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https://www.readbyqxmd.com/read/29108513/reconstruction-of-traumatic-external-iliac-artery-dissection-due-to-vascular-clamping
#1
Mahir Kırnap, Ümit Özçelik, Aydıncan Akdur, Ebru H Ayvazoğlu Soy, İclal Işıklar, Feza Yarbuğ Karakayalı, Gökhan Moray, Mehmet Haberal
Traumatic external iliac artery dissection after renal transplant is a rare complication, but it should be urgently managed due to its devastating effects on graft and lower limb circulation. External iliac artery dissection is seen more in recipients with diabetes mellitus and comorbid disease. Recipients with external iliac artery dissection should be treated immediately by percutaneus angioplasty or surgical reconstruction. In this study, we reported the management of 2 kidney transplant cases with external iliac artery dissection due to vascular clamping of the artery...
October 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29027352/impact-of-spontaneous-donor-hypothermia-on-graft-outcomes-after-kidney-transplantation
#2
P Schnuelle, H M Mundt, F Drüschler, W H Schmitt, B A Yard, B K Krämer, U Benck
A previous donor intervention trial found that therapeutic hypothermia reduced delayed graft function (DGF) after kidney transplantation. This retrospective cohort study nested in the randomized dopamine trial (ClinicalTrials. gov identifier: NCT000115115) investigates the effects of spontaneous donor hypothermia (core body temperature <36°C) on initial kidney graft function, and evaluates five-year graft survival. Hypothermia assessed by a singular measurement in the ICU 4-20 hours before procurement was associated with less DGF after kidney transplantation (OR 0...
October 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28953652/successful-kidney-transplantation-across-a-positive-complement-dependent-cytotoxicity-crossmatch-by-using-c1q-assay-directed-bortezomib-assisted-desensitization-a-case-report
#3
Juhan Lee, Borae G Park, Hyang Sook Jeong, Youn Hee Park, Sinyoung Kim, Beom Seok Kim, Hye Jin Kim, Kyu Ha Huh, Hyeon Joo Jeong, Yu Seun Kim
RATIONALE: Human leukocyte antigen (HLA) is the major immunologic barrier in kidney transplantation (KT). Various desensitization protocols to overcome the HLA barrier have increased the opportunity for transplantation in sensitized patients. In addition, technological advances in solid-phase assays have permitted more comprehensive assessment of donor-specific antibodies. Although various desensitization therapies and immunologic techniques have been developed, the final transplantation decision is still based on the classic complement-dependent cytotoxicity (CDC) crossmatch (XM) technique...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28905454/management-considerations-in-the-failing-renal-allograft
#4
REVIEW
Tom Lea-Henry, Bobby Chacko
Patients with a failed or failing renal transplant are increasing in number. Graft failure resulting in dialysis re-initiation is not uncommon, yet there are limited data to guide management of these patients. Physician practices vary regarding timing of dialysis initiation and the timing and extent of immunosuppression withdrawal. The risks of immunosuppression withdrawal need to be carefully balanced against the benefits of continuing low-dose therapy. The latter helps minimise the risk of sensitisation and has been proposed to possibly slow the loss of residual renal function; however, the use of common immunosuppressive agents may contribute to cardiovascular disease, malignancy, and infection, the major causes of death following the loss of a renal transplant...
September 14, 2017: Nephrology
https://www.readbyqxmd.com/read/28882080/use-of-the-nellix-endovascular-aneurysm-sealing-system-in-combination-with-parallel-grafts-for-the-treatment-of-a-symptomatic-type-v-thoracoabdominal-aortic-aneurysm
#5
Chris Klonaris, Athanasios Katsargyris, Dimitris Athanasiadis, Theodor Liakakos
PURPOSE: To report endovascular treatment of a symptomatic type V thoracoabdominal aortic aneurysm (TAAA) using the combined techniques of endovascular aneurysm sealing and parallel stent-grafts. CASE REPORT: A 70-year-old man was referred with a symptomatic type V TAAA. The Nellix EndoVascular Aneurysm Sealing (EVAS) System was used in combination with 2 chimney grafts for the celiac artery (CA) and the superior mesenteric artery (SMA); one periscope graft perfused the right renal artery...
September 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28858176/midterm-outcomes-of-12-renal-transplant-recipients-treated-with-eculizumab-to-prevent-atypical-hemolytic-syndrome-recurrence
#6
Charlène Levi, Véronique Frémeaux-Bacchi, Julien Zuber, Marion Rabant, Magali Devriese, Renaud Snanoudj, Anne Scemla, Lucile Amrouche, Arnaud Mejean, Christophe Legendre, Rebecca Sberro-Soussan
BACKGROUND: Atypical hemolytic uremic syndrome (aHUS) is an orphan disease with a high rate of recurrence after kidney transplantation. However, reports of successful prevention of posttransplant aHUS recurrence with eculizumab emerged a few years ago. To further delineate its optimal use, we describe the largest series of kidney transplant recipients treated with prophylactic eculizumab. METHODS: Twelve renal transplant recipients with aHUS-related end stage renal disease received eculizumab: 10 from day 0 and 2 at the time of recurrence (days 6 and 25)...
August 25, 2017: Transplantation
https://www.readbyqxmd.com/read/28814591/spleno-renal-artery-transposition-in-a-solitary-functioning-kidney-for-treatment-resistant-hypertension-and-acute-kidney-injury
#7
Subash Somalanka, Fiona E Harris, Eric Chemla, Rebecca Jo Suckling, Pauline A Swift
Renal Artery Stenosis (RAS) is an important cause of treatment-resistant hypertension. Uncontrolled hypertension with RAS can cause progressive chronic kidney disease (CKD) leading to end-stage kidney disease. Therapeutic revascularisation can be helpful in appropriate circumstances where pharmaceutical intervention has failed and significant renovascular disease contributes to resistant hypertension. We present an interesting case of a Caucasian male with peripheral vasculopathy, abdominal aortic aneurysm (AAA), single functioning kidney and ostial RAS caused by stent struts from an endovascular AAA stent graft...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28741665/remote-ischemic-preconditioning-and-clinical-outcomes-in-on-pump-coronary-artery-bypass-grafting-a-meta-analysis-of-14-randomized-controlled-trials
#8
Bin Yi, Jianhui Wang, Dingwu Yi, Yanling Zhu, Yumei Jiang, Yi Li, Shaoyan Mo, Yi Liu, Jian Rong
The purpose of this article is to perform the first pooled analysis on remote ischemic preconditioning (RIPC) used for the improvement of clinical outcomes of patients only undergoing on-pump coronary artery bypass grafting (CABG) in randomized controlled trials (RCTs). A systematic search was performed using PubMed, the Cochrane Library, and the Web of Science to identify studies that described the effect of RIPC on postoperative mortality in patients only undergoing on-pump CABG. The outcomes included postoperative mortality, postoperative morbidity (including incidence of myocardial infarction, atrial fibrillation, stroke, acute kidney injury, and renal replacement therapy), mechanical ventilation (MV), intensive care unit length of stay (ICU LOS), and hospital length of stay (HLOS)...
July 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28739454/parallel-grafts-used-in-combination-with-physician-modified-fenestrated-stent-grafts-for-complex-aortic-aneurysms-in-high-risk-patients-with-hostile-anatomies
#9
Joseph Touma, Dorian Verscheure, Marek Majewski, Pascal Desgranges, Frederic Cochennec
OBJECTIVE: To evaluate the feasibility and early outcomes of complex aortic aneurysm repair in high risk patients with hostile anatomies using both parallel stents and physician-modified stent-graft (PMSG) techniques to address the renovisceral arteries METHODS: Consecutive patients with complex suprarenal (SRA) and thoracoabdominal aortic aneurysms (TAAA) undergoing endovascular repair using combined parallel stents technique and PMSG between September 2013 and November 2015 were evaluated...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28736319/robotic-ureteroplasty-with-buccal-mucosa-graft-for-the-management-of-complex-ureteral-strictures
#10
Ziho Lee, Benjamin T Waldorf, Eric Y Cho, Jeffrey C Liu, Michael J Metro, Daniel D Eun
PURPOSE: Surgical management of proximal and mid ureteral strictures that are not amenable to primary excision and anastomosis is challenging. Although a buccal mucosa graft is commonly used during substitution urethroplasty, its use in substitution ureteroplasty is limited. We describe our technique of robotic ureteroplasty with a buccal mucosa graft to manage complex ureteral strictures and we report our outcomes. MATERIALS AND METHODS: We retrospectively reviewed the records of 12 patients who underwent robotic ureteroplasty with a buccal mucosa graft between September 2014 and June 2016...
December 2017: Journal of Urology
https://www.readbyqxmd.com/read/28735998/assessment-of-spleen-filtrate-function-in-renal-transplant-recipients-using-technetium-99m-stannous-colloid-liver-spleen-scan
#11
N C Araújo, M B Neves, C A Mandarim-de-Lacerda, M M C Orlando
BACKGROUND: Functional hyposplenism (FH) is indicated by an anatomically present spleen that fails to take up radiolabeled colloid. The occurrence of FH has been reported in a small group of renal transplant recipients based on hematologic parameters. The aim of this study was to replicate this association in a larger group of renal transplant recipients with the use of technetium-99m-stannous colloid liver-spleen scan to assess the spleen function. METHODS: This survey based on single samples enrolled 101 unselected adult patients with functional kidney grafts >180 days after transplantation...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28697719/high-position-of-the-third-renal-transplant-and-alternative-urinary-tract-reconstruction-in-a-complicated-case
#12
Wilhelmina M van den Dool, Andrzej G Baranski
The decision-making process for treatment of patients with end-stage renal failure, multiple failed renal transplants, and severe comorbidities can be exceedingly difficult due to the inapplicability of many common surgery methods. In this article, we report the treatment of such a patient who underwent a third renal transplant and subsequently developed a ureteral stenosis. The third kidney had been transplanted with a high abdominal position and a partially intra- and retroperitoneally placed ureter due to a bilaterally obtained iliac fossa and severe abdominal adhesions...
July 11, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28631039/graft-nephrectomy-in-children
#13
Benedict L Phillips, Chris J Callaghan
Kidney transplantation is recognised as the gold standard treatment of end-stage renal disease in most children, with excellent graft survival rates. When graft failure occurs, renal transplant recipients (RTRs) have the option of removal of the transplant (graft nephrectomy [GN]), or leaving the failed transplant in situ. The aims of this review are to discuss the indications for GN, surgical techniques, outcomes after GN (including risks of allosensitisation and the impact on subsequent transplants), and the possible role of routine GN in the asymptomatic RTR with a failed renal allograft...
June 19, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28627425/a-multicenter-retrospective-analysis-stressing-the-importance-of-long-term-follow-up-after-hematopoietic-cell-transplantation-for-%C3%AE-thalassemia
#14
Sonali Chaudhury, M Ayas, Colleen Rosen, Madeline Ma, M Viqaruddin, Suhag Parikh, Sandhya Kharbanda, K Y Chiang, Ann Haight, Monica Bhatia, Greg Guilcher, Alexis Thompson, Shalini Shenoy
Allogeneic hematopoietic cell transplantation (HCT) is curative in patients with β-thalassemia major. However, most reports on HCT outcomes lack long-term follow-up data with the exception of single-center reports. An international multicenter retrospective data collection and analysis was conducted in 176 β-thalassemia patients who were 1 year or beyond after first HCT to evaluate follow-up methods and outcomes at 7 centers. Median age at HCT was 5.5 years (range, .6 to 18.5), and median follow-up was 7 years (range, 1 to 20)...
June 13, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28624104/acute-kidney-injury-after-liver-transplantation-recent-insights-and-future-perspectives
#15
REVIEW
Jubi E de Haan, Ewout J Hoorn, Hilde R H de Geus
Acute kidney injury (AKI) is a common postoperative complication after liver transplantation (LT). The occurrence of postoperative AKI after LT (Post-LT AKI) is associated with inferior patient and graft outcomes. Post-LT AKI is multifactorial in origin and has been related to the severity of liver disease, pre-LT renal dysfunction, graft quality, perioperative events and toxicity of immunosuppressive therapy. Furthermore it is thought that hepatic ischaemia reperfusion injury might be a driving force in the aetiology of post-LT AKI...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28620674/organ-dysfunction-and-failure-following-brain-death-do-not-preclude-successful-donation
#16
Eno-Obong I Essien, Nehu Parimi, Jennifer Gutwald-Miller, Tyree Nutter, Thomas M Scalea, Deborah M Stein
BACKGROUND: Organ dysfunction is common after neurologic determination of death (NDD) but before organ collection. Reliable markers for graft success following transplant of these organs would be useful. We sought to determine the relationship between the donor after neurologic determination of death (DNDD) pathophysiology and successful organ donation. METHODS: Donor information was obtained through the local organ procurement organization. Donor demographics and clinical data points for cardiovascular, renal, respiratory, hepatic, hematological and neuroendocrine systems were reviewed 12 h before and 12 h after neurologic determination of death was declared...
November 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28559175/rescue-of-failed-endovascular-aortic-aneurysm-repair-using-the-fenestrated-anaconda-device
#17
Jürgen Falkensammer, Fadi Taher, Miriam Uhlmann, Kornelia Hirsch, Johannes Strassegger, Afshin Assadian
OBJECTIVE: Endovascular aortic aneurysm repair (EVAR) with a fenestrated device (FEVAR) allows an extension of the proximal sealing zone above the renal arteries to an adequate, healthier segment of the aorta. This feature makes FEVAR an option to treat patients with a diseased aortic neck or type Ia endoleak after EVAR. The aim of this investigation was to present a single-center experience with FEVAR for patients with an abdominal aortic endograft in situ compared with primary FEVAR...
November 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28489277/pancreas-after-islet-transplantation-in-nonuremic-type-1-diabetes-a-strategy-for-restoring-durable-insulin-independence
#18
S A Wisel, J M Gardner, G R Roll, J Harbell, C E Freise, S Feng, S M Kang, R Hirose, D B Kaufman, A M Posselt, P G Stock
Islet transplantation offers a minimally invasive approach for β cell replacement in diabetic patients with hypoglycemic unawareness. Attempts at insulin independence may require multiple islet reinfusions from distinct donors, increasing the risk of allogeneic sensitization. Currently, solid organ pancreas transplant is the only remaining surgical option following failed islet transplantation in the United States; however, the immunologic impact of repeated exposure to donor antigens on subsequent pancreas transplantation is unclear...
September 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28486233/renal-autotransplantation-with-autologous-saphenous-vein-graft-in-a-patient-with-takayasu-arteritis-and-existing-renal-artery-stent-in-her-solitary-kidney
#19
Hakan Bahadir Haberal, Senol Tonyali, Bora Peynircioğlu, Mustafa Arici, Metin Demircin, Fazıl Tuncay Aki
Takayasu arteritis is a disease that results in the granulomatous inflammation of large vessel walls. Takayasu arteritis is generally observed in young females during the second or third decades of life. This disease is treated by the revascularization of the affected organs either by surgery or by endovascular interventions. In this study, we present a case where renal autotransplantation was performed on a lady with an autologous saphenous vein graft subsequent to numerous previous endovascular interventions for her solitary kidney due to Takayasu arteritis-induced renal artery stenosis...
May 10, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28480823/clinical-course-of-hemodialysis-access-after-initial-endovascular-intervention-for-stenosis-in-asian-renal-failure-patients
#20
Dewahar Senthoor, Kyi Zin Thant, Tze-Kiat Ng, Pei Ho
BACKGROUND: Arteriovenous fistula (AVF) and arteriovenous fistula graft (AVG) access for hemodialysis can develop stenosis, eventually leading to thrombosis and access failure. Prompt endovascular intervention can salvage the access but restenosis does occur. Clinical course, restenosis pattern, and risk factors associated with initial stenosis of AVFs/AVGs in Asian hemodialysis patients were studied. METHOD: A retrospective study was conducted (January 2009-June 2012) on consecutive patients with renal failure who developed the first-time stenosis in the vascular access and were managed with endovascular intervention...
August 2017: Vascular and Endovascular Surgery
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