Liver transplantation: history, outcomes and perspectives

Júnior, Roberto Ferreira Meirelles; Salvalaggio, Paolo R.; Rezende, Marcelo Bruno de; Evangelista, Ana Catarina Jorge; Guardia, Bianca Della; Matielo, Celso Eduardo Lourenço; Neves, Douglas Bastos; Pandullo, Fernando Luis; Felga, Guilherme Eduardo Gonçalves; Alves, Juliano; Curvêlo, Lílian Amorim; Díaz, Lourdes; Rusi, Marcela Balbo; Viveiros, Marcelo de Melo; Almeida, Márcio Dias de; Pedroso, Pamella Tung; Rocco, Rodrigo Andrey; Filho, Sérgio Paiva Meira

doi:10.1590/s1679-45082015rw3164

Cited by 170 publications

(125 citation statements)

References 14 publications

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“…Since the first deceased donor liver transplantation (DDLT) and living donor liver transplantation (LDLT) were performed in Brazil in 1968 and 1988, respectively, over 20,000 LT procedures have been performed in the country . After the United States and China, Brazil ranked third worldwide in terms of the absolute number of LTs performed in 2012, and it accounted for 63% of all LTs performed in Latin America in 2014…”

Section: Current Status Of Liver Transplantation In Brazilmentioning

confidence: 99%

“…In Rio Grande do Sul state, 88% of people stated that they were not willing to become organ and tissue donors, and a few years later the law was amended to include a provision requiring family consultation. Over the last 10 years, several strategies have been employed to overcome the scarcity of organs including LDLTs, split LTs, use of marginal donors, and domino LTs, with a limited impact on the size of the donor pool …”

Section: Current and Future Challengesmentioning

confidence: 99%

“…The Model for End-Stage Liver Disease (MELD) and Pediatric End-Stage Liver Disease (PELD) allocation systems were adopted in Brazil in 2006. (1,10) The minimum MELD score required for entry to the LT waiting list for adult patients is 11 points. Most centers usually list patients when they attain MELD scores of over 15 points.…”

Section: Number Of Liver Transplantations and Centers In Brazilmentioning

confidence: 99%

“…Over the last 10 years, several strategies have been employed to overcome the scarcity of organs including LDLTs, split LTs, use of marginal donors, and domino LTs, with a limited impact on the size of the donor pool. (1,5,6,18) In recent years, the main strategy for increasing organ donation has been raising public awareness through national educational campaigns by the Ministry of Health with extensive media coverage of campaigns and high-profile successful surgeries. The federal government has supported the improvement of the transplant network.…”

Section: Strategies To Increase Donation or Viability Of Donor Organsmentioning

confidence: 99%

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Liver Transplantation in Brazil

Bittencourt¹,

Farias²,

Couto

2016

Liver Transpl

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Over 1700 liver transplantations (LTs) are performed annually in Brazil. In absolute terms, the country performs more LT surgeries than anywhere else in Latin America and is third worldwide. However, due to its increasing population and inadequate donor organ supply, the country averages 5-10 LTs per million population, far lower than required. There is a marked heterogeneity in organ donation and LT activity throughout the country. Access to LT in the underprivileged North, Midwest, and Northeast regions of Brazil is scarce. Major challenges for the future of LT in Brazil will be to increase organ donation and access to LT. The reduction of those geographical disparities in donation, organ procurement, and LT due to political and financial constraints is of utmost importance.

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Section: Current Status Of Liver Transplantation In Brazilmentioning

confidence: 99%

Section: Current and Future Challengesmentioning

confidence: 99%

Section: Number Of Liver Transplantations and Centers In Brazilmentioning

confidence: 99%

Section: Strategies To Increase Donation or Viability Of Donor Organsmentioning

confidence: 99%

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Liver Transplantation in Brazil

Bittencourt¹,

Farias²,

Couto

2016

Liver Transpl

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“…1,2 LDLT recipients are likely to have complications such as post-operative infections and death due to the complexity of the surgical procedure. [3][4][5] It is therefore critical to identify LDLT recipients with increased risks at the pre-operative stage.…”

Section: Introductionmentioning

confidence: 99%

Pre-operative volume rather than area of skeletal muscle is a better predictor for post-operative risks for respiratory complications in living-donor liver transplantation

Wada

Kamishima

Shimamura

et al. 2017

BJR

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Objective: To demonstrate the superiority of total psoas volume (TPV) over total psoas area (TPA) in terms of predicting post-operative complications in living-donor liver transplantation (LDLT). Methods: The TPA and TPV were assessed in 32 recipients who underwent CT before LDLT. The TPA was measured using an axial CT image at the level of the upper margin of the fourth lumbar vertebral body. The TPV was calculated using all the CT images from the muscle origin through the level of the pubic symphysis.Patients were divided into a sarcopenia group and nosarcopenia group based on the medians of normalized TPA (nTPA) and normalized TPV (nTPV). We calculated the odds ratio (OR) of post-operative respiratory complications in relation to nTPA and nTPV, respectively. Conclusion: Pre-operative volume of the skeletal muscle might be a better predictor for post-operative risks in LDLT recipients than pre-operative area of the skeletal muscle. Advances in knowledge: Post-operative risks for respiratory complications in LDLT recipients might be evaluated more accurately by using TPV instead of TPA. INTRODUCTIONLiving-donor liver transplantation (LDLT) is a life-saving intervention for many patients with end-stage liver diseases such as cirrhosis, decompensated disease, acute liver failure and hepatocellular cancer. 1,2 LDLT recipients are likely to have complications such as post-operative infections and death due to the complexity of the surgical procedure.3-5 It is therefore critical to identify LDLT recipients with increased risks at the pre-operative stage. 6Recent evidence has shown that sarcopenia may identify LDLT recipients with increased risks for post-operative infections, complications and death. 6,7 Sarcopenia is defined as the loss of skeletal muscle mass caused by aging, chronic medical illness and malnutrition and has been postulated to be a major factor for decline in strength. 8,9 In previous studies, sarcopenia has been assessed by total psoas area (TPA), which is the sum of the area of bilateral psoas major muscles calculated by a single axial crosssectional image. 7,8 Only a few studies have assessed sarcopenia by using total psoas volume (TPV), which is the sum of the volume of bilateral psoas major muscles calculated utilizing volume data.5,10 Furthermore, to the best of our knowledge, there is no article which shows TPV to be more useful than TPA in relation to evaluating postoperative risks of LDLT patients.The aim of this study is to demonstrate the superiority of TPV over TPA based on the idea that TPV may be able to measure skeletal muscle mass more accurately by expanding measuring range and decreasing statistical error. We measured both pre-operative TPA and pre-operative TPV of living-donor liver transplantation (LDLT) recipients and compared TPV with TPA using the odds ratio (OR) of postoperative respiratory complications of LDLT. METHODS AND MATERIALSPatients 32 consecutive recipients (14 males and 18 females) who underwent LDLT at a university hospital between January 2009 and December 2013...

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A Chemically Defined Hydrogel for Human Liver Organoid Culture

Boeter

Mihajlovic

et al. 2020

Adv Funct Materials

113

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End-stage liver diseases are an increasing health burden, and liver transplantations are currently the only curative treatment option. Due to a lack of donor livers, alternative treatments are urgently needed. Human liver organoids are very promising for regenerative medicine; however, organoids are currently cultured in Matrigel, which is extracted from the extracellular matrix of the Engelbreth-Holm-Swarm mouse sarcoma. Matrigel is poorly defined, suffers from high batch-to-batch variability and is of xenogeneic origin, which limits the clinical application of organoids. Here, a novel hydrogel based on polyisocyanopeptides (PIC) and laminin-111 is described for human liver organoid cultures. PIC is a synthetic polymer that can form a hydrogel with thermosensitive properties, making it easy to handle and very attractive for clinical applications. Organoids in an optimized PIC hydrogel proliferate at rates comparable to those observed with Matrigel; proliferation rates are stiffness-dependent, with lower stiffnesses being optimal for organoid proliferation. Moreover, organoids can be efficiently differentiated toward a hepatocyte-like phenotype with key liver functions. This proliferation and differentiation potential maintain over at least 14 passages. The results indicate that PIC is very promising for human liver organoid culture and has the potential to be used in a variety of clinical applications including cell therapy and tissue engineering.

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Liver transplantation: history, outcomes and perspectives

Cited by 170 publications

References 14 publications

Liver Transplantation in Brazil

Liver Transplantation in Brazil

Pre-operative volume rather than area of skeletal muscle is a better predictor for post-operative risks for respiratory complications in living-donor liver transplantation

A Chemically Defined Hydrogel for Human Liver Organoid Culture

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