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Gastrointestinal complication AND transplantation

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
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
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
Muhammad B Hammami, Rebecca Talkin, Ahmad M Al-Taee, Martin W Schoen, Sagun D Goyal, Jin-Ping Lai
Multiple myeloma (MM) is the most common indication for autologous hematopoietic stem cell transplantation (HSCT) in North America. Despite occurring in up to 50% of patients undergoing allogeneic HSCT, the incidence of graft-versus-host disease (GVHD) after autologous HSCT is reportedly only 5-20%. Gastrointestinal involvement with graft-versus-host disease (GI GVHD) is a common and serious complication of allogeneic HSCT. GI GVHD after autologous transplant, which is referred to as autologous GVHD (auto-GVHD), has also been described...
February 2018: Gastroenterology Research
Ferenc Jakab
Numerous outstanding summarizing publications on the milestones of the rapid development of liver surgery in the twentieth century came to light around the year 2000, therefore in this summary only the newest principles and novelties of liver surgery after the second millennium are presented. Among the new principles, the newest indications, the bloodless surgery and the vascular exclusion of the liver, the "associating liver partition and portal vein occlusion for staged hepatectomy" (ALPPS) - as presently the fastest and most successful method for liver regeneration, and the "downsizing of tumors" treatment for the interest of resection of unresectable tumours are analyzed and evaluated...
March 2018: Orvosi Hetilap
Jared W Clouse, Chandrashekhar A Kubal, Jonathan A Fridell, Richard S Mangus
This study reports the clinical complication and infection rates of an active pediatric IT program that has never utilized bowel decontamination in either the donor or the recipient. All patients undergoing IT from 2003 to 2015 at a single pediatric IT center were reviewed. Post-transplant surgical, infectious, and immunosuppressive complications are reported. There were 52 patients who underwent IT during the study period. Among these patients, 4% developed a postoperative abscess, one developed an enteric fistula (2%), and one had an enteric or anastomotic leak (2%)...
March 2, 2018: Pediatric Transplantation
C M Jaramillo-Esparza, A Consuelo-Sánchez, C P Acosta-Rodríguez-Bueno, G Ramón-García, S W Sadowinski-Pine, M A Escobar-Sánchez, I Castorena-Villa, F Gaytán-Morales, R Vázquez-Frias
INTRODUCTION AND AIMS: Graft-versus-host disease (GVHD) is a common multisystemic complication of allogeneic hematopoietic cell transplantation. The most frequent presentations of graft-versus-host disease involve the skin, the gastrointestinal tract, and the liver. The aim of the present study was to know the frequency of gastrointestinal tract and liver GVHD and the characteristics of disease presentation in pediatric patients that underwent hematopoietic stem cell transplantation (HSCT) at a tertiary care hospital center in Mexico City...
February 24, 2018: Revista de Gastroenterología de México
Ann C Gaffey, Carol W Chen, Jennifer J Chung, Jason Han, Christian A Bermudez, Joyce Wald, Pavan Atluri
BACKGROUND: Continuous-flow left ventricular assist devices (CF-LVAD) have become the standard of care for patients with end stage heart failure. Device reliability has increased, bringing the potential for VAD, compared to transplant, into debate. However, complications continue to limit VADs as first line therapy. Bleeding is a major morbidity. A debate exists as to the difference in bleeding profile between the major centrifugal and axial flow devices. We hypothesized that there would be similar adverse bleeding event profiles between the 2 major CF-LVADs...
February 13, 2018: Journal of Cardiothoracic Surgery
Ivetta Danylesko, Avichai Shimoni
Second malignancies are a rare but well-defined late complication after autologous and allogeneic hematopoietic stem-cell transplantation (SCT). Solid malignancies occur in up to 15% of patients 15 years after SCT with myeloablative conditioning, with no plateau in the incidence rates. They are responsible for 5-10% of late deaths after SCT. The incidence is increased with advanced age at SCT. The major risk factors are the use of total body irradiation, which is associated with adenocarcinomas and with chronic graft-versus-host disease which is associated with squamous cell cancers...
February 8, 2018: Current Treatment Options in Oncology
Ashleigh Scott, Siok-Keen Tey, Jason Butler, Glen A Kennedy
BACKGROUND / AIM: Acute gastrointestinal graft versus host disease (GI-GVHD) following haematopoietic progenitor cell transplantation (HPCT) is a common and life-threatening complication. Endoscopic biopsy of the gastrointestinal tract is required for diagnosis. However, clear evidence to optimise this diagnostic approach is lacking, leading to variation in diagnostic sensitivity between institutions. We aimed to assess the clinical, endoscopic and histological findings of endoscopies performed for suspected acute GI-GVHD at our institution to better define the optimal use of this strategy...
February 1, 2018: Biology of Blood and Marrow Transplantation
Larisa Broglie, Alfred Rademaker, John Galvin, Ayita Ray, William T Tse, Reggie Duerst, Jennifer Schneiderman, Morris Kletzel, Sonali Chaudhury
BACKGROUND: Acute graft versus host disease (aGVHD) affects approximately 30-60% of patients after allogeneic hematopoietic stem cell transplantation (HCT) and our ability to predict who develops this complication and their response to treatment is limited. Fecal calprotectin has recently gained popularity as an effective marker of GI inflammation in patients with Inflammatory Bowel Disease (IBD). METHODS: Fecal calprotectin and albumin were evaluated as prognostic and predictive markers of aGVHD in 60 adult and pediatric HCT patients...
January 31, 2018: Hematology/oncology and Stem Cell Therapy
Velu Nair, Vivek Vasdev, Abhishek Kumar, Subramanian Shankar, Vivek Nair, Ajay Sharma
AIM: To prospectively evaluate long term outcomes in a cohort of patients with Systemic sclerosis treated with Hematopoietic stem cell transplant (HSCT). METHOD: This is a prospective observational study of four SSc patients who underwent HSCT at a tertiary care center in India between 2008-2012. The selection criteria included young individuals with rapidly progressive disease and at least one major organ involvement. We used granulocyte colony-stimulating factor for peripheral blood stem cell mobilization, pre-transplant conditioning with fludarabine, cyclophosphamide and rabbit anti-thymocyte globulin followed by re-infusion of autologous stem cells as per standard institute protocol...
February 2, 2018: International Journal of Rheumatic Diseases
Satoshi Kainuma, Kiyokazu Nakajima, Shigeru Miyagawa, Satsuki Fukushima, Atsuhiro Saito, Akima Harada, Masashi Hirota, Yasuhiro Miyazaki, Noriyoshi Sawabata, Tadashi Watabe, Hiroshi Watabe, Koichi Toda, Jun Hatazawa, Meinoshin Okumura, Yoshiki Sawa
OBJECTIVES: We previously reported that cell sheet transplantation combined with an omentopexy (OP) procedure is more effective for repairing heart damage when compared with cell sheet transplantation alone. However, a simultaneous (conventional) laparotomy as part of the OP may adversely affect the general condition of critically ill heart failure patients who would otherwise benefit from cell sheet transplantation, which is a paradox to be reconciled before this treatment can be applied in a clinical setting...
January 18, 2018: Interactive Cardiovascular and Thoracic Surgery
Kana Matsuda, Shoko Ono, Marin Ishikawa, Shuichi Miyamoto, Satoshi Abiko, Momoko Tsuda, Keiko Yamamoto, Takahiko Kudo, Yuichi Shimizu, Eiko Hayase, Daigo Hashimoto, Takanori Teshima, Yoshihiro Matsuno, Naoya Sakamoto
Although graft-versus-host disease (GVHD) is the major complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT), cytomegalovirus (CMV) reactivation also occurs in patients after allo-HSCT and these conditions often clinically overlap. The aim of this study was to determine reliable endoscopic findings of CMV colitis in patients with gastrointestinal graft-versus-host-disease (GI-GVHD). Patients after allo-HSCT who were histologically confirmed to have GI-GVHD with or without CMV colitis and patients with an immunosuppressive condition were retrospectively analyzed...
January 16, 2018: Annals of Hematology
Sanmya Danielle Rodrigues Dos Santos, Antonio Tonete Bafi, Flávio Geraldo Rezende de Freitas, Luciano César Pontes de Azevedo, Flávia Ribeiro Machado
OBJECTIVES: To define the frequency of cytomegalovirus disease among kidney transplant patients in an intensive care unit in which this complication was suspected and to identify predisposing factors and their possible impact on clinical outcome. METHODS: Retrospective observational study in which kidney transplant patients over the age of 18 years were hospitalized for any reason in an intensive care unit with at least one collection of samples to test for the presence of antigenemia or cytomegalovirus via polymerase chain reaction during hospitalization...
October 2017: Revista Brasileira de Terapia Intensiva
John A Snowden, Julián Panés, Tobias Alexander, Matthieu Allez, Sandro Ardizzone, Daan Dierickx, Jürgen Finke, Peter Hasselblatt, Chris Hawkey, Majid Kazmi, James O Lindsay, Francesco Onida, Azucena Salas, Riccardo Saccardi, Severine Vermeire, Montserrat Rovira, Elena Ricart
Despite the major recent progress in the treatment of Crohn's disease (CD), there is a subset of patients in whom the disease runs an aggressive course with progressive tissue damage requiring early and repeated surgical management. Increasing evidence supports sustained and profound improvement in gastrointestinal parameters and quality of life following high dose immunosuppressive therapy and autologous haematopoietic stem cell transplantation (AHSCT) compared to standard therapy in this context. In addition, international transplant registry data reflects the use of AHSCT in CD outside of trials in selected patients...
January 8, 2018: Journal of Crohn's & Colitis
Na Wang, Xiaoyi Qin, Yigeng Cao, Bin Liang, Kang Yu, Haige Ye
Background: Gastrointestinal acute graft-versus-host disease (GI aGVHD) is a lethal complication following allogeneic hematopoietic stem cell transplantation (HSCT). However, it is still very difficult to make a diagnosis of GI aGVHD in practice. To date, no consensus plasma biomarker of GI aGVHD can be used to help make a diagnosis. Here, we attempted to identify GI aGVHD associated plasma proteins in murine model, which can help make a diagnosis of GI aGVHD. Methods: We used 8-plex isobaric tags for relative and absolute quantitation (8-plex iTRAQ) to screen out proteins in plasma samples taken from murine models before and after allogeneic HSCT...
2018: Journal of Inflammation
Anthony D Sung, Syed Hassan, Diana M Cardona, Daniel Wild, Krista Rowe Nichols, Hossein Mehdikhani, Bryan Balmadrid, Claire J Detweiler, Michael Shealy, Constance Cirrincione, Zhiguo Li, Martin Poleski, Tara E Dalton, Sharareh Siamakpour-Reihani, Nelson J Chao, Keith M Sullivan
INTRODUCTION: Gastrointestinal (GI) complications including graft versus host disease (GVHD) are a major cause of morbidity and mortality in allogenic stem transplant recipients. While several studies have previously looked into the acute gastrointestinal complications, fewer smaller studies have reported late complications. In this large study, we focus on the late (100 days post-transplant) gastrointestinal complications in allogenic stem transplant recipients METHODS: This is a single center, retrospective study, of all of the adult allogenic stem cell transplant recipients who had their transplant at Duke University over a six year period...
December 12, 2017: Biology of Blood and Marrow Transplantation
R Todd Stravitz, Caitlyn Ellerbe, Valerie Durkalski, Michael Schilsky, Robert J Fontana, Carolyn Peterseim, William M Lee
In patients with acute liver failure (ALF), elevatedprothrombin time and thrombocytopeniacan fuel a perception of a bleeding tendency. However, the incidence, site, risk factors, and clinical significance of bleeding complications have not been previously quantified in a large cohort of patients with ALF. We studied 1770adult patients enrolled in the ALF Study Group Registry between 1998 and 2016.Bleeding complications and blood component transfusions were collected for 7days after admission. The relationship of bleeding complications to 21-day mortality was assessed...
December 1, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Andrea Cikova, Diana Vavrincova-Yaghi, Peter Vavrinec, Anna Dobisova, Andrea Gebhardtova, Zora Flassikova, Mark A Seelen, Robert H Henning, Aktham Yaghi
BACKGROUND: Post-transplant tuberculosis (PTTB) is a serious opportunistic infection in renal graft recipients with a 30-70 fold higher incidence compared to the general population. PTTB occurs most frequently within the first years after transplantation, manifesting as pulmonary or disseminated TB. Gastrointestinal TB (GITB) is a rare and potentially lethal manifestation of PTTB and may show delayed onset in renal transplant recipients due to the use of lower doses of immunosuppressants...
November 28, 2017: BMC Gastroenterology
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