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  • 1
    Electronic Resource
    Electronic Resource
    Split liver is an effective tool to transplant paediatric patients (2000)
    Springer
    Transplant international 13 (2000), S. S144 
    Details
    ISSN: 1432-2277
    Keywords: Key words Split-liver ; Paediatric transplantation waiting list ; Liver transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Transplantation activity is dependent upon organ procurement; although great efforts are made to enlarge the cadaver donors' pool, it still remains far too small to meet the recipients' need. Waiting time is a particular problem for paediatric patients, and mortality on the waiting list for liver transplantation is very high. The number of paediatric donors is far too small to satisfy the request. To enlarge the liver pool, the split-liver procedure was introduced in several Transplant Centers. In November 1997, the North Italy Transplant program (NITp) Working Group for Liver Transplantation decided to start an official Split-liver Program. A protocol was therefore defined and criteria for donor's and recipient's eligibility were established to minimize the risk. The Working Group also standardized the technical procedure and defined collaboration between centers. Out of 410 cadaver liver donors used in the NITp, from 1 November 1997 until 31 May 1999, 49 patients (37 males and 12 females) were chosen for the split-liver procedure. Mean age was 29.9 ± 17.5 years. Mean ICU stay of the donors was considerably short (2.5 ± 2.1 days), and the other conditions foreseen for donor eligibility were met. In all cases (except two) an “in situ” technique was performed. Forty-nine adult recipients and 43 children were transplanted by the split-liver technique in our Transplant Centers. One right lobe and five left liver lobes were sent to Transplant Centers outside the NITp. Adult recipient age ranged from 18 to 60 years (mean 46.4 ± 11.7 years), and the paediatric one from 2 to 144 months (mean 24.8). Mean patient follow-up was 8.3 ± 5.5 months. In the paediatric group, the graft was successful in 34 cases (79 %), five patients (10.2 %) died and four (9.3 %) were re-transplanted. In the adult group, graft survival was 67.3 %, 11 (22 %) patients died and 5 (10 %) were re-transplanted. On 1 November 1997, 30 paediatric patients were on the liver waiting list. In the preceding 19 months, 52 patients were newly enrolled, and 36 transplants were performed. The mean waiting time of paediatric patients was 259 days (range 1–919 says). From 1 November 1997 to 31 May 1999, 61 paediatric patients were newly enrolled. In this period 70 patients were transplanted. The mean waiting time was 185 days (1–1010 days). At present, the liver waiting list includes eight paediatric patients. Split-liver transplantation is a successful procedure, effective in reducing waiting time for paediatric patients. It should be established if this may be a tool to enlarge the organ pool also for adult liver transplantation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050305
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  • 2
    Electronic Resource
    Electronic Resource
    A retrospective evaluation of HLA-A, B and -DRB1 matching in liver transplantation (1998)
    Springer
    Transplant international 11 (1998), S. S347 
    Details
    ISSN: 1432-2277
    Keywords: Key words HLA matching ; Liver transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Studies on the influence of histocompatibility in liver transplantation have not produced clear-cut results. We retrospectively studied the influence of HLA-A, B and -DRB1 matching on the survival of 517 liver-transplanted patients using univariate analysis. The following parameters were also considered in relation to transplant outcome: donor and recipient age, original disease, transplant center, and pretransplant blood transfusions. Twenty-four-month graft survival according to the number of HLA-A, B, DRB1 mismatches (MM) was 70.9 % (n = 28) for zero to two MM, 76.6 % (n = 248) for three to four MM, and 73.1 % (n = 241) for five to six MM (P = 0.7). We obtained similar results when considering HLA-A, B MM alone. Survival rates according to HLA-DRB1 MM were 71.7 % (n = 36) for zero MM, 73.7 % (n = 236) for one MM, and 76.4 % (n = 245) for two MM (P = 0.6). The same analyses, performed on cirrhotic patients alone, gave identical results. In conclusion, this study suggests, on a large series of patients, that HLA compatibility has no influence on liver transplant survival. On the contrary, an influence on transplant outcome was found for donor age, transplant center, and original disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050495
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Highly sensitive chemiluminescent method for the detection of cell contaminationThis paper has not been peer reviewed. (1998)
    New York : Wiley-Blackwell
    Journal of Bioluminescence and Chemiluminescence 13 (1998), S. 303-305 
    Details
    ISSN: 0884-3996
    Keywords: chemiluminescence ; PCR ; contamination ; polymorphism ; Chemistry ; Biochemistry and Biotechnology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology , Chemistry and Pharmacology
    Notes: Minisatellite analysis is commonly used in forensic disputes but can also be applied to the investigation of cell contamination. Such a problem arises, for example, when transplantation is performed. The presence of contamination has been investigated by other authors using radioactive methods. In the present study we describe a method that allows the detection of contamination with high sensitivity without using radioactive substances. Our technique is based on the use of polymerase chain reaction (PCR) amplification of minisatellite sequences (VNTR), followed by chemiluminescent detection. In particular, biotin-labelled dCTP is included in the PCR mixture and detection of PCR products is obtained following the CSPD chemiluminescent protocol (Southern-Light Nucleic Acid Detection Systems). We applied this method to artificial mixes of DNA of two individuals with alleles of different sizes. We performed progressive dilutions of an individual DNA into the other's DNA and revealed a contamination of 1 in 2500 cells. We also tested our technique searching for maternal contamination in cord blood samples in 60 cases and revealed a 18.3% contamination. The technique that we set up proves to be a very sensitive one which could be applied not only to the detection of maternal cells in cord blood but also in studying any other kind of contamination. © 1998 John Wiley & Sons, Ltd.
    Additional Material: 1 Ill.
    Type of Medium: Electronic Resource
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    Paper (German National Licenses)
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