Orgoi, Sergelen

Товч нэр

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Бүтэн нэр

Orgoi Sergelen

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Orgoi Sergelen

Албан тушаал

Судлаач

Харьяалал

Анагаахын Шинжлэх Ухааны Үндэсний Их Сургууль

ORCID

0000-0003-1267-0207

Now showing 1 - 4 of 4

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P.353: Impact factors leading to renal impairment after liver transplantation: a single center consecutive 12 years’ experience.
(Wolters Kluwer, 2024-09-01)
Batsaikhan Batsuuri
;
Shiirevnyamba Avirmed
;
Chuluunbileg Batbold
;
Fidel López‐Verdugo
;
Jade M. Nunez
Introduction: Renal impairment (RI) is a common life-threatening complication of cirrhosis, affecting one in every five patients. Although LT is a lifeline for cirrhotic patients with impaired renal function, postoperative acute RI is not uncommon and is influenced by multiple factors, leading to poor outcomes. Hepatitis B virus (HBV) infection has been associated with increased risk of developing chronic kidney disease in some studies. The potential role of HBV infection in post-LT RI is unknown. This is likely due to the low prevalence of HBV infection amongst liver transplant recipients, which has been reported to be around 5% in the USA. Low- and Middle income country like Mongolia has the highest rate of hepatocellular carcinoma and hepatitis B in the world. Mongolian First liver transplant (LT) performed at First Central Hospital of Mongolia (FCHM) in September 2011 in a collaborative effort with South Korea’s Asan Medical Center. In this context, the aim of our study is identify the role of HBV infection on the incidence of renal impairment after liver transplantation. We hypothesize that patients with HBV infection will have a higher rate of RI post-LT. Methods: To determine the changes of renal function of peri- and post-LT as well as to identify risk factors for RI, we analyzed the First Central Hospital of Mongolia (FCHM) Liver Transplantation Database retrospectively, which includes patients who received LT between September 21, 2011, and December 31, 2022. Early RI was identified by measuring glomerular filtration rates by Cockcroft-Gault creatinine clearance formulation at pretransplantation, intraoperatively, 24h, 72h, 7d, 14d and 28d post LT. Results: The results revealed that female gender (OR=3.06; 95% CI=1.58–5.91), Child-Tucotte-Pugh (CTP) score B and C (OR=4.23; 95% CI=0.92–19.41), (OR=7.68; 95% CI=1.67–35.30), preoperative continuous renal replacement therapy (CRRT) (OR=5.86; 95% CI=1.1–31.21), high graft to recipient weight ratio (GRWR) (OR=3.45; 95% CI=1.23–9.63) increased the risk of RI among recipients. Moreover, recipients’ age (OR=1.07; 95% CI=1.03–1.11), Model for End-Stage Liver Disease (MELD) score (OR=1.09; 95% CI=1.03–1.16), intraoperative leukoreduced red blood cells (LR-RBC) (OR=1.09; 95% CI=1.04–1.14), platelet (PLT) (OR=1.06; 95% CI=1.00–1.12+), fresh frozen plasma (FFP) (OR=1.07; 95% CI=1.02–1.11) and postoperative LR-RBC (OR=1.09; 95% CI=1.04–1.14), cryoprecipitate transfusion (OR=1.1; 95% CI=1.01–1.19), intubated hours (OR=1.04; 95% CI=1.01–1.07) increased slightly the risk of RI. Conclusions: Female gender, high Child Pugh score, preoperative CRRT and high graft to recipient weight ratio are the primary risk factors RI after liver transplant surgery in Mongolia. The liver transplantation team at the FCHM expresses our gratitude to Prof. Sung-Gyu Lee and Liver transplantation team from the Asan Medical Center, Seoul, South Korea. Their contribution was invaluable in the form of guidance and precious knowledge transfer for developing the robust liver transplantation program in Mongolia.
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Renal Dysfunction After Liver Transplantation: a Single Center Study
(Mongolian National University of Medical Sciences, 2021-12-31)
Batsaikhan Batsuuri
;
Fidel López‐Verdugo
;
Bat-Ireedui Badarch
;
Suvd Nergui
;
Ariunaa Togtokh
Objectives: Mongolia is known as one of the countries with a high prevalence of viral hepatitis infection and its related liver cirrhosis and HCC. Therefor, liver transplantation (LT) surgery increases from year to year in Mongolia. Our goal was to evaluate post-transplant renal dysfunction (PTRD) and to investigate the predicting factors for renal dysfunction after LT. Methods: The impact of graft ischemic time, peri- and postoperative blood product transfusion, perioperative hemodynamics, time to extubating, intensive care length of stay, incidence of chronic renal failure, and mortality and morbidity were examined alone and then as a combined outcome. Results: Early renal dysfunction was identified by measuring serum creatinine and glomerular filtration rate. In our investigation which was a study group of patients following liver transplantation (LT), the following renal dysfunctions were found: 39% of recipients in the study had renal dysfunction, while the rest had no renal dysfunction. The average creatinine level of the recipients who had a renal dysfunction after LT, was 0.825 ± 0.24 mg/dl and the glomerular filtration rate was 111 ± 36.3 ml/min, and statistically significant. Conclusion: Preoperative kidney function plays a crucial role for postoperative renal dysfunction.
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P.389: No difference in recurrent hepatocellular carcinoma rates in liver transplanted patients receiving mTOR inhibitors compared to non-mTOR group.
(Wolters Kluwer, 2024-09-01)
Anar Ganbold
;
Margad-Erdene Erdenechuluun
;
Bayarmaa Ochirkhuree
;
Urnultsaikhan Ganbold
;
Ulzii-Orshikh Namkhai
Introduction: A liver transplantation (LT) is a first line therapeutic choice for patients with hepatocellular carcinoma (HCC). Mammalian Target of Rapamycin (mTOR) inhibitors act as immunosuppressant and indicated against HCC recurrence in LT patients. The efficacy of mTOR inhibitors in preventing HCC recurrence remains contentious. Methods: We retrospectively enrolled 45 patients (average age 50, M/F:29/16) who had a history of HCC at the time of LT operation at a single center (2011-2023) and divided into a mTOR and non-mTOR groups. Initial Alfa-fetoprotein (AFP), Protein induced by vitamin K absence-II (PIVKA-II) levels, contrast-enhanced abdominal computer-assisted tomography (CT) scans were compared to most recent results, explant histology was also assessed for HCC extent. Decision to transplant was made based on Milan criteria. Student t-test was used to determine statistical significance (p<0.05). Results: In the mTOR group (n=23, average age 52.7) there were 2 confirmed HCC recurrences with elevated markers and positive CT scans. In the non-mTOR group (n=22, average age 47.4) there was 1 confirmed case of HCC. A recurrence rate of 6.67% was recorded overall, 8.7% and 4.55% for mTOR and non-mTOR (p=0.28), respectively. All three recurrences were detected within 24 months of the operation. For recurrent HCCs, the average levels of PIVKA-II and AFP were 27010mAU/ml and 2842.7ng/ml, respectively. There was no difference in number and mode of pre-LT bridging therapies (TACE or RFA) with regards to recurrence. There were two cases of elevated PIVKA-II without a radiologic confirmation. Conclusion: Adherence to the Milan criteria and application of pre-LT bridging therapies will keep the recurrence rate below 10%. Any possible recurrence will be diagnosed within 24 months of LT. Administration of mTOR inhibitors can be stopped after 2 years as part of the physician-guided minimization of immune suppression regimen.
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P.367: Outcomes of liver transplantation: A single-center experience. (First Central Hospital of Mongolia).
(Wolters Kluwer, 2024-09-01)
Bat-Ireedui Badarch
;
Batsaikhan Bat‐Erdene
;
Batsaikhan Batsuuri
;
Ganzorig Batjargal
;
Sergelen Orgoi
Methods: This study was conducted in Transplantation Center of the First Central Hospital of Mongolia between September 2011 and May 2023 on a total 200 patients have undergone liver transplantation. Results: There were 105 female patients out of 200, age between 18 months to 62 years old, and the average MELD score was 15±5.5, length of hospital stay were 31±13.94. These transplants were for liver (living donor=189, deceased donor=11, pediatric=7). The most causes of liver transplantation were liver cirrhosis due to HBV/HDV (59.5%), hepatocellular carcinoma (22.5%), primary biliary cirrhosis (5%), and only HBV related cirrhosis, alcoholic cirrhosis. There were 23(11.5%) biliary complication, 17 (8.5%) acute cellular rejection, hepatic artery thrombosis 2 (1%), and 3 cases retransplanted. The five year survival was 87%. Conclusions: This study provides the process of liver transplantation in First Central Hospital of Mongolia, and these positive outcomes support LT as an important therapy for end-stage liver disease and early hepatocellular carcinomas. Introduction: Liver transplantation (LT) is a main treatment of end-stage liver disease. Specially developing country like Mongolia has high prevalence of HBV, HDV, and hepatocellular cancer. Liver transplant is the second-most common solid organ transplant procedure in Mongolia. This study aimed to evaluate the efficacy of liver transplantation in the First Central Hospital of Mongolia.

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