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Bonaccorsi-Riani E, Ghinolfi D, Czigany Z, Dondossola D, Emamaullee J, Yuksel M, Boteon YL, Al-Adra D, Ho CM, Abdelrahim M, Pang L, Barbas A, Meier R, MacParland S, Sayed BA, Pavan-Guimaraes J, Brüggenwirth IMA, Zarrinpar A, Mas VR, Selzner M, Martins PN, Bhat M. What Is Hot and New in Basic and Translational Science in Liver Transplantation in 2023? Report of the Basic and Translational Research Committee of the International Liver Transplantation Society. Transplantation 2024; 108:1043-1052. [PMID: 38494468 DOI: 10.1097/tp.0000000000004980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
The 2023 Joint Annual Congress of the International Liver Transplantation Society, European Liver and Intestine Transplant Association, and Liver Intensive Care Group of Europe were held in Rotterdam, the Netherlands, from May 3 to 6, 2023. This year, all speakers were invited to attend the Congress in person for the first time since the COVID-19 pandemic. The congress was attended by 1159 registered delegates from 54 countries representing 5 continents, with the 10 countries comprising the bulk of the delegates. Of the 647 abstracts initially submitted, 542 were eventually presented at the meeting, coming from 38 countries (mainly North America, Europe, and Asia) and 85% of them (462 abstracts) came from only 10 countries. Fifty-three (9.8%) abstracts, originated from 17 countries, were submitted under the Basic/Translational Scientific Research category, a similar percentage as in 2022. Abstracts presented at the meeting were classified as (1) ischemia and reperfusion injury, (2) machine perfusion, (3) bioengineering and liver regeneration, (4) transplant oncology, (5) novel biomarkers in liver transplantation, (6) liver immunology (rejection and tolerance), and (7) artificial intelligence and machine learning. Finally, we evaluated the number of abstracts commented in the Basic and Translational Research Committee-International Liver Transplantation Society annual reports over the past 5 y that resulted in publications in peer-reviewed journals to measure their scientific impact in the field of liver transplantation.
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Affiliation(s)
- Eliano Bonaccorsi-Riani
- Abdominal Transplant Unit, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- Pôle de Chirurgie Expérimentale et Transplantation-Institute de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Davide Ghinolfi
- Division of Hepatic Surgery and Liver Transplantation, University Hospital of Pisa, Pisa, Italy
| | - Zoltan Czigany
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Medical Faculty Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Daniele Dondossola
- General and Liver Transplant Surgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi, Milan, Italy
| | - Juliet Emamaullee
- Department of Surgery, University of Southern California, Los Angeles, CA
| | - Muhammed Yuksel
- Department of Biomedical Sciences, College of Liberal Arts and Life Sciences, University of Westminster, London, United Kingdom
| | - Yuri L Boteon
- Transplant Centre, Hospital São Luiz Itaim, Rede D'OR, São Paulo, Brazil
| | - David Al-Adra
- Division of Transplantation, Department of Surgery, University of Wisconsin-Madison, Madison, WI
| | - Cheng-Maw Ho
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Maen Abdelrahim
- Section of GI Medical Oncology, Department of Medical Oncology, Houston Methodist Cancer Center, Houston, TX
| | - Li Pang
- Organ Transplantation Center, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Andrew Barbas
- Division of Abdominal Transplant Surgery, Department of Surgery, School of Medicine, Duke University, Durham, NC
| | - Raphael Meier
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD
| | - Sonya MacParland
- Ajmera Transplant Centre, Toronto General Research Institute, University Health Network, Toronto, ON, Canada
| | - Blayne Amir Sayed
- Ajmera Transplant Centre, Toronto General Research Institute, University Health Network, Toronto, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Juliana Pavan-Guimaraes
- Department of Surgery, Transplant Division, UMass Memorial Hospital, University of Massachusetts, Worcester, MA
| | | | - Ali Zarrinpar
- Division of Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Florida, Gainesville, FL
| | - Valeria R Mas
- Surgical Sciences Division, University of Maryland School of Medicine, Baltimore, MD
| | - Markus Selzner
- Ajmera Transplant Centre, Toronto General Research Institute, University Health Network, Toronto, ON, Canada
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Paulo N Martins
- Department of Surgery, Transplant Division, UMass Memorial Hospital, University of Massachusetts, Worcester, MA
| | - Mamatha Bhat
- Ajmera Transplant Centre, Toronto General Research Institute, University Health Network, Toronto, ON, Canada
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
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Jones O, Claasen MP, Ivanics T, Choi WJ, Gavaria F, Rajendran L, Ghanekar A, Hirschfield G, Gulamhusein A, Shwaartz C, Reichman T, Sayed BA, Selzner M, Bhat M, Tsien C, Jaeckel E, Lilly L, McGilvray ID, Cattral MS, Selzner N, Sapisochin G. Pursuing living donor liver transplantation improves outcomes of patients with autoimmune liver diseases - An intention-to-treat analysis. Liver Transpl 2024:01445473-990000000-00360. [PMID: 38619393 DOI: 10.1097/lvt.0000000000000374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/01/2024] [Indexed: 04/16/2024]
Abstract
Background Living donor liver transplantation (LDLT) offers the opportunity to decrease waitlist time and mortality for patients with AILD; autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC). We compared the survival of patients with a potential live donor (pLDLT) on the waitlist vs. no potential live donor (pDDLT), on an intention-to-treat (ITT) basis. Methods Our retrospective cohort study investigated adults with AILD listed for liver transplant at our program between 2000 and 2021. The pLDLT group comprised recipients with a potential live donor. Otherwise, they were included in the pDDLT group. ITT survival was assessed from the time of listing. Results Of the 533 patients included, 244(43.8%) had a potential living donor. Waitlist dropout was higher for the pDDLT groups among all AILDs (pDDLT 85[29.4%] vs. pLDLT 9[3.7], p<0.001). The 1-, 3- and 5-year ITT survival rates were higher for pLDLT vs. pDDLT among all AILDs (95.7%vs.78.1%, 89.0%vs.70.1%, and 87.1%vs.65.5%, p<0.001). After adjusting for covariates, pLDLT was associated with a 38% reduction in the risk of death among the AILD cohort (HR:0.62, 95%CI:0.42-0.93[p<0.05]), and 60% among the PSC cohort (HR:0.40, 95%CI:0.22-0.74[p<0.05]). There were no differences in the 1-, 3- and 5-year post-transplant survival between LDLT and DDLT (AILD: 95.6%vs.92.1%, 89.9%vs.89.4%, and 89.1%vs. 87.1%, p=0.41). This was consistent after adjusting for covariates (HR: 0.97, 95%CI:0.56-1.68[p>0.9]). Conclusion Our study suggests that having a potential live donor could decrease the risk of death in patients with PSC on the waitlist. Importantly, the post-transplant outcomes in this population are similar between the LDLT and DDLT groups.
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Affiliation(s)
- Owen Jones
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
| | - Marco Paw Claasen
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
- Department of Surgery, division of HPB & Transplant Surgery, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Tommy Ivanics
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
- Department of Surgery, Henry Ford Hospital, Detroit, Michigan, United States of America
- Department of Surgical Sciences, Akademiska Sjukhuset, Uppsala University, Uppsala, Sweden
| | - Woo Jin Choi
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Ontario, Canada
| | - Felipe Gavaria
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
| | - Luckshi Rajendran
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Ontario, Canada
| | - Anand Ghanekar
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
| | - Gideon Hirschfield
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
| | - Aliya Gulamhusein
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
| | - Chaya Shwaartz
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
| | - Trevor Reichman
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
| | - Blayne Amir Sayed
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
| | - Markus Selzner
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
| | - Mamatha Bhat
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
| | - Cynthia Tsien
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
| | - Elmar Jaeckel
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
| | - Les Lilly
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
| | - Ian D McGilvray
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
| | - Mark S Cattral
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
| | - Nazia Selzner
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
| | - Gonzalo Sapisochin
- Ajmera Transplant Center, University Health Network Toronto, Ontario, Canada
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Ray S, Shwaartz C, Sayed BA, Sapisochin G, Ghanekar A, McGilvray I, Cattral M, Lilly L, Selzner N, Tsien C, Bhat M, Jaeckel E, Selzner M, Reichman TW. Should advanced donor age be a deterrent in the utilization of grafts from donation after cardiac death in deceased donor liver transplantation? The Toronto experience. Can J Surg 2023; 66:E561-E571. [PMID: 38016726 DOI: 10.1503/cjs.001123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Advanced donor age paired with donation after cardiac death (DCD) increases the risk of transplantation, precluding widespread use of grafts from such donors worldwide. Our aim was to analyze outcomes of liver transplantation using grafts from older DCD donors and donation after brain death (DBD) donors. METHODS Patients who underwent liver transplantation using grafts from deceased donors between January 2016 and December 2021 were included in the study. Short-and long-term outcomes were analyzed for 4 groups of patients: those who received DCD and DBD grafts from younger (< 50 yr) and older (≥ 50 yr) donors. RESULTS Of the 807 patients included in the analysis, 44.7% (n = 361) of grafts were received from older donors, with grafts for older DCD donors comprising 4.7% of the total cohort (n = 38). Patients who received grafts from older donors had a lower incidence of biliary strictures than those who received grafts from younger donors (7.9% v. 20.0% for DCD donation, p = 0.14, and 4.9% v. 6.8% for DBD donation, p = 0.34), with a significantly lower incidence of ischemic-type biliary strictures in patients who received grafts from older versus younger DCD donors (2.6% v. 18.0%, p = 0.04). There was no difference in 1- and 3-year graft survival rates among patients who received grafts from older and younger DCD donors (92.1% v. 90.8% and 80.2% v. 80.9%, respectively) and those who received grafts from older and younger DBD donors (90.1% v. 93.2% and 85.3% v. 84.4%, respectively) (p = 0.85). Pretransplantation admission to the intensive care unit (hazard ratio [HR] 9.041, p < 0.001) and nonalcoholic steatohepatitis (HR 2.197, p = 0.02) were found to significantly affect survival of grafts from older donors. CONCLUSION Donor age alone should not be the criterion to determine the acceptability of grafts in liver transplantation. With careful selection criteria, older DCD donors could make a valuable contribution to expanding the liver donor pool, with grafts that produce comparable results to those obtained with standard-criteria grafts.
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Affiliation(s)
- Samrat Ray
- From the Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ont. (Ray, Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman); and the Department of Surgery, University of Toronto, Toronto, Ont. (Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman)
| | - Chaya Shwaartz
- From the Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ont. (Ray, Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman); and the Department of Surgery, University of Toronto, Toronto, Ont. (Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman)
| | - Blayne Amir Sayed
- From the Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ont. (Ray, Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman); and the Department of Surgery, University of Toronto, Toronto, Ont. (Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman)
| | - Gonzalo Sapisochin
- From the Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ont. (Ray, Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman); and the Department of Surgery, University of Toronto, Toronto, Ont. (Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman)
| | - Anand Ghanekar
- From the Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ont. (Ray, Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman); and the Department of Surgery, University of Toronto, Toronto, Ont. (Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman)
| | - Ian McGilvray
- From the Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ont. (Ray, Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman); and the Department of Surgery, University of Toronto, Toronto, Ont. (Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman)
| | - Mark Cattral
- From the Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ont. (Ray, Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman); and the Department of Surgery, University of Toronto, Toronto, Ont. (Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman)
| | - Leslie Lilly
- From the Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ont. (Ray, Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman); and the Department of Surgery, University of Toronto, Toronto, Ont. (Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman)
| | - Nazia Selzner
- From the Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ont. (Ray, Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman); and the Department of Surgery, University of Toronto, Toronto, Ont. (Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman)
| | - Cynthia Tsien
- From the Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ont. (Ray, Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman); and the Department of Surgery, University of Toronto, Toronto, Ont. (Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman)
| | - Mamatha Bhat
- From the Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ont. (Ray, Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman); and the Department of Surgery, University of Toronto, Toronto, Ont. (Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman)
| | - Elmar Jaeckel
- From the Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ont. (Ray, Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman); and the Department of Surgery, University of Toronto, Toronto, Ont. (Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman)
| | - Markus Selzner
- From the Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ont. (Ray, Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman); and the Department of Surgery, University of Toronto, Toronto, Ont. (Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman)
| | - Trevor W Reichman
- From the Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ont. (Ray, Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman); and the Department of Surgery, University of Toronto, Toronto, Ont. (Schwaartz, Sayed, Sapisochin, Ghanekar, McGilvray, Cattral, Lilly, N. Selzner, Tsien, Bhat, Jaeckel, M. Selzner, Reichman)
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Ray S, Torres-Hernandez A, Bleszynski MS, Parmentier C, McGilvray I, Sayed BA, Shwaartz C, Cattral M, Ghanekar A, Sapisochin G, Tsien C, Selzner N, Lilly L, Bhat M, Jaeckel E, Selzner M, Reichman TW. Medical Assistance in Dying (MAiD) as a Source of Liver Grafts: Honouring the Ultimate Gift. Ann Surg 2023; 277:713-718. [PMID: 36515405 DOI: 10.1097/sla.0000000000005775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To report the clinical outcomes of liver transplants from donors after medical assistance in dying (MAiD) versus donors after cardiac death (DCD) and deceased brain death (DBD). SUMMARY BACKGROUND DATA In North America, the number of patients needing liver transplants exceeds the number of available donors. In 2016, MAiD was legalized in Canada. METHODS All patients undergoing deceased donor liver transplantation at Toronto General Hospital between 2016 and 2021 were included in the study. Recipient perioperative and postoperative variables and donor physiological variables were compared among 3 groups. RESULTS Eight hundred seven patients underwent deceased donor liver transplantation during the study period, including DBD (n=719; 89%), DCD (n=77; 9.5%), and MAiD (n=11; 1.4%). The overall incidence of biliary complications was 6.9% (n=56), the most common being strictures (n=55;6.8%), highest among the MAiD recipients [5.8% (DBD) vs. 14.2% (DCD) vs. 18.2% (MAiD); P =0.008]. There was no significant difference in 1 year (98.4% vs. 96.4% vs. 100%) and 3-year (89.3% vs. 88.7% vs. 100%) ( P =0.56) patient survival among the 3 groups. The 1- and 3- year graft survival rates were comparable (96.2% vs. 95.2% vs. 100% and 92.5% vs. 91% vs. 100%; P =0.37). CONCLUSION With expected physiological hemodynamic challenges among MAiD and DCD compared with DBD donors, a higher rate of biliary complications was observed in MAiD donors, with no significant difference noted in short-and long-term graft outcomes among the 3 groups. While ethical challenges persist, good initial results suggest that MAiD donors can be safely used in liver transplantation, with results comparable with other established forms of donation.
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Affiliation(s)
- Samrat Ray
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network
| | | | | | | | - Ian McGilvray
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Blayne Amir Sayed
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Chaya Shwaartz
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Mark Cattral
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Anand Ghanekar
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Gonzalo Sapisochin
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Cynthia Tsien
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Nazia Selzner
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Leslie Lilly
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Mamatha Bhat
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Elmar Jaeckel
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Markus Selzner
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Trevor W Reichman
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
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Patel MS, Ghanekar A, Sayed BA, Sapisochin G, McGilvray I, Raschzok N, Reichman T, Selzner M, Galvin Z, Bhat M, Stunguris J, Ng VL, Lilly L, Selzner N, Cattral MS. Liver Retransplantation Using Living Donor Grafts: A Western Experience. Liver Transpl 2022; 28:887-890. [PMID: 34597461 DOI: 10.1002/lt.26314] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/10/2021] [Accepted: 09/08/2021] [Indexed: 02/04/2023]
Affiliation(s)
- Madhukar S Patel
- Multi Organ Transplant Program, Ajmera Family Transplant Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Anand Ghanekar
- Multi Organ Transplant Program, Ajmera Family Transplant Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Blayne Amir Sayed
- Multi Organ Transplant Program, Ajmera Family Transplant Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Gonzalo Sapisochin
- Multi Organ Transplant Program, Ajmera Family Transplant Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Ian McGilvray
- Multi Organ Transplant Program, Ajmera Family Transplant Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Nathanael Raschzok
- Multi Organ Transplant Program, Ajmera Family Transplant Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Trevor Reichman
- Multi Organ Transplant Program, Ajmera Family Transplant Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Markus Selzner
- Multi Organ Transplant Program, Ajmera Family Transplant Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Zita Galvin
- Multi Organ Transplant Program, Ajmera Family Transplant Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Mamatha Bhat
- Multi Organ Transplant Program, Ajmera Family Transplant Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Jennifer Stunguris
- Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada
| | - Vicky L Ng
- Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada
| | - Les Lilly
- Multi Organ Transplant Program, Ajmera Family Transplant Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Nazia Selzner
- Multi Organ Transplant Program, Ajmera Family Transplant Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Mark S Cattral
- Multi Organ Transplant Program, Ajmera Family Transplant Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
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Yamoto M, Chusilp S, Alganabi M, Sayed BA, Pierro A. Meso-Rex bypass versus portosystemic shunt for the management of extrahepatic portal vein obstruction in children: systematic review and meta-analysis. Pediatr Surg Int 2021; 37:1699-1710. [PMID: 34714410 DOI: 10.1007/s00383-021-04986-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/01/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE Extrahepatic portal vein obstruction (EHPVO) is a major cause of non-cirrhotic portal hypertension in children. Surgical procedures for EHPVO include portosystemic shunts (PSS) and meso-Rex bypass (MRB). We conducted a systematic review and meta-analysis to compare the effectiveness of MRB versus PSS in EHPVO patients. METHODS A systematic literature search was performed using four databases. Articles reporting EHPVO and comparing patients who received MRB and PSS were included in the analysis. RESULTS We retrieved 851 papers, of which five observational studies met the inclusion criteria. There was no difference in shunt complications, mortality, or gastrointestinal bleeding after surgery between MRB and PSS in the meta-analysis. MRB had increased shunt complications compared with PSS in the non-comparative studies. MRB had a potential advantage over PSS in long-term prognosis in one comparative study. Overall, the quality of the evidence was low. CONCLUSIONS Based on available data, our meta-analysis indicates that MRB does not increase shunt complications, mortality, or gastrointestinal bleeding after surgery. The present study did not reveal superiority for either MRB or PSS. The paucity of well conducted trials in this area justifies future multicenter studies and studies that examine long-term outcomes.
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Affiliation(s)
- Masaya Yamoto
- Division of General and Thoracic Surgery, Translational Medicine, The Hospital for Sick Children, 1526-555 University Ave., Toronto, ON, M5G 1X8, Canada.,Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Sinobol Chusilp
- Division of General and Thoracic Surgery, Translational Medicine, The Hospital for Sick Children, 1526-555 University Ave., Toronto, ON, M5G 1X8, Canada.,Division of Pediatric Surgery, Department of Surgery, Khon Kaen University, Khon Kaen, Thailand
| | - Mashriq Alganabi
- Division of General and Thoracic Surgery, Translational Medicine, The Hospital for Sick Children, 1526-555 University Ave., Toronto, ON, M5G 1X8, Canada
| | - Blayne Amir Sayed
- Division of General and Thoracic Surgery, Translational Medicine, The Hospital for Sick Children, 1526-555 University Ave., Toronto, ON, M5G 1X8, Canada.,Division of General Surgery, Department of Surgery, Toronto General Hospital-University Health Network, Toronto, ON, Canada
| | - Agostino Pierro
- Division of General and Thoracic Surgery, Translational Medicine, The Hospital for Sick Children, 1526-555 University Ave., Toronto, ON, M5G 1X8, Canada.
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Waldron LS, Cerisuelo MC, Lo D, Sayed BA, Vilca-Melendez H, Magliocca J, Lurz E, Baumann U, Vondran FWR, Richter N, von Schweinitz D, Guba M, Muensterer OJ, Berger M. Diaphragmatic Hernia following Pediatric Liver Transplantation: An Underappreciated Complication Prone to Recur. Eur J Pediatr Surg 2021; 31:396-406. [PMID: 33186999 DOI: 10.1055/s-0040-1716882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Postoperative diaphragmatic hernia (DH) is a rare but potentially life-threatening complication following pediatric liver transplantation (LT). In the current literature, a total of 49 such hernias have been reported in 17 case series. We present eight additional cases, three of which reoccurred after surgical correction, and review the current literature with a focus on recurrence. MATERIALS AND METHODS The study sample included children (<18 years of age) who underwent LT between June 2013 and June 2020 at five large transplant centers and who subsequently presented with DH. During the study period, a total of 907 LT was performed. Eight DH were recognized, and risk factors were analyzed. RESULTS For the eight children with DH, the mean age at LT was 28.0 (5-132) months. All patients with a DH received left lateral segment split grafts except one, who received a full left lobe. The mean weight at time of LT was 11.8 (6.6-34) kg. Two patients had a primary abdominal muscle closure, and six had a temporary silastic mesh closure. All eight children presented with a right posterolateral DH. The small bowel was herniated in the majority of cases. Symptoms reported included nausea, vomiting, and respiratory distress. Two patients were asymptomatic, and discovery was incidental. All patients underwent prompt primary surgical repair. Three DH hernias (37.5%) recurred despite successful surgical correction. CONCLUSION DH following liver transplant with technical variant grafts may be underreported and is prone to recur despite surgical correction. A better understanding of the pathophysiology and more thorough reporting may help increase awareness. Early detection and prompt surgical management are the cornerstones of a successful outcome.
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Affiliation(s)
- Lea Sibylle Waldron
- Department of Pediatric Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.,Department of Pediatrics, Hospital of the Philipps-University Marburg, Marburg, Germany
| | - Miriam Cortes Cerisuelo
- Liver Transplant Surgery, Institute of Liver Studies, King's College Hospital, National Health Service Foundation Trust, London, United Kingdom
| | - Denise Lo
- Emory Transplant Center, Emory University, Atlanta, United States
| | - Blayne Amir Sayed
- Department of Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Hector Vilca-Melendez
- Liver Transplant Surgery, Institute of Liver Studies, King's College Hospital, National Health Service Foundation Trust, London, United Kingdom
| | - Joseph Magliocca
- Emory Transplant Center, Emory University, Atlanta, United States
| | - Eberhard Lurz
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Dr. von Hauner Children's Hospital, Ludwig-Maximillians-University, Munich, Germany
| | - Ulrich Baumann
- Department of Pediatric Gastroenterology, Hannover Medical School, Hannover, Germany.,Institute for Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
| | - Florian W R Vondran
- Department for General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Niedersachsen, Germany
| | - Nicolas Richter
- Department for General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Niedersachsen, Germany
| | - Dietrich von Schweinitz
- Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximillians-University, Munich, Germany
| | - Markus Guba
- Department of General, Visceral and Transplant Surgery, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Oliver J Muensterer
- Department of Pediatric Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.,Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximillians-University, Munich, Germany
| | - Michael Berger
- Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximillians-University, Munich, Germany
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Abstract
Although mast cells have long been considered the integral effector cell in allergy and atopic disease, the paradigm of mast cell function is now evolving to incorporate data showing that mast cells make innumerable contributions to both protective and pathologic immune responses. Mast cells express cell surface molecules with costimulatory or co-inhibitory activity and produce a multitude of mediators that can direct dendritic cell (DC) or T-cell differentiation and function. In addition, mast cells exhibit a widespread distribution and are in close proximity to DCs and T cells at several critical sites. While there has been amazing progress in characterizing mast cell populations in vitro, only recently has the ability to monitor their in vivo effects become a reality. In this review, we discuss the evolution of our understanding of mast cell biology with an emphasis on their established and hypothesized roles in influencing T-cell differentiation and function. The fact that T-cell and mast cell interactions exist and are a normal component of most adaptive immune responses is one of the best illustrations of the now established concept that innate and adaptive immunity are not completely independent entities.
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Affiliation(s)
- Blayne Amir Sayed
- Department of Microbiology and Immunology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
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Haines GK, Sayed BA, Rohrer MS, Olivier V, Satchell KJF. Role of toll-like receptor 4 in the proinflammatory response to Vibrio cholerae O1 El tor strains deficient in production of cholera toxin and accessory toxins. Infect Immun 2005; 73:6157-64. [PMID: 16113340 PMCID: PMC1231125 DOI: 10.1128/iai.73.9.6157-6164.2005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Following intranasal inoculation, Vibrio cholerae KFV101 (DeltactxAB DeltahapA DeltahlyA DeltartxA) colonizes and stimulates tumor necrosis factor alpha and interleukin 1beta (IL-1beta) in mice, similar to what occurs with isogenic strain P4 (DeltactxAB), but is less virulent and stimulates reduced levels of IL-6, demonstrating a role for accessory toxins in pathogenesis. Morbidity is enhanced in C3H/HeJ mice, indicating that Toll-like receptor 4 is important for infection containment.
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Affiliation(s)
- G Kenneth Haines
- Northwestern University, Dept. of Microbiology-Immunology, 303 E. Chicago Avenue, Tarry 3-713, Chicago, IL 60611, USA
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Abstract
Analysis of 4500 cases of malignancy encountered in a general hospital in Western India showed that: (1) parts of buccopharynx were the site involved in nearly 25 per cent of these cases. In women the incidence of buccopharyngeal carcinoma was less than in men but was not insignificant (nearly 5 per cent of all malignancies found in women); (2) the cervix was the next frequent site involved accounting for 22 per cent of the total and 80 per cent of the female cancer; (3) cancer of breast was not less common (5 per cent of the total and 12 per cent of the female cancer); (4) oesophageal cancer was far more common than malignant neoplastic lesions of the other parts of the gastrointestinal tract (two-thirds of all cases being found in the oesophagus); (5) carcinoma of skin was not a common lesion.High frequency of the types of cancer mentioned in the first two paragraphs is a "ommon facto" of many such reports from India. On the other hand, reported incidences of the types mentioned in the paragraphs number (3), (4) and (5) show wide variations in different parts of the country.
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Datti SP, Sayed BA, Desouza TJ. Adenomyosis uteri. J Indian Med Assoc 1970; 55:189-194. [PMID: 5501465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Sahgal KN, Balar DB, Vyas BK, Sayed BA. Sieracki bodies: earliest lesion in Whipple's disease? Indian J Pathol Bacteriol 1967; 10:123-6. [PMID: 6041966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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13
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Shah MS, Sayed BA, D'Souza TJ. A bacteriological study of diarrheal disease. Indian J Med Sci 1966; 20:933-40. [PMID: 5980155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Patel IU, D'Souza TJ, Sayed BA. A bacteriological study of Mycobacterium tuberculosis in Baroda. Indian J Med Sci 1966; 20:924-32. [PMID: 4962882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Sayed BA. Molluscum sebaceum. Indian J Med Sci 1966; 20:801-4. [PMID: 5979235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Balar DB, Sahgal KN, Sayed BA. The connective tissue hyalin. 1. Hyaline deposits in tuberculous lymphnodes. Indian J Pathol Bacteriol 1966; 9:46-7. [PMID: 4159512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Byakod BG, Dave BT, Gulati OD, Gokhaie SD, Sayed BA. Clinical evaluation of lincomycin, a new antibiotic. Chemotherapy 1965; 10:53-60. [PMID: 5323855 DOI: 10.1159/000220394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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