Technical Aspects of Orthotopic Liver Transplantation—a Survey-Based Study Within the Eurotransplant, Swisstransplant, Scandiatransplant, and British Transplantation Society Networks View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-03

AUTHORS

Zoltan Czigany, Marcus N. Scherer, Johann Pratschke, Markus Guba, Silvio Nadalin, Arianeb Mehrabi, Gabriela Berlakovich, Xavier Rogiers, Jacques Pirenne, Jan Lerut, Zoltan Mathe, Philipp Dutkowski, Bo-Göran Ericzon, Massimo Malagó, Nigel Heaton, Wenzel Schöning, Jan Bednarsch, Ulf Peter Neumann, Georg Lurje

ABSTRACT

BACKGROUND: Orthotopic liver transplantation (OLT) has emerged as the mainstay of treatment for end-stage liver disease. However, technical aspects of OLT are still subject of ongoing debate and are widely based on personal experience and local institutional protocols. METHODS: An international online survey was sent out to all liver transplant centers (n = 52) within the Eurotransplant, Swisstransplant, Scandiatransplant, and British Transplant Society networks. The survey sought information on center-specific OLT caseload, vascular and biliary reconstruction, graft reperfusion, intraoperative control of hemodynamics, and drain policies. RESULTS: Forty-two centers gave a valid response (81%). Out of these, 50% reported piggy-back and 40.5% total caval replacement as their standard technique. While 48% of all centers generally do not apply veno-venous bypass (vvBP) or temporary portocaval shunt (PCS) during OLT, vvBP/PCS are routinely used in six centers (14%). Portal vein first reperfusion is used in 64%, followed by simultaneous (17%), and retrograde reperfusion (12%). End-to-end duct-to-duct anastomosis without biliary drain (67%) is the most frequently performed method of biliary reconstruction. No significant associations were found between the center caseload and the surgical approach used. The predominant part of the centers (88%) stated that techniques of OLT are not evidence-based and 98% would participate in multicenter clinical trials on these topics. CONCLUSION: Technical aspects of OLT vary widely among European centers. The extent to which center-specific variation of techniques affect transplant outcomes in Europe should be elucidated further in prospective multicenter trials. More... »

PAGES

529-537

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11605-018-3915-6

DOI

http://dx.doi.org/10.1007/s11605-018-3915-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1106097903

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30097968


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