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1. Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study

Author: T Richards, S Shaikh, S Rehman, A Khan, J Shah, C Smith, A Brown, S Singh, A P Arnaud, A Young, D Bowen, P Patel, S Williams, J Dunn, J John, M Loubani, A Hainsworth, A Kolias, PJ Hutchinson, R Singh, S Sinha, S Shaw, J Edwards, S Mukherjee, AAB Jamjoom, A Singh, S Saeed, J Martin, S Smith, S Ross, M Mohan, P Hutchinson, G James, RDC Moon, P Brennan, A Williams, S Brown, A Ward, M Lee, K Thompson, S Ali, J Williams, S Reid, U Khan, J Lambert, A Smith, B Singh, M Hassan, N Sharma, J Reynolds, N Wright, T Williams, H Smith, M Ng, M Rahman, A Taylor, P Shah, D Saxena, J Evans, I Omar, M Ali, A Hanson, Z Li, R Andrade, P Cardoso, H Jeong, P Sharma, M Arrieta, J Clark, L Pearce, J McVeigh, V Sharma, B Kim, J Singh, S Newman, J Byrne, A Hassan, A Persad, A Gardner, H Liu, K Shah, I Hughes, S Davison, A Balakrishnan, K Patel, J Hall, S Mistry, J Parry, R Baumber, N McGrath, E Ross, R Mannion, S Murphy, FL Wright, A Rogers, B Rai, M Thomas, R Ribeiro, E Hamilton, J Teixeira, B Davidson, L Carvalho, R Garrido, A Puppo, A Guimarães, E Santos, M Kamal, M Denning, M Elhadi, J E Fitzgerald, D Miller, M Gowda, C Morris, A Phillips, H Yang, Y Zhang, N Machairas, A Fisher, A Kaufmann, A Aggarwal, L Hansen, M Otify, H Soleymani Majd, A Jones, M Rodrigues, S Sundar, C Jones, R Edmondson, A Sharkey, L Smith, G Williams, J Dunning, E Belcher, D Stavroulias, V Zamvar, M Patel, M Baker, R Evans, M Sherif, J Hopkins, R Mohammed, A Hill, H Jackson, G Jones, K George, J Dixon, A Tong, S Jallad, Deborah S Keller, A Pereira, L Elliott, D Ford, A Sermon, M Almond, Andrew Metcalfe, C Peluso, T White, S Shah, A Witek, Chetan Khatri, A Tiwari, T Lo, K Agarwal, C Sweeney, C Hart, T Holme, S Green, I Ahmed, A Sobti, C Anderson, N Modi, R Campbell, C Magee, M Mirza, D Jones, N Stylianides, X Luo, C Kang, J Ribeiro, L Kumar, J Diaz, A Bhalla, R Young, C Perkins, A James, A Walters, J Reid, R Pereira, C McDonald, A Aujayeb, K Jackson, M Allen, D Ghosh, M Chan, C Price, K Khan, R Moore, M Ibrahim, A Marchbank, M Silva, M Baig, J De Coster, J Castellanos, S Saxena, M Duque, E Li, E Martin, A Isik, J González, RJ Davies, B Smith, R Owen, K Lakhoo, M Rogers, MA Akhtar, K Mellor, S Agrawal, L Foster, G Harris, J McIntyre, M Garner, R West, R Cuthbert, D Johnson, H Gomes, C Roy, N Spencer, D Mehta, J Freedman, J Blair, K Rajput, K Williams, J Wall, A Soliman, F Chen, A Mokhtari, I Mohamed, J Pascoe, M Khalifa, R Das, A Lara, M Costa, A Mahmoud, K Roberts, J Lane, S Robertson, J P Evans, E Krishnan, I Haq, S Rogers, J Knowles, M Chowdhury, A Ghanbari, L Macdonald, S Powell, J Hunt, J Cornish, J Engel, S Page, I Blake, A Rolls, H Ross, D Simpson, J Hammond, A Goyal, K Parkins, A Desai, A Gaunt, A Salim, Y Yousef, A Schache, H Mohan, SR Brown, R Nair, M Flatman, J Lord, RJ Egan, R Harries, N Judkins, K Sugand, T Hine, J Luck, C Johnson, G Salerno, AW Phillips, R Houston, A Volpe, C Walker, C Steele, M Rela, C Barry, R Alves, L Ramsay, A Turnbull, A Daniele, C S Jones, P Gallagher, G Gradinariu, A Oliveira, C Hardie, H Ferguson, S Bhattacharya, E Davies, P Joshi, C Mellor, E Griffiths, A Bhangu, R Mahoney, F Kashora, G Ruiz, K Wong, G Hill, V Testa, S Ford, C Park, P Gomez, C Lopes, A Lázaro, A Shabana, A Agarwal, C Chung, C Politis, G Martin, E Chung, M Ismail, C Cunha, S Correia, I Santos, A Tang, A Robson, T Collier, G Baltazar, M Quintana, C English, M Ip, K Newton, J Kahn, C Tan, D Cheng, R Woods, M Ho, A ABBAS, A Henry, F Rivas, M Mohammed, N Parsons, T Board, S Madan, A Osorio, M Jarvis, M Hashem, A Egglestone, E Halliday, A Ridgway, G Gallo, J Gilliland, W Marx, R Shaw, A Mahmood, K Gohil, B Gallagher, D Alderson, A Karim, G D Stewart, G Peck, L Majkowski, J Carter, H Ishii, L HUMPHREYS, J Khan, S Abbott, C Newton, F Borghi, A Sud, K Bhatia, H Cao, V Vijay, L Sanderson, E Holler, N Hanna, D Ferguson, P Miranda, L Pickering, T Singhal, T Newman, K Ghosh, C Camacho, D Manning, C Lipede, R Clifford, S Higgs, C Menakaya, S Shankar, K Booth, M Abdalla, T Nelson, T Farrell, H Naseem, J Johnstone, A Wilkins, A Brunt, A Nogués, A Patience, D Jeevan, M Vatish, G Stables, S Adegbola, I Hunt, K Dickson, W Matthews, N Dunne, M Maher, G Faulkner, E Hernandez, R Sofat, K Sahnan, A Brunelli, M Raza, K Chui, C Brennan, P Vaughan, H Chu, R Hagger, ASD Liyanage, R Perkins, S Duff, C Gill, H Dean, S Bandyopadhyay, K Ragupathy, Y Cunningham, A Bateman, V Brown, B Ho, E Britton, H Ikram, R Hasan, A Colquhoun, S Handa, A Maqsood, M Caputo, J Torkington, G Fusai, N Hossain, DJ Lin, S Stefan, IR Daniels, D Pournaras, A Askari, P Nisar, S Moug, J Sagar, N Yassin, G Minto, Z Hamady, JR O'Neill, S Chowdhury, R Cresner, D Vimalachandran, FD Mcdermott, RP Jones, P Zerbib, L Sreedharan, S Wahed, SS Gisbertz, MI van Berge Henegouwen, R Preece, I Liew, S McCluney, D Watts, D Nehra, B Dean, D Chaudhry, L Ross, F Solari, S Chatterji, B Barmayehvar, S Lourenco, L Onos, F Mansour, A Radhakrishnan, M Varcada, M Richmond, I Hernández, A Spinelli, H Pham, J Shalhoub, F Wells, K Bevan, A Peckham-Cooper, N Campain, J Steinke, R Wilkin, K McEvoy, S Mastoridis, N Fine, J Bayer, Y Joshi, A Yener, S C McKay, NS Kalson, S Horvath, H Fu, A Parente, SE Lewis, Y Ahmad, G Seidel, M Dunstan, U von Oppell, J Vatish, H Hirsch, K Breen, C Dott, D Mathieu, J Hardie, K Aldridge, A Doorgakant, P Petrone, R Tansey, M El Amrani, C Branco, Y Viswanath, A Meagher, B Keeler, N Tewari, A Gabr, J Kinross, M Longhi, E M Harrison, P Daliya, P Asaad, F Langlands, N Misra, S Kristinsson, S Di Saverio, C Conso, H Roy, E Massie, L Masterson, D Baskaran, A Hannah, O Ismail, S URBAN, J Domenech, S Ranjit, L Massey, S Mannan, D Rutherford, F Colombo, R Kulkarni, D Kearney, Neil J Smart, G Bourke, D Shrestha, P Nankivell, O Breik, R Exley, D Zakai, AK Abou-Foul, P Naredla, R Vidya, G Mundy, H Marin, A E Ward, A Sudarsanam, W Singleton, M Ganau, F Moura, J Blanco, R Myatt, S Sousa, H Zahid, S Garrido, A Fell, E Caruana, D Nepogodiev, F Dhaif, B Bankhad-Kendall, H Kaafarani, C Bretherton, L Marais, K Siaw-Acheampong, B E Dawson, J C Glasbey, R R Gujjuri, E Heritage, S K Kamarajah, J M Keatley, S Lawday, G Pellino, J F F Simoes, I M Trout, M L Venn, R J W Wilkin, A O Ademuyiwa, E Al Ameer, O Alser, K M Augestad, B Bankhead-Kendall, R A Benson, S Chakrabortee, R Blanco-Colino, A Brar, A Minaya Bravo, K A Breen, I Lima Buarque, M F Cunha, G H Davidson, S Farik, M Fiore, G M A Gomes, C Halkias, I Lawani, H Lederhuber, S Leventoglu, M W Loffler, H Mashbari, D Mazingi, D Moszkowicz, J S Ng-Kamstra, S Metallidis, M Niquen, F Ntirenganya, O Outani, F Pata, T D Pinkney, P Pockney, D Radenkovic, A Ramos-De la Medina, A Schnitzbauer, S Shu, K Soreide, S Tabiri, P Townend, G Tsoulfas, G van Ramshorst, Mak JKC, F Tirotta, A Kisiel, LD Cato, AM Pathanki, A Chebaro, K Lecolle, S Truant, FR Pruvot, E Surmei, L Mattei, J Dudek, S El-Hasani, J Cuschieri, GH Davidson, RG Wade, H Elkadi, C Pompili, JR Burke, E Bagouri, Z Abual-Rub, S Munot, M Kowal, SC Winter, F Di Chiara, K Wallwork, A Qureishi, M Lami, S Sravanam, S Chidambaram, R Smillie, AV Shaw, C Cernei, D Jeyaretna, RJ Piper, E Duck, C Jelley, SC Tucker, G Bond-Smith, XL Griffin, GD Tebala, N Neal, TM Noton, H Ghattaura, OBF Risk, H Kharkar, C Verberne, A Senent-Boza, A Sánchez-Arteaga, I Benítez-Linero, F Manresa-Manresa, L Tallón-Aguilar, L Melero-Cortés, MR Fernández-Marín, VM Durán-Muñoz-Cruzado, I Ramallo-Solís, P Beltrán-Miranda, F Pareja-Ciuró, BT Antón-Eguía, AC Dawson, A Drane, F Oliva Mompean, J Gomez-Rosado, J Reguera-Rosal, J Valdes-Hernandez, L Capitan-Morales, del Toro Lopez, A Alanbuki, O Usman, AJ Beamish, D Bosanquet, D Magowan, H Nassa, G Mccabe, D Holroyd, NB Jamieson, NM Mariani, V Nicastro, D Motter, C Jenvey, T Minto, DR Sarma, C Godbole, W Carlos, A Khajuria, H Connolly, G Di Taranto, S Shanbhag, J Skillman, M Sait, H Al-omishy, B Heer, R Lunevicius, ARG Sheel, M Sundhu, AJA Santini, Fathelbab MSAT, KMA Hussein, QM Nunes, K Shahzad, Baig MMAS, JL Hughes, A Kattakayam, SB Shah, AL Clynch, N Georgopoulou, HM Sharples, AA Apampa, IC Nzenwa, D Podolsky, NL Coleman, MP Callahan, P Beak, I Gerogiannis, A Ebrahim, A Alwadiya, C Demetriou, E Grimley, E Theophilidou, E Ogden, FL Malcolm, G Davies-Jones, Ng JCK, N Elmaleh, Z Chia, J A'Court, A Konarski, R Talwar, P S Jambulingam, A Maity, C Hatzantonis, S Kudchadkar, N Cirocchi, CH Chan, H Eberbach, B Erdle, R Sandkamp, G Velmahos, LR Maurer, M El Moheb, A Gaitanidis, L Naar, MA Christensen, C Kapoen, K Langeveld, M El Hechi, B Main, T Maccabe, NS Blencowe, DP Fudulu, D Bhojwani, M Baquedano, F Rapetto, O Flannery, D Tadross, C Blundell, S Forlani, S Guha, CJ Kelty, G Chetty, G Lye, SP Balasubramanian, N Sureshkumar Shah, A Al-mukhtar, E Whitehall, A Giblin, A Adamec, J Konsten, M Van Heinsbergen, A Sou, J Jimeno Fraile, D Morales-Garcia, M Carrillo-Rivas, E Toledo Martínez, Pascual À, A Landaluce-olavarria, M Gonzalez De miguel, Fernández Gómez Cruzado L, E Begoña, D Lecumberri, A Calvo Rey, GM Prada hervella, L Dos Santos Carregal, MI Rodriguez Fernandez, M Freijeiro, S El Drubi Vega, J Van den Eynde, W Oosterlinck, R Van den Eynde, A Boeckxstaens, A Cordonnier, J Jaekers, M Miserez, M Galipienso Eri, JD Garcia Montesino, J Dellonder Frigolé, D Noriego Muñoz, V Lizzi, F Vovola, A Arminio, A Cotoia, AL Sarni, M Bekheit, BS Kamera, M Elhusseini, A Ahmeidat, W Cymes, G Mignot, J Agilinko, A Sgrò, MM Rashid, K Milne, KE Stewart, MSJ Wilson, K McGivern, BC Brown, B Wadham, IA Aneke, J Collis, H Warburton, DM Fountain, R Laurente, KV Sigamoney, M Dasa, Z Naqui, M Galhoum, MT Hasan, R Kalenderov, O Pathmanaban, R Chelva, K Subba, M Khalefa, F Hossain, T Moores, J Anthoney, O Emmerson, R Makin-Taylor, CS Ong, R Callan, O Bloom, G Chauhan, J Kaur, A Burahee, S Bleibleh, N Pigadas, D Snee, S Bhasin, A Crichton, A Habeebullah, AS Bodla, M Mondragon, V Dewan, MC Giuffrida, A Marano, S Palagi, S Di Maria Grimaldi, A Simonato, M D'Agruma, R Chiarpenello, L Pellegrino, F Maione, D Cianflocca, Pruiti Ciarello, G Giraudo, E Gelarda, E Dalmasso, A Abrate, V Ciriello, F Rosato, A Garnero, L Leotta, M Chiozza, G Anania, A Urbani, M Koleva Radica, P Carcoforo, M Portinari, M Sibilla, JE Archer, A Odeh, N Siddaiah, H Carmichael, CG Velopulos, RC McIntyre, TJ Schroeppel, EA Hennessy, L Zier, C Parmar, JM Muñoz Vives, CJ Gómez Díaz, CA Guariglia, C Soto Montesinos, L Sanchon, M Xicola Martínez, N Guàrdia, P Collera, R Diaz Del Gobbo, R Sanchez Jimenez, R Farre Font, R Flores Clotet, CEM Brathwaite, H Hakmi, AH Sohail, R Heckburn, D Townshend, N McLarty, A Shenfine, K Madhvani, M Hampton, AP Hormis, V Miu, K Sheridan, C Luney, MA Williams, A Alqallaf, A Ben-Sassi, R Crichton, J Sonksen, GR Layton, B Karki, S Pankhania, S Asher, A Folorunso, J Winyard, J Mangwani, BHB Babu, C Weerasinghe, M Ballabio, P Bisagni, T Armao, M Madonini, A Gagliano, P Pizzini, A Älgå, M Nordberg, G Sandblom, J El Kafsi, K Logishetty, A Saadya, R Midha, H Subbiah Ponniah, T Stockdale, T Bacarese-Hamilton, N Anjarwalla, D Marujo Henriques, R Hettige, C Baban, A Tenovici, F Anazor, SD King, S Kazzaz, S HKruijff, De Vries JPPM, PJ Steinkamp, PKC Jonker, WY Van der Plas, W Bierman, Y Janssen, ABJ Borgstein, D Enjuto, M Perez Gonzalez, P Díaz Peña, M Marqueta De Salas, P Martinez Pascual, L Rodríguez Gómez, R Garcés García, A Ramos Bonilla, N Herrera-Merino, P Fernández Bernabé, EP Cagigal Ortega, García de Castro Rubio E, I Cervera, MH Siddique, C Barmpagianni, A Basgaran, A Basha, V Okechukwu, A Bartsch, CA Leo, HK Ubhi, N Zafar, H Abdul-Jabar, F Mongelli, M Bernasconi, M Di Giuseppe, D Christoforidis, D La Regina, M Arigoni, A Al-Sukaini, S Mediratta, O Brown, M Boal, S Stanger, H Abdalaziz, J Constable, G Dovell, R Gopi reddy, A Dehal, HB Shah, GWV Cross, P Seyed-Safi, YW Smart, A Kuc, M Al-Yaseen, B Jayasankar, D Balasubramaniam, K Abdelsaid, N Mundkur, RE Soulsby, O Ryska, T Raymond, P Hawkin, G Kinnaman, I Sharma, K Freystaetter, JN Hadfield, A Hilley, S Arkani, M Youssef, I Shaikh, K Seebah, V Kouritas, D Chrastek, G Maryan, DF Gill, F Khatun, J Parakh, V Sarodaya, A Daadipour, KD Bosch, V Bashkirova, LS Dvorkin, VK Kalidindi, A Choudhry, M Espino Segura-Illa, G Sánchez Aniceto, AM Castaño-Leon, L Jimenez-Roldan, J Delgado Fernandez, A Pérez Núñez, A Lagares, D Garcia Perez, M Santas, I Paredes, O Esteban Sinovas, L Moreno-Gomez, E Rubio, V Vega, A Vivas Lopez, M Labalde Martinez, O García Villar, PM Pelaéz Torres, J Garcia Borda, E Ferrero Herrero, C Eiriz Fernandez, C Ojeda-Thies, JM Pardo Garcia, H Wynn Jones, H Divecha, C Whelton, E Powell-Smith, M Alotaibi, A Maashi, A Zowgar, M Alsakkaf, O Izquierdo, D Ventura, D Escobar, U Garcia de cortazar, Villamor Garcia, A Cioci, K Rakoczy, W Pavlis, R Saberi, A Khaleel, A Unnithan, K Memon, RR Pala Bhaskar, F Maqboul, F Kamel, A Al-Samaraee, R Madani, H Llaquet Bayo, N Duchateau, C De Gheldere, A Fayad, ML Wood, G Groot, I Hakami, C Boeker, J Mall, AF Haugstvedt, ML Jönsson, P Caja Vivancos, Villalabeitia Ateca, M Prieto Calvo, P Martin Playa, A Gainza, EJ Aragon Achig, A Rodriguez Fraga, Melchor Corcóstegui, G Mallabiabarrena Ormaechea, JJ Garcia Gutierrez, L Barbier, MA Pesántez Peralta, M Jiménez Jiménez, JA Municio Martín, J Gómez Suárez, G García Operé, LA Pascua Gómez, M Oñate Aguirre, A Fernandez-Colorado, M De la Rosa-Estadella, A Gasulla-Rodriguez, M Serrano-Martin, A Peig-Font, S Junca-Marti, M Juarez-Pomes, S Garrido-Ondono, L Blasco-Torres, M Molina-Corbacho, Y Maldonado-Sotoca, A Gasset-Teixidor, J Blasco-Moreu, V Turrado-Rodriguez, AM Lacy, FB de Lacy, X Morales, A Carreras-Castañer, P Torner, M Jornet-Gibert, M Balaguer-Castro, M Renau-Cerrillo, P Camacho-Carrasco, M Vives-Barquiel, B Campuzano-Bitterling, I Gracia, R Pujol-Muncunill, M Estaire Gómez, D Padilla-Valverde, S Sánchez-García, D Sanchez-Pelaez, E Jimenez Higuera, R Picón Rodríguez, Fernández Camuñas À, C Martínez-Pinedo, EP Garcia Santos, V Muñoz-Atienza, A Moreno Pérez, CA Cano, D Crego-Vita, M Huecas-Martinez, A Roselló Añón, MJ Sangüesa, JC Bernal-Sprekelsen, JC Catalá Bauset, P Renovell Ferrer, C Martínez Pérez, O Gil-Albarova, J Gilabert Estellés, K Aghababyan, R Rivas, J Escartin, JL Blas Laina, B Cros, Talal El-Abur, J Garcia Egea, C Yanez, JH Kauppila, E Sarjanoja, S Tzedakis, PA Bouche, S Gaujoux, D Gossot, A Seguin-Givelet, D Fuks, M Grigoroiu, R Sanchez Salas, X Cathelineau, P Macek, Y Barbé, F Rozet, E Barret, A Mombet, N Cathala, E Brian, F Zadegan, AJ Baldwin, E Gammeri, A Catton, S Marinos Kouris, J Pereca, M Kaushal, A Kler, V Reghuram, S Tezas, V Oktseloglou, F Mosley, MFI De La Cruz Monroy, P Bobak, S Ahad, E Lostis, GK Ambler, J Manara, M Doe, T Jichi, GD Stewart, J Ramzi, AA Singh, J Ashcroft, OJ Baker, P Coughlin, Durst AZED, A Abood, A Habeeb, VE Hudson, B Lamb, L Luke, S Mitrasinovic, Ngu AWT, S Waseem, F Georgiades, XS Tan, J Pushpa-rajah, I Abu-Nayla, S Rooney, E Irune, MHV Byrne, A Durrani, A Sethuraman Venkatesan, T Combellack, G Tahhan, M Kornaszewska, V Valtzoglou, I Deglurkar, M Koutentakis, Syed Nong Chek SAH, M Shinkwin, F Ayeni, H Tustin, M Bordenave, N Manu, N Eardley, OL Serevina, S Roy Mahapatra, K Mohankumar, I Khawaja, A Palepa, T Doulias, Y Premakumar, Y Jauhari, Z Koshnow, A Uberai, F Hirri, BM Stubbs, J Manickavasagam, S Dalgleish, R Kanitkar, CJ Payne, Ng CE, DE Henshall, T Drake, EM Harrison, A Tambyraja, RJE Skipworth, G Linder, R McGregor, J Mayes, R Pasricha, A Razik, S Thrumurthy, D Howden, Z Baxter, L Osagie, M Bence, GE Fowler, N Rajaretnam, A Goubran, JS McGrath, JRA Phillips, DA Raptis, JM Pollok, F Soggiu, S Xyda, C Hidalgo Salinas, H Tzerbinis, T Pissanou, R Mirnezami, N Angamuthu, T Shakir, H Capitelli-McMahon, L Hitchman, A Andronic, A Aboelkassem Ibrahim, J Totty, S Tayeh, T Chase, J Ayorinde, T Cuming, A Trompeter, C Hing, P Tsinaslanidis, MW Benjamin, A Leyte, J Smelt, G Santhirakumaran, A Labib, O Lyons, S Onida, KM Sarraf, S Erridge, S Yalamanchili, A Abuown, D Davenport, S Wheatstone, SM Andreani, MF Bath, A Sahni, L Rigueros Springford, C Sohrabi, J Bacarese-Hamilton, FG Taylor, P Patki, C Tanabalan, ME Alexander, CJ Smart, L Abdeh, M Zeiton, R Advani, S Nikolaou, T Oni, N Ilahi, K Ballantyne, Z Woodward, R Merh, B Robertson-Smith, P Ameerally, JG Finch, C Gnanachandran, I Pop, D Dass, G Thiruchandran, Toh SKC, A Allana, C Bellis, O Babawale, YC Phan, U Lokman, T Koc, L Duggleby, S Shamoon, H Clancy, A Mansuri, A Thakrar, L Wickramarachchi, S Sivayoganathan, E Karam, HV Colvin, A Badran, A Cadersa, A Cumpstey, R Aftab, F Wensley, V Morrison-Jones, GK Sekhon, H Shields, Z Shakoor, T Talbot, A Alzetani, J Rooney, M Rudic, A Aladeojebi, M Kitchen, R Lefroy, P Nanjaiah, AD Rajgor, RJ Scurrah, LJ Watson, T Royle, B Steel, Luk ACO, VG Thiruvasagam, W Marlow, C Konstantinou, D Yershov, A Denning, E Mangos, T Nambirajan, I Flindall, V Mahendran, J De Marchi, NF Davis, A Picciariello, V Papagni, DF Altomare, S Granieri, C Cotsoglou, A Cabeleira, P Serralheiro, T Teles, C Canhoto, J Simões, AC Almeida, O Nogueira, R Athayde Nemésio, MJ Amaral, A Valente da Costa, R Martins, P Guerreiro, A Ruivo, D Breda, JM Oliveira, AL De Oliveira Lopez, M Colino, J De Barros, AP Soares, H Morais, T Revez, MI Manso, JC Domingues, P Henriques, Cardoso N Ribeiro VI, G Martins dos Santos, M Peralta Ferreira, J Ascensão, B Costeira, L Rio Rodrigues, M Sousa Fernandes, P Azevedo, I Lourenço, G Mendinhos, A Nobre Pinto, H Taflin, H Abdou, L O'Meara, Z Cooper, SA Hirji, BU Okafor, V Roxo, CP Raut, JS Jolissaint, DA Mahvi, C Reinke, S Merola, A Ssentongo, P Ssentongo, Oh JS, J Hazelton, J Maines, N Gusani, RCG Martin, N Bhutiani, R Choron, F Soliman, MD E Dauer, E Renza-Stingone, E Gokcen, E Kropf, H Sufrin, J Sewards, J Poggio, K Sanserino, L Rae, M Philp, M Metro, P McNelis, R Petrov, T Pazionis, DB Lumenta, SP Nischwitz, E Richtig, M Pau, P Srekl-Filzmaier, N Eibinger, B Michelitsch, M Fediuk, A Papinutti, TU Cohnert, E Kantor, J Kahiu, S Hosny, A Sultana, M Taggarsi, L Vitone, OP Vaz, I Sarantitis, S Timbrell, A Shugaba, GP Jones, SS Tripathi, MS Greenhalgh, H Emerson, K Vejsbjerg, W McCormick, K Singisetti, Y Aawsaj, R Vanker, M Ghobrial, S Kanthasamy, H Fawi, M Awadallah, J Cheung, S Tingle, F Abbadessa, A Sachdeva, CD Chan, I McPherson, F Mahmoud Ali, S Pandanaboyana, T Grainger, S Nandhra, N Dawe, C McCaffer, J Riches, J Moir, H Elamin Ahmed, C Saleh, RM Koshy, LJ Rogers, PL Labib, N Hope, K Emslie, P Panahi, E Clough, I Enemosah, J Natale, N Raza, JI Webb, M Antar, J Noel, R Nunn, F Eriberto, R Tanna, S Lodhia, C Osório, J Antunes, P Balau, and M Godinho
Subjects: Medicine
Abstract: Objectives Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.Setting Prospective, international, multicentre, observational cohort study.Participants Patients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome 30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.Results This study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).Conclusions Patients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration number NCT04323644
Published: 2021
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2. Future perspectives of robotics in liver transplantation

Author: A, Rammohan and M, Rela
Published: 2024
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3. Outcomes for high‐risk hepatoblastoma in a resource‐challenged setting

Author: A. Rammohan, M. Rela, G. V. Kumar, J. X. Scott, N. Shanmugam, M. S. Reddy, and P. Ramachandran
Subjects: Surgery, RD1-811
Abstract: Background Outcomes of high‐risk hepatoblastoma have been dismal, especially in resource‐challenged countries where access to chemotherapy and paediatric liver transplantation is limited for the underprivileged. This study aimed to assess the results of treatment of high‐risk hepatoblastoma in a tertiary centre, including patients who had non‐transplant surgical procedures in the form of extended resection. Methods A review of patients with high‐risk hepatoblastoma treated between January 2012 and May 2018 was carried out. Perioperative data and long‐term outcomes were analysed. Results Of 52 children with hepatoblastoma, 22 were considered to have high‐risk hepatoblastoma (8 girls and 14 boys). The mean(s.d.) age at diagnosis was 35(20) months. Of these 22 children, five died without surgery. Of the remaining 17 who underwent surgery, six had a resection (4 right and 2 left trisectionectomies) and 11 underwent living‐donor liver transplantation. Median follow‐up was 48 (range 12–90) months. Thirteen of the 17 children were alive at last follow‐up and four developed disseminated disease (3 had undergone liver transplantation and 1 liver resection). The overall survival rate at 1, 3 and 5 years was 77, 64 and 62 per cent for the whole cohort with high‐risk hepatoblastoma. In children who had surgery, 1‐, 3‐ and 5‐year survival rates were 91, 82 and 73 per cent for transplantation and 100, 83 and 83 per cent for resection. There was no difference in survival between the two surgical groups. Conclusion Excellent results in the treatment of high‐risk hepatoblastoma are possible, even in resource‐challenged countries.
Published: 2020
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4. Review of the validity of DOPS as an assessment tool for the procedural skills of surgical trainees

Author: M Rela and T Price
Subjects: Surgery, General Medicine
Abstract: Introduction Surgical trainees at all stages are mandated to use workplace-based assessments (WBAs) to gain feedback from their trainers. Direct observation of procedural skills (DOPS) is a tool to assess hands-on surgical skills. This review of the literature seeks to ascertain how valid DOPS are as an assessment tool for the procedural skills of surgical trainees according to the American Psychology Association (APA) validity framework. Methods Relevant literature was identified through a structured search of Medline, CINAHL and Web of Science databases, with further papers included on citation review. Following this, papers meeting the inclusion and exclusion criteria were included in the final review specifying those investigating WBAs including DOPS, assessments in practice rather than simulation and specifically for postgraduate surgical trainees. Findings Sixteen papers were included in the final analysis. Extracted data from the returned papers were assessed for evidence of validity in each of the five domains on the APA framework: validity based on consequence, response process, reliability, content and relationship to other variables. There are studies that show good parameters for reliability and validity for specific DOPS used in endoscopy and otolaryngology. However, there is confusion over the purpose of DOPS among trainers and trainees as to whether they should be used formatively or summatively. Recent changes to the surgical curriculum have sought to address this, and further work into the impact of this needs to be done.
Published: 2022

5. 546 A Longitudinal Case History of Skin Cancer Presentations from One of the UK's Longest Surviving Renal Transplant Patients

Author: M Rela, J Sarginson, and R Rickard
Subjects: Surgery
Abstract: Introduction The immunosuppression required by solid-organ transplant patients not only increases their risk of severe infections but also pre-disposes them to post-transplant malignancy, with skin cancers being the most frequent type. We present a longitudinal history of skin cancers in a patient who received their kidney transplant as a child and has been on immunosuppression for 50 years. Case Report The patient developed renal failure at 12 years of age and received a living donor renal transplant in 1970. He developed his first skin cancer in 2004, 34 years later. To date he has had a total of 173 lesions excised of which 123 were a non-melanoma skin cancer (NMSC) (108 basal cell carcinomas (BCCs) and 15 squamous cell carcinomas (SCCs)). None of these lesions had any high-severity features such as poor differentiation or lymphovascular invasion. Numbers of BCCs have not varied, but numbers of SCCs, Bowen's disease and Actinic Keratoses have risen gradually over time. Discussion The patient developed his first skin cancer later than has typically been reported in transplant patients and has had a ratio of BCCs to SCCs more similar to the non-transplant population. Conclusion Whilst the patient has had a large number of NMSCs over time, a recognised association for those taking immunosuppressive medications, the types and nature of his lesions mirrored that of the non-transplant population, which could relate to the fact he received his transplant as a child.
Published: 2022
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6. 236 E-Prescribing and Smart Antimicrobial Stewardship in Upper Limb Infections

Author: M. Rela, D. Peberdy, K. Heard, and R. Fok
Subjects: Surgery
Abstract: Aim Upper limb infections secondary to traumatic wounds, animal bites and other causes are a common reason for admission to the plastic surgery service for intravenous antibiotics. This audit investigated the compliance of treatment of upper limb infections with trust guidance. The guidance stipulated an antibiotic treatment duration of five to seven days total and microbiology advice suggested that in cases requiring multiple washouts, this should start from the date of the last surgical washout where pus was present. Method There was retrospective sampling for four months using inpatient lists to include patients admitted for intravenous antibiotics for upper limb infections. Notes were requested by the secretaries and data was collected using patient notes, discharge summaries and electronic drug charts. Results The analysis included twenty-seven suitable patients. All patients had the correct antibiotics prescribed according to guidance, however only 22% of patients had five to seven days total of antibiotics either from the start of therapy or from the date of last infected washout in those who underwent surgical treatment. 14/27 patients had more than seven days total antibiotics. 13/27 patients were discharged with an additional seven days of oral antibiotics regardless of the total duration. Conclusions These infections are significantly over-treated with antibiotics, which has serious potential consequences for antimicrobial resistance. The findings of the audit prompted new trust guidelines to be produced and prescribing guidance was sent to the junior doctors to calculate the total antibiotic duration when preparing discharge summaries. There is a plan for re-audit in a few months’ time.
Published: 2022
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7. 413.11: The Improvement Study: Call for a New International Prospective Non-competitive, Observational Study to Validate And Optimize Kinetic Models to Predict Liver Allograft Failure At 3 and 12 Months After Liver Transplantation

Author: A Avolio, V Agopian, Marco Pascale, P Burra, K Croome, M de Santibanes, H Egawa, C Fondevila, Z Guo, Q Lai, P Martins, G Oniscu, W Polak, C Quintini, M Rela, G Sapisochin, J Wielderkeher, G Spoletini, S Agnes, P Pafundi, T Pasciuto, and U Cillo
Subjects: Transplantation
Published: 2022
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8. 1334 Improving Patient Flow Through the Hand Trauma Pathway

Author: J Hughes, M Rela, E Clough, and H Chu
Subjects: medicine.medical_specialty, business.industry, medicine, Surgery, Intensive care medicine, business, Patient flow
Abstract: Aim A full-cycle audit was conducted at our plastic surgery unit, assessing adherence to hand trauma standards by the British Society for Surgery of the Hand. These stipulate that time from referral to clinic for open injuries and closed fractures should be within 24 hours and 72 hours respectively and time to theatre from date of injury (DOI) within 4 and 7 days, respectively. Method Data for the initial audit was collected from Nov 2019-Feb 2020 and for the re-audit from Aug-Dec 2020. Lists were generated of 50 patients with open injuries including flexor tendon, extensor tendon and nerve injuries and 50 hand fractures in both cycles. Data was collected on DOI, date of referral, clinic review and surgery. Results The initial audit results showed poor DOI documentation (open injuries 30%, fractures 54%). For open injuries, 44% met standards for clinical review within 24 hours and 94% for time to theatre. For fractures, 94% met the standard for time to clinic and 90% for time to theatre. The interventions included adding the standards to the clinic booking form and creating a mandatory DOI field on the referral system. The re-audit showed improvement of DOI documentation (open injuries 95%, fractures 100%) and the proportion of open injuries seen within 24 hours to 60%. Conclusions The interventions had a positive impact on our hand trauma pathway. Areas for improvement include reducing the number of patient visits to the service and encouraging early decision-making, particularly for patients reviewed in the emergency department.
Published: 2021
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9. Classification of Left Hepatic Vein Anatomy and Customised Outflow Reconstruction Techniques for Left Lateral Segment Grafts in Paediatric Liver Transplantation

Author: S. Shankar, V. Gunasekaran, A. Rammohan, and M. Rela
Subjects: Hepatology, Gastroenterology
Published: 2022
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10. BJS commission on surgery and perioperative care post-COVID-19

Author: E. Abahuje, A. Abbas, M. Abd El Aziz Abd El Maksoud, A. Abdelhady, S. Abdelhamid, H. Abdelkarem Ahmed Faraj, B. Abdelqader, T. Abdelrahman, H. Abdou, A. Abdullah, M. Abedua Harrison, E. Abem Owusu, A. Aboalazayem, R. Aboulhosn, S. Abu Oda, A. Abubakar, A. Abutaka, D. Acevedo Fontalvo, S. Acuna, A. Adefemi, S. Adegbola, T. Adenuga, A. Adeyeye, A. Adil Hilmi, A. Adisa, K. Aditya, T. Adjeso, R. Aftab, A. Afzal, V. Aggarwal, A. Aggarwal, R. Aguilera, M. -L. Aguilera-Are´valo, E. J. Aguirre Salamanca, I. Aguirre-Allende, D. Ahari, H. Ahmad, F. Ahmad Rauf, A. Ahmad Zartasht Khan, S. Ahmed, N. Ahmed Fieturi, S. Ahmed Mohamed, Z. Ahmed-Bakhsh, M. Ahsan Javed, L. Akano, A. Akbar, M. Akhbari, P. Akhmedov, G. Aksit, Y. Akula, A. S. Alagaratnam, S. Al Majid, O. Al Mukhtar, H. Al Omran, N. AlAsali, M. Al-Azzawi, R. Al-Habsi, H. Al-Iraqi, H. Al-Naggar, E. Alameer, H. Albirnawi, D. Alderson, F. Aldulaijan, R. Alejandro Miranda Ojeda, A. AlHasan, S. Ali, A. Ali, M. Ali Khan, Y. Alimova, F. Aljanadi, R. Aljubure, N. Allopi, H. Almedbal, M. Almubarak, Z. Alqaidoom, N. Alselaim, M. Alshaar, R. Alshammari, K. Altaf, S. Altıner, B. Altunpak, L. A. Alvarez Lozada, E. Amal Nahal, A. Amer, K. Amin, U. Aminu, N. Amisi Numbi, T. Amjad, R. Amoah, Y. An, N. -A. Anastasopoulos, J. Andre´s Urrutia, F. Angarita, K. -L. Angarita, M. A´ ngel FreirI´a Eiras, A. Antypas, M. A. Anwar, H. Anwar, T. O. Apampa, K. Apostolou, C. Aquina, R. Arachchige Adithi Himika Randeni, M. I. Archila Godı´nez, O. Arez, A. A. Arezzo, P. Armonis, S. Arshad, M. Arshad Salman, A. Arshid, P. C. Arteaga Asensio, T. Arthur, A. Arumuga Jothi, F. Aryo Damara, L. Asensio Gomez, J. Ashcroft, S. Ashraf, A. Asif, M. Atif, M. Attaullah Khan, N. Avellaneda, S. Awad, M. Awadh, A. Axiaq, A. Ayad Mohammed Shuwayyah, D. Ayalew, E. Aytac, F. Azam, J. Azevedo, B. Azhar, J. Aziz, A. Aziz, A. Azzam, A. Baba Ndajiwo, M. Baig, D. Baker, F. Bakko, R. Balachandran, G. Balachandran, J. Balagizi Mudekereza, E. Balai, B. Balci, A. Balduzzi, A. Balhareth, S. Bandyopadhyay, D. Banerjee, D. Bangalore Mahalinga, B. Bankhead-Kendall, N. D. A. Bankole, V. Banwell, F. Baris Bengur, B. Baris Ozmen, M. Barnard, R. Barnett, J. A. Barreras Espinoza, A. Barrios, G. Bass, M. Bass, A. Bausys, A. Bavikatte, J. Bayram, M. Belousov, A. G. Berardi, A. Beamish, C. Beattie, F. Belia, V. Bellato, S. Bellikatti, S. Benjamens, C. Benlice, S. Bennedsgaard, S. Bennett, Z. Bentounsi, H. Bergenfeldt, A. Bergenfelz, M. Besselink, G. Bhandoria, E. Bhangu, M. Bhatia, M. T. Bhatti, Z. Bilgili, G. Bislenghi, C. Bisset, S. Biswas, J. Blake, R. Blanco, L. Boccalatte, R. Boden, C. Bojanic, M. Boland, P. Boland, E. Bollen, E. -A. Bonci, L. Boni, A. Booth, R. Booth, A. Borakati, G. E. Borunda Escudero, S. J. Bosco, P. Bostro¨ m, P. Botelho de Alencar Ferreira Cruz, K. Bouchagier, A. Bouhuwaish, M. Boutros, K. Boyce, C. Boyle, L. Bradshaw, A. Brandl, A. Brar, G. Brat, H. Brenkman, C. Brennan, C. Brines, A. Brookmyre, C. Brosnan, L. Brouwers, A. Brown, L. Brown, C. Brown, J. Brown, V. BS, M. Buksh, M. Bunani Emmanuel, D. Burbano, A. Burelli, A. Burke, J. Burke, N. Burlov, A. Burns, O. Burton, A. Butt, B. Buzra Ozkan, L. Cabrera Silva, E. Y. Caicedo, T. Calderbank, W. Cambridge, G. Campelo, O. Can Tatar, F. Carbone, F. Carrano, D. Casallas, D. Casanova Portoles, F. Casciani, I. Cassimjee, O. A. Castaneda Ramı´rez, V. Catala´ n, J. Caviedes, L. Cayetano, M. ~ Ceresoli, M. Chan, V. Chan, P. Chandrasinghe, S. Chapman, A. Chaturvedi, D. Chaudhry, H. Chaudry, H. W. Chen, A. Cheng, M. Chernykh, A. M. Cherrie, I. Cheruiyot, J. Cheung, C. Chia, J. Chica, N. Chinai, A. Chirwa, J. Chiwaligo, A. Choi, J. Choi, M. R. Chowdhury, E. Christopher, N. Christou, T. Chu, D. Chua, H. W. Chua, C. Chung, A. Cihat Yildirim, M. Cillo, S. Cioffi, H. Claireaux, S. Clermonts, R. Clifford, M. Climent, A. Clynch, R. -J. Coelen, E. Cola´ s-Ruiz, A. Collar, M. Collard, K. C. Conlon, T. Connelly, K. Connor, J. A. Cook, T. Correia de Sa´, N. Cos¸gun Acar, T. Costa, D. Couch, S. Cowper, B. Creavin, B. Crook, A. Curell, R. D’alessio, J. Dale, J. Damgaard Eriksen, I. Dario Martin Gonzalez, A. Darwish, M. Das, R. Das, K. Das, R. Dave, S. O. David, T. Davies, C. Davis, S. Davison, V. Davletshina, A. Dawidziuk, A. Dawson, M. de Andres Crespo, H. de Berker, P. de Dieu Ngo, E. Dekker, R. de la Caridad Espinosa Luis, B. de Lacy, N. Demartines, A. de Montserrat Medina Sifuentes, S. De Silva, C. del Rio, V. Delaune, A. Dell, I. Demirbas¸, S. Demirli Atici, M. Deniz Tepe, M. Derebey, G. Desai, M. Desai, S. Devarakonda, N. Deveras, G. Di Franco, M. Di Martino, F. Di Marzo, A´ . Dı´az, G. Diaz del Gobbo, C. DiazCastrillon, L. Dick, K. Dickinson, E. Diego, I. Dimasi, A. Ding, S. Dingemans, L. Dixon, B. Dixon, W. Doherty, D. Dooreemeah, C. Donohue, M. Dornseifer, F. Dossa, W. Dossou, T. Drake, I. Drami, G. Drevin, M. C. du Plessis, N. Dudi-Venkata, R. Dudley, S. Duffy, D. Duklas, B. -D. Dumbrava, F. Duygu Avlar, A. Dworzynska, W. Ebrahim, A. Ebrahim, E. Efre´n Lozada Herna´ ndez, N. Ehigie, M. El Boghdady, C. El Hasnaoui, M. El Sheikh, A. El-Hussuna, O. Eldurssi, H. Elfeki, M. Elhadi, M. Elhassan, A. Elhissi, B. Elliot, C. Elsenbroek, B. Elsolh, N. Elson, H. Eltyeb, H. Emerson, S. H. Emile, G. Endalle, W. English, C. Ercisli, G. Espinosa, M. Essam Abdelraheem, H. Essangri, P. Etienne, M. D. Evans, T. Evans, C. Ezeme, F. Ezzahraa, T. Fadalla, J. Fagan, M. Fahmy, C. Fairfield, O. Falade, S. Famularo, F. Faqar-Uz-Zaman, Y. Farid, A. Farooq, H. Farooq, F. Farooqui, B. Farquharson, A. Faruqi, R. Faulder, M. Faut, K. Fechner, T. Feenstra, M. Fehervari, L. Fernandez, J. Ferna´ ndez Alberti, L. Ferrario, D. Field, L. Fiore, S. Fingerhut, S. Finlayson, N. Fleming, C. Fleming, E. Florial, M. Fok, D. Fokin, M. Foley, M. P. Forero, T. Forgan, M. Fornasiero, H. Fowler, G. Fowler, E. Franchi, L. Franklin, A˚ . Fredriksson, P. Fruhling, G. Fuentes Navarrette, A. Fu¨ lo¨ p, M. Furtado, T. Gaarder, N. Galbraith, I. T. K. Gallagher, G. Gallo, T. Gana, E. Gaskin, M. Gasparini, R. G. Gatan, E. Geary, K. Gelaye Wudineh, G. Gemenetzis, M. Georgi, H. Ghalige, W. Ghareeb, T. Ghatwary Tantawy, C. Ghomsi, A. Ghuman, P. Giannakis, F. Giron, K. Gjengedal, E. Gkotsis, J. Glasbey, S. Godahewa, D. Godula, P. Goffredo, S. Goh, M. Golriz, L. Gomez, D. Gomez Gomez, R. Gonzalez, D. Gonzalez, E. Gonzalez Gutierrez, D. Gopar, L. Gordini, A. Gori, S. Gorta´ zar, N. Gousy, R. Gowda, M. Gowda, J. Gqada, M. Grechenig, J. Greer, L. Grego´ rio, A. Grigorova, H. Grimes, V. Groot, R. C. Grossman, R. Gruber, A. Gru¨ ter, R. Guest, R. Gujjuri, E. Gu¨ lc¸ek, B. Gulcu, K. Gull, M. Gulmez, V. Gupta, A. Gutlic, T. Guven, T. Gwatirisa, G. Gwini, P. Gwodog, S. Gysling, M. Habib, A. B. Hafeez Bhatti, J. Hallesmith, S. Halloran, M. Hamza Sadiq, C. Haney, N. Hanna, L. Hanna, M. Hannington, J. Harbjerg, D. Haribaskaran, N. Harran, B. Harrington, E. Harrison, R. Hasan, S. Hashmi, M. Hassan, A. Hassan, L. Haverkamp, S. Hazen, B. Heer, J. Heil, J. Helliwell, N. Henriksen, D. Henshall, M. Hermanson, S. Hermena, D. Hettiarachchi, C. Hextall, M. Hidalgo, H. Hidayat, A. Hider, P. Higgins, R. Hinchliffe, D. Hirani, D. Hirpara, I. Hisham, M. Hite, S. M. Hoh, C. Holmberg, E. Ho¨ lmich, F. Holst, A. Hossam, A. Hossam Elfallal, P. Howard, E. Huaman, Y. Huang, L. Huang, D. Huang, T. Huber, J. Hugh, J. Hughes, F. Hu¨ ttner, R. Huynh, A. Hylands, J. Iannuzzi, B. Ielpo, A. Iftikhar Talib, J. Ignacio, P. Ignatavicius, S. Ike, C. Ikwu, M. Inama, A. Ing, A. Ingels, A. Isik, N. Islam, I. J. Ives, A. J. M. S. AlHasan, C. J. Perez Rivera, F. Ja´ come, T. Jaffer, O. Jagiella-Lodise, M. Jain, K. Jain, M. Jakubauskas, M. Jalal, H. James, Y. Jang, B. Janssen, H. Jansson, U´ . Jariod-Ferrer, H. Javanmard, S. Javed, U. Jayarajah, I. Jayasuriya, J. Je, Z. Jessop, E. Jia Lin Tang, H. Jiang, Y. Jiayan, T. Jih Huei, R. Jimenez-Rodriguez, D. Joh, A. Johnson, N. Jones, C. Jones, C. Jordan, J. Jose´ Nu´ nez Ju, ~ M. Jose´ Pizarro, C. Jose Salazar J. Joseph, C. Justiniano, T. Kabir, M. Kadhum, C. Kalfountzos, E. Kalogiannaki, K. Kalyanasundaram, S. Kamarajah, M. Kamil Quraishi, Y. Kanemitsu, A. Kapila, V. Kapila, G. Karagiannidis, M. Kashif, S. Kathiravelupillai, A. Kathiravelupillai, E. Katsogridakis, K. Kaur, H. Kaur Sekhon Inderjit Singh, N. Kausur, M. Kawka, G. Keehan, S. Kehlet Watt, M. Kelly, M. E. Kelly, I. Kelvin Egbuchulem, G. Kembuan, E. Khajeh, A. Khaled Elfaitur, M. F. Khan, S. Khan, M. Khan, D. Khan, H. Khan, H. Khatkar, E. Khatkov, R. Khaw, B. Kim, K. Kishore Siddiraju, D. Kitua, B. Kırımtay, S. Kmezic, S. Knight, T. Koe¨ter, A. Koh, F. Koh Hong Xiang, T. Kojo Anyomih, A. I. N. Kok, R. Kokelaar, I. Koliarakis, S. Kolli, J. Kong, D. Ko¨ nig, M. otze, A. Kourdouli, M. Kowal, A. Kraima, F. Kramer, M. Kryzauskas, I. Kuchynskyi, C. Kuemmerli, S. Kuiper, S. Kumar, A. Kumar, L. Kumar, H. Kumar, N. Kumar, S. Kumar Bandyopadhyay, P. Kumar Garg, S. Kumar Venkatappa, J. Kung, S. Kural, A. Kushairi, E. Kuuzie, M. Kvietkauskas, I. Kwek, J. La, L. Lai, S. Lakpriya, K. Lam, M. Lami, I. Lansdorp-Vogelaar, P. Lapolla, H. Larsen, J. Latif, U. Laudari, A. Laurnezi, A. Lawal, S. Lawday, H. Lederhuber, A. Lednev, R. Lee, M. E. van Leerdam, G. Lefevbre, M. Lesmus, F. A. Leyva Moraga, E. Leyva Moraga, F. Leyva Moraga, H. L. Li, A. Li, Z. Li, E. Licardie, A. Light, A. L. Lightner, A. Lin, E. Lincango, F. Litta, H. Liu, B. Lofthouse, M. A. Londono, R. Lopes, R. Lopes de Freitas, L. Lopez, A. I. Lo´ pez, J. ~ Lopez-Gomez, G. Lopez-Pena, R. Lowe, D. Lowe, M. Lowey, G. Loy, V. Lozanovski, J. Luzon, P. Lynn, T. Maccabe, A. Machielsen, C. A. Mafla Herrerı´a, L. Maggino, K. Mahawar, D. Mahmood, M. Mahmoud, K. Mahtani, I. Maitra, S. Maji, I. Majiet, L. Mal, J. Malherbe, K. Malhotra, P. Malkomes, E. Man, A. Manan Sheikh, S. Manjunath, R. Manzano Nunez, S. Manzoor, R. Maqsood, G. ~ Marchegiani, F. Marchegiani, D. Marı´n, A. Marin, I. Marks, E. Marson, A. Martensen, D. Martin, G. Martı´n Martı´n, B. Martin-Perez, P. Martinez, P. Marwaha, C. 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Dongmo, A, Tamas, T, Tan, L, Tan, J, Tan, K, Tan, E, Tan Yong Hui, A, Tanase, A, Tariverdiev, A, Tasnem, A, Tatar, C, Tay, E, Tejedor, P, Tesfaye, G, Tetinou, F, Thorpe, C, Thyo, A, Tlelo Amastal, D, Tolani, M, Tolga Saracoglu, K, Tolgyes, T, Tong, J, Torrent Jansa, L, Toscano Igartua, S, Tovani Palone, M, Traff, H, Trevis, J, Tummers, W, Tur, A, Turchenko, I, Uche, V, Uddin, A, Udonsak, N, Ullah, M, Urbonas, T, Uwins, C, Uy Magadia, E, Uzair Qureshi, A, Uzun, K, Vadim, P, Valarche, G, Valdez Gonzalez, R, Vallee, M, Van Beek, D, Van Dalen, A, Van Den Hondel, D, Van Der Stok, E, Van Dorp, M, Van Oostendorp, S, Van Praag, E, Van Rees, J, Van Silfhout, L, Varga, Z, Varghese, S, Varghese, C, Varghese, J, Vasilica, A, Vasquez Ojeda, X, Vega, E, Vehler, S, Venchiarutti, R, Vengatesan, S, Venn, M, Verma, D, Vianey Partida Nava, G, Victoria, D, Vieira, P, Vilar Alvarez, M, Vinci, D, Viscasillas Pallas, G, Viswanath, M, Vivanco, J, Vizcaya Rodriguez, V, Vo, J, Volchanski, D, Voron, T, 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Zhukova, L, Zivanovic, M, Zmuc, J, Zope, M, Zubayraeva, A, Zucker, B, Aguilera-Arévalo, M -L, Aguirre Salamanca, E J, Al-Asali, N, Altıner, S, Alvarez Lozada, L A, Anastasopoulos, N -A, Andrés Urrutia, J, Angarita, K -L, Ángel FreirÍa Eiras, M, Anwar, M A, Apampa, T O, Archila Godínez, M I, Arteaga Asensio, P C, Bankole, N D A, Barreras Espinoza, J A, Bhatti, M T, Bonci, E -A, Borunda Escudero, G E, Bosco, S J, Boström, P, Botelho de Alencar Ferreira Cruz, P, Caicedo, E Y, Castañeda Ramírez, O A, Catalán, V, Chen, H W, Chowdhury, M R, Chua, H W, Coelen, R -J, Colás-Ruiz, E, Correia de Sá, T, Coşgun Acar, N, D’Alessio, R, David, S O, de Andres Crespo, M, de Berker, H, de Dieu Ngo, P, de la Caridad Espinosa Luis, R, de Lacy, B, de Montserrat Medina Sifuentes, A, del Rio, C, Demirbaş, I, Díaz, Á, Diaz del Gobbo, G, Diaz-Castrillon, C, du Plessis, M C, Dumbrava, B -D, Efrén Lozada Hernández, E, Fernández Alberti, J, Forero, M P, Fredriksson, Å, Fülöp, A, Gatan, R G, Gortázar, S, Gregório, L, Grüter, A, Gülçek, E, Hafeez Bhatti, A B, Hoh, S M, Hölmich, E, Hüttner, F, Alhasan, A J M S, Perez Rivera, C J, Jácome, F, Jariod-Ferrer, Ú, José, J, José Núñez Ju, J, José Pizarro, M, Khan, M F, Kırımtay, B, Kmezić, S, Koëter, T, König, D, Leyva Moraga, F A, Li, H L, Londoño, M A, Lopes de Freitas, R, López, A I, Mafla Herrería, C A, Manzano Nuñez, R, Marín, D, Martín Martín, G, Masior, Ł, Möckli, B, Mohamed, H M, Mohammad, S A, Mohammed, T O, Montcusí Ventura, B, Mora-Guzmán, I, Morán, R A R, Morera, Á, Moss, J -L, Moyón, M, Müller, P, Muñoz, F, Muñoz, E, Muñoz, A, Muñoz Balderas, D C, Ng, C E, Fhearaigh, R N, Nikolousakis, T -K, Kristensen, H Ø, O’Brien, L, O’Brien, S, O’Reilly, J, O’Rourke, S, O’Sullivan, M, O’Dwyer, M, Oh, K E, Öhlberger, L, Ölçüm, M, Oscullo Yepez, J J, Osei-kuffour, N, Ottlakán, A, Pavan Kumar, O M, Peña Gallardo, M T, Peña Velazquez, A, Pérez-Sánchez, L E, Pompeu Sá, M, Ponniah, H S, Ponte de Sousa, X, Portilla, A L, Pulido Segura, J A, Quimbaya Rodríguez, A S, Racoviţă, A, Rahiri, J -L, Rey Chaves, C E, Roalsø, M, Rodríguez, F, Rodriguez, M C, Ruiz-Úcar, E, Rutegård, M, Sá-Marta, E, Sam, Z H, Emile, Sameh H, Sánchez Fonseca, S, Sgrò, A, Sia, T C, Smart, Y W, Sneep-van Kessel, C, Solórzano Pineda, O, Stephen, B -J, Takoutsing Dongmo, A B, Tamás, T, Tan, J L, Thyø, A, Tölgyes, T, Torrent Jansà, L, Tovani Palone, M R, Valdez Gonzalez, R A, van Beek, D -J, van Dalen, A S, van den Hondel, D, van der stok, E, van Dorp, M, van Oostendorp, S, van Praag, E, van Rees, J, van Silfhout, L, Vasilica, A -M, Vásquez Ojeda, X, Vilar Alvarez, M E, Viscasillas Pallàs, G, Vizcaya Rodríguez, V, Wang, Y Y, Wellington, M J, Wirsik, M M, Wong, W J, Wong, K -Y, Wright, O Wroe, Yang, P -C, Yanzon de la Torre, A, Younis, M U, Zamora, A T, and Surgery
Subjects: Adult, Male, medicine.medical_specialty, Biomedical Research, Coronavirus disease 2019 (COVID-19), International Cooperation, Practice Patterns, Commission, Global Health, Health Services Accessibility, Perioperative Care, Education, Surgeon, COVID-19, surgery, perioperative care, Medical, Pandemic, Humans, Medicine, Practice Patterns, Physicians', Graduate, Pandemics, Surgeons, Health Resource, Infection Control, Physicians', Surgical Procedures, business.industry, General surgery, Middle Aged, Operative, Education, Medical, Graduate, Surgical Procedures, Operative, Perioperative care, Health Resources, Surgery, Female, business, Human
Abstract: Background Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues’ experiences and published evidence. Methods In late 2020, BJS contacted colleagues across the global surgical community and asked them to describe how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had affected their practice. In addition to this, the Commission undertook a literature review on the impact of COVID-19 on surgery and perioperative care. A thematic analysis was performed to identify the issues most frequently encountered by the correspondents, as well as the solutions and ideas suggested to address them. Results BJS received communications for this Commission from leading clinicians and academics across a variety of surgical specialties in every inhabited continent. The responses from all over the world provided insights into multiple facets of surgical practice from a governmental level to individual clinical practice and training. Conclusion The COVID-19 pandemic has uncovered a variety of problems in healthcare systems, including negative impacts on surgical practice. Global surgical multidisciplinary teams are working collaboratively to address research questions about the future of surgery in the post-COVID-19 era. The COVID-19 pandemic is severely damaging surgical training. The establishment of a multidisciplinary ethics committee should be encouraged at all surgical oncology centres. Innovative leadership and collaboration is vital in the post-COVID-19 era.
Published: 2021
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11. Prognostic Models predicting allograft failure at 90 and 365 days after liver transplantation. Call for an international Est to West prospective observational study to guide re-transplantation

Author: A. Avolio, V. Agopian, P. Burra, P. Martins, G. Oniscu, M. Rela, G. Sapisochin, C. Quintini, H. Egawa, W. Polak, X. He, C. Fondevila, C.M. Lo, M. De Santibanes, Z. Guo, Q. Lai, A.J. Hessheimer, G. Spoletini, G. Bianco, G. Moschetta, L. Miele, A. Grieco, S. Agnes, S. Gruttadauria, R. Romagnoli, and U. Cillo
Subjects: Hepatology, Gastroenterology
Published: 2022
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12. Ranking list for scientists: From heightening the rat-race to fraying the scientific temper

Author: A Rammohan and M Rela
Subjects: Ethics, ranking lists, Professionalism, Bibliometrics, View Point, Physicians, Publications, Medicine, Humans, Ethics, Medical, medical professionals
Abstract: Citations and validation of work play a crucial and integral role in a researcher's career. Ranking systems of scientists, on the other hand, potentially scratch and expose the fallible egoistic human face of science, leading to an unhealthy milieu of competition rather than the uplifting one of motivation. We have attempted to highlight and bring to fore these factors in our brief viewpoint. We critically analyze the reasons why ranking systems of scientists, especially in the field of medicine, will shift the focus from advancement of science to advancement of “self.”
Published: 2021

13. Outcomes for high-risk hepatoblastoma in a resource-challenged setting

Author: J X Scott, M S Reddy, G V Kumar, M Rela, Ashwin Rammohan, N Shanmugam, and P Ramachandran
Subjects: Hepatoblastoma, Male, medicine.medical_specialty, medicine.medical_treatment, lcsh:Surgery, India, Liver transplantation, 03 medical and health sciences, 0302 clinical medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Living Donors, Hepatectomy, Humans, Prospective Studies, General, Survival rate, Neoplasm Staging, Chemotherapy, business.industry, Liver Neoplasms, Infant, General Medicine, Perioperative, lcsh:RD1-811, Original Articles, medicine.disease, Prognosis, Chemotherapy regimen, Combined Modality Therapy, digestive system diseases, Surgery, Liver Transplantation, Transplantation, Survival Rate, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Child, Preschool, Cohort, 030211 gastroenterology & hepatology, Female, Original Article, business
Abstract: Background Outcomes of high‐risk hepatoblastoma have been dismal, especially in resource‐challenged countries where access to chemotherapy and paediatric liver transplantation is limited for the underprivileged. This study aimed to assess the results of treatment of high‐risk hepatoblastoma in a tertiary centre, including patients who had non‐transplant surgical procedures in the form of extended resection. Methods A review of patients with high‐risk hepatoblastoma treated between January 2012 and May 2018 was carried out. Perioperative data and long‐term outcomes were analysed. Results Of 52 children with hepatoblastoma, 22 were considered to have high‐risk hepatoblastoma (8 girls and 14 boys). The mean(s.d.) age at diagnosis was 35(20) months. Of these 22 children, five died without surgery. Of the remaining 17 who underwent surgery, six had a resection (4 right and 2 left trisectionectomies) and 11 underwent living‐donor liver transplantation. Median follow‐up was 48 (range 12–90) months. Thirteen of the 17 children were alive at last follow‐up and four developed disseminated disease (3 had undergone liver transplantation and 1 liver resection). The overall survival rate at 1, 3 and 5 years was 77, 64 and 62 per cent for the whole cohort with high‐risk hepatoblastoma. In children who had surgery, 1‐, 3‐ and 5‐year survival rates were 91, 82 and 73 per cent for transplantation and 100, 83 and 83 per cent for resection. There was no difference in survival between the two surgical groups. Conclusion Excellent results in the treatment of high‐risk hepatoblastoma are possible, even in resource‐challenged countries., The outcomes of children with high‐risk hepatoblastoma were assessed in the setting of a resource‐challenged nation, where access to organized chemotherapy and liver transplantation remains limited for the underprivileged. Excellent results were demonstrated. Aggressive surgical resection is a successful approach in selected patients with high‐risk hepatoblastoma, who otherwise would be candidates for liver transplantation. Excellent results in challenging environments
Published: 2019

14. Liver Transplantation for Epithelioid Hemangioendothelioma (EHE) - Short and Long-term Outcomes from 30 Years' Experience

Author: Andreas Prachalias, H. Vilca Melendez, P. Srinivasan, N D Heaton, R. Vellaisamy, K. Menon, Wayel Jassem, Miriam Cortes, and M. Rela
Subjects: medicine.medical_specialty, Hepatology, business.industry, medicine.medical_treatment, Gastroenterology, Long term outcomes, Medicine, Liver transplantation, business, medicine.disease, Epithelioid hemangioendothelioma, Surgery
Published: 2021
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15. High Model for End-Stage Liver Disease Score as a Predictor of Survival During Long-Term Follow-up After Liver Transplantation

Author: Wayel Jassem, Paolo Muiesan, Adam Bartlett, Nigel Heaton, H Suzuki, and M. Rela
Subjects: Adult, Male, medicine.medical_specialty, Time Factors, Tissue and Organ Procurement, Cirrhosis, Multivariate analysis, medicine.medical_treatment, Kaplan-Meier Estimate, Liver transplantation, Risk Assessment, Severity of Illness Index, Liver disease, Model for End-Stage Liver Disease, Predictive Value of Tests, Risk Factors, Internal medicine, London, Severity of illness, medicine, Health Status Indicators, Humans, Proportional Hazards Models, Retrospective Studies, Transplantation, Univariate analysis, business.industry, Liver Diseases, Middle Aged, medicine.disease, Liver Transplantation, Surgery, body regions, Treatment Outcome, surgical procedures, operative, Multivariate Analysis, Female, business
Abstract: Background The allocation of cadaveric livers for transplantation in the United States is now based on the severity of illness as determined by the Model for End-Stage Liver Disease (MELD), which was developed to predict short-term mortality in patients with cirrhosis. However, its impact to predict posttransplantation survival is controversial. The objective of this study was to determine the association of various pretransplantation risk factors, including the MELD score and whether its use to allocate organs is likely to lead to overall poorer outcomes of liver transplantation. Methods The 1,032 consecutive adult liver transplantation patients at King's College Hospital between 2 January 1994 and 29 December 2001 were examined for 9 preoperative risk factors, including MELD score, using univariate and multivariate techniques. Based on their pretransplantation MELD scores, we categorized recipients as low ( 25). Kaplan-Meier patient survival analysis was used to identify differences in outcomes. Results The patients had a mean age of 47.2 years and mean posttransplantation follow-up of 5.3 years. Univariate analysis showed recipient diabetes mellitus, renal dysfunction, and pretransplantation MELD score to be associated with patient survival. Multivariate analysis showed the MELD score to be significantly associated with death during long-term follow-up. Conclusions A high pretransplantation MELD score was associated with poor posttransplantation outcomes.
Published: 2012
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16. Reducing Bile Leak Following Segmental Liver Transplantation: Understanding Biliary Anatomy of the Caudate Lobe

Author: Wayel Jassem, M. Rela, and Nigel Heaton
Subjects: Adult, Leak, medicine.medical_specialty, medicine.medical_treatment, Liver transplantation, Postoperative Complications, Living Donors, medicine, Hepatectomy, Humans, Immunology and Allergy, Caudate lobe, Pharmacology (medical), Child, Bile leak, Transplantation, business.industry, Anastomosis, Surgical, Gallbladder, Postoperative complication, Liver Transplantation, Surgery, Biliary anatomy, Liver, Biliary tract, Tissue and Organ Harvesting, Complication, business
Abstract: Bile leak in split and living donor liver transplantation is not an uncommon postoperative complication with significant morbidity to both donor and recipients. Nonanastomotic bile leaks in these transplants are less well characterized and generally described as cut-surface leaks. A proportion of these leaks may derive from biliary radicles draining the caudate lobe. Based on the caudate lobe biliary anatomy the authors describe measures that may help to reduce such complications after segmental liver transplantation.
Published: 2008
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17. The Impact of Ischemia/Reperfusion Injury on Liver Allografts from Deceased after Cardiac Death versus Deceased after Brain Death Donors

Author: Ana María Casas-Ferreira, Nigel Heaton, Wayel Jassem, Cristina Legido-Quigley, Blayne A. Sayed, Jin Xu, Yun Ma, Parthi Srinivasan, Susan V. Fuggle, and M Rela
Subjects: Male, 0301 basic medicine, Pathology, Critical Care and Emergency Medicine, Neutrophils, Physiology, Biopsy, medicine.medical_treatment, lcsh:Medicine, Apoptosis, Liver transplantation, Pathology and Laboratory Medicine, White Blood Cells, 0302 clinical medicine, Animal Cells, Medicine and Health Sciences, Brain Damage, lcsh:Science, Immune Response, Transplante de órganos, Trauma Medicine, Multidisciplinary, Cell Death, medicine.diagnostic_test, Liver Diseases, Hematology, Middle Aged, Allografts, Tissue Donors, Body Fluids, Blood, Treatment Outcome, Neurology, Liver, Cell Processes, Reperfusion Injury, Female, 030211 gastroenterology & hepatology, Cellular Types, Anatomy, medicine.symptom, Research Article, Platelets, Adult, Brain Death, medicine.medical_specialty, Cell biology, Immune Cells, Immunology, Ischemia, Surgical and Invasive Medical Procedures, Inflammation, Brain damage, Digestive System Procedures, 03 medical and health sciences, Signs and Symptoms, medicine, Humans, Aged, Transplantation, Blood Cells, business.industry, lcsh:R, Biology and Life Sciences, Organ Transplantation, medicine.disease, Liver Transplantation, 030104 developmental biology, Multivariate Analysis, lcsh:Q, business, Reperfusion injury
Abstract: [EN] Background and aims. The shortage of organs for transplantation has led to increased use of organs procured from donors after cardiac death (DCD). The effects of cardiac death on the liver remain poorly understood, however. Using livers obtained from DCD versus donors after brain death (DBD), we aimed to understand how ischemia/reperfusion (I/R) injury alters expression of pro-inflammatory markers ceramides and influences graft leukocyte infiltration. Methods Hepatocyte inflammation, as assessed by ceramide expression, was evaluated in DCD (n = 13) and DBD (n = 10) livers. Allograft expression of inflammatory and cell death markers, and allograft leukocyte infiltration were evaluated from a contemporaneous independent cohort of DCD (n = 22) and DBD (n = 13) livers. Results When examining the differences between transplant stages in each group, C18, C20, C24 ceramides showed significant difference in DBD (p
Published: 2016
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18. Human Islets Derived From Donors After Cardiac Death Are Fully Biofunctional

Author: Paolo Muiesan, Shanta J. Persaud, Guo Huang, J Jones, Stephanie A. Amiel, Min Zhao, Parthi Srinivasan, W. Littlejohn, Peter M. Jones, Henry Asare-Anane, S Ashraf, L Fairbanks, Nigel Heaton, and M. Rela
Subjects: Adult, Male, endocrine system, medicine.medical_specialty, Adolescent, endocrine system diseases, Cell Survival, Islets of Langerhans Transplantation, Islets of Langerhans, Internal medicine, Diabetes mellitus, medicine, Humans, Immunology and Allergy, Pharmacology (medical), Pancreas, Transplantation, Type 1 diabetes, geography, geography.geographical_feature_category, Warm Ischemia Time, business.industry, Diabetic mouse, Organ Size, Middle Aged, medicine.disease, Islet, Tissue Donors, Death, Sudden, Cardiac, Diabetes Mellitus, Type 1, medicine.anatomical_structure, Endocrinology, Cytokines, Female, business
Abstract: Islets from brain-dead donors (BDDs) are being used in the treatment of Type 1 diabetes. However, both donor numbers and islet survival are limited. We explored the clinical potential for islets from non-heart-beating donors (NHBDs), who have lower circulating cytokines, by comparing islets from 10 NHBDs against 12 identically-isolated islets from BDDs over the same time period. The quantity and quality of islets from NHBDs was good. NHBD yielded approximately 12.6% more islets than those of BDDs (505,000 +/- 84,230 vs. 400,970 +/- 172,430 islet equivalent number [IEQ]/pancreas, p = 0.01) with comparable viability. ATP and GTP contents were lower (6.026 +/- 3.076 vs. 18.105 +/- 7.8 nM/mg protein, p = 0.01 and 1.52 +/- 0.87 vs. 3.378 +/- 0.83 nM/mg protein, p = 0.04) and correlated negatively to warm ischemia time (R(2)= 0.8022 and R(2)= 0.7996, respectively). Islets from NHBDs took longer to control hyperglycemia in diabetic mice, but were equally able to sustain euglycemia. With a warm ischemia time (WIT) ofor=25 min, islets from NHBDs are at least as competent as islets from BDDs and should be suitable for clinical use.
Published: 2007
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19. Selection of patients with hepatocellular carcinoma for liver transplantation

Author: M. Rela, Robert P. Sutcliffe, Bernard Portmann, Nigel Heaton, and Donal Maguire
Subjects: medicine.medical_specialty, Carcinoma, Hepatocellular, Orthotopic liver transplantation, medicine.medical_treatment, MEDLINE, Liver transplantation, Risk Factors, Biological property, Biopsy, medicine, Humans, Intensive care medicine, Neoplasm Staging, medicine.diagnostic_test, business.industry, Patient Selection, Liver Neoplasms, Prognosis, medicine.disease, Liver Transplantation, Surgery, Transplantation, Donation, Hepatocellular carcinoma, Neoplasm Recurrence, Local, business
Abstract: Background Orthotopic liver transplantation (OLT) plays a pivotal role in the management of selected patients with initial hepatocellular carcinoma (HCC). After disappointing early results and a shortage of cadaveric grafts, patients are currently selected for OLT on the basis of tumour size and number. Limitations of these criteria and the advent of living donation have prompted their re-evaluation. The principal aims of this review were to define the limitations of current transplant criteria for HCC, and to identify potential areas for improvement. Methods A Medline search using the terms ‘liver transplantation’ and ‘hepatocellular carcinoma’ was conducted. Additional references were sourced from key articles. Results and conclusion In patients with HCC, biological properties of the tumour are more accurate than radiological criteria in determining outcome after transplantation. Despite the risks of tumour biopsy, which may have been previously overstated, histological evaluation before transplantation may have a role and warrants further study. By expanding the donor pool and eliminating waiting times, live donor liver transplantation is a valuable resource that has yet to fulfil its potential because of unresolved ethical issues concerning the safety of the donor. The availability of long-term outcome data may help to clarify this in the near future.
Published: 2005
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20. Anti-Interleukin 2 Receptor Antibodies and Mycophenolate Mofetil for Treatment of Steroid-Resistant Rejection in Adult Liver Transplantation

Author: Michael A. Heneghan, D W Orr, Nigel Heaton, M. Rela, S. Stoll, Bernard Portmann, A. S. Knisely, J.G. O'Grady, Paolo Muiesan, and Matthew Bowles
Subjects: Adult, Graft Rejection, Male, medicine.medical_specialty, Daclizumab, Adolescent, Basiliximab, Recombinant Fusion Proteins, medicine.medical_treatment, Drug Resistance, Liver transplantation, Antibodies, Monoclonal, Humanized, Gastroenterology, Mycophenolic acid, Liver Function Tests, Adrenal Cortex Hormones, Internal medicine, medicine, Humans, Aged, Retrospective Studies, Transplantation, medicine.diagnostic_test, business.industry, Graft Survival, Antibodies, Monoclonal, Receptors, Interleukin-2, Immunosuppression, Middle Aged, Mycophenolic Acid, Liver Transplantation, Surgery, Treatment Outcome, Immunoglobulin G, Liver biopsy, Drug Therapy, Combination, Female, Liver function tests, business, Immunosuppressive Agents, medicine.drug
Abstract: Background Steroid-resistant rejection (SRR) results in significant morbidity and mortality from the adverse effects of rescue therapy and in graft loss from chronic rejection. In our knowledge, the efficacy and safety of anti–interleukin (IL) 2r antibodies (daclizumab and basiliximab) for the treatment of SRR in adult liver transplantation has not previously been evaluated. Methods Twenty-five patients received either daclizumab or basiliximab as rescue therapy for SRR. Outcome and biochemical parameters were recorded before and after treatment with an anti–IL-2r antibody. Results The median time from transplantation to SRR was 25 days. Secondary immunosuppression included mycophenolate mofetil in 18 patients. Twelve patients (48%) had complete resolution of SRR. Aspartate transaminase levels normalized at a median of 37 days (range, 1–168 days). In 13 patients (52%) progressive hepatic dysfunction developed. Four of these patients received another transplant, and 6 patients had chronic rejection. Three patients died with graft failure. Of 16 patients with acute cellular rejection, 12 (75%) had resolution, 2 had chronic rejection, 1 required a repeat transplantation, and 1 died with graft failure. In contrast, all 9 patients with established chronic rejection in their pretreatment biopsy continued to have significant graft dysfunction, with 4 having persistent chronic graft dysfunction, 3 requiring repeat transplantation, and 2 dying with graft failure. Conclusion Twelve (48%) of 25 patients who received an anti–IL-2r antibody because of SRR were successfully treated. All successfully treated patients had ongoing acute cellular rejection at liver biopsy (75%), whereas patients with histologic evidence of chronic rejection responded poorly.
Published: 2005
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21. Risk factors for fungal infection in paediatric liver transplant recipients

Author: M. Rela, Anil Dhawan, Paul Cheeseman, Giorgina Mieli-Vergani, Jim Wade, Anita Verma, Beatrice Samaroo, and Nigel Heaton
Subjects: medicine.medical_specialty, Adolescent, medicine.medical_treatment, Liver transplantation, Fulminant hepatic failure, Risk Factors, Biliary atresia, Internal medicine, medicine, Humans, Risk factor, Child, Mycosis, Retrospective Studies, Transplantation, business.industry, Liver Diseases, Incidence (epidemiology), Candidiasis, Infant, medicine.disease, Liver Transplantation, Surgery, Mycoses, Child, Preschool, Multivariate Analysis, Pediatrics, Perinatology and Child Health, Complication, business, Immunosuppressive Agents
Abstract: Fungal infection (FI) is a major and potentially fatal complication in liver transplantation (LT). Published experience of FI in paediatric LT is limited. We therefore reviewed case records of 79 children, aged between 0.16 and 16 yr, who underwent LT between 1997 and 1998 to document the incidence of, and identify risk factors for, FI. Sixty-eight pre-, peri- and post-LT variables were assessed in relation to FI by univariate and multivariate analyses. The major indications for LT were biliary atresia in 26 (33%) patients, fulminant hepatic failure in 16 (20%) and intrahepatic cholestasis in 11 (14%); eight patients required re-LT. Thirty-two (40.5%) children developed a FI within 1 yr of LT. The median time to FI was 42 days (range 1-342 days). Candida spp. caused 29 (90.7%) FIs; 21 (66%) of these were Candida albicans. Although FI was associated with increased mortality, most patients responded well to antifungal treatment. The variables independently associated with FI were pre-LT fungal colonization and pyrexia and, post-LT, bacterial infection, Epstein-Barr virus (EBV) infection and tacrolimus administration. Identifying risk factors for FI should contribute to the development of strategies for prophylaxis or preemptive therapy.
Published: 2005
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22. Basiliximab (Simulect) for the treatment of steroid-resistant rejection in pediatric liver transpland recipients: a preliminary experience1

Author: Anita Verma, D. Hadzic, N D Heaton, Anil Dhawan, A Baker, A Parke, M. Rela, Marion M. Aw, G. Mieli-Vergani, Paolo Muiesan, and Rhiannon Taylor
Subjects: Transplantation, medicine.medical_specialty, Basiliximab, business.industry, medicine.medical_treatment, Immunosuppression, Azathioprine, Liver transplantation, Gastroenterology, Tacrolimus, Surgery, Internal medicine, medicine, Prednisolone, business, Prospective cohort study, medicine.drug
Abstract: Background. The role of interleukin-2 receptor antibodies as rescue therapy in steroid-resistant rejection (SRR) has not been studied. We evaluated the safety and efficacy of an interleukin-2 receptor antibody, basiliximab (Simulect, Novartis, East Hanover, NJ), in treating SRR in pediatric liver transplant recipients. Methods. This was a prospective study of seven pediatric liver transplant recipients with biopsy-proven SRR who would have otherwise received OKT3 or antithymocyte globulin. The primary immunosuppression consisted of cyclosporine (Neoral, Novartis), azathioprine, and prednisolone in four patients and tacrolimus and prednisolone in three patients who had undergone retransplantation for chronic rejection (n=2) and hyperacute rejection (n=1). Four patients had received two cycles of high-dose steroids, and three patients had received a single cycle; all had been converted to tacrolimus, followed by the addition of mycophenolate mofetil. Results. The median time from transplant to SRR was 30 days (range, 8 days–23 months). Five children received two doses of basiliximab (10 mg, 3–7 days apart), and two children received a single dose. Aspartate aminotransferase levels normalized in three children 12, 21, and 30 days after basiliximab treatment. Aspartate aminotransferase levels decreased without normalizing in two children, but there was no further evidence of cellular rejection on repeat biopsies. All five children are rejection-free with a median follow-up of 22 months (range, 5–32 months). Biochemical abnormalities persisted in the remaining two children, and both developed chronic rejection. There were no immediate side effects associated with basiliximab. Two patients were treated empirically for possible cytomegalovirus infection 21 and 57 days after basiliximab treatment, with no evidence of cytomegalovirus disease. Conclusion. Five of seven pediatric liver transplant recipients with SRR experienced successful outcomes with basiliximab treatment without major side effects, indicating that it is a safe alternative to OKT3 and other antilymphocyte antibodies.
Published: 2003
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23. Adult-to-adult living donor liver transplant

Author: Roger Williams, Akeel Alisa, Paolo Muiesan, John Karani, Shamsudin M Rela, and Nigel Heaton
Subjects: Adult, Liver Cirrhosis, Male, medicine.medical_specialty, Alcoholic liver disease, Cirrhosis, medicine.disease_cause, Sepsis, Hepatitis B, Chronic, Postoperative Complications, Living Donors, medicine, Hepatectomy, Humans, Decompensation, Aged, Hepatitis B virus, Hepatology, medicine.diagnostic_test, business.industry, Gastroenterology, Hepatitis C, Chronic, Middle Aged, medicine.disease, Liver regeneration, Liver Regeneration, Liver Transplantation, Surgery, Survival Rate, Transplantation, Treatment Outcome, Liver, Tissue and Organ Harvesting, Female, Tomography, X-Ray Computed, business, Liver function tests, Liver Failure
Abstract: Background Adult-to-adult living donor liver transplantation (ALDLT) is being adopted widely in the USA and mainland Europe, fuelled by the increasing waiting lists for cadaver organs. The present report describes the first UK experience with the procedure in patients from overseas who have the lowest priority for cadaver organ allocation. Methods The 16 patients seen over the period November 1998 to March 2002 had end-stage cirrhosis from chronic hepatitis C virus (HCV) or hepatitis B virus (HBV) infection (13 cases), with single instances of cryptogenic cirrhosis, secondary biliary cirrhosis and alcoholic liver disease. Grafts were left lobe in the first two recipients and right lobe in the subsequent 14 recipients, donated by nine sons/daughters and seven brothers/sisters. Results Twelve of the 16 recipients did well. The four recipients who died had recurrent sepsis; two of these died following hepatic arterial occlusion, and in three major surgical factors were present before transplantation. Serial computed tomography (CT) measurements in the survivors showed regeneration of the grafted lobe with final volumes reaching in each case the calculated standard liver volume for body size. In the donors, liver function tests had returned to normal by day 7–14, with rapid regeneration of the remaining lobe, although the final size attained that estimated before donation in only four donors. Conclusions ALDLT, although requiring considerable facilities and organization, can give good results for both recipient and donor. As with cadaver grafts, outcome in the recipient if the larger right lobe is used is dependent on surgical risk factors and the severity of clinical decompensation before transplantation. Measures to ensure the safety of the donors remain the main concern.
Published: 2003
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24. Surgical anatomy of segmental liver transplantation

Author: M. Rela, R R Deshpande, and Nigel Heaton
Subjects: Adult, medicine.medical_specialty, medicine.medical_treatment, Hepatic Veins, Liver transplantation, Hepatic Artery, Surgical anatomy, Living Donors, Humans, Medicine, Biliary Tract, Child, Portal Vein, business.industry, Mortality rate, Whole liver transplantation, Liver Transplantation, Surgery, Transplantation, Liver, Biliary tract, Split liver transplantation, Venae Cavae, Tomography, X-Ray Computed, business, Living donor liver transplantation
Abstract: Background The emergence of split and living donor liver transplantation has necessitated re-evaluation of liver anatomy in greater depth and from a different perspective than before. Early attempts at split liver transplantation were met with significant numbers of vascular and biliary complications. Technical innovations in this field have evolved largely by recognizing anatomical anomalies and variations at operation, and devising novel ways of dealing with them. This has led to increasing acceptance of these procedures and decreased morbidity and mortality rates, similar to those observed with whole liver transplantation. Methods and results The following review is based on clinical experience of more than 180 split and living related liver transplantations in adults and children, performed over a 7-year period from 1994 to 2001. Conclusion A comprehensive understanding and application of surgical anatomy of the liver is essential to improve and maintain the excellent results of segmental liver transplantation.
Published: 2002
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25. Liver transplantation

Author: A S Shaw, S M Ryan, R C Beese, S Norris, M Bowles, M Rela, and P S Sidhu
Subjects: Radiology, Nuclear Medicine and imaging
Published: 2002
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26. Is it Justified for all Cholecystectomy Specimens to Undergo Histological Evaluation?

Author: T. Pelly, A. Lunt, K. Hamdan, and M. Rela
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, General surgery, Medicine, Surgery, Cholecystectomy, General Medicine, business
Published: 2017
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27. LIVER TRANSPLANTATION IN ADULTS COINFECTED WITH HIV

Author: Paolo Muiesan, Matthew E. Cramp, P. Srinivasan, Roger Williams, Andreas Prachalias, J A Wendon, M. Rela, J.G. O'Grady, Claire Taylor, N D Heaton, and A Pozniak
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, HIV Infections, Liver transplantation, Asymptomatic, Liver disease, Acquired immunodeficiency syndrome (AIDS), Internal medicine, medicine, Humans, Prospective Studies, Hepatitis, Transplantation, business.industry, Infant, Hepatitis C, Middle Aged, Viral Load, Hepatitis B, medicine.disease, CD4 Lymphocyte Count, Liver Transplantation, Surgery, surgical procedures, operative, Child, Preschool, Female, medicine.symptom, business
Abstract: Objective. To report our experience of prospectively identifying and transplanting livers into HIV-positive patients. Design. Liver transplantation in HIV-positive patients remains controversial. The finding of HIV is usually considered a contraindication to any form of transplantation. Previously reported cases are few and refer to patients who tested HIV positive after they had their liver transplantations or who seroconverted in the posttransplantation period. This is, to our knowledge, the only report of patients who were known to be HIV positive at the time of decision for listing for transplantation. Methods. The medical records of five HIV-positive patients who received liver transplants in King's College Hospital, London, during a 5-year period (January 1995-December 1999) were reviewed. All five were known to be HIV positive at the time of listing for liver replacement. Three of them had end-stage liver disease due to hepatitis C (two of them had underlying Hemophilia A) while the other two had acute liver failure, one due to hepatitis B infection and one due to nonA-nonB-nonC hepatitis. In all but one patient the HIV infection had been asymptomatic. Results. All patients survived the immediate posttransplantation period, but the three patients with hepatitis C died of complications of recurrent hepatitis C between 6 and 25 months posttransplantation. The other two patients are currently alive 4 and 34 months posttransplantation with good graft function and without complications from their HIV infection. Conclusion. The early outcome of liver transplantation in HIV seropositive patients can be good, and patients should not be excluded from transplantation if their liver disease determines their prognosis. More effective antiviral therapy for hepatitis C given posttransplantation, and for hepatitis B reinfection, should improve the longer-term outcome of HIV patients with end-stage liver disease due to hepatitis.
Published: 2001
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28. PROGRESSIVE CARDIAC AMYLOIDOSIS FOLLOWING LIVER TRANSPLANTATION FOR FAMILIAL AMYLOID POLYNEUROPATHY

Author: J.G. O'Grady, Mark J. Monaghan, Philip N. Hawkins, P. Nihoyannopoulos, N D Heaton, A. J. Stangou, Roger Williams, MB Pepys, and M. Rela
Subjects: Male, endocrine system, Pathology, medicine.medical_specialty, Amyloid, medicine.medical_treatment, Liver transplantation, Amyloid Neuropathies, medicine, Humans, Serum amyloid P component, Transplantation, biology, business.industry, Amyloidosis, nutritional and metabolic diseases, medicine.disease, Liver Transplantation, Transthyretin, Amyloid Neuropathy, surgical procedures, operative, Cardiac amyloidosis, Echocardiography, biology.protein, Female, Cardiomyopathies, business
Abstract: Background Circulating transthyretin (TTR) is derived from the liver, and orthotopic liver transplantation (OLT) is widely performed for variant TTR-associated familial amyloid polyneuropathy (FAP). The effect of OLT on FAP-related cardiac amyloid is of particular interest because wild-type TTR can itself be deposited as senile cardiac amyloid. Methods Serial echocardiography was performed in 20 FAP patients, 14 of whom underwent OLT, and 10 other liver transplant patients. Follow-up included serum amyloid P component scintigraphy and measurement of plasma TTR before and after OLT. Results Cardiac amyloidosis progressed rapidly in three FAP patients (TTR Pro52 and Thr84 mutations) after OLT, even though the deposits elsewhere had stabilized or regressed. Results of echocardiography improved in three transplant patients with TTR Met30 and remained normal in seven other patients. Plasma TTR levels were altered substantially after OLT, but they did not reflect the cardiac findings. Conclusions Although amyloid deposition in FAP is generally inhibited after OLT, cardiac amyloidosis can be exacerbated, probably due to enhanced deposition of wild-type TTR on a template of amyloid derived from variant TTR. The phenomenon may be mutation-dependent. These findings suggest that amyloid formation de novo and its subsequent accumulation can be promoted by different factors, which may be organ-specific.
Published: 1998
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29. Bowel perforation after paediatric orthotopic liver transplantation

Author: M. Rela, Nigel Heaton, V. Vougas, G Mieli-Vergani, H. Vilca Melendez, P. Andreani, and Paolo Muiesan
Subjects: Nephrology, medicine.medical_specialty, Transplantation, business.industry, medicine.medical_treatment, Incidence (epidemiology), Perforation (oil well), Infant, Liver transplantation, medicine.disease, Gastroenterology, Liver Transplantation, Surgery, Intestinal Perforation, Biliary atresia, Child, Preschool, Internal medicine, Epidemiology, medicine, Humans, Child, business, Complication
Abstract: Bowel perforation is a well-recognized complication following orthotopic liver transplantation. Of 194 paediatric liver transplantations performed in our hospital, 13 patients (6.7 %) developed bowel perforation post-transplantation. Contributory factors included previous operation, steroid therapy and viral infection. The incidence was higher in children who underwent transplantation for biliary atresia after a previous Kasai portoenterostomy. Seven patients (53 % of this group) reperforated. Diagnosis may be difficult and a high index of suspicion is needed.
Published: 1998
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30. The incidence and management of biliary complications following liver transplantation in children

Author: Roger Williams, K C Tan, V. Bhatnagar, Anil Dhawan, Nigel Heaton, A. P. Mowat, Paolo Muiesan, H. Chaer, and M Rela
Subjects: Male, Nephrology, medicine.medical_specialty, Adolescent, Cholangitis, medicine.medical_treatment, Anastomosis, Liver transplantation, Gastroenterology, Internal medicine, Epidemiology, medicine, Humans, Child, Transplantation, Cholestasis, business.industry, Incidence, Incidence (epidemiology), Infant, Liver Transplantation, Surgery, Biliary tract, Child, Preschool, Female, business, Complication
Abstract: Biliary complications following liver transplantation are a cause of significant morbidity and mortality. During the period 1988-1993 ten cases of biliary complications occurred after 98 transplantations in 78 children. The complications were four bile leaks, three intrahepatic biliary strictures (one with recurrent cholangitis), two anastomotic biliary strictures (one with recurrent cholangitis) and one recurrent cholangitis. All leaks occurred within 6 weeks of transplantation whereas all strictures and cholangitic episodes occurred after 3 months. Two biliary complications (20%) - one intrahepatic and one anastomotic stricture - developed secondary to hepatic artery thrombosis. The incidence of biliary complications was 13.2% with whole liver grafts as compared to 6.7% with partial liver grafts and it was 4.3% with duct-to-duct anastomosis as compared to 12.0% with Roux-en-Y hepatico-jejunostomy. Seven children required intervention for management of biliary complications and three were managed conservatively. There were no deaths related to the biliary complications.
Published: 1995
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31. Lessons from look-back in acute liver failure? A single centre experience of 3300 patients

Author: Roger Williams, Georg Auzinger, Amit Gera, John O'Grady, M Rela, Anna Hyyrylainen, Vinod K. Audimoolam, Mark J. W. McPhail, William Bernal, Julia Wendon, and Nigel Heaton
Subjects: Adult, Male, medicine.medical_specialty, Critical Care, medicine.medical_treatment, Liver transplantation, law.invention, Young Adult, Fulminant hepatic failure, law, Risk Factors, Intensive care, Severity of illness, London, medicine, Humans, Renal replacement therapy, Intensive care medicine, Hepatic encephalopathy, Acetaminophen, Hepatology, business.industry, digestive, oral, and skin physiology, Analgesics, Non-Narcotic, Liver Failure, Acute, Middle Aged, medicine.disease, Intensive care unit, Liver Transplantation, Transplantation, Hepatic Encephalopathy, Emergency medicine, Female, Emergencies, Intracranial Hypertension, business
Abstract: Acute liver failure (ALF) is a rapidly progressive critical illness with high mortality. Complex intensive care unit (ICU) protocols and emergency liver transplantation (ELT) are now often available, but rarity and severity of illness have limited its study and evidence-base for care. We reviewed patients treated over a 35-year period at a specialist high-volume ICU, quantifying changes in disease aetiology, severity and evolution of ICU support and ELT use and outcome.Review of adult patients admitted during the period 1973-2008, with acute liver dysfunction and coagulopathy with overt hepatic encephalopathy (ALF) and those without (acute liver injury; ALI).3305 patients fulfilled inclusion criteria, 2095 with ALF. Overall hospital survival increased from 30% in 1973-78 to 76% in 2004-08; in ALF from 17% to 62% (both p0.0001). In ALF patients treated without ELT, survival rose from 17% to 48% (p0.0001); in those undergoing ELT (n=387) from 56% in 1984-88 to 86% in 2004-08 (p0.01). Coincident with drug sales-restriction, paracetamol-related admissions fell significantly. Viral admissions fell from 56% to 17% of non-paracetamol cases (p0.0001). Admission markers of liver injury severity fell significantly and the proportion of patients with intracranial hypertension (ICH) fell from 76% in 1984-88 to 20% in 2004-08 (p0.0001). In those with ICH, mortality fell from 95% to 55% (p0.0001).The nature and outcome of ALF have transformed over 35 years, with major improvements in survival and a fall in prevalence of cerebral oedema and ICH, likely consequent upon earlier illness recognition, improved ICU care, and use of ELT.
Published: 2012

32. The use of TachoSil in children undergoing liver resection with or without segmental liver transplantation

Author: Alastair J. W. Millar, Hector Vilca-Melendez, N. Heaton, Khalid Sharif, Darius F. Mirza, and M. Rela
Subjects: Surgical Sponges, medicine.medical_specialty, medicine.medical_treatment, Blood Loss, Surgical, Liver transplantation, Clinical endpoint, Medicine, Hepatectomy, Humans, Prospective Studies, Adverse effect, Prospective cohort study, Child, business.industry, Liver Diseases, Infant, Newborn, Thrombin, Fibrinogen, Infant, TachoSil, Hemostasis, Surgical, Surgery, Liver Transplantation, Transplantation, Drug Combinations, Treatment Outcome, Hemostasis, Child, Preschool, Pediatrics, Perinatology and Child Health, Segmental resection, business, Follow-Up Studies
Abstract: Introduction Local haemostatic agents are used for the control of surgical haemorrhage when standard techniques are inadequate, but there are few studies of these products in children. Patients and methods This was a prospective, open-label study in which children (aged 4 weeks to 6 years) undergoing liver resection with or without segmental liver transplantation were treated with TachoSil, a collagen patch coated with a dry layer of human fibrinogen and human thrombin, if minor (i. e., oozing) or moderate bleeding was present after primary haemostatic treatment. Time to haemostasis after TachoSil application was the primary endpoint. Safety was assessed by adverse events (AEs), including post-operative infections, symptoms of graft rejection and re-operations. Results Enrolment was stopped early after 16 children had entered the study. 13 children underwent whole liver resection and transplantation and 3 patients underwent segmental resection. Satisfactory haemostasis was achieved in 13 children (81.3%; 95% CI: 61.8-100%) at 3 min and in 1 child at 8 min. Occurrence of AEs was as expected, with most being known complications of the underlying disease, surgical procedure, or use of immunosuppressive medication. No AEs were considered to be related to the use of TachoSil. Conclusions The use of TachoSil for haemostasis after primary haemostatic treatment appears to be safe and effective in children undergoing liver resection.
Published: 2011

33. Manganese-enhanced MRI predicts the histological grade of hepatocellular carcinoma in potential surgical candidates

Author: Bernard Portmann, Robert P. Sutcliffe, Dylan Lewis, Pauline A. Kane, John Karani, Nigel Heaton, John O'Grady, and M. Rela
Subjects: Male, Poor prognosis, medicine.medical_specialty, Carcinoma, Hepatocellular, Contrast Media, Disease-Free Survival, Mri image, Mangafodipir, medicine, Humans, Radiology, Nuclear Medicine and imaging, Manganese enhanced mri, Retrospective Studies, Manganese, medicine.diagnostic_test, business.industry, Liver Neoplasms, Cancer, Magnetic resonance imaging, General Medicine, Middle Aged, medicine.disease, Prognosis, Magnetic Resonance Imaging, digestive system diseases, Liver Transplantation, Transplantation, Hepatocellular carcinoma, Female, Radiology, business, Nuclear medicine, Tomography, X-Ray Computed, medicine.drug
Abstract: To evaluate the role of manganese-enhanced magnetic resonance (Mn-MRI) in predicting tumour differentiation prior to liver transplant or resection for hepatocellular carcinoma (HCC).The inclusion criteria were patients with HCC who underwent Mn-MRI prior to transplantation or resection from 2001-2008. T1-weighted MRI images were acquired at 0 and 24h after manganese dipyridoxal diphosphate (MnDPDP) intravenous contrast medium and reviewed prospectively. Manganese retention at 24h was correlated with tumour differentiation and disease-free survival.Eighty-six patients underwent Mn-MRI (transplantation 60, resection 26); 114/125 lesions (91%) that were arterialised as evidenced at computed tomography (CT) and had manganese uptake on MRI were HCC. There were 11 false positives (9%) that were regenerative nodules. Ten of fourteen non-manganese-retaining HCC (71%) were poorly differentiated, compared with only 13/114 manganese-retaining HCC (11%) (p0.0001). Sensitivity, specificity, positive and negative predictive values of non-retention of MnDPDP in predicting poorly differentiated tumours were 0.43, 0.96, 0.71 and 0.88. Median disease-free survival of patients with non-manganese-retaining HCC was less than for patients with manganese-retaining HCC (14±5 months versus 39±3 months, log rank p=0.025).Non-manganese-retaining HCCs are likely to be poorly differentiated and have a poor prognosis. Manganese-enhanced MRI appears to have a role in preoperative assessment of HCC and warrants further evaluation.
Published: 2010

34. Systemic Diseases: From Amyloidosis to CryoglobulinemiaHereditary fibrinogen A $\alpha$-chain amyloidosis: Phenotypic characterization of a systemic disease and the role of liver transplantation. Blood 115: 2998--3007, 2010Long-term TNF-$\alpha$ blockade in patients with amyloid A amyloidosis complicating rheumatic diseases. Am J Med 123: 454--461, 2010Bortezomib with or without dexamethasone in primary systemic (light-chain) amyloidosis. J Clin Oncol 28: 1031--1037, 2010Rituximab plus Peg-interferon-$\alpha$/ribavirin compared with Peg-interferon-$\alpha$/ribavirin in hepatitis C-related mixed cryoglobulinemia. Blood 116: 326--334, 2010

Author: Grünfeld, Jean-Pierre Stangou, Arie J Fernandez-Nebro, Antonio Kastritis, Efstathios Saadoun, David Banner, Nicholas R Hendry, Bruce M Rela, Mohamed Portmann, Bernard Wendon, Julia others
Subjects: Health Sciences, Επιστήμες Υγείας
Published: 2010

35. Heat transfer in a bar: Numerical method and group dynamics

Author: Agustin M. Rela and Jorge Sztrajman
Subjects: FTCS scheme, Mathematics (miscellaneous), Partial differential equation, Method of characteristics, Differential equation, Applied Mathematics, Numerical analysis, Mathematical analysis, Exponential integrator, Education, Mathematics, Numerical stability, Numerical partial differential equations
Abstract: We present the solution of the classical problem of propagation of heat in a bar. Using ordinary analytical methods, it would require manipulation of partial differential equations and some algebra, but in the method we propose it is just necessary to add and divide by three. We point out that all operations are performed by the students themselves, who act as mass elements and memory modules. The whole class works therefore as a computer.
Published: 1991
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36. Predicting Fatty Liver Disease in Healthy Potential Liver Donors

Author: S. Govil, M. Vij, Dinesh Jothimani, D. Sheridan, Matthew E. Cramp, and M. Rela
Subjects: medicine.medical_specialty, Hepatology, business.industry, Internal medicine, Liver donors, Fatty liver, Medicine, Disease, business, medicine.disease, Gastroenterology
Published: 2016
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37. Splenic artery aneurysm and orthotopic liver transplantation

Author: John Karani, Nigel Heaton, M. Rela, and A. J. Robertson
Subjects: Adult, Male, medicine.medical_specialty, Cirrhosis, medicine.medical_treatment, Splenic artery, Liver transplantation, Chronic liver disease, Postoperative Complications, Aneurysm, medicine.artery, Hypertension, Portal, medicine, Humans, Transplantation, Alpha 1-antitrypsin deficiency, business.industry, Ultrasonography, Doppler, Middle Aged, medicine.disease, Liver Transplantation, Surgery, surgical procedures, operative, cardiovascular system, Portal hypertension, Radiology, business, Splenic Artery
Abstract: Splenic artery aneurysms are a rare but potentially fatal complication after liver transplantation. We report three cases presenting in a 12-month period in adult patients who underwent transplantation for chronic liver disease. Doppler ultrasound of the splenic artery should be performed in all patients with cirrhosis and portal hypertension who are being assessed for liver transplantation. The aneurysm can be ligated at the time of transplantation.
Published: 1999
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38. Reperfusion of the liver allograft with blue blood: is it still the royal perfusate?

Author: Adam Bartlett, M Rela, and Nigel Heaton
Subjects: medicine.medical_treatment, Hemodynamics, Liver transplantation, law.invention, Lesion, Orthotopic transplantation, Hepatic Artery, Randomized controlled trial, law, medicine, Immunology and Allergy, Animals, Humans, Transplantation, Homologous, Pharmacology (medical), Transplantation, business.industry, Arterial perfusion, medicine.disease, Liver Transplantation, Portal System, Anesthesia, Models, Animal, Reperfusion, medicine.symptom, business, Reperfusion injury, Liver Circulation
Abstract: The technique of liver transplantation has become relatively standardized. Although not commonly practiced, arterial reperfusion has been shown in both animal and human trials to offer hemodynamic and functional benefits to liver allograft recipients. Whether this is the result of shortening the time to re-establishing arterial perfusion or an effect of the sequence which the liver is revascularized remains unknown. Further randomized clinical trials are needed to answer this question and support our practice of arterial reperfusion.
Published: 2007

39. Artificial neural network is superior to MELD in predicting mortality of patients with end-stage liver disease

Author: N D Heaton, Fabio Piscaglia, S. Phillips, Antonio Daniele Pinna, Luigi Bolondi, Marco Vivarelli, Alessandro Cucchetti, G. La Barba, Matthew R. Foxton, John O'Grady, M. Rela, Cucchetti A, Vivarelli M, Heaton ND, Phillips S, Piscaglia F, Bolondi L, La Barba G, Foxton MR, Rela M, O'grady J, and Pinna AD.
Subjects: Liver Cirrhosis, Male, medicine.medical_specialty, Cirrhosis, medicine.medical_treatment, Liver transplantation, Gastroenterology, Models, Biological, Cohort Studies, Liver disease, Predictive Value of Tests, Internal medicine, Epidemiology, Medicine, Humans, business.industry, Liver Diseases, End stage liver disease, Middle Aged, medicine.disease, Prognosis, Liver Transplantation, body regions, ROC Curve, Liver, Predictive value of tests, Area Under Curve, Cohort, Chronic Disease, Female, Neural Networks, Computer, business, Cohort study
Abstract: Background: Despite its accuracy, the model for end-stage liver disease (MELD), currently adopted to determine the prognosis of patients with liver cirrhosis, guide referral to transplant programmes and prioritise the allocation of donor organs, fails to predict mortality in a considerable proportion of patients. Aims: To evaluate the possibility to better predict 3-month liver disease-related mortality of patients awaiting liver transplantation using an artificial neural network (ANN). Patients and methods: The ANN was constructed using data from 251 consecutive people with cirrhosis listed for liver transplantation at the Liver Transplant Unit, Bologna, Italy. The ANN was trained to predict 3-month survival on 188 patients, tested on the remaining 63 (internal validation group) unknown by the system and finally on 137 patients listed for liver transplantation at the King’s College Hospital, London, UK (external cohort). Predictions of survival obtained with ANN and MELD on the same datasets were compared using areas under receiver-operating characteristic (ROC) curves (AUC). Results: The ANN performed significantly better than MELD both in the internal validation group (AUC = 0.95 v 0.85; p = 0.032) and in the external cohort (AUC = 0.96 v 0.86; p = 0.044). Conclusions: The ANN measured the mortality risk of patients with cirrhosis more accurately than MELD and could better prioritise liver transplant candidates, thus reducing mortality in the waiting list.
Published: 2007

40. O105 : Comparison of short-term and long-term outcomes after DCD and DBD donor liver transplantation

Author: K. Menon, Miriam Cortes, M. Diaz, Y. Puri, B. Reyes, N. Heaton, Michael A. Heneghan, Wayel Jassem, M. Rela, J.G. O'Grady, Shirin Elizabeth Khorsandi, M. Tedeschi, D. Chasiotis, Parthi Srinivasan, B. Amir Sayed, G. Rompianesi, Hector Vilca-Melendez, R. Patcha, and Andreas Prachalias
Subjects: Transplantation, Toxicology, Pediatrics, medicine.medical_specialty, Hepatology, business.industry, Long term outcomes, Medicine, Living donor liver transplantation, business, Term (time)
Published: 2015
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41. Diaphragmatic nerve palsy in young children following liver transplantation

Author: Paolo Muiesan, Nigel Heaton, M. Rela, G Mieli-Vergani, Vassilis Smyrniotis, and P. Andreani
Subjects: Nephrology, Transplantation, medicine.medical_specialty, biology, business.industry, Pleural effusion, medicine.medical_treatment, Diaphragmatic breathing, Atelectasis, Liver transplantation, Diaphragmatic paralysis, medicine.disease, biology.organism_classification, Surgery, Anesthesia, Internal medicine, Diaphragma, Medicine, Respiratory system, business
Abstract: Diaphragmatic paralysis was identified in four children after liver transplantation. All presented with persistent right upper lobe atelectasis, pleural effusion and recurrent respiratory infections and could not be weaned from mechanical ventilatory support. Fluoroscopy and real-time ultrasound confirmed paradoxical right diaphragmatic movements. Diaphragmatic plication was undertaken and enabled rapid and sustained weaning from respiratory support in all four cases. Vascular clamping of the suprahepatic vena cava seems to be the cause. Diaphragmatic plication allows optimal recruitment of the respiratory muscles with a favourable impact on lung mechanics and gas exchange.
Published: 1998
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42. Change in model for end-stage liver disease score on the transplant waiting list predicts survival in patients undergoing liver transplantation

Author: Stewart Kendrick, Matthew R. Foxton, John O'Grady, Paolo Muiesan, Nigel Heaton, Elizabeth Sizer, Michael A. Heneghan, M Rela, and Julia Wendon
Subjects: Nephrology, Adult, Male, medicine.medical_specialty, Tissue and Organ Procurement, Waiting Lists, medicine.medical_treatment, Liver transplantation, Chronic liver disease, Liver disease, Model for End-Stage Liver Disease, Internal medicine, Intensive care, medicine, Humans, Transplantation, business.industry, Transplant Waiting List, Middle Aged, medicine.disease, Surgery, Liver Transplantation, Treatment Outcome, Female, business, Liver Failure
Abstract: Allocation of donor livers through the model for end-stage liver disease (MELD) score has resulted in a fall in waiting list deaths in the United States. Change in MELD score (DeltaMELD) whilst awaiting transplant has been suggested as a method of refining organ allocation. Our aims were to analyse the effect of DeltaMELD between listing and transplant, and examine its impact on patient survival, intensive care stay and hospital stay in 402 patients transplanted for chronic liver disease at a single centre. Patients who had a DeltaMELD score of >+1 point were more likely to die in hospital following transplant (P < 0.05) and had a significantly worse 12- and 36-month survival post transplant (P < 0.0001) when compared with patients with DeltaMELD
Published: 2006

43. Segmental liver transplantation from non-heart beating donors--an early experience with implications for the future

Author: Hector Vilca-Melendez, Anil Dhawan, Raffaele Girlanda, M. Rela, Paolo Muiesan, Nigel Heaton, R. Steinberg, Wayel Jassem, and G Mieli-Vergani
Subjects: Adult, Male, Hepatoblastoma, medicine.medical_specialty, Adolescent, Pleural effusion, medicine.medical_treatment, Liver transplantation, Primary hyperoxaluria, medicine, Immunology and Allergy, Hepatectomy, Humans, Pharmacology (medical), Asystole, Child, Retrospective Studies, Hepatitis, Transplantation, Donor selection, business.industry, Liver Diseases, Infant, Middle Aged, medicine.disease, Tissue Donors, Surgery, Heart Arrest, Child, Preschool, Tissue and Organ Harvesting, Female, business
Abstract: We report our experience of pediatric liver transplantation with partial grafts from non-heart beating donors (NHBD). Controlled donors less than 40 years of age with a warm ischemia time (WI) of less than 30 min were considered for pediatric recipients. Death was declared 5 min after asystole. A super-rapid recovery technique with aortic and portal perfusion was utilized. Mean donor age was 29 years and WI 14.6 min (range 11–18). Seven children, mean age 4.9 years (0.7–11), median weight 20 kg (8.4–53) received NHBD segmental liver grafts. Diagnoses included seronegative hepatitis, neonatal sclerosing cholangitis, familial intrahepatic cholestasis, hepatoblastoma, primary hyperoxaluria and factor VII deficiency (n = 2).The grafts included four reduced and one split left lateral segments, one left lobe and one right auxiliary graft. Mean cold ischemia was 7.3 h (6.2–8.8). Complications included one pleural effusion and one biliary collection drained percutaneously. At 20 months (10–36) follow-up all children are alive and well with functioning grafts. Donation after cardiac death is a significant source of liver grafts for adults and children with careful donor selection and short cold ischemic times.
Published: 2006

44. Replacement of the retrohepatic vena cava in segmental liver transplantation

Author: H. Vilca Melendez, Nigel Heaton, and M. Rela
Subjects: Male, Nephrology, medicine.medical_specialty, Vena cava, medicine.medical_treatment, Hepatic Veins, Iliac Vein, Liver transplantation, Inferior vena cava, Suture (anatomy), Internal medicine, medicine, Humans, cardiovascular diseases, Child, Vein, Transplantation, business.industry, Anastomosis, Surgical, Suture Techniques, Infant, Newborn, Infant, Tissue Donors, Liver Transplantation, Surgery, surgical procedures, operative, medicine.anatomical_structure, medicine.vein, cardiovascular system, Venae Cavae, Radiology, Lateral segment, business, Follow-Up Studies
Abstract: Reduced grafts represent an important technical development in paediatric liver transplantation. The use of a left lateral segment graft has required preservation of the native inferior vena cava to "piggy-back" the graft onto it. We report four children who underwent left lateral segment transplantation with caval replacement using the donor iliac vein because the native retrohepatic inferior vena cava was small, friable or difficult to preserve. There were no caval or hepatic vein complications post-transplant and the donor iliac vein proved to be a satisfactory interpositional graft. The technique offers the advantages of a wider retrohepatic cava avoiding venous outflow or caval obstruction, provides good tissue to suture and is well suited for the triangulation technique of the left hepatic vein.
Published: 1997
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45. A case of post-reperfusion syndrome following surgery for liver trauma

Author: P.B. Gopal, M Rela, R Ginsburg, and S.K. Kodakat
Subjects: Male, medicine.medical_specialty, Abdominal compartment syndrome, Adolescent, medicine.medical_treatment, Ischemia, Medicine, Hepatectomy, Humans, Tampons, Surgical, Decompensation, Intraoperative Complications, business.industry, Vascular disease, Surgical pack, Accidents, Traffic, Syndrome, Total Hepatectomy, medicine.disease, Surgery, Liver Transplantation, surgical procedures, operative, Anesthesiology and Pain Medicine, Liver, Reperfusion Injury, business, Complication
Abstract: We report the case of a young trauma patient who needed tight perihepatic surgical packing to control bleeding from a ruptured liver. He developed severe cardiovascular and respiratory decompensation on removal of the surgical packs as a result of the post-reperfusion syndrome. He underwent a total hepatectomy and, 35 h later, orthotopic liver transplantation. The pathophysiology of post-reperfusion syndrome is discussed, and its importance to anaesthetists in the non-transplant setting is emphasized.
Published: 2005

46. Peribiliary cysts can mimic Caroli's disease: a case report

Author: Olga N. Tucker, G. Fusai, N. M. Nik Sulaiman, M. Rela, John Karani, and Bernard Portmann
Subjects: 0301 basic medicine, Adult, Male, Pathology, medicine.medical_specialty, medicine.medical_treatment, Autopsy, Bile Duct Diseases, Liver transplantation, Asymptomatic, Pathology and Forensic Medicine, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, Choledochal cysts, Caroli s disease, Cholangiopancreatography, Endoscopic Retrograde, business.industry, medicine.disease, Caroli Disease, 030104 developmental biology, Bile Ducts, Intrahepatic, 030220 oncology & carcinogenesis, Choledochal Cyst, Surgery, Anatomy, medicine.symptom, business
Abstract: Peribiliary cysts, otherwise known as cystic dilatation of the peribiliary glands, are uncommon, and are usually discovered incidentally at autopsy, or in explants following liver transplantation. Preoperative diagnosis is often difficult owing to their asymptomatic nature and small size. Exclusion of a premalignant or malignant cystic condition is mandatory. We report a case of peribiliary cysts, initially thought to represent Caroli’s disease, and briefly discuss the management of this condition.
Published: 2005

47. Long-term outcome of immunosuppression withdrawal after liver transplantation

Author: Nigel Heaton, Raffaele Girlanda, Roger Williams, M. Rela, and J.G. O'Grady
Subjects: Adult, Male, medicine.medical_specialty, Cirrhosis, Time Factors, Adolescent, medicine.medical_treatment, Autoimmune hepatitis, Liver transplantation, Drug Administration Schedule, Primary sclerosing cholangitis, Primary biliary cirrhosis, medicine, Humans, Kidney transplantation, Transplantation, business.industry, Liver Diseases, Immunosuppression, Middle Aged, medicine.disease, Survival Analysis, Surgery, Liver Transplantation, Treatment Outcome, Female, business, Immunosuppressive Agents, Follow-Up Studies
Abstract: Eighteen liver transplant recipients were followed up for 10 years after a trial of immunosuppression withdrawal. Three groups were identified according to the early outcome of complete (group A, n = 5), partial (group B, n = 9), and unsuccessful (group C, n = 4) withdrawal of immunosuppression. The indications for liver transplantation (LT) (August 1983-December 1988) were as follows: primary biliary cirrhosis (n = 3), primary sclerosing cholangitis (n = 3), Budd-Chiari syndrome (n = 3), acute liver failure (n = 3), hepatitis C virus (HCV) cirrhosis (n = 1), HCV and autoimmune hepatitis (n = 1), HCV and alcohol-related cirrhosis (n = 1), HCV and hepatocellular carcinoma (HCC) (n = 1), cystic fibrosis (n = 1), and liver metastases from testicular teratoma (n = 1). Immunosuppression was based on cyclosporine. All patients experienced 1 or more complications of prolonged immunosuppression (median, 7 years; range, 5-11). Thirteen patients (72%) are alive at a median interval of 17 years (range, 16-21) after LT. Of the 5 patients in group A, 2 currently have normal graft function with no rejection episodes, and 3 have restarted immunosuppression following late low-grade acute rejection (n = 1), retransplantation for chronic rejection (n = 1), and kidney transplantation (n = 1). Of the 9 patients in group B, 5 died. The deaths were due to ruptured arterial pseudoaneurysm following retransplantation, HCC recurrence, cardiac failure, renal failure, and posttransplant lymphoma at 5, 7, 7, 14, and 17 years after LT, respectively. All 4 patients in group C are alive on a full immunosuppressive regimen. Long-term follow-up of 18 LT recipients withdrawn from immunosuppression has shown that at a median of 17 years 10% of patients remain off all immunosuppression.
Published: 2005

48. Immunosuppression withdrawal after auxiliary liver transplantation for acute liver failure

Author: Paolo Muiesan, N D Heaton, P. Srinivasan, J.G. O'Grady, M. Rela, Raffaele Girlanda, and Hector Vilca-Melendez
Subjects: Adult, Male, Reoperation, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Autoimmune hepatitis, Liver transplantation, medicine.disease_cause, Sudden death, Drug Administration Schedule, Cause of Death, medicine, Humans, Child, Hepatitis B virus, Hepatitis, Transplantation, business.industry, Liver Diseases, Immunosuppression, Liver Failure, Acute, medicine.disease, Survival Analysis, Surgery, Liver Transplantation, Child, Preschool, Female, Viral hepatitis, business, Immunosuppressive Agents, Follow-Up Studies
Abstract: Background The potential for immunosuppression withdrawal is the rationale for auxiliary liver transplantation (AUX) in patients with acute liver failure (ALF). Patients and methods Forty-four AUX were performed in 28 adults and 16 children with ALF secondary to seronegative hepatitis (n = 20; 45%), paracetamol hepatotoxicity (n = 14; 32%), acute viral hepatitis (hepatitis B virus [HBV] n = 3, Epstein-Barr virus n = 1; 9%), drug-induced hepatitis (n = 3; 7%), autoimmune hepatitis (n = 2; 5%), and mushroom poisoning (n = 1; 2%). All patients fulfilled the King’s College Hospital transplant criteria for ALF. After partial hepatectomy, 38 patients received a segmental auxiliary graft and six, a whole auxiliary graft. Immunosuppression was based on calcineurin inhibitors and steroids. Results Thirty-four patients (77%) are alive after a median follow-up of 30 months (range 4 to 124). Eight adults and two children died of sepsis (n = 6; 14%) at a median interval of 30 days (range 2 to 66), intraoperative cardiac failure (n = 1), brain edema on postoperative day 8 (n = 1), sudden death on day 35 (n = 1), and multiple organ failure associated with HBV recurrence 4 years after transplantation (n = 1). Three patients underwent retransplantation for small-for-size graft syndrome with sepsis on postoperative day 15 (n = 1) and for ductopenic rejection 4 and 15 months after AUX (n = 2). In 10/31 (32%) survivors (6/18 adults and 4/13 children) immunosuppression was completely withdrawn after a median of 19 months. Conclusion Complete immunosuppression withdrawal can be achieved in a significant proportion of patients after AUX for ALF.
Published: 2005

49. HEPATIC ARTERY THROMBOSIS AFTER LIVER TRANSPLANTATION IN CHILDREN UNDER 5 YEARS OF AGE

Author: G. Mieli-Vergani, M. Rela, N D Heaton, V. Bhatnagar, A P Mowat, A Baker, Paolo Muiesan, Roger Williams, and John Karani
Subjects: Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Liver transplantation, Chronic liver disease, Cold Ischemia Time, Hepatic Artery, Ischemia, Risk Factors, medicine.artery, medicine, Humans, Transplantation, Common hepatic artery, business.industry, Liver Diseases, Infant, Newborn, Infant, Thrombosis, Organ Preservation, medicine.disease, Liver Transplantation, Surgery, surgical procedures, operative, Biliary tract, Child, Preschool, Female, Complication, business
Abstract: The incidence of hepatic artery thrombosis (HAT) following orthotopic liver transplantation in children varies from 4% to 26% and represents a significant cause of graft loss. The purpose of this study was to analyze the risk factors for HAT following liver transplantation in children less than 5 years old. Seventy-three transplants were performed in 62 children under 5 years of age, including 16 for acute hepatic failure, 46 for chronic liver disease, and 11 retransplants. Twenty-four whole liver grafts (WLG) and 49 reduced size grafts (3 right lobes, 16 left lobes, and 30 left lateral segments) were transplanted. The recipient common hepatic artery was used to provide arterial inflow in 22 transplants and an infrarenal iliac conduit in 51 transplants. The overall incidence of HAT was 8 out of 73 transplants (11%). The cold ischemia time (14.3 +/- 3.03 hr) in this group was significantly longer than the cold ischemia time for those without HAT (11.7 +/- 3.94 hr) (P = 0.049). The incidence of HAT for whole and reduced grafts was 25% (6/24) and 4% (2/49), respectively (P = 0.01). HAT occurred in 6 of 22 grafts (27.3%) revascularized from the recipient common hepatic artery, compared with 2 of 51 grafts (3.9%) using an infrarenal arterial conduit (P = 0.008). The combination of recipient hepatic arterial inflow to a WLG resulted in HAT in 50% (6/12), whereas there were no cases of HAT with an iliac conduit to a WLG (P = 0.01). Of the eight patients with HAT, five are alive (median follow-up, 20 months; range, 7-27 months). Five patients were retransplanted, three within the first 2 weeks and two at 4 and 5 months for abnormal liver function in association with clinical and histological features of chronic rejection. Prolonged cold ischemia time and use of a whole graft with recipient hepatic arterial inflow are risk factors for developing HAT. The use of reduced size grafts and infrarenal iliac arterial conduits are associated with a low incidence of HAT.
Published: 1996
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50. Fibrinogen a α-Chain Amyloidosis: Clinical Features and Outcome after Hepatorenal or Solitary Kindey Transplantation

Author: A.J. Stangou, H.J. Lachmann, H.J.B. Goodman, A. Bybee, D. Rowzcenio, G. Tennent, S.O. Brennan, J.G. O’Grady, N.D. Heaton, M. Rela, M.B. Pepys, and P.N. Hawkins
Published: 2004
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