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Gastrointestinal complication AND transplantation

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https://www.readbyqxmd.com/read/28067684/diarrhea-after-allogeneic-stem-cell-transplantation-beyond-graft-versus-host-disease
#1
Katarzyna Robak, Joanna Zambonelli, Jaroslaw Bilinski, Grzegorz W Basak
Diarrhea constitutes a frequent and often debilitating complication of allogeneic hematopoietic cell transplantation (alloHCT). Especially when accompanied by jaundice, skin rash, and symptoms of the upper gastrointestinal tract, diarrhea strongly suggests emergence of acute graft-versus-host disease (GvHD), which is a serious immune complication of the procedure, with possible fatal consequences. However, especially when diarrhea occurs as an isolated symptom, the other causes must be excluded before initiation of GvHD treatment with immune-suppressive drugs...
January 6, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28065646/-what-the-family-doctor-must-know-about-lung-transplantation-complications-health-promotion-and-outcomes-part-2
#2
L Zurbano, F Zurbano
The lung transplantation is a therapeutic procedure indicated for lung diseases that are terminal and irreversible (except lung cancer) despite the best medical current treatment. It is an emergent procedure in medical care. In this review, an analyse is made of the most frequent complications of lung transplant related to the graft (rejection and chronic graft dysfunction), immunosuppression (infections, arterial hypertension, renal dysfunction, and diabetes), as well as others such as gastrointestinal complications, osteoporosis...
January 5, 2017: Semergen
https://www.readbyqxmd.com/read/28060108/diagnostic-utility-of-complement-immunohistochemical-studies-in-post-stem-cell-transplant-intestinal-thrombotic-microangiopathy-case-report
#3
Jenna E Rossoff, Jennifer Schneiderman, Sonali Chaudhury, Nicoleta C Arva
Thrombotic complications are a significant source of morbidity and mortality following hematopoietic stem cell transplants. Among them, transplant-associated thrombotic microangiopathy (TA-TMA) is a well-recognized syndrome that can affect various organ systems. Its etiology is related to endothelial injury accompanied by complement activation. As many of the signs and symptoms of the disease are also encountered in other complications following hematopoietic stem cell transplant, it can often be difficult to establish the diagnosis based on clinical data alone...
January 5, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28050475/role-of-hrct-chest-in-post-stem-cell-transplant-recipients-suspected-of-pulmonary-complications
#4
Abhishek Dwivedi, R Ravi Kumar, Ajay Sharma, S K Pannu
INTRODUCTION: Stem cell transplantation is today's procedure of choice for management of various hematopoietic malignant and severe immunogenic disorders. High Resolution Computed Tomography (HRCT) is a common technique for the diagnosis of pulmonary complications in stem cell transplant recipients. There are a large number of complications which can complicate the post-transplant period. AIM: To study the role of HRCT chest in stem cell transplant patients developing pulmonary complications, detect any evidence of infection, detect clinical signs of lung infections, Graft versus Host Disease (GvHD) or other regimen related toxicities outlined earlier, detect any evidence of GvHD and correlate these clinical signs with radiological changes in the lungs...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28043445/a-decade-of-experience-with-continuous-flow-left-ventricular-assist-devices
#5
Ranjit John, Christopher T Holley, Peter Eckman, Samit S Roy, Rebecca Cogswell, Laura Harvey, Sara Shumway, Kenneth Liao
The use of continuous-flow left ventricular assist devices (CF-LVADs) has revolutionized the landscape of mechanical circulatory support for patients with heart failure. Clinical trials are already testing the next generation of CF-LVADs. In this study, our objective was to review our long-term experience with the current generation of CF-LVADs, specifically, the HeartMate (HM) II (Thoratec Corp, Pleasanton, CA). In this single-center retrospective analysis, we evaluated the records of 278 consecutive patients who underwent a total of 302 HM II placements from June 2005 through June 2014...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27990484/initial-experience-of-video-capsule-endoscopy-after-intestinal-transplantation
#6
Jonas Varkey, Mihai Oltean, Andreas Bernd Pischel, Magnus Simrén, Gustaf Herlenius
BACKGROUND: Intestinal transplantation is a procedure which inflicts immunological and infectious complications that affect the transplanted graft, posing both diagnostic and therapeutic challenges. Video capsule endoscopy (VCE) offers easy access to the entire small intestine and presents itself as an interesting option. However, at present, no studies evaluating the usefulness of video capsule endoscopies in this setting have been published. Our aim was to evaluate the usefulness of VCE in detecting complications that arise after intestinal transplantation...
December 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27988971/antibody-depletion-strategy-for-the-treatment-of-suspected-antibody-mediated-rejection-in-lung-transplant-recipients-does-it-work
#7
Mary Vacha, Godefroy Chery, Amanda Hulbert, Jennifer Byrns, Clark Benedetti, C Ashley Finlen Copeland, Alice Gray, Oluwatoyosi Onwuemene, Scott M Palmer, Laurie D Snyder
BACKGROUND: Donor specific antibodies (DSAs) after lung transplantation correlate with poor outcomes. The ideal treatment strategy for antibody mediated rejection AMR is not defined. Our institution implemented an aggressive multi-modality protocol for the treatment of suspected AMR. METHODS: Lung transplant recipients with suspected AMR were treated with a standardized protocol of plasma exchange, steroids, bortezomib, rituximab, and intravenous immune globulin...
December 17, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27959298/acute-liver-failure
#8
Ami Grek, Lisa Arasi
Acute liver failure, also known as fulminant hepatic failure, is a rare life-threatening disease that has a high mortality rate and affects many organ systems. Causes of acute liver failure vary-it can be attributed to drugs, viruses, and other uncommon sources. Complications of liver failure can include encephalopathy, cerebral edema, sepsis, renal failure, gastrointestinal bleeding, and respiratory failure. Fortunately, with advances in critical care medicine and emergent liver transplant, mortality rates have decreased in the past decade...
October 2016: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/27940759/human-parechovirus-as-a-cause-of-isolated-pediatric-acute-liver-failure
#9
Amee M Bigelow, John P Scott, Johnny C Hong, David C Cronin, Bernadette E Vitola, Roger A Fons, Tara L Petersen
Among infants, almost half of acute liver failure cases are classified as indeterminate, whereas only a small number of cases show a documented viral infection. We present the first reported case of isolated acute hepatic failure in an infant in the setting of a human parechovirus (HPeV) infection. HPeV also may have been contributory to the posttransplant complication of 2 intussusceptions. This is a 10-month-old girl who presented with only symptoms of fussiness and was noted to have progressive decline in synthetic liver function as well as worsening coagulopathy requiring a liver transplant...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27894188/challenges-of-endoscopic-management-of-pancreaticobiliary-complications-in-surgically-altered-gastrointestinal-anatomy
#10
REVIEW
Tin Moe Wai, Eun Young Kim
Pancreaticobiliary complications following various surgical procedures, including liver transplantation, are not uncommon and are important causes of morbidity and mortality. Therapeutic endoscopy plays a substantial role in these patients and can help to avoid the need for reoperation. However, the endoscopic approach in patients with surgically altered gastrointestinal (GI) anatomy is technically challenging because of the difficulty in entering the enteral limb to reach the target orifice to manage pancreaticobiliary complications...
November 2016: Clinical Endoscopy
https://www.readbyqxmd.com/read/27881814/chronic-norovirus-infections-in-cardiac-transplant-patients-considerations-for-evaluation-and-management
#11
Paul T Jurgens, Larry A Allen, Amrut V Ambardekar, Colleen K McIlvennan
Norovirus is a common self-limiting gastrointestinal infection, but in transplant recipients, symptoms can last for months and result in serious health complications. As there is currently no established treatment for chronic norovirus infection in transplant patients, management has been directed at symptom control, trial of various antivirals, and ultimately reductions in immunosuppression. We present 3 cases of chronic norovirus infection in cardiac transplant patients to illustrate various approaches to diagnosis, the prolonged nature of disease symptoms, and treatment options...
November 23, 2016: Progress in Transplantation
https://www.readbyqxmd.com/read/27848185/pediatric-intestinal-beh%C3%A3-et-disease-complicated-by-myeloid-malignancies
#12
Kiichiro Kanamitsu, Akira Shimada, Ritsuo Nishiuchi, Tomonari Shigemura, Yozo Nakazawa, Kenichi Koike, Yuichi Kodama, Yuichi Shinkoda, Yoshifumi Kawano, Kozo Yasui, Koji Sasaki, Ryosuke Kajiwara, Hirokazu Tsukahara, Atsushi Manabe
Behçet disease (BD) is rarely seen in children. Its clinical manifestations are believed to differ between pediatric and adult patients. The characteristics of BD complicated by myelodysplastic syndrome (MDS) are well established for adult patients; however, because only a few cases of pediatric-onset BD complicated by MDS have been reported, its clinical characteristics remain unknown. We here retrospectively review pediatric-onset BD complicated by myeloid malignancies in Japan, having identified five such patients...
November 15, 2016: International Journal of Hematology
https://www.readbyqxmd.com/read/27829829/the-pretransplant-systemic-metabolic-profile-reflects-a-risk-of-acute-graft-versus-host-disease-after-allogeneic-stem-cell-transplantation
#13
Håkon Reikvam, Kimberley Hatfield, Øystein Bruserud
Allogeneic stem cell transplantation is used in the treatment of younger patients with severe hematological diseases, especially hematological malignancies, and acute graft versus host disease (GVHD) is then an important immune-mediated posttransplant complication. Several risk factors for acute GVHD have been identified, including pretransplant factors that possibly influence the posttranspant course through their effects on host immunocompetent cells. Metabolic regulation is important for immunoregulation, and we therefore investigated whether the pretransplant metabolic status of allotransplant recipients was associated with later acute GVHD...
2016: Metabolomics: Official Journal of the Metabolomic Society
https://www.readbyqxmd.com/read/27799810/novel-treatment-options-for-lysosomal-acid-lipase-deficiency-critical-appraisal-of-sebelipase-alfa
#14
REVIEW
Kim Su, Emma Donaldson, Reena Sharma
Lysosomal acid lipase deficiency (LAL-D) is a rare disorder of cholesterol metabolism with an autosomal recessive mode of inheritance. The absence or deficiency of the LAL enzyme gives rise to pathological accumulation of cholesterol esters in various tissues. A severe LAL-D phenotype manifesting in infancy is associated with adrenal calcification and liver and gastrointestinal involvement with characteristic early mortality. LAL-D presenting in childhood and adulthood is associated with hepatomegaly, liver fibrosis, cirrhosis, and premature atherosclerosis...
2016: Application of Clinical Genetics
https://www.readbyqxmd.com/read/27796637/how-to-make-insulin-producing-pancreatic-%C3%AE-cells-for-diabetes-treatment
#15
REVIEW
Jiaqi Lu, Qing Xia, Qiao Zhou
Around 400 million people worldwide suffer from diabetes mellitus. The major pathological event for Type 1 diabetes and advanced Type 2 diabetes is loss or impairment of insulin-secreting β cells of the pancreas. For the past 100 years, daily insulin injection has served as a life-saving treatment for these patients. However, insulin injection often cannot achieve full glucose control, and over time poor glucose control leads to severe complications and mortality. As an alternative treatment, islet transplantation has been demonstrated to effectively maintain glucose homeostasis in diabetic patients, but its wide application is limited by the scarcity of donated islets...
October 27, 2016: Science China. Life Sciences
https://www.readbyqxmd.com/read/27796517/gastric-motility-and-emptying-assessment-by-magnetic-resonance-imaging-after-lung-transplantation-correlation-with-gastric-emptying-scintigraphy
#16
Nobuyuki Hayakawa, Yuji Nakamoto, Toyofumi F Chen-Yoshikawa, Aki Kido, Takayoshi Ishimori, Koji Fujimoto, Tetsu Yamada, Masaaki Sato, Akihiro Aoyama, Hiroshi Date, Kaori Togashi
PURPOSE: Gastroparesis is a frequent gastrointestinal complication after lung transplantation. Although gastric emptying scintigraphy (GES) is the standard technique to evaluate gastroparesis, magnetic resonance imaging (MRI) can also assess gastric motility and emptying. This study compared the results obtained by these two modalities. METHODS: Twenty-two lung transplant recipients underwent MRI and GES after ingesting a small pancake as a test meal. Parameters assessed on MRI included antral peristaltic wave velocity and frequency, and the ratios of gastric content volume at 15 and 35 min...
October 31, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27744342/immunohistochemistry-improves-the-detection-of-adenovirus-in-gastrointestinal-biopsy-specimens-from-hematopoietic-stem-cell-transplant-recipients
#17
Anna-Sophie Weidner, Nicole C Panarelli, Hanna Rennert, Jose Jessurun, Rhonda K Yantiss
OBJECTIVES: Gastrointestinal infections by cytomegalovirus (CMV) and adenovirus may complicate hematopoietic stem cell transplantation (HSCT). Although CMV and adenovirus produce recognizable cytopathic changes, these changes may be subtle or focal. The value of viral immunohistochemistry in detecting infection in HSCT recipients when cytopathic changes are not identified has not been demonstrated. METHODS: H&E-stained sections from gastrointestinal biopsy specimens were reviewed by three pathologists...
October 15, 2016: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/27696648/gastrointestinal-histoplasmosis-in-a-patient-after-autologous-stem-cell-transplant-for-multiple-myeloma
#18
Meera Mohan, Bradley Fogel, Thomas Eluvathingal, Carolina Schinke, Atul Kothari
A 59-year-old patient with multiple myeloma on maintenance chemotherapy presented with fever, weight loss, and night sweats. An F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) computed tomography (CT) showed intra-abdominal lymphadenopathy with a mesenteric mass that led to further workup and diagnosis of histoplamosis. The patient was treated with amphotericin B and subsequently switched to itraconazole. This exemplifies the usefulness of FDG PET CT in diagnosis of infectious complications...
December 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27689202/gastrointestinal-side-effects-of-post-transplant-therapy
#19
REVIEW
Valerian Ciprian Lucan, Luisa Berardinelli
Modern immunosuppressive therapy has produced a real revolution in renal and organ transplantation but it comes with the price of multiple side effects. There are many gastrointestinal (GI) complications that are the consequence of transplant immunosuppressant medication. In fact, for any immunosuppressant therapy, certain standardized precepts and attitudes that aim to reduce the incidence and the impact of the medication side effects must be applied. Many patients undergo renal transplantation and the physicians have to be aware of the advantages and the risks associated...
September 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/27645810/the-emergency-medicine-approach-to-transplant-complications
#20
REVIEW
Brit Long, Alex Koyfman
INTRODUCTION: Organ transplantation provides improved quality of life and longevity in patients with end-organ disease. These patients have significant physiological and anatomical modifications, and with new immunosuppressive agents, many of these patients will present to the emergency department with complications. OBJECTIVE: The objective was to provide emergency physicians with a review of transplant complications, including infection, rejection, medication adverse effects, and specific complications related to the transplant...
November 2016: American Journal of Emergency Medicine
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