x

75% of people globally want unbiased news (Pew Research) but are concerned they're not getting that.

Get balanced coverage with Symby. See how stories are covered across diverse outlets and spot when one side covers a story the other skips.

PODCAST

Trenches in Transplant Surgery

Step into the forefront of abdominal transplant surgery — where innovation meets ongoing complexity. Machine perfusion and normothermic regional perfusion (NRP) are reshaping organ preservation and donor utilization, with growing evidence that these technologies improve graft assessment and early outcomes. Yet reviews continue to highlight key challenges — ischemia–reperfusion injury, biliary complications in DCD grafts, and the logistical demands of perfusion platforms. Despite these hurdles,

health & fitness medicine

All Episodes

00:19:02

Frailty and Sarcopenia in Liver Transplant - Impact...

Trenches in Transplant Surgery ·

2025/07/08

Frailty and sarcopenia are highly prevalent in patients undergoing liver transplantation, with significant implications for both pre- and post-transplant outcomes. Frailty, often assessed using tools like the Liver Frailty Index (LFI), and sarcopenia, typically measured by CT-based muscle mass, independently predict increased waitlist mortality, longer hospital and ICU stays, higher risk of infections, and reduced post-transplant survival. These conditions often persist or worsen after transplant,

en

00:25:06

Hepatic Artery Variants in Liver Transplantation

Trenches in Transplant Surgery ·

2025/07/07

Reconstruction of variant hepatic artery anatomy during liver transplantation is a critical component of graft revascularization, given that up to 50% of donors exhibit anatomical variations such as replaced or accessory right or left hepatic arteries. Techniques include back-table reconstructions using Carrel or branch patches, end-to-end anastomoses, or grafting variant arteries to donor gastroduodenal or splenic artery stumps. When recipient arterial inflow is inadequate, alternatives like

en

00:24:33

Blockchain for Organ Tracking and Registry Management

Trenches in Transplant Surgery ·

2025/07/06

Blockchain technology offers a promising solution to critical challenges in global organ transplant systems, such as lack of transparency, data tampering, and inefficiencies in organ tracking and registry management. By providing a decentralized, immutable, and auditable ledger, blockchain can enhance trust among stakeholders, ensure the integrity of consent and allocation processes, and prevent fraud or manipulation. Emerging pilot projects in countries like the U.S., Sri Lanka, and Korea have

en

00:19:55

AI in Transplant Donor-Recipient Matching

Trenches in Transplant Surgery ·

2025/07/05

Artificial intelligence is transforming donor-recipient matching in abdominal organ transplantation by integrating complex datasets—such as clinical variables, imaging, genomics, and immunologic profiles—into predictive models that can optimize graft allocation and improve outcomes. Machine learning techniques like gradient boosting, random forests, and deep neural networks have demonstrated superior accuracy over traditional scoring systems in predicting graft survival, organ usability, and

en

00:18:35

NAFLD/NASH in Liver Transplantation: Global Trends...

Trenches in Transplant Surgery ·

2025/07/04

NAFLD/NASH epidemic has two-fold impact on transplantation: it threatens the donor supply (steatotic grafts have higher risk) and creates a new high-risk recipient population (with metabolic complications and graft steatosis). Recent consensus and meta-analytic data emphasize using donor livers with ≤30% macrosteatosis whenever possible, careful evaluation with advanced imaging (CAP, CT) and possibly machine perfusion for high-fat grafts. Post-LT, aggressive control of weight and cardiometabolic

en

00:15:49

A Century of Surgical Progress in Kidney Transplantation

Trenches in Transplant Surgery ·

2025/07/03

Overall, the surgical technique of kidney transplant has evolved from its early open forms to incorporate modern minimally invasive technology, but the core principles remain: precise vascular suturing and a secure ureteral reimplantation. Major contributors include Joseph Murray (Brigham Hospital, Boston) and colleagues (first transplants), Folkert Belzer (UW solution), Lloyd Ratner (laparoscopic nephrectomy), and many centers such as Cleveland Clinic and Johns Hopkins that pioneered robotics

en

00:12:41

Classical Versus Piggyback Techniques in Liver...

Trenches in Transplant Surgery ·

2025/07/02

The evolution of liver transplantation techniques has shifted from the classical (conventional) approach, which involves removal of the retrohepatic inferior vena cava (IVC) and typically requires veno-venous bypass, to the piggyback technique, which preserves the recipient’s IVC and offers improved hemodynamic stability. While the classical method remains useful in complex cases (e.g., IVC thrombosis, Budd–Chiari syndrome), the piggyback approach has become the preferred standard due to reduced

en

00:20:04

Omics Technologies in Kidney and Liver...

Trenches in Transplant Surgery ·

2025/06/29

The past 5–10 years have witnessed remarkable progress in applying genomics, proteomics, and metabolomics to kidney and liver transplant medicine. Genomic tools are uncovering polymorphisms and gene expression signatures that predict rejection or identify tolerance, as well as informing tailored drug dosing. Proteomic studies have yielded noninvasive protein biomarkers (chemokines, injury molecules) for early rejection detection and provided mechanistic insights into how rejection alters graft

en

00:30:36

Deceased Donor Management and Evaluation

Trenches in Transplant Surgery ·

2025/06/28

Deceased Donor Management and EvaluationPhase 3 (donor evaluation) and Phase 4 (ICU donor management) are pivotal in the deceased donation pathway, directly impacting how many and how well organs can be transplanted. Recent years have seen significant progress: standardized donor management protocols, better understanding of pathophysiology after brain death, and technological innovations all contribute to improved outcomes. By thoroughly evaluating each organ with modern diagnostics and diligently

en

00:15:55

Zimislecel - Stem Cell Therapy for Type 1 Diabetes

Trenches in Transplant Surgery ·

2025/06/27

This podcast presents an original article detailing a phase 1-2 clinical study called VX-880-101 FORWARD, which investigates zimislecel as an allogeneic stem cell-derived islet-cell therapy for type 1 diabetes. The research aimed to assess the safety and efficacy of this new treatment, particularly its ability to restore physiologic islet function and potentially lead to insulin independence. The methods section outlines the study design, participant eligibility, and dosage regimens for zimislecel,

en

00:37:11

Anesthetic Management in Liver Transplantation

Trenches in Transplant Surgery ·

2025/06/27

Liver transplantation demands meticulous intraoperative management tailored to each surgical phase. By anticipating the typical hemodynamic changes in the pre-anhepatic, anhepatic, and neohepatic phases, the anesthesia and surgical teams at high-volume centers can proactively mitigate risks. In the pre-anhepatic phase, controlling bleeding (often by keeping CVP low and employing rapid transfusion protocols) and maintaining perfusion is paramount. In the anhepatic phase, preserving hemodynamic

en

00:23:06

Minimizing Immunosuppression and Achieving Tolerance...

Trenches in Transplant Surgery ·

2025/06/25

Immunosuppression minimization and withdrawal in liver transplantation is an area where clinical practice and cutting-edge research intersect. The driving rationale is clear – mitigating the long-term deleterious effects of chronic immunosuppressive therapy – but the execution requires navigating complex immunological and ethical terrain. Over the past two decades, we have learned that operational tolerance, once deemed a rare curiosity, is attainable in a meaningful subset of liver recipients,

en

00:20:56

Liver Viability Testing with Ex Vivo Machine Perfusion

Trenches in Transplant Surgery ·

2025/06/24

Ex vivo machine perfusion has ushered in a new era where a liver graft’s viability can be tested before the irreversible step of transplantation. Both normothermic and hypothermic perfusion techniques play roles in modern liver preservation, with NMP in particular enabling real-time functional evaluation. Key viability markers – lactate clearance, perfusate pH, glucose consumption, transaminase release, perfusion flow dynamics, bile production, and bile composition – have been identified through

en

00:22:16

Transplant Tourism - Ethics, Illicit Trade, and...

Trenches in Transplant Surgery ·

2025/06/23

Transplant tourism sits at the troubling intersection of medical need and global inequality. On one hand, it underscores the desperation of patients willing to do anything for a life-saving organ; on the other, it exposes the plight of the poor who are driven (or coerced) to literally sell parts of their bodies. The ethical global practice of transplantation demands that life be preserved without sacrificing human rights or dignity. The international community – through the WHO, the Declaration of

en

00:13:11

NRP Cannulation techniques and Blood Conservation...

Trenches in Transplant Surgery ·

2025/06/22

A-NRP utilizes extracorporeal membrane oxygenation (ECMO) technology, including a pump, oxygenator, and heater, to maintain normothermic (37°C) blood flow to abdominal organs in situ. This process reverses warm ischemic damage, improving organ quality for transplantation. However, simultaneous procurement of thoracic organs, such as lungs, can lead to significant blood loss in the chest, compromising circulatory support for abdominal organs. Blood conservation techniques are thus essential to ensure

en

00:15:47

Liver Enzyme Elevation Post Transplant - Causes,...

Trenches in Transplant Surgery ·

2025/06/21

Elevated liver enzymes after a liver transplant can stem from various causes, including surgical complications, infections, or rejection, with no single definitive source. Workup involves blood tests, imaging like ultrasounds, and sometimes biopsies to identify the cause, though outcomes can vary. The evidence leans toward treatments being tailored to the specific cause, such as medications for infections or procedures for blockages, but effectiveness depends on timely diagnosis.

en

00:13:19

AI and Deep Learning in Liver Transplantation

Trenches in Transplant Surgery ·

2025/06/20

• Research suggests AI and deep learning are enhancing liver transplant outcomes.• It seems likely that donor-recipient matching and post-transplant predictions are improving.• The evidence leans toward AI helping with organ allocation and surgical innovations.• Challenges include data quality and validation, with ongoing efforts to address them.

en

00:13:58

Viral Infections in Organ Transplant - Updates and...

Trenches in Transplant Surgery ·

2025/06/19

Research suggests EBV is a significant risk post-transplant, with PTLD incidence at 4-22% in children and 1-2% in adults, higher in EBV-negative recipients. It seems likely that CMV remains the most common viral infection, with varying incidence based on donor/recipient status. The evidence leans toward BK virus being a major concern for kidney transplants, with no effective prophylaxis. HHV8 is linked to Kaposi’s sarcoma, with higher incidence in endemic areas (3-5%). Diagnosis typically

en

00:13:45

Biliary Dilemmas in Liver Transplants

Trenches in Transplant Surgery ·

2025/06/18

• Ductopenia is mainly caused by chronic rejection, where the immune system attacks the bile ducts. Ischemic cholangiopathy, on the other hand, comes from poor blood flow, like when the hepatic artery is blocked.• Research shows ischemic cholangiopathy can lead to ductopenia by causing bile duct damage that results in their loss, but ductopenia can also happen from rejection, not just ischemia.• The evidence leans toward both conditions causing cholestasis and potentially needing retransplantation,

en

00:15:46

Solving the Liver Organ Shortage - Strategies and...

Trenches in Transplant Surgery ·

2025/06/17

• Research suggests increasing public awareness and opt-out donation systems can boost liver donations, though effectiveness varies by region.• It seems likely that using extended criteria donors and split liver techniques can expand the donor pool, but outcomes may differ.• The evidence leans toward machine perfusion and bioengineered livers as promising innovations, though they are still experimental.• Policy changes, like optimizing allocation, may help, but face ethical debates; living-donor

en

45 results

Similar Podcasts

Доктор Тройняшкин

Доктор Тройняшкин

The Dry Eye Treatment PODCAST

Dry Eye Treatment

Différent et alors ?

PATRICK SULAY

Kyle Kingsbury Podcast

Kyle Kingsbury

The Real Weight Loss Coach

Matty Lansdown