Anterior Approach for Hepatectomy Before Piggyback Liver Transplantation in Giant Polycystic Liver Disease

Kniepeiss, Daniela; Stiegler, Philipp; Talakić, Emina; Schemmer, Peter

doi:10.1002/lt.25824

Cited by 4 publications

(5 citation statements)

References 5 publications

(10 reference statements)

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“…Risk factors for CMV infection/disease identified across the 15 countries of interest consisted of older age in organ donors, D+/R– CMV serostatus, and use of antirejection therapies such as antithymocyte globulin, sodium mycophenolate, and prednisolone. These risk factors are consistent with those reported in studies from Europe 83–84,87,94,99–100 and North America 63,65,68 …”

Section: Discussionsupporting

confidence: 91%

“…Risk factors for CMV infection/disease identified across the 15 countries of interest consisted of older age in organ donors, D+/R-CMV serostatus, and use of antirejection therapies such as antithymocyte globulin, sodium mycophenolate, and prednisolone. These risk factors are consistent with those reported in studies from Europe [83][84]87,94,[99][100] and North America. 63,65,68 Despite the paucity of data on the long-term outcomes (e.g., graft survival, graft rejection) in SOT recipients who have developed CMV disease in the countries of interest, the high rates of CMV infection and CMV disease that have been observed are likely to negatively impact graft and patient outcomes posttransplantation, as previously reported.…”

Section: Discussionsupporting

confidence: 91%

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Epidemiology, management, and burden of cytomegalovirus in solid organ transplant recipients in selected countries outside of Europe and North America: A systematic review

Silva

Tokat

Cai

et al. 2023

Transplant Infectious Dis

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BackgroundCytomegalovirus (CMV) is a frequent infectious complication following solid organ transplantation (SOT). Considering significant differences in healthcare systems, a systematic review was conducted to describe the epidemiology, management, and burden of CMV post‐SOT in selected countries outside of Europe and North America.MethodsMEDLINE, Embase, and Cochrane databases were searched for observational studies in SOT recipients across 15 countries in the regions of Asia, Pacific, and Latin America (search period: January 1, 2011 to September 17, 2021). Outcomes included incidence of CMV infection/disease, recurrence, risk factors, CMV‐related mortality, treatment patterns and guidelines, refractory and/or resistant CMV, patient‐reported outcomes, and economic burden.ResultsOf 2708 studies identified, 49 were eligible (n = 43/49; 87.8% in adults; n = 34/49, 69.4% in kidney recipients). Across studies, selection of CMV preventive strategy was based on CMV serostatus. Overall, rates of CMV infection (within 1 year) and CMV disease post‐SOT were respectively, 10.3%–63.2% (9 studies) and 0%–19.0% (17 studies). Recurrence occurred in 35.4%–41.0% cases (3 studies) and up to 5.3% recipients died of CMV‐associated causes (11 studies). Conventional treatments for CMV infection/disease included ganciclovir (GCV) or valganciclovir. Up to 4.4% patients were resistant to treatment (3 studies); no studies reported on refractory CMV. Treatment‐related adverse events with GCV included neutropenia (2%–29%), anemia (13%–48%), leukopenia (11%–37%), and thrombocytopenia (13%–24%). Data on economic burden were scarce. imageConclusionOutside of North America and Europe, rates of CMV infection/disease post‐SOT are highly variable and CMV recurrence is frequent. CMV resistance and treatment‐associated adverse events, including myelosuppression, highlight unmet needs with conventional therapy.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Epidemiology, management, and burden of cytomegalovirus in solid organ transplant recipients in selected countries outside of Europe and North America: A systematic review

Silva

Tokat

Cai

et al. 2023

Transplant Infectious Dis

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“…The liver and kidney volumes and the inflammatory consistency of the cysts make it difficult to access the abdominal cavity, complicating the control of perioperative bleeding. (5) Perioperative dissection difficulty was noted in another three cases in the literature, in which liver sizes varied on an average of 7kg. (15) Thus, the importance of knowing how to manage, indicate and manage the case of a patient with polycystic kidney and liver disease is clear because of the great impact it has had on patients' lives.…”

Section: ❚ Case Reportmentioning

confidence: 94%

“…(1,4) Only 10-20% of patients have clinical manifestations resulting from hepatomegaly due to multiple cysts. (2,3,5) The most common symptoms of ADPKD in the kidneys are hypertension, flank pain, and urinary tract complications. Approximately half of the patients with ADPKD have chronic renal failure and are indicated for transplantation.…”

Section: ❚ Case Reportmentioning

confidence: 99%

“…(7) Our patient presented with poor nutrition, esophageal and gastric symptoms such as dyspnea and reflux, massive ascites, and back pain. (2,3,5) Some risk factors for the disease include the feminine gender, advanced age, and multiple pregnancies. (8) Most patients require clinical treatment, such as drug therapy, focusing on improving symptoms and complications, such as hypertension, urinary tract infections, ascites, and edema.…”

Section: ❚ Case Reportmentioning

confidence: 99%

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Combined liver-kidney transplant in polycystic diseases: a case report

Fonseca,

Martins,

Jucá

et al. 2023

Einstein (São Paulo)

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Polycystic liver disease, a hereditary pathology, usually manifests as autosomal dominant polycystic kidney disease. The many cysts in the liver cause massive hepatomegaly, majorly affecting the patient's quality of life. In cases of refractory symptoms, liver transplantation is the only treatment choice. A 43-year-old woman was followed up as a hepatology outpatient in August 2020, with a progressive increase in abdominal volume, lower limb edema, and cachexia. The patient was diagnosed with polycystic renal and liver disease with massive hepatomegaly in March 2021, a combined kidney-liver transplant. Liver size represented 13% of the patient's corporal composition, weighing 8.6kg. The patient was discharged on the 7 th postoperative day with no complications. Only 10-20% of patients with polycystic liver disease have clinical manifestations, most of which result from hepatomegaly. An increase in liver volume deteriorates liver function until the condition becomes end-stage liver disease, as kidney function is already compromised; liver-kidney transplantation remains the only treatment choice. The case described drew significant attention to the massive hepatomegaly presented in the patient, with the liver representing over 10% of the patient's body weight, approximately five to six times larger than a normal-sized liver.

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Leber, Gallenblase und Gallenwege

Hoffmann¹,

Schemmer²

2021

Facharztwissen Viszeralchirurgie

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Anterior Approach for Hepatectomy Before Piggyback Liver Transplantation in Giant Polycystic Liver Disease

Cited by 4 publications

References 5 publications

Epidemiology, management, and burden of cytomegalovirus in solid organ transplant recipients in selected countries outside of Europe and North America: A systematic review

Epidemiology, management, and burden of cytomegalovirus in solid organ transplant recipients in selected countries outside of Europe and North America: A systematic review

Combined liver-kidney transplant in polycystic diseases: a case report

Leber, Gallenblase und Gallenwege

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