Updates in Surgery最新文献_第4页

Survival benefit of living donor liver transplant for patients with hepatocellular carcinoma. 活体肝移植对肝细胞癌患者生存的益处。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2025-10-01 Epub Date: 2024-07-22 DOI: 10.1007/s13304-024-01947-8

Sarah R Kaslow, Alejandro Torres-Hernandez, Feng Su, AnnMarie Liapakis, Adam Griesemer, Karim J Halazun

引用次数: 0

Technical note: biliary reconstruction in living-donor liver transplant. 技术说明：活体肝移植中的胆道重建。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2025-10-01 Epub Date: 2025-03-09 DOI: 10.1007/s13304-024-02057-1

Henrik Petrowsky, Cristiano Guidetti, Stefano Di Sandro, Fabrizio Di Benedetto

引用次数: 0

Pre-operative assessment of living liver donors' liver anatomy and volumes. 对活体肝脏捐献者的肝脏解剖结构和体积进行术前评估。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2025-10-01 Epub Date: 2024-03-25 DOI: 10.1007/s13304-024-01806-6

Nicolas Goldaracena, Paola A Vargas, Lucas McCormack

{"title":"Pre-operative assessment of living liver donors' liver anatomy and volumes.","authors":"Nicolas Goldaracena, Paola A Vargas, Lucas McCormack","doi":"10.1007/s13304-024-01806-6","DOIUrl":"10.1007/s13304-024-01806-6","url":null,"abstract":"Decades of experience supports LDLT as a favorable strategy to reduce waitlist mortality. The multiple regenerative pathways of hepatocytes and other hepatic cells justify the rationale behind it. Nonetheless, living liver donation is still underused and its broader implementation is challenging, mostly due to variability in practices leading to concerns related to donor safety. A non-systematic literature search was conducted for peer-reviewed original articles related to pre-operative evaluation of living liver donor candidates. Eligible studies were synthesized upon consensus for discussion in this up-to-date review. Review of the literature demonstrate that the importance of preoperative assessment of vascular, biliary and liver volume to ensure donor safety and adequate surgical planning for graft procurement is widely recognized. Moreover, data indicates that anatomic variants in vascular and biliary systems in healthy donors are common, present in up to 50% of the population. Therefore, comprehensive mapping and visualizations of each component is needed. Different imaging modalities are reported across practices and are discussed in detail. Lastly, assessment of liver volume must take into account several technical and donor factors that increase the chances of errors in volume estimation, which occurs in up to 10% of the cases. Experience suggests that maximizing donor safety and lessening their risks is a result of integrated experience between hepatobiliary and transplant surgery, along with multidisciplinary efforts in performing a comprehensive pre-operative donor assessment. Although technical advances have increased the accuracy of volume estimation, over- or under-estimation remains a challenge that needs further attention.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"1729-1744"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140288995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The long-term follow-up of the living liver donors. 活体肝脏捐献者的长期随访。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2025-10-01 Epub Date: 2024-06-26 DOI: 10.1007/s13304-024-01894-4

Riccardo De Carlis, Gabriele Di Lucca, Andrea Lauterio, Leonardo Centonze, Luciano De Carlis

{"title":"The long-term follow-up of the living liver donors.","authors":"Riccardo De Carlis, Gabriele Di Lucca, Andrea Lauterio, Leonardo Centonze, Luciano De Carlis","doi":"10.1007/s13304-024-01894-4","DOIUrl":"10.1007/s13304-024-01894-4","url":null,"abstract":"Living donor liver transplantation (LDLT) has been proposed in many countries to reduce organ shortage. While the early postoperative outcomes have been well investigated, little is known about the long-term follow-up of the living donors. We, therefore, designed a systematic review of the literature to explore long-term complications and quality of life among living donors. We searched MEDLINE and EMBASE registries for studies published since 2013 that specifically addressed long-term follow-up following living-donor liver donation, concerning both physical and psychological aspects. Publications with a follow-up shorter than 1 year or that did not clearly state the timing of outcomes were excluded. A total of 2505 papers were initially identified. After a thorough selection, 17 articles were identified as meeting the eligibility criteria. The selected articles were mostly from North America and Eastern countries. Follow-up periods ranged from 1 to 11.5 years. The most common complications were incision site discomfort (13.2-38.8%) and psychiatric disorders (1-22%). Biliary strictures occurred in 1-14% of cases. Minimally invasive donor hepatectomy could improve quality of life, but long-term data are limited. About 30 years after the first reported LDLT, little has been published about the long-term follow-up of the living donors. Different factors may contribute to this gap, including the fact that, as healthy individuals, living donors are frequently lost during mid-term follow-up. Although the reported studies seem to confirm long-term donor safety, further research is needed to address the real-life long-term impact of this procedure.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"1767-1775"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Actual perspectives on LDLT in Europe. 欧洲 LDLT 的实际前景。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2025-10-01 Epub Date: 2024-07-04 DOI: 10.1007/s13304-024-01933-0

Stefanie Josefine Hehl, Henrik Petrowsky, Silvio Nadalin

引用次数: 0

The small-for-size syndrome in living donor liver transplantation: current management. 活体肝移植中的 "小尺寸综合征"：目前的管理方法。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2025-10-01 Epub Date: 2024-10-29 DOI: 10.1007/s13304-024-01964-7

Luca Del Prete, Cristiano Quintini, Teresa Diago Uso

{"title":"The small-for-size syndrome in living donor liver transplantation: current management.","authors":"Luca Del Prete, Cristiano Quintini, Teresa Diago Uso","doi":"10.1007/s13304-024-01964-7","DOIUrl":"10.1007/s13304-024-01964-7","url":null,"abstract":"Small-for-size syndrome poses a significant challenge in living donor liver transplantation, with potentially severe consequences including liver failure and death. This review explores the management strategies for SFSS, starting from the pathophysiology of the disease. SFSS arises from insufficient liver mass in the graft and hyperdynamic circulation in cirrhotic recipients, leading to portal hyperperfusion and subsequent liver injury. Risk factors include graft size, quality, recipient factors, and hemodynamic changes during transplantation.Hemodynamic monitoring is crucial during living donor liver transplantation to optimize portal vein and hepatic artery flow. Prevention strategies focus on donor-recipient matching and intraoperative graft inflow modulation. Optimizing venous outflow and avoiding portal hyperperfusion is essential. Management of established small-for-size syndrome involves supportive care, pharmacologic interventions, and radiological and surgical options. Pharmacotherapy includes somatostatin analogues, beta-blockers, and vasopressin analogues to reduce portal flow and pressure. Surgical interventions aim to modulate portal flow and mitigate complications. Retransplantation may be necessary in severe cases, guided by persistent graft dysfunction despite liver flow modulations. In conclusion, preventing and managing small-for-size syndrome in living donor liver transplantation requires comprehensive assessment and tailored interventions. Advancements in graft/recipient matching, hemodynamic monitoring, pharmacologic and surgical techniques aiming to inflow modulation have improved outcomes, enabling successful transplantation even with ultra-small grafts.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"1797-1806"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Indications and recipient outcomes of adult left lobe living donor liver transplantation. 成人左肝活体肝移植的适应证及受体预后。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2025-10-01 Epub Date: 2025-01-31 DOI: 10.1007/s13304-024-02050-8

Taizo Hibi

引用次数: 0

Current role and perspectives of living donor liver transplantation for hepatocellular carcinoma: systematic review of the past 20 years. 活体肝移植治疗肝细胞癌的当前作用和前景：过去 20 年的系统回顾。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2025-10-01 Epub Date: 2024-05-04 DOI: 10.1007/s13304-024-01862-y

Stefano Di Sandro, Leonardo Centonze, Barbara Catellani, Roberta Odorizzi, Daniela Caracciolo, Cristiano Guidetti, Paolo Magistri, Giuseppe Esposito, Gian Piero Guerrini, Fabrizio Di Benedetto

{"title":"Current role and perspectives of living donor liver transplantation for hepatocellular carcinoma: systematic review of the past 20 years.","authors":"Stefano Di Sandro, Leonardo Centonze, Barbara Catellani, Roberta Odorizzi, Daniela Caracciolo, Cristiano Guidetti, Paolo Magistri, Giuseppe Esposito, Gian Piero Guerrini, Fabrizio Di Benedetto","doi":"10.1007/s13304-024-01862-y","DOIUrl":"10.1007/s13304-024-01862-y","url":null,"abstract":"Hepatocellular carcinoma (HCC) poses a significant global health challenge, and liver transplantation (LT) remains the best curative option. Living donor liver transplantation (LDLT) emerged as a potential solution to organ scarcity, reducing waitlist times. This comprehensive review explores LDLT practices, focusing on patient selection criteria and oncologic outcomes. A systematic review following PRISMA guidelines included 50 studies (2004-2023) with 8062 patients. Data encompassed baseline characteristics, HCC features, and oncologic outcomes. Further analysis categorized results by geography and publication year. Heterogeneity in patient demographics, tumor burden, and transplant characteristics was observed. Recent LDLT series demonstrated a shift towards refined selection criteria, increased neoadjuvant treatment, and improved oncologic outcomes. Geographic disparities revealed unique challenges in Eastern and Western practices. LDLT proves effective for HCC, addressing donor shortages. Evolving practices highlight the importance of refining inclusion criteria and optimizing tumor management. While geographic differences exist, LDLT, when judiciously applied, offers promising outcomes.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"1817-1829"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Safety and feasibility of pure laparoscopic living donor right hepatectomy. 纯腹腔镜活体右肝切除术的安全性和可行性。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2025-10-01 Epub Date: 2024-10-15 DOI: 10.1007/s13304-024-01920-5

Sang-Hoon Kim, Ki-Hun Kim, Fernando Rotellar, Daniel Aliseda

{"title":"Safety and feasibility of pure laparoscopic living donor right hepatectomy.","authors":"Sang-Hoon Kim, Ki-Hun Kim, Fernando Rotellar, Daniel Aliseda","doi":"10.1007/s13304-024-01920-5","DOIUrl":"10.1007/s13304-024-01920-5","url":null,"abstract":"Pure laparoscopic living-donor right hepatectomy (PLDRH) has emerged as a significant advancement in liver transplantation, offering reduced donor morbidity and improved recovery times. However, PLDRH is still performed in only a limited number of centers. This retrospective study reports on the outcomes of 215 living donors who underwent PLDRH at Asan Medical Center in Seoul, Korea between November 2014 and December 2021. We reviewed donor and recipient demographics and anatomical characteristics of the donor grafts. Donor complications were classified and evaluated based on the Clavien-Dindo classification. The incidence of early donor complications within 30 days of surgery was 0.9% (n = 3), with minor complications in 0.3% (n = 1) patients and major complications in 0.6% (n = 2). No biliary complications were observed and no late complications had been reported by 30 days after surgery. The mean length of postoperative hospital stay was 7.2 days. PLDRH was a safe and feasible surgical technique characterized by a low complication rate and short hospital stays. PLDRH has the potential to become the standard procedure for the retrieval of right liver grafts from living donors.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"1865-1869"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

American perspectives for LDLT in 2024. 2024 年美国对 LDLT 的展望。

IF 2.2 3区医学

Updates in Surgery Pub Date : 2025-10-01 Epub Date: 2024-09-20 DOI: 10.1007/s13304-024-01994-1

Jean C Emond, Stefano Di Sandro, Elizabeth A Pomfret

{"title":"American perspectives for LDLT in 2024.","authors":"Jean C Emond, Stefano Di Sandro, Elizabeth A Pomfret","doi":"10.1007/s13304-024-01994-1","DOIUrl":"10.1007/s13304-024-01994-1","url":null,"abstract":"Living donor liver transplantation (LDLT) was first performed in the US in 1989, primarily benefiting pediatric patients. Its adoption for adults faced setbacks after a donor death in 2001, causing widespread risk aversion. Despite ethical justification and demonstrated safety, LDLT remains underutilized, with fewer than 10% of liver transplants being LDLT. Recent trends indicate improved access to deceased donor liver transplantation (DDLT) due to increased organ donation and technological advances like Normothermic Regional Perfusion (NRP). However, LDLT remains critical, especially for pediatric patients and specific adult populations who benefit significantly from it. Barriers to LDLT include public and clinician apprehensions about donor risks, despite studies showing low-complication rates. Non-directed donations and broader social media engagement have increased donor pools, though the volume of LDLT in the US remains lower than in Asia due to limited training and experience. The A2ALL consortium has been pivotal in studying LDLT safety and outcomes. Currently, around 40 US centers perform LDLT, with high-volume centers leading by example. Training paradigms for LDLT are evolving, with initiatives like the ASTS LDLT master class aiming to enhance surgical expertise. While LDLT is embedded in US liver-transplant practices, its expansion is hampered by risk aversion and the availability of DDLT. Nonetheless, LDLT is essential for addressing the supply-demand mismatch in liver transplantation.","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"1705-1712"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0