someone in need of a transplant – has been used in some places to mitigate the issue of the shortage of deceased donor livers. Living liver donation carries a significantly greater risk than living kidney donation, involving a major 5- to 8-h surgery with a recovery time of approximately 6 weeks, during which time patients experience significant pain and discomfort [5,6]. Though research on the psychological impacts of living liver donation surgery on donors is scarce, some evidence has found reduced mental quality of life, and higher rates of anxiety and depression in living liver donors as compared to healthy controls [7]. Of the approximately 3000, adult liver transplants conducted at University Health Network (Toronto, Canada) since 1985, there have been approximately 800 living liver donations, approximately 50 of which have been anonymous living liver donations (i.e., donors whose identity was not made known to their recipient prior to donation) [6].
Therapeutic Potential of HNF4α in End-stage Liver Disease
Published in Organogenesis, 2021
Ricardo Diaz-Aragon, Michael C. Coard, Sriram Amirneni, Lanuza Faccioli, Nils Haep, Michelle R. Malizio, Takashi Motomura, Zehra N. Kocas-Kilicarslan, Alina Ostrowska, Rodrigo M. Florentino, Carla Frau
Currently, medical therapy of ESLD involves mitigation of risk factors, nutritional support coupled with the avoidance of harmful medications, and avoidance of high risk, low reward procedures.4 Medical interventions can increase life expectancy, but OLT remains the only definitive treatment for ESLD.5 However, liver transplantation is extremely limited due to a shortage of donor livers. According to data collected by the Organ Procurement and Transplantation Network, less than half (49.0%) of waiting list registrants listed in 2018 received a deceased donor liver transplant within one year. Additionally, from 2014 to 2016, only 56.0% of adult liver transplant candidates had undergone the necessary transplant.6 This critical situation is further exacerbated by a forecasted increase in the cost of liver transplantation in the near future.5