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2. Thromboprophylaxis With Heparin During Orthotopic Liver Transplantation: Comparison of Hepcon HMS Plus and Anti-Xa Assays for Low-Range Heparin

Author

Nicolau-Raducu, Ramona, Occhipinti, Elise, Marshall, Thomas, Koveleskie, Joseph, Ganier, Donald, Evans, Brian, Daly, William, Fish, Brian, Cohen, Ari J., Reichman, Trevor W., Bruce, David, Bohorquez, Humberto, Seal, John, Ahmed, Emily, Carmody, Ian, Loss, George, Rayburn, Jonathan, and Nossaman, Bobby

Published
2017
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8. A multicentre outcome analysis to define global benchmarks for donation after circulatory death liver transplantation

Author

Schlegel, Andrea, van Reeven, Marjolein, Croome, Kristopher, Parente, Alessandro, Dolcet, Annalisa, Widmer, Jeannette, Meurisse, Nicolas, De Carlis, Riccardo, Hessheimer, Amelia, Jochmans, Ina, Mueller, Matteo, van Leeuwen, Otto B., Nair, Amit, Tomiyama, Koji, Sherif, Ahmed, Elsharif, Mohamed, Kron, Philipp, van der Helm, Danny, Borja-Cacho, Daniel, Bohorquez, Humberto, Germanova, Desislava, Dondossola, Daniele, Olivieri, Tiziana, Camagni, Stefania, Gorgen, Andre, Patrono, Damiano, Cescon, Matteo, Croome, Sarah, Panconesi, Rebecca, Carvalho, Mauricio Flores, Ravaioli, Matteo, Caicedo, Juan Carlos, Loss, George, Lucidi, Valerio, Sapisochin, Gonzalo, Romagnoli, Renato, Jassem, Wayel, Colledan, Michele, De Carlis, Luciano, Rossi, Giorgio, Di Benedetto, Fabrizio, Miller, Charles M., van Hoek, Bart, Attia, Magdy, Lodge, Peter, IJzermans, Jan N.M., Polak, Wojciech G., Claasen, Marco, de Meijer, Vincent E., Metselaar, Herold J., Schlegel, Andrea, van Reeven, Marjolein, Croome, Kristopher, Parente, Alessandro, Dolcet, Annalisa, Widmer, Jeannette, Meurisse, Nicolas, De Carlis, Riccardo, Hessheimer, Amelia, Jochmans, Ina, Mueller, Matteo, van Leeuwen, Otto B., Nair, Amit, Tomiyama, Koji, Sherif, Ahmed, Elsharif, Mohamed, Kron, Philipp, van der Helm, Danny, Borja-Cacho, Daniel, Bohorquez, Humberto, Germanova, Desislava, Dondossola, Daniele, Olivieri, Tiziana, Camagni, Stefania, Gorgen, Andre, Patrono, Damiano, Cescon, Matteo, Croome, Sarah, Panconesi, Rebecca, Carvalho, Mauricio Flores, Ravaioli, Matteo, Caicedo, Juan Carlos, Loss, George, Lucidi, Valerio, Sapisochin, Gonzalo, Romagnoli, Renato, Jassem, Wayel, Colledan, Michele, De Carlis, Luciano, Rossi, Giorgio, Di Benedetto, Fabrizio, Miller, Charles M., van Hoek, Bart, Attia, Magdy, Lodge, Peter, IJzermans, Jan N.M., Polak, Wojciech G., Claasen, Marco, de Meijer, Vincent E., and Metselaar, Herold J.

Abstract

Background & Aims: The concept of benchmarking is established in the field of transplant surgery; however, benchmark values for donation after circulatory death (DCD) liver transplantation are not available. Thus, we aimed to identify the best possible outcomes in DCD liver transplantation and to propose outcome reference values. Methods: Based on 2,219 controlled DCD liver transplantations, collected from 17 centres in North America and Europe, we identified 1,012 low-risk, primary, adult liver transplantations with a laboratory MELD score of ≤20 points, receiving a DCD liver with a total donor warm ischemia time of ≤30 minutes and asystolic donor warm ischemia time of ≤15 minutes. Clinically relevant outcomes were selected and complications were reported according to the Clavien-Dindo-Grading and the comprehensive complication index (CCI). Corresponding benchmark cut-offs were based on median values of each centre, where the 75th-percentile was considered. Results: Benchmark cases represented between 19.7% and 75% of DCD transplantations in participating centres. The 1-year retransplant and mortality rates were 4.5% and 8.4% in the benchmark group, respectively. Within the first year of follow-up, 51.1% of recipients developed at least 1 major complication (≥Clavien-Dindo-Grade III). Benchmark cut-offs were ≤3 days and ≤16 days for ICU and hospital stay, ≤66% for severe recipient complications (≥Grade III), ≤16.8% for ischemic cholangiopathy, and ≤38.9 CCI points 1 year after transplant. Comparisons with higher risk groups showed more complications and impaired graft survival outside the benchmark cut-offs. Organ perfusion techniques reduced the complications to values below benchmark cut-offs, despite higher graft risk. Conclusions: Despite excellent 1-year survival, morbidity in benchmark cases remains high. Benchmark cut-offs targeting morbidity parameters offer a valid tool to assess the protective value of new preservation technologies in hi

Published
2022

9. A multicentre outcome analysis to define global benchmarks for donation after circulatory death liver transplantation

Author

Schlegel, A, van Reeven, M, Croome, K, Parente, A, Dolcet, A, Widmer, J, Meurisse, N, De Carlis, R, Hessheimer, A, Jochmans, I, Mueller, M, van Leeuwen, O, Nair, A, Tomiyama, K, Sherif, A, Elsharif, M, Kron, P, van der Helm, D, Borja-Cacho, D, Bohorquez, H, Germanova, D, Dondossola, D, Olivieri, T, Camagni, S, Gorgen, A, Patrono, D, Cescon, M, Croome, S, Panconesi, R, Flores Carvalho, M, Ravaioli, M, Caicedo, J, Loss, G, Lucidi, V, Sapisochin, G, Romagnoli, R, Jassem, W, Colledan, M, De Carlis, L, Rossi, G, Di Benedetto, F, Miller, C, van Hoek, B, Attia, M, Lodge, P, Hernandez-Alejandro, R, Detry, O, Quintini, C, Oniscu, G, Fondevila, C, Malagó, M, Pirenne, J, Ijzermans, J, Porte, R, Dutkowski, P, Taner, C, Heaton, N, Clavien, P, Polak, W, Muiesan, P, Schlegel, Andrea, van Reeven, Marjolein, Croome, Kristopher, Parente, Alessandro, Dolcet, Annalisa, Widmer, Jeannette, Meurisse, Nicolas, De Carlis, Riccardo, Hessheimer, Amelia, Jochmans, Ina, Mueller, Matteo, van Leeuwen, Otto B, Nair, Amit, Tomiyama, Koji, Sherif, Ahmed, Elsharif, Mohamed, Kron, Philipp, van der Helm, Danny, Borja-Cacho, Daniel, Bohorquez, Humberto, Germanova, Desislava, Dondossola, Daniele, Olivieri, Tiziana, Camagni, Stefania, Gorgen, Andre, Patrono, Damiano, Cescon, Matteo, Croome, Sarah, Panconesi, Rebecca, Flores Carvalho, Mauricio, Ravaioli, Matteo, Caicedo, Juan Carlos, Loss, George, Lucidi, Valerio, Sapisochin, Gonzalo, Romagnoli, Renato, Jassem, Wayel, Colledan, Michele, De Carlis, Luciano, Rossi, Giorgio, Di Benedetto, Fabrizio, Miller, Charles M, van Hoek, Bart, Attia, Magdy, Lodge, Peter, Hernandez-Alejandro, Roberto, Detry, Olivier, Quintini, Cristiano, Oniscu, Gabriel C, Fondevila, Constantino, Malagó, Massimo, Pirenne, Jacques, IJzermans, Jan Nm, Porte, Robert J, Dutkowski, Philipp, Taner, C Burcin, Heaton, Nigel, Clavien, Pierre-Alain, Polak, Wojciech G, Muiesan, Paolo, Schlegel, A, van Reeven, M, Croome, K, Parente, A, Dolcet, A, Widmer, J, Meurisse, N, De Carlis, R, Hessheimer, A, Jochmans, I, Mueller, M, van Leeuwen, O, Nair, A, Tomiyama, K, Sherif, A, Elsharif, M, Kron, P, van der Helm, D, Borja-Cacho, D, Bohorquez, H, Germanova, D, Dondossola, D, Olivieri, T, Camagni, S, Gorgen, A, Patrono, D, Cescon, M, Croome, S, Panconesi, R, Flores Carvalho, M, Ravaioli, M, Caicedo, J, Loss, G, Lucidi, V, Sapisochin, G, Romagnoli, R, Jassem, W, Colledan, M, De Carlis, L, Rossi, G, Di Benedetto, F, Miller, C, van Hoek, B, Attia, M, Lodge, P, Hernandez-Alejandro, R, Detry, O, Quintini, C, Oniscu, G, Fondevila, C, Malagó, M, Pirenne, J, Ijzermans, J, Porte, R, Dutkowski, P, Taner, C, Heaton, N, Clavien, P, Polak, W, Muiesan, P, Schlegel, Andrea, van Reeven, Marjolein, Croome, Kristopher, Parente, Alessandro, Dolcet, Annalisa, Widmer, Jeannette, Meurisse, Nicolas, De Carlis, Riccardo, Hessheimer, Amelia, Jochmans, Ina, Mueller, Matteo, van Leeuwen, Otto B, Nair, Amit, Tomiyama, Koji, Sherif, Ahmed, Elsharif, Mohamed, Kron, Philipp, van der Helm, Danny, Borja-Cacho, Daniel, Bohorquez, Humberto, Germanova, Desislava, Dondossola, Daniele, Olivieri, Tiziana, Camagni, Stefania, Gorgen, Andre, Patrono, Damiano, Cescon, Matteo, Croome, Sarah, Panconesi, Rebecca, Flores Carvalho, Mauricio, Ravaioli, Matteo, Caicedo, Juan Carlos, Loss, George, Lucidi, Valerio, Sapisochin, Gonzalo, Romagnoli, Renato, Jassem, Wayel, Colledan, Michele, De Carlis, Luciano, Rossi, Giorgio, Di Benedetto, Fabrizio, Miller, Charles M, van Hoek, Bart, Attia, Magdy, Lodge, Peter, Hernandez-Alejandro, Roberto, Detry, Olivier, Quintini, Cristiano, Oniscu, Gabriel C, Fondevila, Constantino, Malagó, Massimo, Pirenne, Jacques, IJzermans, Jan Nm, Porte, Robert J, Dutkowski, Philipp, Taner, C Burcin, Heaton, Nigel, Clavien, Pierre-Alain, Polak, Wojciech G, and Muiesan, Paolo

Abstract

Background & Aims: The concept of benchmarking is established in the field of transplant surgery; however, benchmark values for donation after circulatory death (DCD) liver transplantation are not available. Thus, we aimed to identify the best possible outcomes in DCD liver transplantation and to propose outcome reference values. Methods: Based on 2,219 controlled DCD liver transplantations, collected from 17 centres in North America and Europe, we identified 1,012 low-risk, primary, adult liver transplantations with a laboratory MELD score of ≤20 points, receiving a DCD liver with a total donor warm ischemia time of ≤30 minutes and asystolic donor warm ischemia time of ≤15 minutes. Clinically relevant outcomes were selected and complications were reported according to the Clavien-Dindo-Grading and the comprehensive complication index (CCI). Corresponding benchmark cut-offs were based on median values of each centre, where the 75th-percentile was considered. Results: Benchmark cases represented between 19.7% and 75% of DCD transplantations in participating centres. The 1-year retransplant and mortality rates were 4.5% and 8.4% in the benchmark group, respectively. Within the first year of follow-up, 51.1% of recipients developed at least 1 major complication (≥Clavien-Dindo-Grade III). Benchmark cut-offs were ≤3 days and ≤16 days for ICU and hospital stay, ≤66% for severe recipient complications (≥Grade III), ≤16.8% for ischemic cholangiopathy, and ≤38.9 CCI points 1 year after transplant. Comparisons with higher risk groups showed more complications and impaired graft survival outside the benchmark cut-offs. Organ perfusion techniques reduced the complications to values below benchmark cut-offs, despite higher graft risk. Conclusions: Despite excellent 1-year survival, morbidity in benchmark cases remains high. Benchmark cut-offs targeting morbidity parameters offer a valid tool to assess the protective value of new preservation technologies in higher risk grou

Published
2022

11. A multicentre outcome analysis to define global benchmarks for donation after circulatory death liver transplantation

Author

Schlegel, Andrea, primary, van Reeven, Marjolein, additional, Croome, Kristopher, additional, Parente, Alessandro, additional, Dolcet, Annalisa, additional, Widmer, Jeannette, additional, Meurisse, Nicolas, additional, De Carlis, Riccardo, additional, Hessheimer, Amelia, additional, Jochmans, Ina, additional, Mueller, Matteo, additional, van Leeuwen, Otto B., additional, Nair, Amit, additional, Tomiyama, Koji, additional, Sherif, Ahmed, additional, Elsharif, Mohamed, additional, Kron, Philipp, additional, van der Helm, Danny, additional, Borja-Cacho, Daniel, additional, Bohorquez, Humberto, additional, Germanova, Desislava, additional, Dondossola, Daniele, additional, Olivieri, Tiziana, additional, Camagni, Stefania, additional, Gorgen, Andre, additional, Patrono, Damiano, additional, Cescon, Matteo, additional, Croome, Sarah, additional, Panconesi, Rebecca, additional, Carvalho, Mauricio Flores, additional, Ravaioli, Matteo, additional, Caicedo, Juan Carlos, additional, Loss, George, additional, Lucidi, Valerio, additional, Sapisochin, Gonzalo, additional, Romagnoli, Renato, additional, Jassem, Wayel, additional, Colledan, Michele, additional, De Carlis, Luciano, additional, Rossi, Giorgio, additional, Di Benedetto, Fabrizio, additional, Miller, Charles M., additional, van Hoek, Bart, additional, Attia, Magdy, additional, Lodge, Peter, additional, Hernandez-Alejandro, Roberto, additional, Detry, Olivier, additional, Quintini, Cristiano, additional, Oniscu, Gabriel C., additional, Fondevila, Constantino, additional, Malagó, Massimo, additional, Pirenne, Jacques, additional, IJzermans, Jan N.M., additional, Porte, Robert J., additional, Dutkowski, Philipp, additional, Taner, C. Burcin, additional, Heaton, Nigel, additional, Clavien, Pierre-Alain, additional, Polak, Wojciech G., additional, Muiesan, Paolo, additional, Alwayn, Ian P.J., additional, van der Berg, Aad P., additional, Carbonaro, Margherita, additional, Claasen, Marco, additional, Daud, Amna, additional, de Meijer, Vincent E., additional, Metselaar, Herold J., additional, Monbaliu, Diethard, additional, Paolucci, Maite, additional, Vets, Sofie, additional, and Winter, Erin, additional

Published
2022
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12. Protection from childhood hay fever in farm environment

Author

Pechlivanis, Sonali, primary, Depner, Martin, additional, Pekkanen, Juha, additional, Roduit, Caroline, additional, Riedler, Josef, additional, Divaret-Chauveau, Amandine, additional, Lauener, Roger, additional, Karvonen, Anne M., additional, Roponen, Marjut, additional, Schaub, Bianca, additional, Schmausser-Hechfellner, Elisabeth, additional, Loss, George, additional, Kirjavainen, Pirkka V., additional, Mills, David, additional, Renz, Harald, additional, Pfefferle, Petra I., additional, Illi, Sabina, additional, and Von Mutius, Erika, additional

Published
2021
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16. Liver Transplantation Using Hepatitis C Virus–Viremic Donors Into Hepatitis C Virus–Aviremic Recipients as Standard of Care

Author

Bohorquez, Humberto, primary, Bugeaud, Emily, additional, Bzowej, Natalie, additional, Scheuermann, Jennifer, additional, Hand, Jonathan, additional, Bruce, David, additional, Carmody, Ian, additional, Cohen, Ari, additional, Joshi, Shobha, additional, Seal, John, additional, Sonnier, Dennis, additional, Therapondos, George, additional, Girgrah, Nigel, additional, Anders, Stephanie, additional, and Loss, George E., additional

Published
2021
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19. A Step toward Standardization: Results of two National Surveys of Best Practices in Donation after Circulatory Death Liver Recovery and Recommendations from The American Society of Transplant Surgeons and Association of Organ Procurement Organizations

Author

Hobeika, Mark J., primary, Glazner, Robert, additional, Foley, David P., additional, Hanish, Steven, additional, Loss, George, additional, Quintini, Cristiano, additional, Eidbo, Elling, additional, Zollinger, Charles, additional, Ruterbories, Jay, additional, Lebovitz, Daniel J., additional, and Axelrod, David, additional

Published
2020
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29. Antibody-Mediated Rejection: A Review

Author

Garces, Jorge Carlos, Giusti, Sixto, Staffeld-Coit, Catherine, Bohorquez, Humberto, Cohen, Ari J., and Loss, George E.

Subjects
Focus on Transplantation
Abstract

Chronic antibody injury is a serious threat to allograft outcomes and is therefore the center of active research. In the continuum of allograft rejection, the development of antibodies plays a critical role. In recent years, an increased recognition of molecular and histologic changes has provided a better understanding of antibody-mediated rejection (AMR), as well as potential therapeutic interventions. However, several pathways are still unknown, which accounts for the lack of efficacy of some of the currently available agents that are used to treat rejection.We review the current diagnostic criteria for AMR; AMR paradigms; and desensitization, treatment, and prevention strategies.Chronic antibody-mediated endothelial injury results in transplant glomerulopathy, manifested as glomerular basement membrane duplication, double contouring, or splitting. Clinical manifestations of AMR include proteinuria and a rise in serum creatinine. Current strategies for the treatment of AMR include antibody depletion with plasmapheresis (PLEX), immunoadsorption (IA), immunomodulation with intravenous immunoglobulin (IVIG), and T cell- or B cell-depleting agents. Some treatment benefits have been found in using PLEX and IA, and some small nonrandomized trials have identified some benefits in using rituximab and the proteasome inhibitor-based therapy bortezomib. More recent histologic follow-ups of patients treated with bortezomib have not shown significant benefits in terms of allograft outcomes. Furthermore, no specific treatment approaches have been approved by the US Food and Drug Administration. Other agents used for more difficult rejections include bortezomib and eculizumab (an anti-C5 monoclonal antibody).AMR is a fascinating field with ample opportunities for research and progress in the future. Despite the use of advanced techniques for the detection of human leukocyte antigen (HLA) or non-HLA donor-specific antibodies, alloimmune response remains an important barrier for successful long-term allograft function. Treatment of AMR with currently available therapies has produced a variety of results, some of them suboptimal, precluding the development of standardized protocols. New therapies are promising, but randomized controlled trials are needed to find surrogate markers and improve the efficacy of therapy.

Published
2017

30. Novel Biliary Reconstruction Techniques During Liver Transplantation

Author

Carmody, Ian C., Romano, John, Bohorquez, Humberto, Bugeaud, Emily, Bruce, David S., Cohen, Ari J., Seal, John, Reichman, Trevor W., and Loss, George E.

Subjects
Focus on Transplantation
Abstract

Biliary complications remain a significant problem following liver transplantation. Several surgical options can be used to deal with a significant size mismatch between the donor and recipient bile ducts during the biliary anastomosis. We compared biliary transposition to recipient biliary ductoplasty in cadaveric liver transplant.A total of 33 reconstructions were performed from January 1, 2005 to December 31, 2013. In the biliary transposition group (n=23), 5 reconstructions were performed using an internal stent (5 or 8 French pediatric feeding tube), and 18 were performed without. Of the 10 biliary ductoplasties, 2 were performed with a stent. All patients were managed with standard immunosuppression and ursodiol. Follow-up ranged from 2 months to 5 years.No patients in the biliary transposition group required reoperation; 1 patient had an internal stent removed for recurrent unexplained leukocytosis, and 2 patients required endoscopic retrograde cholangiography and stent placement for evidence of stricture. Three anastomotic leaks occurred in the biliary ductoplasty group, and 2 patients in the biliary ductoplasty group required reoperation for biliary complications.Our results indicate that biliary reconstruction can be performed with either biliary transposition or biliary ductoplasty. These techniques are particularly useful when a significant mismatch in diameter exists between the donor and recipient bile ducts.

Published
2017

33. Role of Special Coagulation Studies for Preoperative Screening of Thrombotic Complications in Simultaneous Pancreas-Kidney Transplantation

Author

Moiz, Abdul, Javed, Tariq, Bohorquez, Humberto, Bruce, David S., Carmody, Ian C., Cohen, Ari J., Staffeld-Coit, Catherine, Luo, Qingyang, Loss, George E., and Garces, Jorge

Subjects
Article, Original Research
Abstract

Vascular thrombosis is a well-known complication after simultaneous pancreas-kidney (SPK) transplantation procedures. The role of preoperative special coagulation studies to screen patients at high risk for vascular thrombosis is unclear and not well studied.This study reports a retrospective medical record review of 83 SPK procedures performed between April 2007 and June 2013 in a single institution. All SPK transplantation recipients underwent preoperative screening for hypercoagulable state.Eighteen of 83 patients (21.69%) were diagnosed with vascular thrombosis of the pancreas. Of the 23 patients with at least 1 positive screening test, only 4 had a thrombotic event (17.39%). On the other hand, 14 of 60 patients with negative screening tests developed vascular thrombosis (23.33%). The hypercoagulable screening workup had a positive predictive value of 17.39% and a negative predictive value of 76.67%. The workup also demonstrated low sensitivity (22.22%) and specificity (70.77%).No differences were seen in patient or graft survival between groups at 12 months. This retrospective study did not show any benefit of using special coagulation studies to rule out patients at risk for vascular thrombosis after SPK transplantation.

Published
2015

34. Sa1626 Transcatheter Aortic Valve Replacement (TAVR) for Severe Aortic Stenosis as a Bridge to Liver Transplantation

Author

Syed, Rashid Z., primary, Cox-Alomar, Pedro, additional, Bohorquez, Humberto, additional, Therapondos, George, additional, Girgrah, Nigel, additional, Joshi, Shobha, additional, Tyson, Gia, additional, Reichman, Trevor, additional, Carmody, Ian, additional, Loss, George, additional, Cohen, Ari, additional, Bruce, David, additional, Ahmed, Emily, additional, Seal, John, additional, Parrino, Patrick, additional, Ramee, Stephen, additional, and Bzowej, Natalie, additional

Published
2016
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35. Reply

Author

Seal, John B., primary, Selzner, Markus, additional, and Loss, George, additional

Published
2015
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39. Post-Liver Transplant Delirium Increases Mortality and Length of Stay.

Author

Oliver, Nathan, Bohorquez, Humberto, Anders, Stephanie, Freeman, Andrew, Fine, Kerry, Ahmed, Emily, Bruce, David S., Carmody, Ian C., Cohen, Ari J., Seal, John, Reichman, Trevor W., and Loss, George E.

Subjects
COGNITION disorders, RISK of delirium, LIVER transplantation
Abstract

The article discusses the risk of delirium following liver transplant (LT) to increase the possibility of morbidity and mortality months after posttransplant.

Published
2017

40. Balloon-Occlusion Technique for Managing Portal Vein Hemorrhage in Liver Transplantation.

Author

Seal, John B., Bohorquez, Humberto, Battula, Naren, DeGregorio, Lucia, Bugeaud, Emily, Bruce, David S., Carmody, Ian C., Cohen, Ari J., and Loss, George E.

Subjects
ENDOVASCULAR surgery, PREOPERATIVE care, LIVER transplantation, BALLOON occlusion, PORTAL vein, HEMORRHAGE
Abstract

The article discusses the essential of careful preoperative planning and expectation of possible problems for safe and effective management of complex portal vein thrombosis (PVT) intraoperatively.

Published
2017

41. Impaired Expression of Type I and Type II Interferon Receptors in HCV-Associated Chronic Liver Disease and Liver Cirrhosis

Author

Chandra, Partha K., primary, Gunduz, Feyza, additional, Hazari, Sidhartha, additional, Kurt, Ramazan, additional, Panigrahi, Rajesh, additional, Poat, Bret, additional, Bruce, David, additional, Cohen, Ari J., additional, Behorquez, Humberto E., additional, Carmody, Ian, additional, Loss, George, additional, Balart, Luis A., additional, Wu, Tong, additional, and Dash, Srikanta, additional

Published
2014
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