Aude Vanlander

Pure laparoscopic full-left living donor hepatectomy for calculated small-for-size LDLT in adults: proof of concept.

Adult‐to‐adult living donor liver transplantation (A2ALDLT) is an accepted mode of treatment for end‐stage liver disease. Right‐lobe grafts have usually been preferred in view of the higher graft volume, which lowers the risk of a small‐for‐size syndrome. However, donor left hepatectomy is associated with less morbidity than when it is compared to right hepatectomy. Laparoscopic donor hepatectomy (LDH) has been considered almost exclusively in pediatric transplantation. The results of laparoscopic left‐liver graft procurement for calculated small‐for‐size A2ALDLT in four donors are presented. The graft‐to‐recipient body weight ratio was <0.8 in all recipients. The mean portal vein flow and the pressure and hepatic artery flows were measured at 190 ± 56 mL/min/100 g, 13 ± 1.4 mm/Hg and 109 ± 19 mL/min, respectively. No early postoperative donor complications were recorded. One graft was lost due to intrahepatic abscesses. Asymptomatic stenosis of a right posterior duct was treated with a Roux‐en‐Y loop 4 months later in one donor. We show that LDH of the full‐left lobe is feasible. LDH is a very demanding operation, potentially decreasing donor morbidity. Standardization of this procedure, making it accessible to the growing number of experienced laparoscopic liver surgeons, could help renewing the interest for A2ALDLT in the Western world.

Quality of life after liver transplantation: State of the art

Quality of life (QoL) after deceased donor liver transplantation is increasingly recognized as a major outcome parameter. We reviewed recent publications in this rapidly evolving field in order to summarize recent achievements in the field and to define opportunities and perspectives for research and improvement of patient care. QoL does improve after liver transplantation according to a typical pattern. During the first year, there is a significant improvement in QoL. After one year, the improvement does stabilise and tends to decline slightly. In addition to the physical condition, different psychological parameters (such as depression, anxiety, sexual function) and sociodemographic elements (professional state, sex, marital state) seem to impact QoL. Opportunities for further research are the use of dedicated questionnaires and identification of influencing factors for QoL.

Pathophysiology and management of post resection liver failure

Abstract Post resection liver failure (PRLF) is defined by the occurrence of jaundice, coagulopathy and encephalopathy after liver resection. When PRLF is present, it has a high morbidity and mortality. The incidence of PRLF ranges between 0–30%. For having a healthy regeneration of the liver remnant an adequate number of hepatocytes and non-parenchymal cells, a normal functional and regenerative capacity and also a good accommodation of haemodynamic changes without congestion are needed. To avoid the presence of PRLF ongoing parenchymal damage after the liver resection should be avoided. So, ischemia reperfusion injury should be minimalized, infection and sepsis should be treated immediately and small for size syndrome should be avoided.

A comparative outcome analysis of incisional hernia repair in patients who underwent liver transplantation vs. those that underwent hepatopancreaticobiliary surgery using the EHS guidelines as a means of comparison

We retrospectively analyzed incisional hernia (IH) outcomes of liver transplant (LT) vs. hepatopancreaticobiliary (HPB) cases sharing the same incision.

A glycomic serum marker analysed at one week after liver transplantation is an independent predictor of graft loss during the first year after liver transplantation

Belgian Transplantation Society npa. Ave. W. Churchill-ln 11/30, Bruxelles 1180 Brussel info@transplant.be N° entreprise 450.961.314 Ondernemingsnummer Whole-genome array-based methylation analysis was performed on two cohorts of kidney allograft biopsies: 95 obtained at implantation (82 brain-dead donors and 13 living donors), using EPIC BeadChips and 67 obtained after reperfusion (58 brain-dead donors and 9 living donors), using Infinium 450K Beadchips. Donor age ranged from 16 to 73 years, and from 16 to 79 years, respectively. Comb-p was used to identify differentially methylated regions (DMRs). The genes mapped to DMRs with a FDR q-value <.0001 were selected for inguinity pathway analysis. Donor age associated significantly with methylation levels at 89,293 cpgs (10% of all probes) in the implantation cohort and 87,393 (20% postreperfusion (q-value < 0.05), adjusted gender cold ischemia time. q-value <0.0001 corresponded to 17,077, respectively 15,225 differentially methylated regions. both cohorts, top enriched was wnt signalling pathway, which is involved kidney injury, repair fibrosis, as well renal senescence. There a strikingly pervasive association between DNA changes kidney. These occur preferentially genes suggesting link advanced chronic allograft dysfunction.

Prospective clinical evaluation of a self-gripping large pore mesh for incisional hernia repair

Introduction: A new class of hernia repair devices has been created through the combination of optimally processed extracellular matrices (ECM) and select monofilament polymers. The resulting Reinforced BioScaffolds (RBS) are designed to exceed physiological forces and remodel in response to these forces, with the goal of providing a load sharing construct during the remodeling process. The materials and manufacturing methods used allow for infinite tuning of the RBS functional properties. Polypropylene (PP) monofilament suture is interwoven through ECM layers by an automated lock stitch sewing process to form the RBS and to create a ripstop effect. Final device thickness and the amount of polymer interwoven through the ECM was arranged to govern mechanical properties of the final RBS.