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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
Tissue Transplantation01:24

Tissue Transplantation

Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...

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Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
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Liver transplantation: an update 2009.

Catherine Skagen1, Michael Lucey, Adnan Said

  • 1Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, USA.

Current Opinion in Gastroenterology
|April 8, 2009
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Summary

Living donor liver transplantation offers a viable option to increase transplants and reduce waitlist deaths. However, donor risks and hepatocellular carcinoma recurrence require further study, while careful management is crucial for HIV-positive recipients.

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Last Updated: Jun 24, 2026

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08:39

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Published on: November 7, 2020

Area of Science:

  • Hepatology
  • Transplant Surgery
  • Immunology

Background:

  • Liver transplantation faces challenges including donor organ shortage and managing complex recipient populations.
  • Living donor liver transplantation (LDLT) and transplantation in human immunodeficiency virus (HIV)-positive individuals represent evolving areas.
  • Hepatocellular carcinoma (HCC) management and down-staging prior to liver transplant are critical concerns.

Purpose of the Study:

  • To review current challenges and advancements in liver transplantation.
  • Focus on living donor liver transplant, HIV-positive recipients, and HCC down-staging.
  • To provide insights into outcomes, risks, and future directions in these areas.

Main Methods:

  • Review of recent studies and cohort data on liver transplantation outcomes.
  • Analysis of recipient and donor data for living donor liver transplantation.
  • Evaluation of outcomes and management strategies for HIV-positive and coinfected recipients.
  • Assessment of down-staging techniques for hepatocellular carcinoma.

Main Results:

  • LDLT outcomes are comparable to deceased donor transplants, but with higher HCC recurrence rates and donor morbidity/mortality concerns.
  • Liver transplantation in selected HIV-positive recipients shows equivalent outcomes to HIV-negative recipients; coinfected recipients have less favorable outcomes.
  • Drug interactions between immunosuppressants and antiretroviral therapy necessitate dose adjustments.
  • Loco-regional therapy for HCC down-staging is expanding, with waiting time post-therapy predicting recurrence.

Conclusions:

  • LDLT is a viable strategy to increase transplants and reduce waitlist mortality, though donor risks and HCC recurrence need further investigation.
  • Careful management and coordination are essential for HIV-positive liver transplant recipients.
  • The role of loco-regional therapies in down-staging HCC is growing and shows promise.