Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Challenges for liver transplantation during recovery from the COVID-19 pandemic: Insights and recommendations(New York Stratton., 2020) Niriella, M.A.; Siriwardana, R.C.; Perera, M.T.P.R.; Narasimhan, G.; Chan, S.C.; Dassanayake, A.S.ABSTRACT: The coronavirus disease 2019 (COVID-19) pandemic is placing an increasing burden on liver transplant (LT) services worldwide. At the peak of the pandemic, many LT services worldwide reduced or halted their activities. With the gradual easing of lockdowns, LT teams face new challenges when restarting activities. The numbers of LTs are likely to drop in the immediate post-COVID era. Prolonged and intermittent lockdowns are likely to lead to a shortage of supplies, especially in poor resource settings. Special attention is needed to avoid nosocomial COVID-19 infection among cirrhotic patients awaiting transplant, post-transplant patients, and members of transplant teams. LT programs may have to revise existing strategies in selecting donors and recipients for transplants. Redesigning service provision, restructuring outpatient care, carefully screening and selecting donors and recipients, and performing LT with limited resources will have to be initiated in the post-COVID era if long-term recovery of LT services is to be expected. Costs involved with LT are likely to increase, considering the change in protocols of testing, quarantining, and interstate traveling. This paper discusses the different elements affecting and the widespread impact of the COVID-19 pandemic on LT and strategies to minimize the impact of these factors and to adapt so LT services can meet the health care needs during this pandemic and beyond.Item Living with biliary atresia: From Kasai portoenterostomy to liver transplantation(Sri Lanka College of Paediatricians, 2016) Shanmugam, N.P.; Narasimhan, G.; Rajindrajith, S.Item Reconstruction of the middle hepatic vein in live donor liver transplantation: will it improve donor liver function?(College of Surgeons of Sri Lanka,, 2014) Liyanage, C.A.H.Right liver graft with the middle hepatic vein sometimes induces postoperative liver failure in donors due to insufficient functional remnant liver volume. Venous drainage of the graft is important for prevention of congestion and proper function of the graft. Therefore right hepatic veins and the tributaries of the middle hepatic vein need reconstruction. The unique technique of reconstructing the middle hepatic vein, the right hepatic vein and the short hepatic veins using allografts and artificial grafts are discussed. Patients who had right hepatic and middle hepatic vein reconstructions had good graft functions and less hepatic congestion. This technique will be useful for preserving liver function in right liver lobe donors in Sri Lanka where more than 31% of the general population has fatty liver disease.