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Gastroenterology Clinics of North America

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https://www.readbyqxmd.com/read/29735036/gastrointestinal-transplantation
#1
EDITORIAL
Enrico Benedetti, Ivo G Tzvetanov
No abstract text is available yet for this article.
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735035/transplantation-of-abdominal-organs
#2
EDITORIAL
Alan L Buchman
No abstract text is available yet for this article.
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735034/robotic-pancreas-transplantation
#3
REVIEW
Mario Spaggiari, Ivo G Tzvetanov, Caterina Di Bella, Jose Oberholzer
Obesity is considered a relative contraindication to pancreas transplantation due to an overall increased risk in wound-related complications and surgical site infections. The rationale for performing pancreas transplantation in a minimally invasive fashion is to reduce these risks, which can be associated with inferior patient and graft survival following pancreas transplantation in morbidly obese patients. At the University of Illinois at Chicago, the initial series of robotic-assisted pancreas transplantation in obese patient with type 1 and 2 diabetes has been performed...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735033/pancreas-transplantation-for-patients-with-type-1-and-type-2-diabetes-mellitus-in-the-united-states-a-registry-report
#4
REVIEW
Angelika C Gruessner, Rainer W G Gruessner
Successful pancreas transplantation is still the only method to restore short-term and long-term insulin independence and good metabolic control for patients with diabetes. Since the first transplant in 1966, tremendous progress in outcome was made; however, transplant numbers have declined since 2004. This article describes the development and risk factors of pancreas transplantation with or without a kidney graft between 2001 and 2016. Patient survival and graft function improved significantly owing to careful recipient and donor selection, which reduced technical failure and immunologic graft loss rates...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735032/composite-and-multivisceral-transplantation-nomenclature-surgical-techniques-current-practice-and-long-term-outcome
#5
REVIEW
Guilherme Costa, Neha Parekh, Mohammed Osman, Sherif Armanyous, Masato Fujiki, Kareem Abu-Elmagd
The successful development of multivisceral and composite visceral transplantation is among the milestones in the recent history of human organ transplantation. All types of gastrointestinal transplantation have evolved to be the standard of care for patients with gut failure and complex abdominal pathologic conditions. The outcome has markedly improved over the last 3 decades owing to technical innovation, novel immunosuppression, and better postoperative care. Recent data documented significant improvement in the long-term therapeutic indices of all types of visceral transplantation close to that achieved with thoracic and solid abdominal organs...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735031/endoscopic-follow-up-of-intestinal-transplant-recipients
#6
REVIEW
Robert E Carroll
The growing population of intestinal transplant recipients present a unique challenge to the gastroenterologists responsible for their support and evaluation. Improvements in patient and graft survival are largely attributed to surgical advancements, refined antirejection therapy, and enhanced endoscopic surveillance protocols that better perceive rejection and other complications. This article reviews the endoscopic management and interventions provided for transplant recipients at the University of Illinois Hospital with complications, such as acute rejection, ischemia, bleeding, fistula, post-transplant lymphoproliferative disorder, and gastroparesis...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735030/living-donor-intestinal-transplantation
#7
REVIEW
Ivo G Tzvetanov, Kiara A Tulla, Giuseppe D'Amico, Enrico Benedetti
Living donor intestinal transplantation (LDIT) has been improved leading to results comparable to those obtained with deceased donors. LDIT should be limited to specific indications and patient selection. The best indication is combined living donor intestinal/liver transplantation in pediatric recipients with intestinal and hepatic failure; the virtual elimination of waiting time may avoid the high mortality experienced by candidates on the deceased waiting list. Potentially, LDIT could be used in highly sensitized recipients to allow the application of de-sensitization protocols...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735029/pediatric-intestinal-transplantation
#8
REVIEW
Neslihan Celik, George V Mazariegos, Kyle Soltys, Jeffrey A Rudolph, Yanjun Shi, Geoffrey J Bond, Rakesh Sindhi, Armando Ganoza
Pediatric intestinal transplantation has moved from the theoretic to an actual therapy for children with irreversible intestinal failure who are suffering from complications of total parenteral nutrition. Owing to significant advancement in the management of intestinal failure and prevention of parenteral nutrition-related complications that have led to reduction in incidence of parenteral nutrition-associated liver disease and have improved intestinal adaptation, the indications for intestinal transplantation are evolving...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735028/adult-intestinal-transplantation
#9
REVIEW
Cal S Matsumoto, Sukanya Subramanian, Thomas M Fishbein
Adult intestinal transplantation differs significantly from pediatric intestinal transplantation. While indications have remained largely consistent since 2000, indications for adults have expanded over the last two decades to include motility disorders and desmoid tumors. Graft type in adult recipients depends on the distinct anatomic characteristics of the adult recipient. Colonic inclusion, while initially speculated to portend unfavorable outcomes due to complex host-bacterial interactions has increased over the past two decades with superior graft survival and improved patient quality of life...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735027/intestinal-failure-and-rehabilitation
#10
REVIEW
Alan L Buchman
The rendering of proper care for the patient with intestinal failure requires the provider to have a functional understanding of digestion and absorption, nutrient requirements, and intestinal adaptation. Inherent in those concepts is that not only is nutritional absorption compromised, but medication absorption is as well. The principles of the management of home parenteral nutrition must be mastered and then proper and controlled weaning of parenteral nutrition may be commenced by use of dietary and pharmacologic means with appropriate clinical outcome measures followed...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735026/modern-management-of-acute-liver-failure
#11
REVIEW
Ruben Khan, Sean Koppe
Acute liver failure is a rare but life-threatening disease that can lead to progressive encephalopathy, intracranial hypertension, and multiorgan failure. In the developed world, the most common cause remains acetaminophen overdose, but there are still many cases in which there is acute liver failure of unknown etiology. The mainstay of acute liver failure management remains supportive care in the critical care setting. If supportive treatment does not stabilize the disease process, the patient may require emergent liver transplantation...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735025/status-of-adult-living-donor-liver-transplantation-in-the-united-states-results-from-the-adult-to-adult-living-donor-liver-transplantation-cohort-study
#12
REVIEW
Samir Abu-Gazala, Kim M Olthoff
This article reviews the Adult-to-Adult Living Donor Liver Transplant Cohort Study (A2ALL). The findings show that the number of adult-to-adult living donor liver transplants is consistently increasing. Living donor liver transplantation has an important benefit for patients with acute liver failure, does not compromise donor safety, and has lower rates of acute cellular rejection in biologically related donor and recipient. The conclusions from the A2ALL consortium have been critical in transplant advancement, supporting increased use to help decrease waitlist death and improve long-term survival of transplant recipients...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735024/immunologic-monitoring-to-personalize-immunosuppression-after-liver-transplant
#13
REVIEW
Andrew Zhu, Alexandra Leto, Abraham Shaked, Brendan Keating
Although immunosuppressive drugs have enhanced patient outcomes in transplantation, the liver transplant community has made significant research efforts into the discovery of more accurate and precise methods of posttransplant monitoring and diagnosing. Current research in biomarkers reveals many promising approaches.
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735023/liver-transplant-for-cholangiocarcinoma
#14
REVIEW
Daniel Zamora-Valdes, Julie K Heimbach
Liver transplant (LT) for perihilar cholangiocarcinoma (CCA) offers an opportunity for survival among patients with early-stage but anatomically unresectable disease. The 5-year survival rate after LT is 65% to 70%, higher among patients with primary sclerosing cholangitis, who are often diagnosed earlier, and lower among patients with de novo CCA. The results of LT for hilar CCA, along with recent limited data suggesting favorable survival among patients with very early intrahepatic CCA (ICC), have reignited interest in the subject...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735022/living-donor-liver-transplantation-technical-innovations
#15
REVIEW
Kiara A Tulla, Hoonbae Jeon
Living donor liver transplantation (LDLT) has found a place to serve the end-stage liver disease community as the donor safety and recipient suitability has been elucidated. Donor safety is of paramount importance and transplant programs must continue endeavors to maintain the highest possible standards. At the same time, adequacy of grafts based on recipient clinical status via their model for end-stage liver disease (MELD) score and volumetric studies to achieve a GRBWR >0.8, along with special attention to anatomic tailoring and portal venous flow optimization are necessary for successful transplantation...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29413028/nutritional-management-of-gastrointestinal-diseases
#16
EDITORIAL
Andrew Ukleja
No abstract text is available yet for this article.
March 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29413027/nutrition-and-disease
#17
EDITORIAL
Alan L Buchman
No abstract text is available yet for this article.
March 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29413022/nutritional-management-of-gastrointestinal-disease
#18
Andrew Ukleja
No abstract text is available yet for this article.
March 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29413021/nutritional-therapy-in-chronic-pancreatitis
#19
REVIEW
J Enrique Domínguez-Muñoz, Mary Phillips
Malnutrition is a frequent complication in patients with chronic pancreatitis. Maldigestion as a consequence of pancreatic exocrine insufficiency is the major cause of malnutrition in these patients. Together with that, toxic habits and alterations of the gastroduodenal transit may play a relevant role. Malnutrition in chronic pancreatitis is associated with osteoporosis, sarcopenia, poor quality of life, and increased mortality. An adequate nutritional evaluation including anthropometric, biochemical, and morphologic parameters is recommended in these patients...
March 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29413020/nutritional-aspects-of-acute-pancreatitis
#20
REVIEW
Kristen M Roberts, Marcia Nahikian-Nelms, Andrew Ukleja, Luis F Lara
The goal of nutritional support in acute pancreatitis is to reduce inflammation, prevent nutritional depletion, correct a negative nitrogen balance, and improve outcomes. Enteral nutrition (EN) in severe acute pancreatitis (SAP) should be preferred to parenteral nutrition. It maintains the integrity of the gut barrier, decreases intestinal permeability, downregulates the systemic inflammatory response, maintains intestinal microbiota equilibrium, and reduces the complications of the early phase of SAP, improving morbidity and possibly improving mortality, and it is less expensive...
March 2018: Gastroenterology Clinics of North America
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