Living-donor hepatectomy

BACKGROUND

Organ transplantation from deceased donors is still far below the need. Because of this deficiency, liver transplantations are performed mostly from live donors in many transplant centers in our country. Living-donor liver transplantation (LDLT) has evolved dramatically over the past decade. The aim of this study was to present our clinical experience with living-donor hepatectomy.

METHODS

We retrospectively analyzed all patients who underwent donor hepatectomy between March 2000 and September 2010. We reviewed demographic data, operation type, operation and cold ischemia times, duration of hospital stay, and postoperative complications.

RESULTS

During the study period, 140 living donors underwent operations for liver transplantation. We performed 108 right hepatectomies, 17 left hepatectomies, and 15 left lateral hepatectomies. The mean age of the donors was 30.8 years. There was no operative or postoperative mortality. Overall morbidity rate was 13.57% (n = 19). Nine patients had biliary leakages, 4 biliomas; 2 urinary tract infections, and 1 each inferior vena caval injury, pneumonia, portal vein thrombosis, and acute tubular necrosis. Reoperation was not required in any of these patients.

CONCLUSIONS

Living-donor liver transplantation is a valuable alternative for patients awaiting a cadaver organ. Live-donor hepatectomy can be performed with low morbidity. The greatest disadvantage of this procedure is the risk of the surgical operation for the individual who will experience no medical benefit from this procedure.

Giant retroperitoneal liposarcoma extending into the scrotum: a case report

Liposarcomas are the most common soft-tissue sarcomas in adults. Soft tissue sarcomas can be seen almost every localisation in the body, 10-15% of these are located in the retroperitoneum. Due to their slow growth and lack of specific anatomical compartments, retroperitoneal liposarcomas frequently reach an enormous size long before diagnosis. We describe a case of giant retroperitoneal liposarcoma successfully treated by surgical resection. The interest of our report is that the dimension alone should not be considered a contraindication for surgery and to remind the effectiveness of the first operation is the most important part of the therapy.

Unaltered graft survival and intragraft lymphocytes infiltration in the cardiac allograft of Cxcr3-/- mouse recipients

Previous studies showed that absence of chemokine receptor Cxcr3 or its blockade prolong mouse cardiac allograft survival. We evaluated the effect of the CXCR3 receptor antagonist MRL-957 on cardiac allograft survival, and also examined the impact of anti-CXCR3 mAb in human CXCR3 knock-in mice. We found only a moderate increase in graft survival (10.5 and 16.6 days, p < 0.05) using either the antagonist or the antibody, respectively, compared to control (8.7 days). We re-evaluated cardiac allograft survival with two different lines of Cxcr3(-/-) mice. Interestingly, in our hands, neither of the independently derived Cxcr3(-/-) lines showed remarkable prolongation, with mean graft survival of 9.5 and 10.8 days, respectively. There was no difference in the number of infiltrating mononuclear cells, expansion of splenic T cells or IFN-gamma production of alloreactive T cells. Mechanistically, an increased other chemokine receptor fraction in the graft infiltrating CD8 T cells in Cxcr3(-/-) recipients compared to wild-type recipients suggested compensatory T-cell trafficking in the absence of Cxcr3. We conclude Cxcr3 may contribute to, but does not govern, leukocyte trafficking in this transplant model.

Immediate postimplant hemodialysis through a new “self-sealing” heparin-bonded polycarbonate/urethane graft

BACKGROUND

Immediate accessibility of a newly implanted dialysis graft is desirable to avoid temporary catheters. The most commonly used dialysis graft, expanded polytetrafluorethylene (ePTFE), does not allow early access. This report presents the first clinical data regarding the immediate puncturability of a newly introduced "self-sealing" polycarbonate urethane graft (PUG).

METHODS

Patients implanted with a PUG due to the need for immediate vascular access through their new grafts were followed prospectively for early and late complications.

RESULTS

Five patients who were implanted with a PUG were dialyzed through their grafts within hours after surgery. Dialysis was continued three times per week in each patient, without a puncture-related problem.

CONCLUSION

The availability of a self-sealing graft allowing immediate vascular access on the same day of the implant was achieved with the PUG system. Decreasing the need for temporary catheters may initiate some of the complications associated with hemodialysis.

The effect of diosmin hesperidin on intestinal ischaemia--reperfusion injury

AIM

The effect of Diosmin Hesperidin on intestinal ischaemia reperfusion injury was evaluated in an experimental model in rats.

MATERIAL AND METHODS

Forty Spraque-Dawley rats were divided into 4 groups of (n = 10) (sham, sham + Diosmin Hesperidin, Reperfusion, Reperfusion + Diosmin Hesperidin). Diosmin Hesperidin oral gavage was administrated at a dose of 50 mg/kg to rats 14 and 2 hours before the operation and 30 minutes of ischaemia and 30 minutes of reperfusion was performed in the groups when appropriate. Ileum samples were resected for histopathological evaluation and tissue malondialdehyde (MDA) and myeloperoxidase (MPA) level determination.

RESULTS

Mean mucosal injury score of IR group (4,50+/-0,23) was significantly higher than the other groups (p < 0.05). Although mean mucosal injury score of IR + DH group was higher than sham and sham + DH groups, difference was not statistically significant (p > 0.05). Tissue MDA and MPO activities of IR group were 45,55+/-2.61 nmol/g/wet tissue and 1.68+/-0.25 U/g/wet tissue respectively and were significantly higher than the other groups (p < 0.008). Although tissue MDA and MPO activities of IR + DH group was higher than sham and sham + DH groups, differences were not statistically significant (p > 0.008).

CONCLUSION

Diosmin Hesperidin seems to be effective in the prevention of intestinal reperfusion injury.