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Your search keyword '"Mergental, Hynek"' showing total 41 results
Start Over Author "Mergental, Hynek" Publisher lippincott williams & wilkins
41 results on '"Mergental, Hynek"'

1. Discarded livers tested by normothermic machine perfusion in the VITTAL trial: Secondary end points and 5-year outcomes.

Author

Mergental, Hynek, Laing, Richard W., Kirkham, Amanda J., Clarke, George, Boteon, Yuri L., Barton, Darren, Neil, Desley A. H., Isaac, John R., Roberts, Keith J., Abradelo, Manuel, Schlegel, Andrea, Dasari, Bobby V. M., Ferguson, James W., Cilliers, Hentie, Morris, Chris, Friend, Peter J., Yap, Christina, Afford, Simon C., Perera, M. Thamara P. R., and Mirza, Darius F.

Published
2024
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3. In situ normothermic regional perfusion versus ex situ normothermic machine perfusion in liver transplantation from donation after circulatory death.

Author

Mohkam, Kayvan, Nasralla, David, Mergental, Hynek, Muller, Xavier, Butler, Andrew, Jassem, Wayel, Imber, Charles, Monbaliu, Diethard, Perera, M. Thamara P. R., Laing, Richard W., García‐Valdecasas, Juan Carlos, Paul, Andreas, Dondero, Federica, Cauchy, François, Savier, Eric, Scatton, Olivier, Robin, Fabien, Sulpice, Laurent, Bucur, Petru, and Salamé, Ephrem

Published
2022
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13. The Reactive Oxygen Species–Mitophagy Signaling Pathway Regulates Liver Endothelial Cell Survival During Ischemia/Reperfusion Injury.

Author

Bhogal, Ricky H., Weston, Christopher J., Velduis, Susanne, G. D. Leuvenink, Henri, Reynolds, Gary M., Davies, Scott, Nyguet‐Thin, Luu, Alfaifi, Mohammed, Shepard, Emma L., Boteon, Yuri, Wallace, Lorraine, Oo, Ye H., Adams, David H., Mirza, Darius F., Mergental, Hynek, Muirhead, Gillian, Stephenson, Barnaby T. F., and Afford, Simon C.

Published
2018
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14. Development of Clinical Criteria for Functional Assessment to Predict Primary Nonfunction of High‐Risk Livers Using Normothermic Machine Perfusion.

Author

Mergental, Hynek, Stephenson, Barnaby T. F., Laing, Richard W., Kirkham, Amanda J., Neil, Desley A. H., Wallace, Lorraine L., Boteon, Yuri L., Widmer, Jeannette, Bhogal, Ricky H., Perera, M. Thamara P. R., Smith, Amanda, Reynolds, Gary M., Yap, Christina, Hübscher, Stefan G., Mirza, Darius F., and Afford, Simon C.

Published
2018
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20. Intention to Split Policy.

Author

Battula, Narendra R., Platto, Marco, Anbarasan, Ravindar, Perera, M. Thamara P. R., Ong, Evelyn, Roll, Garrett R., Ferraz Neto, Ben-Hur, Mergental, Hynek, Isaac, John, Muiesan, Paolo, Sharif, Khalid, and Mirza, Darius F.

Abstract

Objective: The primary aim of this study is to evaluate the role of split liver transplantation (SLT) in a combined pediatric and adult liver transplant center. The secondary aim is to reflect on our clinical practice and discuss strategies to build a successful split program using an "intention to split policy." Background: SLT is an established procedure to expand the organ pool and reduce wait list mortality; however, technical and logistic issues are limiting factors. Methods: Prospectively collected data and outcomes of SLT procedures performed between November 1992 and March 2014 were analyzed retrospectively. To assess the effect of standardization and learning curve, the experience was divided into 2 time periods. Results: Out of 3449 liver transplant procedures performed, 516(15%) were SLT. The recipients included 266 children (290 grafts; 56%) and 212 adults (226 grafts; 44%). The median donor age was 25(7-63 years) and the median weight was 70(22-111 kg). The cold and warm ischemic times improved significantly during the second period (SP) (2001-2014). With experience, there was a significant reduction in the biliary complications for both grafts. The introduction of "intention to split policy" resulted in a significantly increased usage of SLT. There was no mortality on the pediatric wait list for last 4 years. Over the last decade 65% of our pediatric transplants were SLT. The overall 1-, 5-, 10-year patient and graft survival of left graft recipients was 91%, 90%, and 89% and 90%, 87%, and 86%. For right grafts it was 87%, 82%, and 81% and 82%, 81%, and 79%, respectively. Conclusions: SLT is an effective surgical strategy to meet the demands in a combined adult and pediatric transplant center. Good outcomes can be achieved with a standardized technique. [ABSTRACT FROM AUTHOR]

Published
2017
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22. Is Hepatocyte Necrosis a Good Marker of Donor Liver Viability During Machine Perfusion?

Author

Neil, Desley A.H., Mergental, Hynek, Hann, Angus, Laing, Richard W, Hartog, Hermien, Mirza, Darius F, and Perera, M. Thamara P.R.

Subjects
LIVER, PERFUSION, NECROSIS, MACHINERY
Abstract

They use histological assessment of hepatocyte necrosis as the basis of determining whether a liver is nonviable and conclude that lactate clearance during NMP is not able to differentiate between viable and nonviable livers. In conclusion, significant hepatocyte necrosis in DBD grafts can be successfully transplanted following NMP, indicating that hepatocyte necrosis I per se i is not a reliable surrogate for viability of a donor liver. [Extracted from the article]

Published
2022
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39. Challenges With the Implementation of Machine Perfusion in Clinical Liver Transplantation.

Author

De Goeij FHC, De Meijer V, Mergental H, Guarrera JV, Asthana S, Ghinolfi D, Boteon YL, Selzner N, Kalisvaart M, Pulitano C, Sonnenday C, Martins PN, Berlakovich G, and Schlegel A

Subjects
Humans, Treatment Outcome, Cost-Benefit Analysis, Liver blood supply, Liver surgery, Liver Transplantation methods, Perfusion methods, Organ Preservation methods
Abstract

Dynamic organ preservation is a relatively old technique which has regained significant interest in the last decade. Machine perfusion (MP) techniques are applied in various fields of solid organ transplantation today. The first clinical series of ex situ MP in liver transplantation was presented in 2010. Since then, the number of research and clinical applications has substantially increased. Despite the notable beneficial effect on organ quality and recipient outcome, MP is still not routinely used in liver transplantation. Based on the enormous need to better preserve organs and the subsequent demand to continuously innovate and develop perfusion equipment further, this technology is also beneficial to test and deliver future therapeutic strategies to livers before implantation. This article summarizes the various challenges observed during the current shift from static to dynamic liver preservation in the clinical setting. The different organ perfusion strategies are discussed first, together with ongoing clinical trials and future study design. The current status of research and the impact of costs and regulations is highlighted next. Factors contributing to costs and other required resources for a worldwide successful implementation and reimbursement are presented third. The impact of research on cost-utility and effectivity to guide the tailored decision-making regarding the optimal perfusion strategy is discussed next. Finally, this article provides potential solutions to the challenging field of innovation in healthcare considering the various social and economic factors and the role of clinical, regulatory, and financial stakeholders worldwide., Competing Interests: J.V.G. consults for and received grants from Organ Recovery Systems (Itasca, IL) and consults for GATT Technologies. The other authors declare no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Published
2024
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40. Ex-situ liver preservation with machine preservation.

Author

Lembach Jahnsen H, Mergental H, Perera MTPR, and Mirza DF

Subjects
Graft Survival, Humans, Liver, Perfusion, Liver Transplantation adverse effects, Organ Preservation
Abstract

Purpose of Review: To summarize key studies in liver preservation published over the last 3 years and evaluate benefits and limitations of the different perfusion techniques. Selected experimental applications that may be translated to the clinical use will be also discussed., Recent Findings: Normothermic machine perfusion (NMP) has transitioned into clinical practice. Viability assessment is a reliable tool for clinical decision-making, and safety of the back-to-base approach has facilitated adoption of the technology. Data supporting well tolerated use of declined livers after NMP and new protocols selecting complex recipients aim to improve access to suitable organs. Hypothermic machine perfusion (HMP) is showing promising clinical results by decreasing biliary complications in recipients' receiving organs donated after circulatory death (DCD) and improving early graft function in extended criteria organs. Long-term data of HMP on DCD livers shows improved graft survival over standard SCS. Novel approaches utilizing sequential HMP--NMP or ischaemia-free preservation aim to improve outcomes of extended criteria organs., Summary: Machine perfusion for organ transplantation has become an established technique but the field is rapidly evolving. Ongoing research focuses on evaluation of the intervention efficacy and finding optimal indications to use each perfusion strategy according to graft type and clinical scenario., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Published
2021
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41. Preoperative Thromboelastography as a Sensitive Tool Predicting Those at Risk of Developing Early Hepatic Artery Thrombosis After Adult Liver Transplantation.

Author

Zahr Eldeen F, Roll GR, Derosas C, Rao R, Khan MS, Gunson BK, Hodson J, Mergental H, Ferraz-Neto BH, Isaac J, Muiesan P, Mirza DF, Iqbal A, and Perera MT

Subjects
Adult, Female, Humans, Male, Middle Aged, Retrospective Studies, Risk, Hepatic Artery, Liver Transplantation adverse effects, Thrombelastography, Thrombosis diagnosis
Abstract

Background: Whilst causes of hepatic artery thrombosis (HAT) after liver transplantation (LT) are multifactorial, early HAT (E-HAT) remains pertinent complication impacting on graft and patient survival. Currently there is no screening tool that would identify patients with increased risk of developing E-HAT., Methods: We analyzed the native procoagulant state of LT recipients, identified through pretransplant thromboelastographic (TEG) data among other known risk factors, to identify risk factors for E-HAT., Results: The outcomes of 828 adult patients undergoing LT between 2008 and 2013 were analyzed. Overall, 79 (9.5%) patients experienced HAT, E-HAT was diagnosed in 23, and in the remainder this was "late" HAT. The maximum amplitude (MA) on preoperative TEG was significantly higher in patients diagnosed with E-HAT compared with those who did not (71.2 mm vs 57.9 mm; P < 0.0001). Receiver operating characteristic analysis with the cutoff value for MA of 65 mm or greater returned area under the curve of 0.750 (P < 0.001) predicting E-HAT with a sensitivity of 70%. A total of 7% of patients with an MA of 65 mm or greater went on to develop E-HAT (hazard ratio, 5.28; 95% confidence interval, 2.10-12.29; P < 0.001), whereas only 1.2% patients with an MA less than 65 mm experienced E-HAT., Conclusions: Preoperative TEG may reliably identify group of recipients at greater risk of developing E-HAT, and intense surveillance and anticoagulation prophylaxis may avoid this serious complication after LT.

Published
2016
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