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Intestinal transplantation

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https://www.readbyqxmd.com/read/28544183/clinical-outcomes-of-intestinal-transplant-recipients-colonized-with-multi-drug-resistant-organisms-a-retrospective-study
#1
Jacques Simkins, Michele I Morris, Jose F Camargo, Rodrigo Vianna, Thiago Beduschi, Lilian M Abbo
Rates of multi-drug resistant organisms (MDRO) colonization among intestinal transplant (ITx) recipients have not been reported. Colonization rates with vancomycin-resistant Enterococcus (VRE), carbapenem-resistant gram-negative bacteria (CR-GNB) and methicillin-resistant Staphylococcus aureus (MRSA) were obtained retrospectively in adults undergoing ITx (isolated or multi-visceral) from 1/2009-12/2015. We assessed for VRE, CR-GNB and MRSA bacteremia during the first year post-transplant for patients colonized with VRE, CR-GNB and MRSA respectively and for those who were not colonized...
May 19, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28536682/a-case-of-intramural-coronary-amyloidosis-associated-with-hemodialysis
#2
Faisal M Huq Ronny, George Kleinman, Paul James Kurtin, John Thomas Fallon
Dialysis-related amyloidosis predominantly occurs in osteo-articular structures and dialysis-related amyloid (DRA) substances also deposit in extra-articular tissues. Clinical manifestations of DRA include odynophagia, gastrointestinal hemorrhage, intestinal obstruction, kidney stones, myocardial dysfunction, and subcutaneous tumors. The pathological characteristics of DRA in the heart of hemodialysis patients have rarely been reported. We report the case of a 73-year-old female with a history of cerebral palsy and end-stage renal disease status post two failed renal transplants who had been on hemodialysis for 30 years...
January 2017: Autopsy & case reports
https://www.readbyqxmd.com/read/28536321/-disruption-of-gut-immune-system-caused-by-damage-of-intestinal-stem-cells-and-their-niche-in-graft-versus-host-disease-after-allogeneic-hematopoietic-stem-cell-transplantation
#3
Eiko Hayase, Takanori Teshima
Allogeneic hematopoietic stem cell transplantation(allo-SCT)is curative therapy for various hematological diseases. Graft-versus-host disease(GVHD)and infection remain the main problems in allo-SCT. Gastrointestinal tract is targeted by GVHD. In intestinal GVHD, intestinal stem cells and Paneth cells reside at the base of crypts are damaged by donor T cells. These damage leads to disruption of intestinal mucosal barrier and intestinal dysbiosis, resulting in more exaggerated GVHD. Recently, we and others have reported that R-Spondin1 and interleukin-22 as factors regenerated intestinal tissue homeostasis in murine model of bone marrow transplantation...
2017: Clinical Calcium
https://www.readbyqxmd.com/read/28533908/ascites-refractory-ascites-and-hyponatremia-in-cirrhosis
#4
Brett Fortune, Andres Cardenas
Ascites is the most common complication related to cirrhosis and is associated with increased morbidity and mortality. Ascites is a consequence of the loss of compensatory mechanisms to maintain the overall effective arterial blood volume due to worsening splanchnic arterial vasodilation as a result of clinically significant portal hypertension. In order to maintain effective arterial blood volume, vasoconstrictor and antinatriuretic pathways are activated, which increase overall sodium and fluid retention...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28524868/diabetes-associated-microbiota-in-fa-fa-rats-is-modified-by-roux-en-y-gastric-bypass
#5
Tulika Arora, Florian Seyfried, Neil G Docherty, Valentina Tremaroli, Carel W le Roux, Rosie Perkins, Fredrik Bäckhed
Roux-en-Y gastric bypass (RYGB) and duodenal jejunal bypass (DJB), two different forms of bariatric surgery, are associated with improved glucose tolerance, but it is not clear whether the gut microbiota contributes to this effect. Here we used fa/fa rats as a model of impaired glucose tolerance to investigate whether (i) the microbiota varies between fa/fa and nondiabetic fa/+ rats; (ii) the microbiota of fa/fa rats is affected by RYGB and/or DJB; and (iii) surgically induced microbiota alterations contribute to glucose metabolism...
May 19, 2017: ISME Journal
https://www.readbyqxmd.com/read/28524827/impact-of-human-leukocyte-antigen-loci-and-haplotypes-on-intestinal-acute-graft-versus-host-disease-after-human-leukocyte-antigen-matched-sibling-peripheral-blood-stem-cell-transplantation
#6
Fa-Hong Yan, Mei Wang, Jian-Feng Yao, Er-Lie Jiang, Ming-Zhe Han
BACKGROUND: Acute graft-versus-host disease (aGVHD) is a common and severe complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Some studies have found that the presence of certain specific human leukocyte antigen (HLA) loci could affect the occurrence of aGVHD. Meanwhile, the impact of HLA haplotypes on aGVHD has been rarely studied. This study aimed to investigate the effects of HLA loci and haplotypes on intestinal aGVHD. METHODS: Totally, 345 consecutive patients undergoing first HLA-matched sibling peripheral blood stem cell transplantation (PBSCT) from February 2004 to June 2013 at Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, were enrolled in this study...
June 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28520587/complementary-roles-of-nod2-in-hematopoietic-and-nonhematopoietic-cells-in-preventing-gut-barrier-dysfunction-dependent-on-mlck-activity
#7
Ziad Al Nabhani, Nicolas Montcuquet, Maryline Roy, Monique Dussaillant, Jean-Pierre Hugot, Frédérick Barreau
BACKGROUND: Crohn's disease (CD) pathogenesis is multifactorial involving genetic and environmental factors. Loss of function mutations in the nucleotide oligomerization domain 2 (NOD2) gene are the main genetic risk factor for CD. Like patients with CD, Nod2 mice are characterized by an enhanced Th1 immune response and a defective mucosal barrier function evidenced by increased intestinal permeability. We previously showed that the latter is related to hematopoietic Nod2 deficiency. Our aim was to explore the mechanisms by which Nod2 expressed in the hematopoietic and in the nonhematopoietic compartments interplay to control epithelial paracellular permeability...
May 16, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28511069/ischaemic-preconditioning-current-knowledge-and-potential-future-applications-after-30-years-of-experience
#8
REVIEW
Karolina Stokfisz, Anna Ledakowicz-Polak, Maciej Zagorski, Marzenna Zielinska
Ischaemic preconditioning (IPC) phenomenon has been known for thirty years. During that time several studies showed that IPC provided by brief ischaemic and reperfusion episodes prior to longer ischaemia can bestow a protective effect to both preconditioned and also remote organs. IPC affecting remote organs is called remote ischaemic preconditioning. Initially, most IPC studies were focused on enhancing myocardial resistance to subsequent ischaemia and reperfusion injury. However, preconditioning was found to be a universal phenomenon and was observed in various organs and tissues including the heart, liver, brain, retina, kidney, skeletal muscles and intestine...
May 13, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28510265/severity-and-outcome-of-the-norovirus-infection-in-children-after-intestinal-transplantation
#9
Marie Patte, Danielle Canioni, Véronique Avettand Fenoel, Pierre Frange, Marion Rabant, Cécile Talbotec, Florence Lacaille
In immunocompromised patients, the NoV infection is prolonged and severe. We retrospectively studied the severity of the NoV infection in children after an ITx, the treatment, and the long-term evolution. Norovirus PCR in stools was positive for 19 children in 21 separate episodes. The infection was symptomatic in 18 cases. At diagnosis, the median weight loss was 5% (0-11) and the creatinine clearance was 75 mL/min/1.73 m(2) (19-142). On 14 digestive biopsies, the pathological findings were non-specific with a constant mononuclear infiltration, showing signs of rejection in one case...
May 16, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28508661/post-transplant-lymphoproliferative-disease-in-liver-transplant-recipients
#10
Mercedes Rubio-Manzanares Dorado, José María Álamo Martínez, Carmen Bernal Bellido, Luis Miguel Marín Gómez, Gonzalo Suárez Artacho, Carmen Cepeda Franco, Jize Wang, Miguel Ángel Gómez Bravo, Francisco Javier Padillo
INTRODUCTION: Post-transplant lymphoproliferative syndrome (PTLD) is a rare and potentially life-threatening complication after liver transplantation. The aim of this study was to analyze the clinicopathologic features related to PTLD in a single institution after liver transplantation. METHODS: Observational study where we have retrospectively analyzed 851 cases who underwent liver transplantation. Ten cases have developed PTLD. Their clinical-pathological characteristics and the treatment received have been analyzed...
May 16, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28502441/intestinal-transplant-in-children
#11
REVIEW
Nidhi Rawal, Nada Yazigi
The past decade has seen major advances in the field of transplantation; it is the treatment of choice for many with intestinal failure. One-year mortality from pediatric intestinal transplantation has significantly declined, from 30% to 10% to 15% nationally, mainly due to a multidisciplinary approach in transplant centers. Pediatric age carries special considerations along the spectrum of care that continue to cause challenges but also offers growth opportunities. Pediatric intestinal transplantation indications and timing are changing as a result of new developments in diagnostic and treatment tools...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28498996/protective-factors-in-the-intestinal-microbiome-against-clostridium-difficile-infection-in-recipients-of-allogeneic-hematopoietic-stem-cell-transplantation
#12
Yeon Joo Lee, Esther S Arguello, Robert R Jenq, Eric Littmann, Grace J Kim, Liza C Miller, Lilan Ling, Cesar Figueroa, Elizabeth Robilotti, Miguel-Angel Perales, Juliet N Barker, Sergio Giralt, Marcel R M van den Brink, Eric G Pamer, Ying Taur
Background: Clostridium difficile infection (CDI) is a frequent complication in recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT), who receive intensive treatments that significantly disrupt the intestinal microbiota. In this study, we examined the microbiota composition of allo-HSCT recipients to identify bacterial colonizers that confer protection against CDI after engraftment. Methods: Feces collected from adult recipients allo-HSCT at engraftment were analyzed; 16S ribosomal RNA genes were sequenced and analyzed from each sample...
April 1, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28497755/autologous-stem-cell-transplantation-in-treatment-refractory-crohn-s-disease-an-analysis-of-pooled-data-from-the-astic-trial
#13
James O Lindsay, Mathieu Allez, Miranda Clark, Myriam Labopin, Elenor Ricart, Gerhard Rogler, Montserrat Rovira, Jack Satsangi, Dominique Farge, Christopher J Hawkey
BACKGROUND: The randomised controlled ASTIC trial showed no benefit of mobilisation and autologous haematopoietic stem-cell transplantation (HSCT) compared with mobilisation followed by conventional therapy using a stringent primary endpoint (steroid-free clinical remission for 3 months with no endoscopic or radiological evidence of intestinal inflammation) in patients with treatment-refractory Crohn's disease. We now assess HSCT in patients enrolled in the ASTIC trial using endpoints that are traditional for clinical trials in Crohn's disease, and identify factors that predict benefit or harm...
June 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28495755/intestinal-microbiota-contributes-to-colonic-epithelial-changes-in-simulated-microgravity-mouse-model
#14
Junxiu Shi, Yifan Wang, Jian He, Pingping Li, Rong Jin, Ke Wang, Xi Xu, Jie Hao, Yan Zhang, Hongju Liu, Xiaoping Chen, Hounan Wu, Qing Ge
Exposure to microgravity leads to alterations in multiple systems, but microgravity-related changes in the gastrointestinal tract and its clinical significance have not been well studied. We used the hindlimb unloading (HU) mouse model to simulate a microgravity condition and investigated the changes in intestinal microbiota and colonic epithelial cells. Compared with ground controls (Ctrls), HU affected fecal microbiota composition with a profile that was characterized by the expansion of Firmicutes and decrease of Bacteroidetes The colon epithelium of HU mice showed decreased goblet cell numbers, reduced epithelial cell turnover, and decreased expression of genes that are involved in defense and inflammatory responses...
May 11, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28490481/vitamin-a-deficiency-due-to-chronic-malabsorption-an-ophthalmic-manifestation-of-a-systemic-condition
#15
James Cheshire, Sai Kolli
A 47-year-old woman presented with a 4-week history of progressive loss of vision, first manifesting as night blindness. Additionally, the patient reported frequent severe episodes of diarrhoea over the past month. Her medical history included end-stage renal failure for which she was currently on haemodialysis after a failed renal transplant, chronic pancreatitis and autonomic diabetes mellitus. Ophthalmological examination revealed severe bilateral corneal xerosis, bilateral Bitot's spots and inferior ulceration of the right cornea...
May 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28484466/the-st2-il-33-axis-in-immune-cells-during-inflammatory-diseases
#16
REVIEW
Brad Griesenauer, Sophie Paczesny
Il1rl1 (also known as ST2) is a member of the IL-1 superfamily, and its only known ligand is IL-33. ST2 exists in two forms as splice variants: a soluble form (sST2), which acts as a decoy receptor, sequesters free IL-33, and does not signal, and a membrane-bound form (ST2), which activates the MyD88/NF-κB signaling pathway to enhance mast cell, Th2, regulatory T cell (Treg), and innate lymphoid cell type 2 functions. sST2 levels are increased in patients with active inflammatory bowel disease, acute cardiac and small bowel transplant allograft rejection, colon and gastric cancers, gut mucosal damage during viral infection, pulmonary disease, heart disease, and graft-versus-host disease...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28484247/total-fecal-microbiota-transplantation-alleviates-high-fat-diet-induced-steatohepatitis-in-mice-via-beneficial-regulation-of-gut-microbiota
#17
Da Zhou, Qin Pan, Feng Shen, Hai-Xia Cao, Wen-Jin Ding, Yuan-Wen Chen, Jian-Gao Fan
Non-alcoholic steatohepatitis (NASH) is an epidemic metabolic disease with limited therapeutic strategies. Cumulative data support the pivotal role of gut microbiota in NASH. Here, we investigated the hypothesis regarding whether fecal microbiota transplantation (FMT) is effective in attenuating high-fat diet (HFD)-induced steatohepatitis in mice. Mice were randomized into control, HFD and HFD + FMT groups. After an 8-week HFD, FMT treatment was initiated and carried out for 8 weeks. The gut microbiota structure, butyrate concentrations of the cecal content, liver pathology and intrahepatic lipid and cytokines were examined...
May 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28481229/parenteral-nutrition-and-intestinal-failure
#18
REVIEW
Barbara Bielawska, Johane P Allard
Severe short bowel syndrome (SBS) is a major cause of chronic (Type 3) intestinal failure (IF) where structural and functional changes contribute to malabsorption and risk of micronutrient deficiencies. Chronic IF may be reversible, depending on anatomy and intestinal adaptation, but most patients require long-term nutritional support, generally in the form of parenteral nutrition (PN). SBS management begins with dietary changes and pharmacologic therapies taking into account individual anatomy and physiology, but these are rarely sufficient to avoid PN...
May 6, 2017: Nutrients
https://www.readbyqxmd.com/read/28481070/-negative-pressure-system-in-the-treatment-of-enterocutaneous-fistulas-in-the-pediatric-population
#19
V Núñez Cerezo, M I Romo Muñoz, M V Amesty Morello, A Vilanova Sánchez, M Dore Reyes, M Gómez Cervantes, A M Andrés Moreno, E Martínez-Ojinaga Nodal, L Martínez Martínez, M López Santamaría
AIM OF THE STUDY: The management of children with enterocutaneous fistulas (EF) along with large abdominal wall defects secondary to multiple surgical interventions can be difficult and sometimes lead to intestinal failure (IF). The aim of this study is to present the results of negative pressure systems and their properties (edema reduction angiogenesis promotion and granulation tissue formation) in children with enterocutaneous fistulas (EF) and their prognosis. MATERIALS AND METHODS: A retrospective analysis of children with refractory, high output EF treated with NPS between 2008-2014...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28480091/duodenal-graft-perforation-after-simultaneous-pancreas-kidney-transplantation
#20
Akihito Sannomiya, Ichiro Nakajima, Yuichi Ogawa, Kotaro Kai, Ichiro Koyama, Shohei Fuchinoue
A 45-year-old woman with type 1 diabetes and chronic renal failure on dialysis underwent simultaneous pancreas-kidney transplantation from a brain dead donor. On postoperative day 15, acute generalized peritonitis was diagnosed and emergency laparotomy was performed. Perforation of the donor duodenum was found, which had apparently resulted from duodenal compression by the tip of the intestinal fistula tube placed for decompression. The perforation was sutured and the intestinal fistula tube was exchanged. Following this, perforation repeatedly recurred at the same site and open repair at laparotomy was required a total of four times...
2017: Case Reports in Transplantation
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