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  • Bhangui, Prashant  (2)
  • Sah, Jayant Kumar  (2)
  • Yadav, Sanjay Kumar  (2)
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  • 1
    Online Resource
    Online Resource
    Cytomegalovirus infection in living donor liver transplant recipients significantly impacts the early post‐transplant outcome: A single center experience
    Wiley ; 2018
    In:  Transplant Infectious Disease Vol. 20, No. 4 ( 2018-08)
    Details
    In: Transplant Infectious Disease, Wiley, Vol. 20, No. 4 ( 2018-08)
    Abstract: Cytomegalovirus ( CMV ) is the most common viral infection in liver transplant recipients that influences the outcomes of liver transplantation. However, its impact on early outcomes following living donor liver transplantation ( LDLT ) is not fully defined in the Indian subcontinent. This study was done to assess the impact of CMV infection on early post‐transplant outcomes in LDLT recipients. Methods Out of 272 LDLT s performed from January 2012 to April 2013, 151 recipients underwent CMV viral load analysis in plasma within 90 days post LDLT based on clinical suspicion. Patients with CMV infection (n = 55) were compared with those without CMV infection (n = 96). Results The median time interval of CMV infection from LDLT was 25 days (range 2‐90 days). The mean age of study population was 48.92 years. About 116 (76.8%) of the patients were male. Hepatitis C virus ( HCV ) (39.1%)‐related chronic liver disease ( CLD ) was most common indication for liver transplant. No statistically significant difference was observed in etiology of liver disease ( P  = .38), Chid‐Turcotte‐Pugh ( CTP ) ( P  = .41), and Model for End‐stage Liver Disease ( MELD ) ( P  = .12) scores between the groups. Patients with CMV infection had significantly higher incidence of acute cellular rejection (16.1% vs 5.4%, P  = .02); longer ICU stay ( P  = .01); and a higher overall 90‐day mortality (24.2% vs 6.7%, P  = .001). Bacteremia and fungemia were significantly more common in the CMV infection group. Conclusion Cytomegalovirus infection significantly influences the early post LDLT outcomes and contributes to increased overall mortality.
    Type of Medium: Online Resource
    ISSN: 1398-2273 , 1399-3062
    URL: Issue
    URL: Article
    DOI: 10.1111/tid.2018.20.issue-4
    DOI: 10.1111/tid.12905
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2010983-0
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  • 2
    Online Resource
    Online Resource
    Living Donor Liver Transplantation for Acute‐on‐Chronic Liver Failure
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Liver Transplantation Vol. 25, No. 3 ( 2019-03), p. 459-468
    Details
    In: Liver Transplantation, Ovid Technologies (Wolters Kluwer Health), Vol. 25, No. 3 ( 2019-03), p. 459-468
    Abstract: Acute‐on‐chronic liver failure (ACLF) is a syndrome characterized by acute decompensation of previously diagnosed or undiagnosed liver disease with organ failure(s) with high short‐term mortality. This study was conducted to report the outcomes of living donor liver transplantation (LDLT) in ACLF and assess the survival benefit of liver transplantation (LT) in these patients. It was a retrospective study of 218 ACLF patients on the basis of European Association for the Study of the Liver (EASL)–chronic liver failure criteria from January 2014 through November 2017. Patients were considered for LDLT if there was no improvement on standard medical therapy for 5‐10 days. Prior to LDLT, active sepsis was excluded/treated, and renal, circulatory, and respiratory failures were improved to the greatest extent possible. The mean age was 42.9 years, and 181 patients were male. Sepsis was the most common acute precipitating event followed by alcohol. Of the patients, 35 (16.1%), 66 (30.3%), and 117 (53.7%) were classified into ACLF grades 1, 2, and 3, respectively. Although 80% of the ACLF 1 group and 72.7% of the ACLF 2 group underwent LDLT, only 35% of the ACLF 3 group could undergo LDLT. The circulatory and respiratory failures at admission were significantly higher in the nontransplant group with poor subsequent response to standard medical therapy, exclusion from LDLT, and poor outcomes. None of the patients on high support for circulatory and respiratory failure underwent LDLT. Posttransplant survival at 1 year was comparable among different grades of ACLF (92.9%, 85.4%, and 75.6%; P  = 0.15). Among patients in the ACLF 3 group, survival at 90 days was extremely poor in those who could not undergo LDLT (5.9% versus 78%; P   〈  0.001). In conclusion, LDLT results in good survival with acceptable post‐LT morbidity in patients with ACLF.
    Type of Medium: Online Resource
    ISSN: 1527-6465 , 1527-6473
    URL: Article
    DOI: 10.1002/lt.25395
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2002186-0
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