HV, hepatic vein

HV,肝静脉
  • 文章类型: Journal Article
    UNASSIGNED: Donor liver graft quality plays an especially important role that contributes to the success of organ transplantation. Almost all local and international authors are interested in the techniques and results of transplantation, however, in Vietnam, there have not been any studies that report the results of liver procurement from brain-dead donors from a technical perspective as well as the morphology and function of the transplanted organ.
    UNASSIGNED: This study is descriptive cross-section study with analysis of retrospective occurrences of a series of cases of liver procurement from brain-dead donors from March 2010 to March 2020. All cases were proceeded the multiple organ procurement with warm liver dissection and in vivo cannulation and perfusion.
    UNASSIGNED: The average age of brain-dead donors was 29.7 ± 10.7 (18-69), 92.16% of the harvested organs were of good quality macroscopically; and the rate of anatomical modification was 33.3% that occurred mostly in the left hepatic artery (LHA). Technically, warm dissection was proceeded in majority of cases (98,0%), the graft implantation was performed by this technique with mean cold ischemia time (CIT) of 190,0 ± 100,5 min and WIT of 74,0 ± 39,2 s. There were no complications relating to graft injuries occurring during procurement and no primary liver failure, good results accounted for 94.1% of the total number of transplants postoperatively.
    UNASSIGNED: Multiple organ procurement with warm liver dissection and in vivo cannulation and perfusion was a safe technique and may be effective by avoiding any donor\'s damages in cold-phase dissection.
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  • 文章类型: Journal Article
    急性肝衰竭(ALF)是罕见的,不可预测的,各种病因导致的急性肝损伤(ALI)的潜在致命并发症。文献中报道的ALF病因具有区域差异,影响临床表现和自然病程。在旨在反映印度临床实践的共识文章的这一部分中,疾病负担,流行病学,临床表现,监测,和预测已经讨论过了。在印度,病毒性肝炎是ALF的最常见原因,抗结核药物引起的药物性肝炎是第二常见的原因。ALF的临床表现以黄疸为特征,凝血病,和脑病。区分ALF和其他肝衰竭的原因是很重要的,包括慢性急性肝衰竭,亚急性肝功能衰竭,以及某些可以模仿这种表现的热带感染。该疾病通常具有暴发性临床过程,短期死亡率很高。死亡通常归因于脑部并发症,感染,导致多器官衰竭。及时肝移植(LT)可以改变结果,因此,在可以安排LT之前,为患者提供重症监护至关重要。评估预后以选择适合LT的患者同样重要。已经提出了几个预后评分,他们的比较表明,本土开发的动态分数比西方世界描述的分数更具优势。ALF的管理将在本文件的第2部分中描述。
    Acute liver failure (ALF) is an infrequent, unpredictable, potentially fatal complication of acute liver injury (ALI) consequent to varied etiologies. Etiologies of ALF as reported in the literature have regional differences, which affects the clinical presentation and natural course. In this part of the consensus article designed to reflect the clinical practices in India, disease burden, epidemiology, clinical presentation, monitoring, and prognostication have been discussed. In India, viral hepatitis is the most frequent cause of ALF, with drug-induced hepatitis due to antituberculosis drugs being the second most frequent cause. The clinical presentation of ALF is characterized by jaundice, coagulopathy, and encephalopathy. It is important to differentiate ALF from other causes of liver failure, including acute on chronic liver failure, subacute liver failure, as well as certain tropical infections which can mimic this presentation. The disease often has a fulminant clinical course with high short-term mortality. Death is usually attributable to cerebral complications, infections, and resultant multiorgan failure. Timely liver transplantation (LT) can change the outcome, and hence, it is vital to provide intensive care to patients until LT can be arranged. It is equally important to assess prognosis to select patients who are suitable for LT. Several prognostic scores have been proposed, and their comparisons show that indigenously developed dynamic scores have an edge over scores described from the Western world. Management of ALF will be described in part 2 of this document.
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  • 文章类型: Journal Article
    怀孕期间发生的肝脏疾病可能很严重,进展迅速,影响母亲和胎儿的结局。它们是产科医生关注的常见原因,也是转诊给肝病医生的重要原因,胃肠病学家,或医生。怀孕期间的肝脏疾病可以分为妊娠特有的疾病,那些与怀孕巧合的人,和先前存在的肝脏疾病因怀孕而加剧。需要与妊娠相关或无关的肝脏疾病之间的快速鉴别诊断,以便可以对这些疾病进行专科和紧急处理。缺乏专门的印度指南来管理这些患者。印度全国肝脏研究协会(INASL)与印度妇产科协会联合会(FOGSI)联合成立了一个工作组,以制定妊娠期肝病患者管理的共识指南,与印度有关。为了制定这些准则,为期两天的圆桌会议于2018年5月26日至27日在新德里举行,讨论,辩论,并最终确定共识声明。只有工作组大多数成员一致批准的声明才被接受。本综述的主要目的是提出INASL和FOGSI联合批准的诊断和管理肝病孕妇的共识声明。本文概述了妊娠期发生的肝脏疾病,关于其发病机制的关键机制的更新,以及推荐的治疗方案。
    Liver diseases occurring during pregnancy can be serious and can progress rapidly, affecting outcomes for both the mother and fetus. They are a common cause of concern to an obstetrician and an important reason for referral to a hepatologist, gastroenterologist, or physician. Liver diseases during pregnancy can be divided into disorders unique to pregnancy, those coincidental with pregnancy, and preexisting liver diseases exacerbated by pregnancy. A rapid differential diagnosis between liver diseases related or unrelated to pregnancy is required so that specialist and urgent management of these conditions can be carried out. Specific Indian guidelines for the management of these patients are lacking. The Indian National Association for the Study of the Liver (INASL) in association with the Federation of Obstetric and Gynaecological Societies of India (FOGSI) had set up a taskforce for development of consensus guidelines for management of patients with liver diseases during pregnancy, relevant to India. For development of these guidelines, a two-day roundtable meeting was held on 26-27 May 2018 in New Delhi, to discuss, debate, and finalize the consensus statements. Only those statements that were unanimously approved by most members of the taskforce were accepted. The primary objective of this review is to present the consensus statements approved jointly by the INASL and FOGSI for diagnosing and managing pregnant women with liver diseases. This article provides an overview of liver diseases occurring in pregnancy, an update on the key mechanisms involved in its pathogenesis, and the recommended treatment options.
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  • 文章类型: Journal Article
    UNASSIGNED: Portal hypertension is a serious adverse event of liver cirrhosis. Recently, we developed a simple novel technique for EUS-guided portal pressure gradient (PPG) measurement (PPGM). Our animal studies showed excellent correlation between EUS-PPGM and interventional radiology-acquired PPGM. In this video we demonstrate the results of the first human pilot study of EUS-PPGM in patients with liver disease.
    UNASSIGNED: EUS-PPGM was performed by experienced endosonographers using a linear echoendoscope, a 25-gauge FNA needle, and a novel compact manometer. The portal vein and hepatic vein (or inferior vena cava) were targeted by use of a transgastric or transduodenal approach. Feasibility was defined as successful PPGM in each patient. Safety was based on adverse events captured in a postprocedural interview.
    UNASSIGNED: Twenty-eight patients underwent EUS-PPGM with 100% technical success and no adverse events. PPG ranged from 1.5 to 19 mm Hg and had excellent correlation with clinical parameters of portal hypertension, including the presence of varices (P = .0002), PH gastropathy (P = .007), and thrombocytopenia (P = .036).
    UNASSIGNED: This novel technique of EUS-PPGM using a 25-gauge needle and compact manometer is feasible and appears safe. Given the availability of EUS and the simplicity of the manometry setup, EUS-guided PPG may represent a promising breakthrough for procuring indispensable information in the management of patients with liver disease.
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