Liver Transplantation at Mayo Clinic Florida.

Clinical transplants Pub Date : 2014-01-01
David D Lee, Kristopher P Croome, Dana K Perry, Justin M Burns, Justin H Nguyen, Andrew P Keaveny, C Burcin Taner
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Abstract

Over the sixteen year history of liver transplantation (LT) at Mayo Clinic in Jacksonville, Florida (MCF), we have maintained a practice devoted to excellence in pre- and post-LT management for patients suffering from end stage liver disease. With an emphasis on quality, MCF has made several adjustments with the goal of better utilizing marginal grafts for both successful post-transplant outcomes and minimizing waitlist mortality. This systematic approach is most exemplified in our experience with donation after cardiac death (DCD) liver allografts. Understanding the events during procurement has been critical to reducing the complications associated with donor warm ischemia time that are unique to DCD allografts. Better matching of donors to recipients has helped identify patients who are safe to receive more marginal grafts with successful patient and graft survival. Recognizing the spectrum of degree of sickness in patients undergoing LT, we implemented a multidisciplinary approach that allows for the avoidance of the intensive care unit after LT. In these ways, MCF continues to distinguish itself as an innovator in the field of transplantation for the benefit of continued better care for our patients suffering from end stage liver disease.

肝移植在佛罗里达州梅奥诊所。
在佛罗里达州杰克逊维尔(Jacksonville, Florida, MCF)梅奥诊所(Mayo Clinic) 16年的肝移植(LT)历史中,我们一直致力于对终末期肝病患者进行肝移植前后的卓越管理。随着对质量的重视,MCF已经做出了一些调整,目标是更好地利用边缘移植物来获得成功的移植后结果,并最大限度地降低候诊死亡率。这种系统的方法在我们的心脏死亡(DCD)后捐赠的同种异体肝脏移植的经验中最具代表性。了解采购过程中的事件对于减少与供体热缺血时间相关的并发症至关重要,这是DCD同种异体移植物所特有的。供体与受者更好的匹配有助于确定安全接受更多边缘移植的患者,并且患者和移植物存活成功。认识到肝移植患者的疾病程度,我们实施了一种多学科方法,允许肝移植后避免重症监护病房。在这些方面,MCF继续作为移植领域的创新者,为我们的终末期肝病患者提供持续更好的护理。
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