Special Issue "Liver Transplantation"
A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".
Deadline for manuscript submissions: closed (31 January 2020).
Interests: HPB and liver transplantation surgery, adult and paediatric, surgery for cholangiocarcinoma, for epatocellular carcinoma. Ex situ and ante situ liver resection. Mini invasive HPB hepatic and pancreatic surgery
Clinical practice and research in the field of liver transplantation is moving at a fast pace. The breakthrough in HCV treatment in the past 5 years has already had an impact on the numbers of patients affected by HCV cirrhosis that will not progress to liver decompensation and failure. This is having a significant impact on the current and future indications for this procedure. Non-alcoholic steatohepatitis has become one of the major indications for liver transplantation in the western world, where obesity has become endemic. Transplant oncology is becoming a big part of most liver transplant centres worldwide. This includes further expansions of the criteria for transplantation for hepatocellular carcinoma and transplantation for diseases which were once contraindicated such as cholangiocarcinoma and colorectal liver metastatic disease.
Shortage of cadaveric donors led to the growth of living donor liver transplant centres worldwide. The expansion of liver transplant programs from donors after circulatory death (DCD) in the past 2 decades has shown how, in a number of countries, you can expect to increase the number of liver grafts by 20 to 30% using DCDs. However these and other marginal donors have issues which may limit their use, including the possibility of primary non function, acute kidney injury and biliary complications, which may be responsible for early and late graft loss. In the attempt to overcome these concerns, research has focused of modern organ preservation devices including in situ normothermic abdominal perfusion, particularly in DCD donors using a technique similar to ECMO, and extracorporeal machines perfusing and preserving livers and other organs out of the body. This allows for a test of functionality prior to implantation, making transplant a safer practice, and for prolonged storage, thus helping with difficult logistics. Further research is looking at potential improvement of marginal livers like defatting steatotic grafts.
Prof. Dr. Paolo Muiesan
Manuscript Submission Information
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- Non alcoholic steatohepatitis
- Colorectal metastatic liver disease
- Hepatocellular carcinoma
- Normothermic regional perfusion
- Extracorporeal machine preservation
- Auxiliary liver transplantation
- Domino liver transplantation