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Hand transplantation

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https://www.readbyqxmd.com/read/28424230/a-quiet-revolution-in-organ-transplant-ethics
#1
Arthur Caplan, Duncan Purves
A quiet revolution is occurring in the field of transplantation. Traditionally, transplants have involved solid organs such as the kidney, heart and liver which are transplanted to prevent recipients from dying. Now transplants are being done of the face, hand, uterus, penis and larynx that aim at improving a recipient's quality of life. The shift away from saving lives to seeking to make them better requires a shift in the ethical thinking that has long formed the foundation of organ transplantation. The addition of new forms of transplants requires doctors, patients, regulators and the public to rethink the risk and benefit ratio represented by trade-offs between saving life, extending life and risking the loss of life to achieve improvements in the quality of life...
April 19, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28422434/rat-hindlimb-cryopreservation-and-transplantation-a-step-towards-organ-banking
#2
Amir Arav, Or Friedman, Yehudit Natan, Eyal Gur, Nir Shani
In 2016 over 5 million reconstructive procedures were performed in the USA. The recent successes of clinical vascularized composite allotransplantations (VCA), hand and face transplantations included, established the tremendous potential of these life-enhancing reconstructions. Nevertheless, Due to limited availability and lifelong immunosuppression, application is limited. Long term banking of composite transplants may increase the availability of esthetically compatible parts with partial or complete HLA matching, reducing the risk of rejection and the immunosuppressive burden...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28409550/erk-and-p38-upregulation-versus-bcl-6-downregulation-in-rat-kidney-epithelial-cells-exposed-to-prolonged-hypoxia
#3
Fengbao Luo, Jian Shi, Qianqian Shi, Xiaozhou He, Ying Xia
Hypoxia is a common cause of kidney injury and a major issue in kidney transplantation. Mitogen-activated protein kinases (MAPKs) are involved in the cellular response to hypoxia, but the precise roles of MAPKs in renal cell reaction to hypoxic stress are not well known yet. This work was conducted to investigate the regulation of ERK1/2 and p38 and their signaling-relevant molecules in kidney epithelial cells exposed to prolonged hypoxia. Rat kidney epithelial cells NRK-52E were exposed to hypoxic conditions (1% O2) for 24-72 hrs...
April 12, 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28394527/-laparoscopic-resection-of-the-transplanted-kidney-for-renal-cell-carcinoma-t1n0m0
#4
V I Vtorenko, R N Trushkin, A E Lubennikov, N O Kolesnikov
Laparoscopic resection of the transplanted kidney has been very rarely reported in the literature. On the one hand, this is due to the extremely low incidence of tumors of renal transplants. On the other hand, these patients are usually managed by open surgery due to difficulties in laparoscopic resection because of the scar tissue in the kidney area. Other options, though rarely performed, are cryosurgery and radiofrequency ablation of the tumor. In this article we report our own experience with a patient who underwent laparoscopic resection of renal transplant for renal cell carcinoma T1aN0M0 19 years after kidney transplantation...
April 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28390796/handle-with-care-a-systematic-review-on-frailty-in-cardiac-care-and-its-usefulness-in-heart-transplantation
#5
REVIEW
Oliver Mauthner, Veerle Claes, Mieke Deschodt, Sunita R Jha, Sandra Engberg, Peter S Macdonald, Phillip J Newton, Sabina De Geest
BACKGROUND: There is growing consensus that frailty, a state of vulnerability and a decline in functioning across multiple physiological body systems, is a valuable criterion to guide clinicians' risk prediction for poor outcomes in adult transplant candidates. In its 2016 listing criteria for heart transplantation the International Society for Heart Lung Transplantation recommends frailty assessment. We aimed to summarize the usefulness of frailty assessment in heart transplant candidates or recipients reported throughout the literature...
March 30, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28390109/vascularized-composite-allograft-vca-donation-and-transplantation-a-survey-of-public-attitudes-in-the-united-states
#6
James R Rodrigue, David Tomich, Aaron Fleishman, Alexandra K Glazier
Vascularized composite allograft (VCA) transplantation has emerged as a groundbreaking surgical intervention to return identity and function following traumatic injury, congenital deformity, or disfigurement. While public attitudes toward traditional organ/tissue donation are favorable, little is known about attitudes toward VCA donation and transplantation. A survey was conducted of 1,485 U.S. residents in August 2016 to assess VCA donation attitudes. Participants also completed the Revised Health Care System Distrust Scale...
April 8, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28389091/workload-even-affects-hand-hygiene-in-a-highly-trained-and-well-staffed-setting-a-prospective-365-7-24-observational-study
#7
S Scheithauer, B Batzer, M Dangel, J Passweg, A Widmer
INTRODUCTION: Compliance with hand hygiene (HH) has often not proved satisfactory; high workload is a commonly self-reported reason. Previous studies comparing workload and compliance have not measured workload precisely and have focused on certain times of day. This study aimed to investigate the association between HH compliance and workload, both electronically defined 365/7/24 (primary endpoint). In addition, the quality of commonly used compliance defining methods (hand disinfectant usage, direct observation) was investigated (secondary endpoint)...
February 20, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28383624/use-of-corneas-for-transplant-after-self-inflicted-eyeballs-enucleation-in-the-italian-law
#8
G Montanari Vergallo, E Pacella, A Di Luca, N M Di Luca, R Cecchi, E Marinelli
The authors analyze from an ethical and legal point of view the case of a 37 year old man, hospitalized for four days because of a 'dissociative syndrome', who had introduced in both his orbits a portable radio antenna. Most likely, he completed the self-enuclation using his own hands. He was brought to the Ophtalmic Hospital by nurses who handed the two eyeballs to the physicians who ascertained that the corneas were intact. Then, they performed the conservative extraction. In the following days those corneas were transplanted (keratoplasty) on two subjects on the waiting list at that hospital...
March 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28371193/chronic-allograft-deterioration-ndash-a-clinical-reality-in-vascularized-composite-allotransplantation
#9
EDITORIAL
N Krezdorn, B Pomahac
The first successful transplantation of a vascularized composite tissue allotransplantation (VCA)-NDASH- a hand -NDASH- was achieved in 1998. However, it was not until the first partial face transplant was performed in France in 2005 that the world first witnessed with fascination the vast implications of vascularized composite allotransplantation (VCA). Since then, there have been over 107 upper extremities and 35 face transplantations, with the longest follow up of 18 years for hand transplantation (1), and 10 years for face transplantation...
March 30, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28361279/outcomes-after-hand-and-upper-extremity-transplantation
#10
Jaimie T Shores, Veronika Malek, W P Andrew Lee, Gerald Brandacher
Hand and upper extremity transplantation (HUET) has emerged as the most frequently performed reconstructive procedure in the burgeoning field of vascularized composite allotransplantation (VCA). VCA refers to a form of transplant with multiple tissue types that represents a viable treatment option for devastating injuries where conventional reconstruction would be unable to restore form and function. As hand transplantation becomes increasingly more common, discussions on advantages and disadvantages of the procedure seem to intensify...
May 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28361115/detection-of-donor-derived-microparticles-in-the-peripheral-blood-of-a-hand-transplant-recipient-during-rejection
#11
Joseph Y Kim, Theodoros Kelesidis, Otto O Yang
BACKGROUND: Microparticles (MPs) are released from the plasma membrane of activated or dying cells and bear surface molecules from those cells. We examined whether donor-derived MPs in the peripheral blood of the recipient could serve as a marker of tissue damage due to rejection of a transplanted hand. METHODS: Platelet-free plasma from the recipient of the transplanted hand was analyzed for MPs bearing the donor-specific HLA molecule A*02 using flow cytometry...
March 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28352600/soft-tissue-reconstruction-of-complete-circumferential-defects-of-the-upper-extremity
#12
Zhi Yang Ng, Shaun Shi Yan Tan, Alexandre Gaston Lellouch, Curtis Lisante Cetrulo, Harvey Wei Ming Chim
BACKGROUND: Upper extremity soft tissue defects with complete circumferential involvement are not common. Coupled with the unique anatomy of the upper extremity, the underlying etiology of such circumferential soft tissue defects represent additional reconstructive challenges that require treatment to be tailored to both the patient and the wound. The aim of this study is to review the various options for soft tissue reconstruction of complete circumferential defects in the upper extremity...
March 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28340844/anatomic-diversity-encountered-during-laparoscopic-hand-assisted-transperitoneal-donor-nephrectomy-a-case-report-of-complete-caval-duplication
#13
S L Kirecci, M Demir, M Ilgi, M Battal, A I Dokucu, A Unsal
INTRODUCTION: Laparoscopic donor nephrectomy is widely used to retrieve a kidney for transplantation. Preoperative evaluation of the donor is of crucial importance to the recipient. In particular, vascular anatomy should be assessed with the help of modern imaging modalities. We present a hand-assisted laparoscopic nephrectomy of a kidney donor with a complete duplex vena cava. CASE REPORT: A 40-year-old male patient was admitted to our clinic as a kidney donor for his 20-year-old son...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340837/complications-in-donors-using-right-liver-graft-analysis-of-280-consecutive-cases
#14
M Özbilgin, T Ünek, T Egeli, C Ağalar, S Ozkardesler, E Karadeniz, H Ellidokuz, F Obuz, I Astarcıoğlu
INTRODUCTION: Living donor liver transplantation (LDLT) is performed with increasing frequency worldwide due to the shortage of donated organs. It is a life-saving procedure for the recipient, but, on the other hand, a major surgical procedure for healthy donors and it may cause morbidity and even mortality. PATIENTS AND METHODS: This research was completed at Dokuz Eylül University Faculty of Medicine Hospital General Surgery Department Liver Transplant Unit and included 280 cases (4 with simultaneous liver and kidney transplants from living donors) who underwent donor right hepatectomy for LDLT from June 2000 to June 2016...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340822/risk-factors-of-hyperuricemia-after-renal-transplantation-and-its-long-term-effects-on-graft-functions
#15
S Eyupoglu, D Eyupoglu, Z Kendi-Celebi, S Akturk, A Tuzuner, K Keven, S Sengul
BACKGROUND: Hyperuricemia is a common complication in renal transplant recipients. Recent studies have suggested that hyperuricemia may contribute to the deterioration of graft function. METHODS: In this study, we aimed to investigate the risk factors related to hyperuricemia and the effects of hyperuricemia on graft dysfunction, graft survival, cardiovascular events, and mortality rates. Between the years 2005 and 2016, 141 renal transplantation patients with at least 5 years of follow-up were included in this retrospective cohort study...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340803/evaluation-of-ureteral-stent-colonization-in-live-donor-renal-transplant-recipients
#16
M Sarier, M Demir, I Duman, Y Yuksel, A Demirbas
BACKGROUND: Ureteral stent insertion during kidney transplantation is a matter of debate. Stenting has been proven to reduce the risk of surgical complications. In addition, it has been reported to increase risks such as urinary tract infections especially after operation. Ureteral stent colonization (USC) is known to play a role in the pathogenesis of stent related-infections. The aim of this study was (1) to assess the frequency of USC and values of urine cultures in identifying colonizing bacteria; (2) to assess the importance of indwelling time for USC in live-donor renal transplant recipients; and (3) to evaluate the biomarker role of neutrophil-to-lymphocyte ratio (NLR) on USC...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340673/the-advent-of-vascularized-composite-allotransplantation
#17
REVIEW
Curtis L Cetrulo, Zhi Yang Ng, Jonathan M Winograd, Kyle R Eberlin
Modern microsurgical techniques have made possible a broad spectrum of novel means for the reconstruction of complex bone and soft tissue defects. These techniques, in combination with developments in transplant immunology, have led to successful hand and facial allotransplantation and achievement of the highest rung in the reconstructive ladder - truly replacing like with like. The utilization of contemporary microsurgical technique in the context of vascularized composite allotransplantation (VCA) (1) permits successful technical execution and feasibility of VCA, (2) facilitates the study of immunologic tolerance in VCA preclinical models, and (3) optimizes functional VCA outcomes...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28338515/surgeon-participation-in-early-accountable-care-organizations
#18
Matthew J Resnick, Amy J Graves, Melinda B Buntin, Michael R Richards, David F Penson
OBJECTIVE: We aimed to characterize the landscape of surgeon participation in early accountable care organizations (ACOs) and to identify specialty-, organization-, and market-specific factors associated with ACO participation. BACKGROUND: Despite rapid deployment of alternative payment models (APMs), little is known about the prevalence of surgeon participation, and key drivers behind surgeon participation in APMs. METHODS: Using data from SK&A, a research firm, we evaluated the near universe of US practices to characterize ACO participation among 125,425 US surgeons in 2015...
March 23, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28338118/unusual-discovery-after-an-examination-for-abdominal-pain-abernethy-1b-malformation-and-liver-adenomatosis-a-case-report
#19
Romeo Ioan Chira, Adriana Calauz, Simona Manole, Simona Valean, Petru Adrian Mircea
Congenital extrahepatic portosystemic shunt (Abernethy malformation) is a rare condition characterized by developmental abnormalities of the portal venous system resulting in the diversion of the portal blood from the liver to the systemic venous system through a complete or partial shunt of the portomesenteric blood. We report the case of an 18 year-old female examined for abdominal pain, presenting cholestasis syndrome and an elevated serum aspartate aminotransferase level. Liver ultrasound examination revealed the absence of the portal vein with a complete extrahepatic shunt of the portal blood, multiple focal liver lesions, and multiple associated vascular anomalies...
March 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28331981/vaccination-in-oncology-practice-and-predictors
#20
Ali Alkan, Ebru Karcı, Arzu Yaşar, Gülseren Tuncay, Elif Berna Köksoy, Muslih Ürün, Filiz Çay Şenler, Ahmet Demirkazık, Güngör Utkan, Hakan Akbulut, Yüksel Ürün
PURPOSE: Despite, vaccination is a highly effective and widely recommended for prevention of certain infections, vaccination coverage is very low. The purposes of this study were to evaluate the attitudes of medical oncologists towards vaccination and to identify predictors of intention to recommend vaccination in patients with cancer. METHODS: A structured questionnaire is formed to evaluate the daily practice of vaccination. Turkish medical oncologists were invited to this study via email, SMS, or phone call...
March 22, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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