Living-Donor Liver Transplantation in 126 Patients with Biliary Atresia: Single-Center Experience

Mizuta, Koichi; Sanada, Yukihiro; Wakiya, Taiichi; Urahashi, Taizen; Umehara, Minoru; Egami, Satoshi; Hishikawa, Shuji; Okada, Noriki; Kawano, Youichi; Saito, Takeshi; Hayashida, Miyeko; Takahashi, Satoko; Yoshino, Hiroyuki; Shimizu, Atsushi; Takatsuka, Yuka; Kitamura, Tsugio; Kita, Yoshiaki; Uno, Takeji; Yoshida, Yoshiyuki; Hyodo, Masanobu; Sakuma, Yoshiki; Fujiwara, T.; Ushijima, K.; Sugimoto, Koh‐ichi; Ohmori, Masami; Ohtomo, Sho; Sakamoto, Koichi; Nakata, Manabu; Yano, Tomonori; Yamamoto, Hironori; Kobayashi, Eiji; Yasuda, Yoshikazu; Kawarasaki, Hideo

doi:10.1016/j.transproceed.2010.11.002

Cited by 23 publications

(15 citation statements)

References 14 publications

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“…(12) Biliary reconstruction using Roux-en-Y choledochojejunostomy has been associated with a higher rate of infection, (12,13) but in almost all pediatric patients, Roux-en-Y hepaticojejunostomy was performed because biliary atresia is a dominant indication of LDLT, and in many other pediatric patients, the biliary tract is small and fragile. (14) Liver transplantation for biliary atresia after a previous Kasai portoenterostomy has been reported to be a risk factor for bowel perforation. (15) On the basis of the univariate analysis, the graft type was one of the risk factors for early relaparotomy.…”

Section: Discussionmentioning

confidence: 99%

The Causes and Outcomes of Early Relaparotomy Following Pediatric Living Donor Liver Transplantation

et al. 2019

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Early relaparotomy of adult recipients after living donor liver transplantation (LDLT) is significantly associated with poor prognosis. However, there are few reports focusing on pediatric recipients after LDLT. The aim of this study is to clarify the causes and outcomes of early relaparotomy after pediatric LDLT. A total of 265 pediatric recipients (272 LDLTs) transplanted from May 2001 to October 2015 were retrospectively analyzed. Early relaparotomy was defined as surgical intervention performed within 3 months after LDLT. Early relaparotomy was performed 49 times for 33 recipients (12.5%). The recipient and graft survival rates in the early relaparotomy group were significantly lower than those in the nonearly relaparotomy group, respectively (75.0% and 63.6% versus 96.6% and 95.8%; both P < 0.001). Left lateral segment grafts were used significantly more frequently in the nonrelaparotomy group (P = 0.01). According to the multivariate analysis, the preoperative Pediatric End‐Stage Liver Disease (PELD)/Model for End‐Stage Liver Disease (MELD) score of the early relaparotomy group was significantly higher than that of the nonearly relaparotomy group (13.7 versus 6.3; P = 0.04). According to the receiver operating characteristic curve, the preoperative PELD/MELD score cutoff point was 17.2. Early relaparotomy due to infectious causes led to significantly poorer graft survival than that due to noninfectious causes (P = 0.04). In conclusion, the recipient and graft survival rates of the early relaparotomy group were significantly lower than those of the nonearly relaparotomy group. A high preoperative PELD/MELD score was a risk factor for early relaparotomy. In particular, early relaparotomy due to infection showed a poor prognosis.

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Section: Discussionmentioning

confidence: 99%

The Causes and Outcomes of Early Relaparotomy Following Pediatric Living Donor Liver Transplantation

et al. 2019

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“…The most common indication was cholestatic disease represented by biliary atresia in 151 patients (75.1%). The surgical procedures have been described previously . The graft and patient survival rates were 95.5% and 96.0%, respectively.…”

Section: Methodsmentioning

confidence: 99%

Iron overload as a risk factor for hepatic ischemia-reperfusion injury in liver transplantation: Potential role of ferroptosis

Yamada

Karasawa

Wakiya

et al. 2020

American Journal of Transplantation

181

130

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Hepatic ischemia-reperfusion (I/R) injury is a major problem in liver transplantation (LT). Although hepatocyte cell death is the initial event in hepatic I/R injury, the underlying mechanism remains unclear. In the present study, we retrospectively analyzed the clinical data of 202 pediatric living donor LT and found that a high serum ferritin level, a marker of iron overload, of the donor is an independent risk factor for liver damage after LT. Since ferroptosis has been recently discovered as an iron-dependent cell death that is triggered by a loss of cellular redox homeostasis, we investigated the role of ferroptosis in a murine model of hepatic I/R injury, and found that liver damage, lipid peroxidation, and upregulation of the ferroptosis marker Ptgs2 were induced by I/R, and all of these manifestations were markedly prevented by the ferroptosis-specific inhibitor ferrostatin-1 (Fer-1) or α-tocopherol. Fer-1 also inhibited hepatic I/R-induced inflammatory responses. Furthermore, hepatic I/R injury was attenuated by iron chelation by deferoxamine and exacerbated by iron overload with a high iron diet. These findings demonstrate that iron overload is a novel risk factor for hepatic I/R injury in LT, and ferroptosis contributes to the pathogenesis of hepatic I/R injury. K E Y W O R D Scell death, liver transplantation/hepatology, liver transplantation: living donor, translational research/science

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“…It is the leading cause of end-stage liver disease in children and the most common indication for liver transplantation (LT) in the pediatric population [1,2]. Early diagnosis and portoenterostomy (Kasai procedure) within the first 2 mo of life restores bile flow from the liver into the intestinal tract in 30-80 % of patients [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Living Related Liver Transplantation for Biliary Atresia in the Last 5 years: Experience from the First Liver Transplant Program in India

et al. 2015

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Living-Donor Liver Transplantation in 126 Patients with Biliary Atresia: Single-Center Experience

Cited by 23 publications

References 14 publications

The Causes and Outcomes of Early Relaparotomy Following Pediatric Living Donor Liver Transplantation

The Causes and Outcomes of Early Relaparotomy Following Pediatric Living Donor Liver Transplantation

Iron overload as a risk factor for hepatic ischemia-reperfusion injury in liver transplantation: Potential role of ferroptosis

Living Related Liver Transplantation for Biliary Atresia in the Last 5 years: Experience from the First Liver Transplant Program in India

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