Technical Aspects of Orthotopic Liver Transplantationa Survey-Based Study Within the Eurotransplant, Swisstransplant, Scandiatransplant, and British Transplantation Society Networks
| Autor: | Massimo Malagó, Zoltan Mathe, Gabriela A. Berlakovich, Jacques Pirenne, Jan Lerut, Silvio Nadalin, Jan Bednarsch, Philipp Dutkowski, Johann Pratschke, Markus Guba, Nigel Heaton, Zoltan Czigany, Wenzel Schöning, Ulf P. Neumann, Georg Lurje, Xavier Rogiers, Marcus N. Scherer, Arianeb Mehrabi, Bo-Göran Ericzon |
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| Přispěvatelé: | Surgery, RS: FHML non-thematic output, University of Zurich, Lurje, Georg, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de chirurgie et transplantation abdominale |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
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medicine.medical_specialty Portocaval shunt Orthotopic liver transplantation DRAINAGE medicine.medical_treatment 610 Medicine & health 030230 surgery Anastomosis Liver transplantation Abdominal drain PIGGYBACK TECHNIQUE End Stage Liver Disease 03 medical and health sciences Liver disease 0302 clinical medicine Humans Medicine 2715 Gastroenterology RECONSTRUCTION Prospective Studies INTRAOPERATIVE PORTACAVAL SHUNTS PRESERVATION Survey Societies Medical Retrospective Studies 10217 Clinic for Visceral and Transplantation Surgery Piggy-back Portacaval Shunt Surgical business.industry General surgery Gastroenterology VENA-CAVA medicine.disease Standard technique 2746 Surgery SINGLE-CENTER EXPERIENCE Europe Transplantation Clinical trial surgical procedures operative 030220 oncology & carcinogenesis Reperfusion Female Surgery business |
| Zdroj: | Journal of Gastrointestinal Surgery, 23(3), 529-537. Springer Verlag Journal of gastrointestinal surgery, Vol. 23, no. 3, p. 529-537 (2019) |
| ISSN: | 1091-255X |
| Popis: | BACKGROUND: Orthotopic liver transplantation (OLT) has emerged as the mainstay of treatment for end-stage liver disease. However, technical aspects of OLT are still subject of ongoing debate and are widely based on personal experience and local institutional protocols. METHODS: An international online survey was sent out to all liver transplant centers (n = 52) within the Eurotransplant, Swisstransplant, Scandiatransplant, and British Transplant Society networks. The survey sought information on center-specific OLT caseload, vascular and biliary reconstruction, graft reperfusion, intraoperative control of hemodynamics, and drain policies. RESULTS: Forty-two centers gave a valid response (81%). Out of these, 50% reported piggy-back and 40.5% total caval replacement as their standard technique. While 48% of all centers generally do not apply veno-venous bypass (vvBP) or temporary portocaval shunt (PCS) during OLT, vvBP/PCS are routinely used in six centers (14%). Portal vein first reperfusion is used in 64%, followed by simultaneous (17%), and retrograde reperfusion (12%). End-to-end duct-to-duct anastomosis without biliary drain (67%) is the most frequently performed method of biliary reconstruction. No significant associations were found between the center caseload and the surgical approach used. The predominant part of the centers (88%) stated that techniques of OLT are not evidence-based and 98% would participate in multicenter clinical trials on these topics. CONCLUSION: Technical aspects of OLT vary widely among European centers. The extent to which center-specific variation of techniques affect transplant outcomes in Europe should be elucidated further in prospective multicenter trials. |
| Databáze: | OpenAIRE |
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