1.Post-living donor liver transplant biliary strictures: prevalence, predictors, and long-term outcomes in a retrospective study
Shekhar Singh JADAUN ; Phani Kumar NEKARAKANTI ; Sushant BHATIA ; Mukesh KUMAR ; Pankaj SINGH ; Vikas SINGLA ; Shweta A. SINGH ; Shaleen AGARWAL ; Sanjiv SAIGAL ; Subhash GUPTA
Clinical Transplantation and Research 2025;39(1):55-65
Background:
Post-liver transplant biliary strictures are a common cause of morbidity among patients who have undergone living donor liver transplantation (LDLT). Limited data are available concerning the response rates to various treatment modalities and the long-term outcomes for these individuals.
Methods:
This study was a retrospective analysis of a prospectively collected database, including adult patients aged 18 years or older who underwent LDLT between 2006 and 2022.
Results:
Between 2006 and 2022, a total of 3,550 patients underwent liver transplantation. After applying exclusion criteria, 2,956 patients were included in the analysis.During the study period, 344 patients (11.6%) developed biliary strictures. Of these, 77.0% underwent endoscopic retrograde cholangiopancreatography as the primary treatment for biliary strictures, while the remainder received percutaneous transhepatic biliary drainage. Identified risk factors for post-liver transplant biliary strictures included the presence of multiple biliary anastomoses, bile leak, and older donor and recipient ages. The overall graft and patient survival rates were comparable between patients with and without biliary strictures, at both 1 year (93.0% vs. 96.3%) and 5 years (82.3% vs. 79.2%).
Conclusions
Biliary strictures are observed in approximately 11% of recipients following LDLT. While the presence of biliary strictures is associated with increased morbidity, it does not significantly impact patient survival.
2.Post-living donor liver transplant biliary strictures: prevalence, predictors, and long-term outcomes in a retrospective study
Shekhar Singh JADAUN ; Phani Kumar NEKARAKANTI ; Sushant BHATIA ; Mukesh KUMAR ; Pankaj SINGH ; Vikas SINGLA ; Shweta A. SINGH ; Shaleen AGARWAL ; Sanjiv SAIGAL ; Subhash GUPTA
Clinical Transplantation and Research 2025;39(1):55-65
Background:
Post-liver transplant biliary strictures are a common cause of morbidity among patients who have undergone living donor liver transplantation (LDLT). Limited data are available concerning the response rates to various treatment modalities and the long-term outcomes for these individuals.
Methods:
This study was a retrospective analysis of a prospectively collected database, including adult patients aged 18 years or older who underwent LDLT between 2006 and 2022.
Results:
Between 2006 and 2022, a total of 3,550 patients underwent liver transplantation. After applying exclusion criteria, 2,956 patients were included in the analysis.During the study period, 344 patients (11.6%) developed biliary strictures. Of these, 77.0% underwent endoscopic retrograde cholangiopancreatography as the primary treatment for biliary strictures, while the remainder received percutaneous transhepatic biliary drainage. Identified risk factors for post-liver transplant biliary strictures included the presence of multiple biliary anastomoses, bile leak, and older donor and recipient ages. The overall graft and patient survival rates were comparable between patients with and without biliary strictures, at both 1 year (93.0% vs. 96.3%) and 5 years (82.3% vs. 79.2%).
Conclusions
Biliary strictures are observed in approximately 11% of recipients following LDLT. While the presence of biliary strictures is associated with increased morbidity, it does not significantly impact patient survival.
3.Post-living donor liver transplant biliary strictures: prevalence, predictors, and long-term outcomes in a retrospective study
Shekhar Singh JADAUN ; Phani Kumar NEKARAKANTI ; Sushant BHATIA ; Mukesh KUMAR ; Pankaj SINGH ; Vikas SINGLA ; Shweta A. SINGH ; Shaleen AGARWAL ; Sanjiv SAIGAL ; Subhash GUPTA
Clinical Transplantation and Research 2025;39(1):55-65
Background:
Post-liver transplant biliary strictures are a common cause of morbidity among patients who have undergone living donor liver transplantation (LDLT). Limited data are available concerning the response rates to various treatment modalities and the long-term outcomes for these individuals.
Methods:
This study was a retrospective analysis of a prospectively collected database, including adult patients aged 18 years or older who underwent LDLT between 2006 and 2022.
Results:
Between 2006 and 2022, a total of 3,550 patients underwent liver transplantation. After applying exclusion criteria, 2,956 patients were included in the analysis.During the study period, 344 patients (11.6%) developed biliary strictures. Of these, 77.0% underwent endoscopic retrograde cholangiopancreatography as the primary treatment for biliary strictures, while the remainder received percutaneous transhepatic biliary drainage. Identified risk factors for post-liver transplant biliary strictures included the presence of multiple biliary anastomoses, bile leak, and older donor and recipient ages. The overall graft and patient survival rates were comparable between patients with and without biliary strictures, at both 1 year (93.0% vs. 96.3%) and 5 years (82.3% vs. 79.2%).
Conclusions
Biliary strictures are observed in approximately 11% of recipients following LDLT. While the presence of biliary strictures is associated with increased morbidity, it does not significantly impact patient survival.
4.Post-living donor liver transplant biliary strictures: prevalence, predictors, and long-term outcomes in a retrospective study
Shekhar Singh JADAUN ; Phani Kumar NEKARAKANTI ; Sushant BHATIA ; Mukesh KUMAR ; Pankaj SINGH ; Vikas SINGLA ; Shweta A. SINGH ; Shaleen AGARWAL ; Sanjiv SAIGAL ; Subhash GUPTA
Clinical Transplantation and Research 2025;39(1):55-65
Background:
Post-liver transplant biliary strictures are a common cause of morbidity among patients who have undergone living donor liver transplantation (LDLT). Limited data are available concerning the response rates to various treatment modalities and the long-term outcomes for these individuals.
Methods:
This study was a retrospective analysis of a prospectively collected database, including adult patients aged 18 years or older who underwent LDLT between 2006 and 2022.
Results:
Between 2006 and 2022, a total of 3,550 patients underwent liver transplantation. After applying exclusion criteria, 2,956 patients were included in the analysis.During the study period, 344 patients (11.6%) developed biliary strictures. Of these, 77.0% underwent endoscopic retrograde cholangiopancreatography as the primary treatment for biliary strictures, while the remainder received percutaneous transhepatic biliary drainage. Identified risk factors for post-liver transplant biliary strictures included the presence of multiple biliary anastomoses, bile leak, and older donor and recipient ages. The overall graft and patient survival rates were comparable between patients with and without biliary strictures, at both 1 year (93.0% vs. 96.3%) and 5 years (82.3% vs. 79.2%).
Conclusions
Biliary strictures are observed in approximately 11% of recipients following LDLT. While the presence of biliary strictures is associated with increased morbidity, it does not significantly impact patient survival.
5.Incidentally Detected Gallbladder Carcinoma: Can F‑18 FDG PET/CT Aid in Staging and Prognostication?
Venkata Subramanian KRISHNARAJU ; Rajender KUMAR ; Bhagwant Rai MITTAL ; Harjeet SINGH ; Piyush AGGARWAL ; Harmandeep SINGH ; Thakur Deen YADAV ; Ritambhra NADA ; Vikas GUPTA ; Rajesh GUPTA
Nuclear Medicine and Molecular Imaging 2024;58(3):104-112
Purpose:
Incidental gallbladder carcinoma (IGBC) is diagnosed in post-cholecystectomy specimens for benign indications, where the role of 2-fluro-2-deoxyglucose positron emission tomography/computed tomography(FDG-PET/CT) is not clearly defined. The present study aimed to assess the benefits of staging and prognosticating with FDG-PET/CT in IGBC.
Materials and Methods:
A retrospective observational study from a tertiary-care center from January 2010 to July 2020 was performed. The demographic, clinical, histopathological, and treatment-related histories were collected. FDG-PET/CT-image findings were compared with survival outcomes through telephonic follow-up. The chi-square test was used for comparing frequencies. The univariate and multivariate survival estimates were analyzed using the Kaplan–Meier analysis and the Cox-proportional hazard model, respectively. Log-rank test was used to compare the Kaplan–Meier curves.
Results:
The study included 280 postcholecystectomy participants (mean age: 52 ± 11 years; women: 227) of whom 52.1% had open surgery(146/280). Residual disease in the gallbladder fossa (54.8% vs. 36.6%, p = 0.002) and liver infiltration (32.9% vs. 22.4%, p = 0.05) were seen more frequently in open surgery compared to laparoscopic surgery, while anterior abdominal wall deposits were more common in laparoscopy(35.1% vs. 24%,p = 0.041). FDG-PET/CT changed the management in 10% (n = 28) of patients compared to contrast-enhanced CT. The median survival was 14 months (95%CI-10.3–17.7). A higher stage of the disease on the FDG-PET/CT (loco-regional disease-HR 4.86, p = 0.006; metastatic disease-HR 7.53, p < 0.001) and the presence of liver infiltration (HR-1.92, p = 0.003) were independent predictors of poor survival outcomes.
Conclusion
FDG-PET/CT detects residual and metastatic disease in patients with IGBC, enabling the institution of appropriate management and acting as a tool for prognostication of survival.
6.DEMOGRAPHIC PROFILE, SUBSTANCE USE TRENDS AND ASSOCIATED PSYCHOTIC DISORDERS AMONG VETERANS WITH MENTAL HEALTH CONDITIONS: A RETROSPECTIVE COHORT STUDY OF US VETERANS
Jason Obermann ; Krishna Divadeenam ; Alexandra V. Flynn ; Hemant Thakur ; Vikas Singh ; Rishi Sharma ; Thomas Wiegmann ; Varun Boinpelly ; Kenneth Grasing ; Mukut Sharma ; Ram Sharma
ASEAN Journal of Psychiatry 2024;25(5):1-11
DEMOGRAPHIC PROFILE, SUBSTANCE USE TRENDS AND ASSOCIATED PSYCHOTIC DISORDERS AMONG VETERANS WITH MENTAL HEALTH CONDITIONS: A RETROSPECTIVE COHORT STUDY OF US VETERANS
Background: Amphetamine and other substances induced psychotic disorder and associated
suicidal risk among hospitalized US veterans is not clear.
Aims: To understand the demographic profile, substance use trends, psychotic disorders
and suicide attempts in veterans hospitalized with acute Mental Health Conditions (MHC).
Methods: Veterans Affairs Informatics and Computing Infrastructure Database (ICD)
and codes were used to identify veterans hospitalized with MHC diagnosis between 1999
and 2022. Laboratory records used to determine types of substances used hospitalization
frequency, all-cause mortality, suicide attempts and suicide outcomes. SAS was used for
statistical analysis.
Results: Among veterans with MHC, psychosis, manic-bipolar and PTSD were common
diagnosis. Psychosis was comparatively less among males above 50 years of age, but prevalent
among Hispanics. In general, substances use was significantly higher, and amphetamines
were most used, followed by cannabis codeine, morphine, cocaine, barbiturates, fentanyl,
and PCP among veterans with MHC. Amphetamine induced psychotic disorder persisted
in 22.28% and other substance induced psychotic disorder persisted in 77.72% of veterans
hospitalized with MHC. Psychosis was associated with higher rates of hospitalization,
suicide attempts, and suicide death.
Conclusions: Among US Veterans with MHC, amphetamine was most used substance
associated with higher rates of psychotic disorders, hospitalization, suicide attempts, and
death. ASEAN Journal of Psychiatry, Vol. 25 (7) July, 2024; 1-11.
7.Correlation of fecal calprotectin and patient-reported outcome measures in patients with ulcerative colitis
Nagesh KAMAT ; Sudheer K VUYYURU ; Saurabh KEDIA ; Pabitra SAHU ; Bhaskar KANTE ; Peeyush KUMAR ; Mukesh Kumar RANJAN ; Mukesh Kumar SINGH ; Sambuddha KUMAR ; Vikas SACHDEV ; Govind MAKHARIA ; Vineet AHUJA
Intestinal Research 2022;20(2):269-273
8.Surgical Outcomes of Transpedicular Decompression with or without Global Reconstruction in Thoracic/Thoracolumbar Pott’s Spine: A 7-Year Institutional Retrospective Study
Kalyan Kumar Varma KALIDINDI ; Kuldeep BANSAL ; Gourab BISWAS ; Anuj GUPTA ; Gayatri VISHWAKARMA ; Vikas TANDON ; Harvinder Singh CHHABRA
Asian Spine Journal 2022;16(2):173-182
Methods:
Using the hospital records and imaging database obtained from January 2014 to January 2020, this study retrospectively analyzed patients who underwent surgery for Pott’s spine and met the eligibility criteria.
Results:
This study included 230 patients with a mean±standard deviation age of 47.7±18.1 years (109 males, 121 females). The Visual Analog Scale score, Oswestry Disability Index, and Cobb angle were significantly improved in these patients (p<0.001). Patients who underwent anterior reconstruction had a greater correction in Cobb angle postoperatively (p=0.042) but also had a greater blood loss (p=0.04). During the follow-up, they experienced a significant loss of correction compared with those who only underwent transpedicular decompression (p=0.026). Nevertheless, patients who underwent anterior reconstruction using mesh/PEEK cages showed no significance difference in the clinical or radiological outcomes.
Conclusions
Transpedicular decompression used in the surgical management of Pott’s spine showed favorable clinical and radiological outcomes. The additional use of anterior reconstruction obtained equivalent clinical outcomes but resulted in excessive blood loss. Meanwhile, the use of mesh/PEEK cage for anterior reconstruction did not affect the clinical and radiological outcomes.
9.Letter to the Editor: An Indian Perspective on Universal Open Access Publishing: Think of the Fire before Venturing Out of the Frying Pan!
Durga Prasanna MISRA ; Vinod RAVINDRAN ; Aman SHARMA ; Anupam WAKHLU ; Sakir AHMED ; Vir Singh NEGI ; Vikas AGARWAL
Journal of Korean Medical Science 2020;35(8):85-
No abstract available.
Fires
;
Open Access Publishing


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