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New Orleans, LA, United States

Carmody I.C.,Multi Organ Transplant Institute
Clinical transplants | Year: 2012

Liver transplantation has become the best and most durable treatment for both acute and chronic liver disease. Over 1400 liver transplants have been performed at the Ochsner Clinic since the first successful transplant in 1987. Since its inception, the program has gone through several changes and advancements and has become one of the largest liver transplant programs in the United States. We have helped evolve steroid sparing immunosuppression and the use of extended criteria, donor organs. Establishment of criteria for the selection of recipients for re-transplantation has resulted in better than expected short and long-term results. Our center has faced the challenge of Hurricane Katrina and overcome it. We have improved steadily in both outcomes and transplants performed. The Ochnser Clinic Liver Transplant program will continue to improve access and outcomes for all patients with liver disease. Source

Rampolla R.,Multi Organ Transplant Institute
Ochsner Journal | Year: 2014

Background: Various factors must be taken into account when considering lung transplantation, including candidacy, contraindications, and outcomes.Methods: This article presents a review of the data and literature on lung transplantation, tracking the evolution of the treatment as it applies to different conditions, as well as an examination of patient survival rates in relation to pathology and treatment.Results: Timely referral and careful selection of candidates for lung transplantation maximize the outcomes of the procedure, resulting in a longer lifespan with improved physical health for patients.Conclusion: Lung transplantation is a therapeutic option for patients with various lung diseases. Adapting treatment options and follow-up treatment to the individual patient’s lifestyle and pathology optimizes patient survival rates after transplantation. © 2014, Academic Division of Ochsner Clinic Foundation. Source

Joshi S.N.,Multi Organ Transplant Institute | Joshi S.N.,Tulane University
Ochsner Journal | Year: 2014

Background: Hepatitis C screening is now recommended for all individuals born between the years 1945-1965 in addition to individuals who have high-risk factors. Although most clinicians have extensive experience with the diagnosis and treatment of the disease, they have limited experience screening for it.Methods: We report current screening guidelines and methods.Results: By identifying the disease as early as possible, screening and treatment can reduce morbidity and mortality.Conclusion: Screening for hepatitis C leads to the appropriate evaluation and treatment of individuals chronically infected with the hepatitis C virus and prevents the progression of liver disease to cirrhosis, hepatocellular carcinoma, and the associated morbidity and mortality. Screening for hepatitis C is also cost effective. © 2014, Academic Division of Ochsner Clinic Foundation. Source

Cohen A.J.,Multi Organ Transplant Institute | Cohen A.J.,University of New Orleans | Williams D.S.,Tulane University | Bohorquez H.,Multi Organ Transplant Institute | And 8 more authors.
Ochsner Journal | Year: 2015

Background: The number of robotic operations performed with the da Vinci Surgical System has increased during the past decade. This system allows for greater maneuverability and control than hand-assisted laparoscopic procedures, resulting in less tissue manipulation and irritation. Methods: We retrospectively analyzed the results of 100 consecutive robotic-assisted laparoscopic donor nephrectomies and compared them to our most recent 20 hand-assisted laparoscopic donor nephrectomies. Results: Between May 2008 and June 2012, 120 laparoscopic donor nephrectomies were performed at Ochsner Clinic Foundation. Of those, 100 live kidney donors underwent robotic-assisted laparoscopic donor nephrectomies. Surgical time and hospital length of stay improved after the first 20 patients receiving robotic-assisted laparoscopic nephrectomies, which was considered the learning curve. Sixty percent of patients who underwent robotic-assisted laparoscopic donor nephrectomies were released on postoperative day 1 compared to 45% of patients who underwent hand-assisted laparoscopic techniques. Conclusion: In our experience, robotic-assisted laparoscopic donor nephrectomy resulted in decreased postoperative length of stay that decreased the global cost of the procedure and allowed our institution to admit more patients. © Academic Division of Ochsner Clinic Foundation. Source

Fischer S.,University of Toronto | Trivedi P.J.,University of Birmingham | Ward S.,University of Birmingham | Greig P.D.,University of Toronto | And 2 more authors.
International Journal of Experimental Pathology | Year: 2014

Dense tissue infiltrates of IgG4+ plasma cells >50/high-powered field (HPF) are purportedly highly specific for IgG4-related disease. However, the frequency and significance of liver-infiltrating IgG4+ plasma cells in primary sclerosing cholangitis (PSC) applying these cut-offs has not been determined. We sought to determine the incidence of intrahepatic IgG4-positive staining in PSC patients undergoing transplantation, correlating findings with clinical parameters. Immunohistochemical staining was performed on liver explants obtained between 1991 and 2009. Of 122 explants obtained, hilar IgG4+ staining was found to be mild (10-29 IgG4+ cells/HPF) in 23.0%, moderate (30-50/HPF) in 9.0% and marked (>50/HPF) in 15.6%. Marked hilar lymphoplasmacytic infiltration was significantly associated with marked hilar IgG4+ staining (P < 0.001). No patient had marked peripheral IgG4+ staining, although mild and moderate staining was observed in 24.5% and 3.3% respectively. Marked hilar IgG4+ staining was significantly associated with the presence of dominant biliary strictures (P = 0.01) and need for biliary stenting (P = 0.001). There did not, however, exist any significant differences in the age at PSC diagnosis, presence of inflammatory bowel disease or extrahepatic autoimmune disease, frequency of cholangiocarcinoma, interval between diagnosis and transplantation, or post-transplant PSC recurrence or survival. Of 51 control liver sections (PBC = 18; HCV = 19; HBV = 8; AIH = 6), none had marked or moderate hilar IgG4+ staining, whereas mild staining was seen in only 10% (P < 0.001). Marked (>50/HPF) hilar IgG4+ lymphoplasmacytic infiltration is frequently observed in PSC and associated with the presence of dominant biliary strictures. However, unlike serum IgG4+ , this does not seemingly associate with clinical disease course. © 2014 The Authors. International Journal of Experimental Pathology © 2014 International Journal of Experimental Pathology. Source

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