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Gastrointestinal complication AND transplantation

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https://www.readbyqxmd.com/read/29765165/detection-of-cytomegalovirus-dna-in-fecal-samples-as-a-method-for-cmv-enterocolitis-diagnosis-after-allogeneic-stem-cell-transplantation
#1
Alzbeta Zavrelova, Jakub Radocha, Lenka Pliskova, Pavla Paterova, Eva Vejrazkova, Jiri Cyrany, Filip Gabalec, Miroslav Podhola, Pavel Zak
BACKGROUND: Cytomegalovirus enterocolitis is a rare but potentially life threatening complication after allogeneic stem cell transplantation. Its early diagnosis and treatment are essential for a successful outcome. OBJECTIVE: To determine the potential benefit of fecal CMV DNA detection in the diagnosis of CMV colitis among stem cell transplant recipients. STUDY DESIGN: Biopsies from the lower gastrointestinal tract, taken during 69 episodes of diarrhea, were compared with fecal samples previously examined for CMV DNA in 45 patients after allogeneic stem cell transplantation...
May 16, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29749783/acute-graft-v-host-disease-developing-an-extracorporeal-photopheresis-outreach-service
#2
Tracy Maher, Peter Taylor, Arun Alfred
Acute graft v host disease (AGVHD) is the main complication and cause of non-relapse mortality following allogenic hematopoietic stem cell transplantion. It occurs when donor immune cells attack host tissues. The three main organs that AGVHD affects are skin, liver and gastrointestinal tract, with one or more organs being involved. Extracorporeal photopheresis (ECP) is a second-line treatment for AGVHD in patients who fail to respond to high-dose steroids. It is an immuno-modulatory rather than immunosuppressive therapy...
May 10, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29748558/the-gastroenterologist-s-guide-to-management-of-the-post-liver-transplant-patient
#3
REVIEW
David M Chascsa, Hugo E Vargas
The management of the post-liver transplant patient is complex and involves a large interdisciplinary team. After referral to a transplant center, evaluation and listing, and eventual transplantation, the patient is cared for closely by the transplant center. Once deemed ready for discharge, the patient returns to the primary care provider for ongoing management of the various issues that increase in incidence post transplant such as osteoporosis, cardiovascular, and renal diseases, as well as metabolic syndrome...
May 11, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29742694/association-between-histopathological-alterations-and-diarrhea-severity-in-acute-intestinal-graft-versus-host-disease
#4
Loredana Nilkenes Gomes da Costa, Carolina Costa-Lima, Luciana Rodrigues de Meirelles, Rita B Carvalho, Marcos Paulo Colella, Francisco Jose Penteado Aranha, Afonso Celso Vigorito, Erich Vinicius De Paula
Gastrointestinal (GI) acute graft-versus-host disease (aGVHD) remains one of the most important complications of allogeneic hematopoietic cell transplantation (allo-HCT). The diagnosis of this complication is largely dependent on clinical symptoms, but GI biopsies are warranted in most cases, due to the multitude of potential causes that coexist in patients with a clinical suspicion of this complication. In addition, several lines of evidence support that the GI is not only a target organ in aGVHD, but also a key mediator of the pathogenesis of this condition...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29729943/phenotype-penetrance-and-treatment-of-133-ctla-4-insufficient-individuals
#5
Charlotte Schwab, Annemarie Gabrysch, Peter Olbrich, Virginia Patiño, Klaus Warnatz, Daniel Wolff, Akihiro Hoshino, Masao Kobayashi, Kohsuke Imai, Masatoshi Takagi, Ingunn Dybedal, Jamanda A Haddock, David Sansom, Jose M Lucena, Maximilian Seidl, Annette Schmitt-Gräff, Veronika Reiser, Florian Emmerich, Natalie Frede, Alla Bulashevska, Ulrich Salzer, Desirée Schubert, Seiichi Hayakawa, Satoshi Okada, Maria Kanariou, Zeynep Yesim Kucuk, Hugo Chapdelaine, Lenka Petruzelkova, Zdenek Sumnik, Anna Sediva, Mary Slatter, Peter D Arkwright, Andrew Cant, Hanns-Martin Lorenz, Thomas Giese, Vassilios Lougaris, Alessandro Plebani, Christina Price, Kathleen E Sullivan, Michel Moutschen, Jiri Litzman, Tomas Freiberger, Frank L van de Veerdonk, Mike Recher, Michael H Albert, Fabian Hauck, Suranjith Seneviratne, Jana Pachlopnik Schmid, Antonios Kolios, Gary Unglik, Christian Klemann, Carsten Speckmann, Stephan Ehl, Alan Leichtner, Richard Blumberg, Andre Franke, Scott Snapper, Sebastian Zeissig, Charlotte Cunningham-Rundles, Lisa Giulino-Roth, Olivier Elemento, Gregor Dückers, Tim Niehues, Eva Fronkova, Veronika Kanderová, Craig D Platt, Janet Chou, Talal Chatila, Raif Geha, Elizabeth McDermott, Su Bunn, Monika Kurzai, Ansgar Schulz, Laia Alsina, Ferran Casals, Angela Deyà-Martinez, Sophie Hambleton, Hirokazu Kanegane, Kjetil Taskén, Olaf Neth, Bodo Grimbacher
BACKGROUND: Cytotoxic-T-lymphocyte-antigen-4 (CTLA-4) is a negative immune regulator. Heterozygous CTLA4 germline mutations can cause a complex immune dysregulation syndrome in humans. OBJECTIVE: To characterize the penetrance, the clinical features and the best treatment options in 133 CTLA4 mutation carriers. METHODS: Genetics, clinical features, laboratory values, and outcome of treatment options were assessed in a worldwide cohort of CTLA4 mutation carriers...
May 3, 2018: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29713813/gastrointestinal-complications-after-lung-transplantation-in-japanese-patients
#6
Hidenao Kayawake, Toyofumi F Chen-Yoshikawa, Hideki Motoyama, Masatsugu Hamaji, Daisuke Nakajima, Akihiro Aoyama, Hiroshi Date
PURPOSE: Gastrointestinal complications after lung transplantation (LTx) are an important postoperative morbidity associated with malnutrition and the malabsorption of drugs. We reviewed our experience of managing gastrointestinal complications after LTx. METHODS: Between June, 2008 and April, 2017, 160 lung transplants were performed at our institution, as living-donor lobar lung transplants in 77 patients, and as deceased-donor lung transplants in 83. We reviewed, retrospectively, the incidence, type and management of gastrointestinal complications...
April 30, 2018: Surgery Today
https://www.readbyqxmd.com/read/29705344/postoperative-complications-as-a-predictor-for-survival-after-liver-transplantation-proposition-of-a-prognostic-score
#7
Thomas R Daugaard, Hans-Christian Pommergaard, Andreas A Rostved, Allan Rasmussen
BACKGROUND: Liver transplantation is major surgery with a high risk of complications. Existing scoring systems for evaluating complications after surgery are not specific for liver transplantation. Nor are they designed to evaluate the relation to recipient survival or graft loss. We wished to uncover the relation between postoperative complications and one-year risk of death or retransplantation, and to develop a prognostic score for complications based on our findings. METHOD: The study was a retrospective cohort study including 253 adult liver recipients...
April 25, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29701352/two-years-of-experience-in-the-implantation-of-heartmate-iii
#8
Vítor Mendes, Candido Cerca, Monique Crosset, Matthias Kirsh
INTRODUCTION: Left ventricular assist devices as long-term mechanical circulatory support are increasingly used as an option for medically refractory advanced heart failure. Heartmate III is one of the alternative devices for circulatory support in those patients. OBJECTIVES: Analyze a two years Heartmate III implantation Program. METHODS: From November 2015 to August 2017, Heartmate III was implanted in 16 patients with chronic end-stage heart failure, in 81% (n = 13) as a bridge to transplant and 19% (n = 3) as destination therapy...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29697275/use-of-the-national-institutes-of-health-consensus-guidelines-improves-the-diagnostic-sensitivity-of-gastrointestinal-graft-versus-host-disease
#9
Diana M Cardona, Claire J Detweiler, Michael J Shealy, Anthony D Sung, Daniel M Wild, Martin H Poleski, Bryan L Balmadrid, Constance T Cirrincione, David N Howell, Keith M Sullivan
CONTEXT: - Graft-versus-host disease of the gastrointestinal tract is a common complication of hematopoietic stem cell transplant associated with significant morbidity and mortality. Accurate diagnosis can be difficult and is a truly clinicopathologic endeavor. OBJECTIVES: - To assess the diagnostic sensitivity of gastrointestinal graft-versus-host disease using the 2015 National Institutes of Health (NIH) histology consensus guidelines and to analyze histologic findings that support the guidelines...
April 26, 2018: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/29689120/acute-on-chronic-liver-failure-getting-ready-for-prime-time
#10
Jasmohan S Bajaj, Richard Moreau, Patrick S Kamath, Hugo E Vargas, Vicente Arroyo, K Rajender Reddy, Gyongyi Szabo, Puneeta Tandon, Jody Olson, Constantine Karvellas, Thierry Gustot, Jennifer C Lai, Florence Wong
Acute on chronic liver failure (ACLF) is a culmination of chronic liver disease and extra-hepatic organ failures, which is associated with a high short-term mortality and immense healthcare expenditure. There are varying definitions for organ failures and ACLF in Europe, North America and Asia. These differing definitions need to be reconciled to enhance progress in the field. The pathogenesis of ACLF is multi-factorial and related to interactions between the immuno-inflammatory system, microbiota and the precipitating factors...
April 24, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29688916/gastrointestinal-bleeding-with-left-ventricular-assist-devices-lvad-locating-the-leak-and-identifying-outcomes
#11
Sarah Malik, Shahbaz A Malik, Laura L Ulmer, Lokesh K Jha, Michael S Strupp, Eugenia Raichlin, Elizabeth R Lyden, Alexander T Hewlett
BACKGROUND AND GOALS: Gastrointestinal bleeding (GIB) is a significant complication following left ventricular assist device (LVAD) implantation. We evaluated the incidence, predictors, endoscopic findings, and outcomes of GIB in LVAD recipients. STUDY: Retrospective review of 205 adult patients undergoing HeartMate II LVAD implantation from January 2012 to June 2016. Patients were reviewed and separated into GIB (n=57; 28%) and non-GIB (n=148; 72%) groups. RESULTS: Median time to GIB was 55 (range, 3 to 730) days...
April 23, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29684976/pharmabiotic-manipulation-of-the-microbiota-in-gastrointestinal-disorders-a-clinical-perspective
#12
Fanny Giron, Eamonn M M Quigley
The advent and widespread availability of high-throughput technology has revolutionized the assessment of the communities of microorganisms that inhabit the gastrointestinal tract - the gut microbiota. As our understanding of the role of the microbiota in health and human disease increases so to do efforts to prevent and treat disease through the modulation of the microbiota. Several strategies are available to us and range from time honored approaches, such as antibiotics and probiotics, to changes in diet, the administration of prebiotics as food supplements and fecal microbiota transplantation...
April 24, 2018: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/29655662/evaluation-of-low-intensity-anti-coagulation-with-a-fully-magnetically-levitated-centrifugal-flow-circulatory-pump-the-magentum-1-study
#13
Ivan Netuka, Peter Ivák, Zuzana Tučanová, Stanislav Gregor, Ondrej Szárszoi, Poornima Sood, Daniel Crandall, Jessica Rimsans, Jean Marie Connors, Mandeep R Mehra
BACKGROUND: The HeartMate 3 left ventricular assist system is engineered to avoid pump thrombosis, yet bleeding complications persist. We investigated the safety of low-intensity anti-coagulation in patients with the HeartMate 3. METHODS: The Minimal AnticoaGulation EvaluatioNTo aUgment heMocompatibility (MAGENTUM 1) pilot study is a prospective, single-arm study of low-intensity warfarin anti-coagulation in patients implanted with the HeartMate 3 pump. After standard warfarin anti-coagulation (international normalized ratio [INR] 2...
March 27, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29624817/fatal-hyperammonemia-associated-with-disseminated-serratia-marcescens-infection-in-a-pediatric-liver-transplant-recipient
#14
Stephen Mouat, Jonathan Bishop, Emma Glamuzina, Simon Chin, Emma J Best, Helen M Evans
Hyperammonemia is a rare and important complication post-liver transplantation. We review a case of a 5-month-old boy with biliary atresia who received a split liver transplant following a variceal bleed. The transplant was complicated by recurrent portal vein thrombosis. Colonized with Serratia marcescens pretransplant, he developed disseminated infection associated with very high levels of ammonia that led to his death. It is important to be aware of serum ammonia levels in patients with portal vein thrombosis, particularly in the setting of gastrointestinal bleeding and sepsis...
April 6, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29605022/posttransplant-complications-in-adult-recipients-of-intestine-grafts-without-bowel-decontamination
#15
Jared W Clouse, Chandrashekhar A Kubal, Jonathan A Fridell, Richard S Mangus
BACKGROUND: Selective digestive decontamination is commonly used to decrease lumenal bacterial flora. Preoperative bowel decontamination may be associated with a lower wound infection rate but has not been shown to decrease risk of intra-abdominal abscess or lower leak rate for enteric anastomoses. Alternatively, the decontamination disrupts the normal flora of the gastrointestinal tract and may affect normal physiology, including immunologic function. This study reports complication rates of an intestine transplant program that has never used bowel decontamination...
May 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29573830/gastric-mucormycosis-in-a-liver-and-kidney-transplant-recipient-case-report-and-concise-review-of-literature
#16
G Alfano, F Fontana, D Francesca, G Assirati, P Magistri, G Tarantino, R Ballarin, G Rossi, E Franceschini, M Codeluppi, G Guaraldi, C Mussini, F Di Benedetto, G Cappelli
Mucormycosis is an uncommonly encountered fungal infection in solid organ transplantation. The infection is severe and often results in a fatal outcome. The most common presentations are rhino-sino-orbital and pulmonary disease. We describe a rare case of gastric mucormycosis in a patient with a combined liver-kidney transplant affected by glycogen storage disease type Ia. A 42-year-old female patient presented with gastric pain and melena 26 days after transplantation. Evaluation with upper endoscopy showed two bleeding gastric ulcers...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29570132/xanthomatous-cells-in-cutaneous-graft-versus-host-disease-biopsies-a-clue-for-the-diagnosis-of-hepatic-graft-versus-host-disease
#17
Denise Gamé, Lucia López, Concepción Román, Ángel Santos-Briz
Graft-versus-host disease (GVHD) is one of the most common and serious complications of hematopoietic stem-cell transplantation that mainly affects the skin, gastrointestinal tract, and liver. Hepatic GVHD is associated with high morbidity and mortality, and its diagnosis can be especially challenging because of nonspecific clinical signs and symptoms. It must be suspected in patients with elevated liver enzymes and cholestasis, especially in those with a history of preceding skin rash and diarrhea. We describe 3 patients with cutaneous and hepatic GVHD that presented with severe hypercholesterolemia and hypertriglyceridemia, and no xanthomatous macular lesions, in which cutaneous biopsies revealed the presence of xanthomatous dermal histiocytes...
March 21, 2018: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/29534657/role-of-endoscopic-findings-and-biopsies-in-renal-transplant-recipients-with-gastrointestinal-complications-a-tertiary-care-experience
#18
Rajesh Kumar Wadhwa, Aisha Nazeer, Ayesha Aslam Rai, Nasir Hassan Luck
OBJECTIVES: We investigated the incidence of gastrointestinal disorders requiring endoscopic and histopathologic diagnoses in renal transplant recipients. MATERIALS AND METHODS: In this retrospective analysis, we examined records of patients seen at the Department of Hepato-Gastroenterology and Transplantation Sciences, Sindh Institute of Urology and Trans?lantation (Karachi, Pakistan) from January 2010 to December 2014. Renal transplant recipients with gastrointestinal disorders who required endoscopy, including proctoscopy and upper and lower gastrointestinal endoscopy as per indication, were included...
March 9, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29525258/one-year-outcomes-with-the-heartmate-3-left-ventricular-assist-device
#19
Jasmin S Hanke, Günes Dogan, Amelie Zoch, Marcel Ricklefs, Leonhard Wert, Christina Feldmann, Christoph Bara, Malakh Shrestha, Jochen Tillmanns, Tibor Kempf, Johann Bauersachs, Axel Haverich, Jan D Schmitto
BACKGROUND: The HeartMate 3 (HM3; Abbott Laboratories, Lake Forest, Ill) left ventricular assist device (LVAD) received its Conformité Européenne mark for Europe in October 2015 and is currently under investigation of the Food and Drug Administration to gain approval in the United States. Within this study, we present the first real-world experiences, 1-year outcomes, and adverse events of a single-center cohort treated with the HM3. METHODS: We prospectively studied midterm results of 27 consecutive patients receiving the HM3 at a single institution...
February 13, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29515252/variability-of-nutritional-practices-in-peritransplant-period-after-allogeneic-hematopoietic-stem-cell-transplantation-a-survey-by-the-complications-and-quality-of-life-working-party-of-the-ebmt
#20
Zinaida Peric, Stefano Botti, Jacqui Stringer, Joanna Krawczyk, Steffie van der Werf, Anja van Biezen, Mahmoud Aljurf, John Murray, Sarah Liptrott, Diana M Greenfield, Rafael F Duarte, Tapani Ruutu, Grzegorz W Basak
Recommendations on screening and nutritional support for patients undergoing hematopoietic stem cell transplantation (HSCT) have been presented by international nutritional societies, but nutritional practices remain poorly standardized. Following the general policy of the European Society for Blood and Marrow Transplantation (EBMT) to standardize transplantation procedures, the Complications and Quality of Life Working Party and Nursing Research Group carried out a survey among all EBMT centers about their current nutritional practices...
March 7, 2018: Bone Marrow Transplantation
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