20130512 移植相關 issue
Ann of Surg- PAP
A retrospective study was performed on 287 patients who
received right-lobe living donor liver transplantation with duct-to-duct
anastomosis.
The morphology of BAS was categorized into 3 types: pouched, intermediately pouched, and
triangular.
Results:
Fifty-nine patients (20.6%) had BAS and received ERC and
balloon dilatation with or without stenting.
The success rate was 73.2%.
The median number of sessions needed for successful ERC was 3.
In the
15 patients with failed ERC,
4 : percutaneous transhepatic biliary drainage and balloon dilatation, 11: hepaticojejunostomy
Risk factors for failed ERC:
Recipient age [odds ratio (OR): 0.922; 95% confidence
interval (CI): 0.85-1.00; P = 0.049], Operation time (OR: 1.007; 95% CI:
1.001-1.013; P = 0.025),
Morphology of stricture (OR: 6.722; 95%
CI: 1.31-34.48; P = 0.022)
The success rates for the 3 types of BAS-pouched,
intermediately pouched, and triangular-were 42.9%, 63.6%, and 88.9%,
respectively (P = 0.021). Association was found between bile leak and
pouched BAS (P = 0.008).
Transplantation 15 May 2013 - Volume 95 - Issue 9
Six randomized controlled trials (n=2499) and 15 observational
studies (n=2886) were included in the review.
Results:
No significant
differences in
biopsy-proven acute rejection (two trials, n=1093; risk
ratio [RR; confidence interval (CI)], 1.24 [0.93–1.65]; P=0.15; I2=0%),
patient survival (three trials, n=1156; RR [CI], 0.99 [0.97–1.02];
P=0.55; I2=32%), and
graft survival (three trials, n=1156; RR [CI], 0.99
[0.97–1.02]; P=0.67; I2=0%) between the two formulations at 12 months.
Similar results for
acute rejection (five studies, n=391; RR [CI], 0.99
[0.93–1.06]; P=0.84; I2=0%) and
overall patient survival (two studies,
n=218; RR [CI], 1.02 [0.94–1.10]; P=0.62; I2=0%) were observed in
observational studies.
Conclusions: Once-daily tacrolimus appears to be as effective as
twice-daily tacrolimus up to 12 months after kidney transplantation.
360 adult LDLT recipients who survived more
than 1 year after transplantation.
Results: Mean follow-up period was 7.5±3.4 years.
During the follow-up
period, 27 de novo malignancies were diagnosed in 26 recipients.
Colorectal cancer was the most commonly detected malignancy.
The overall
mortality of the recipients with de novo malignancies was similar to
the findings of the Japanese general population-based study
(standardized mortality ratio=0.9).
Overall, the incidence of cancer was
significantly higher in transplant recipients than in the Japanese
general population (standardized incidence ratio=1.8).
The 5-year
estimated survival rate of recipients with de novo malignancies was 81%
and those of recipients without malignancies was 93% (P<0 .0001="" font="" nbsp="">
Conclusions: Colorectal malignancies predominated in Japanese liver
transplant recipients. Although de novo malignancies correlated with a
poor prognosis, the standardized mortality ratio was 0.9 compared with
that of subjects of a Japanese population-based study.
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