Long-term outcomes of liver transplantation using grafts from donors with active hepatitis B virus replication: a multicenter cohort study

Purpose@#Liver grafts from donors with HBV infection contributed to expanding the donor pool under the hepatitis B immunoglobulin and antiviral agents (nucleos(t)ide analogues) in the HBV-endemic area. We report long-term outcomes of liver transplantations (LTs) using grafts from donors with active or chronic HBV infection. @*Methods@#Overall, 2,260 LTs performed in 3 major hospitals in Seoul from January 2000 to April 2019 were assessed for inclusion. Twenty-six grafts (1.2%) were obtained from HBsAg (+), HBeAb (+), or HBcAb (+) donors, and recipient outcomes were retrospectively reviewed. Donor and recipient demographics and transplantation outcomes were analyzed. @*Results@#Sixteen deceased donor LTs were performed using active HBsAg (+) grafts. Ten other LTs were sourced from 10 living donors. There was no significant difference in survival in patients who received deceased donor LTs compared with that in those who underwent LT with non–hepatitis virus-infected grafts. Fourteen patients who were followed up for >5 years were stable, and no difference in hepatocellular carcinoma recurrence rate was observed 5 years after transplantation between transplants from donors with and those without HBV. @*Conclusion@#Considering long-term outcomes, liver grafts from donors with active HBV replication can be safely used for LT.

The outcome of hiatal hernia repair and factors associated with surgical outcome in the pediatric population: a single-center experience

Purpose@#Hiatal hernia in children is a rare condition, and there is limited knowledge available about the disease itself. There is currently no agreement or consensus on the treatment of hiatal hernia in the pediatric population due to lack of evidence. In this study, we were to assess our experience with hiatal hernia, including the characteristics of our patients, surgical outcomes, and factors that influence the outcomes. @*Methods@#We retrospectively reviewed the medical records of 49 patients below the age of 18 years who underwent hiatal hernia repair at the Asan Medical Center between 2006 and 2021. We analyzed and compared the general characteristics and surgical outcomes based on the presence of recurrence and coexisting congenital diseases. @*Results@#Hiatal hernia progression was found to be associated with various medical conditions; however, no significant differences in patient characteristics or surgical outcomes between those with and without comorbidities were observed.There were no significant differences in patient characteristics or outcomes between the initial and redo operations. Fundoplication was performed in 19 patients (36.7%) during the initial operation and in 7 patients (87.5%) during repeat hiatal hernia repair. @*Conclusion@#The presence of an underlying disease didn’t influence the treatment and progression of hiatal hernia. Furthermore, there were no significant differences in the clinical course between patients with recurrent hiatal hernia and those experiencing it for the first time. Additionally, the impact of fundoplication on the recurrence of hiatal hernia in pediatric patients was found to be minimal.

Sedative and analgesic effects of intravenous xylazine and tramadol on horses

This study was performed to evaluate the sedative and analgesic effects of xylazine (X) and tramadol (T) intravenously (IV) administered to horses. Six thoroughbred saddle horses each received X (1.0 mg/kg), T (2.0 mg/kg), and a combination of XT (1.0 and 2.0 mg/kg, respectively) IV. Heart rate (HR), respiratory rate (RR), rectal temperature (RT), indirect arterial pressure (IAP), capillary refill time (CRT), sedation, and analgesia (using electrical stimulation and pinprick) were measured before and after drug administration. HR and RR significantly decreased from basal values with X and XT treatments, and significantly increased with T treatment (p < 0.05). RT and IAP also significantly increased with T treatment (p < 0.05). CRT did not change significantly with any treatments. The onset of sedation and analgesia were approximately 5 min after both X and XT treatments; however, the XT combination produced a longer duration of sedation and analgesia than X alone. Two horses in the XT treatment group displayed excited transient behavior within 5 min of drug administration. The results suggest that the XT combination is useful for sedation and analgesia in horses. However, careful monitoring for excited behavior shortly after administration is recommended.