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Gastrointestinal complication AND transplantation

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https://www.readbyqxmd.com/read/28914862/-liver-diseases-the-pathogenetic-role-of-the-gut-microbiome-and-the-potential-of-treatment-for-its-modulation
#1
K A Aitbaev, I T Murkamilov, V V Fomin
The paper gives an update on the role of the gut microbiome (GM) in the development of nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, alcoholic liver disease, liver cirrhosis (LC), and its complications, such as hepatic encephalopathy (HE) and hepatocellular carcinoma (HCC), and discusses the possibilities of its correction with prebiotics, probiotics, synbiotics, antibiotics, and fecal microbiota transplantation (FMT). The pathophysiology of the liver diseases in question demonstrates some common features that are characterized by pathogenic changes in the composition of the gastrointestinal tract microflora, by intestinal barrier impairments, by development of endotoxemia, by increased liver expression of proinflammatory factors, and by development of liver inflammation...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28838898/protocol-for-a-pilot-randomised-controlled-trial-of-metformin-in-pre-diabetes-after-kidney-transplantation-the-transplantation-and-diabetes-transdiab-study
#2
Basil Alnasrallah, Helen Pilmore, Paul Manley
INTRODUCTION: Post-transplant diabetes mellitus (PTDM) is a common complication of kidney transplantation and is associated with significant morbidity and mortality. In the general population, metformin has been used for diabetes prevention in high-risk individuals. Improving insulin sensitivity is one of many proven favourable effects of metformin. Despite the high incidence of PTDM in kidney transplant recipients, there is a lack of evidence for the role of metformin in the prevention of diabetes in this setting...
August 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28838432/autosomal-dominant-polycystic-kidney-disease-transplant-recipients-after-kidney-transplantation-a-single-center-experience
#3
L Illesy, D Á Kovács, R P Szabó, A B L Asztalos, B Nemes
Kidney transplantation is indicated for end-stage renal disease. Autosomal dominant polycystic kidney disease (ADPKD) causes structural degeneration of the kidney and eventually becomes end-stage renal disease. ADPKD patients usually have several renal and nonrenal complications. We analyzed our kidney transplantation activities between 1991 and 2010 regarding ADPKD. We followed up with patients to December 31, 2016. Data were collected as patient and graft survival rates, the prevalence of polycystic manifestation of the gastrointestinal tract and other organs, and the attendance of urinary tract infection...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28833332/pharmacotherapeutic-management-of-gastrointestinal-bleeding-in-patients-with-continuous-flow-left-ventricular-assist-devices
#4
Adam Sieg, Jeremy D Moretz, Edward Horn, Douglas L Jennings
Continuous-flow left ventricular assist devices (CF-LVADs) have become an integral component of the management in patients with advanced heart failure, serving as destination therapy or as a bridge to heart transplantation. Despite significant advances in the design and longevity of the device, the ongoing risk for bleeding remains a significant concern. The genesis of gastrointestinal bleeding (GIB) in patients with CF-LVADs is likely multifactorial and may include components of acquired von Willebrand disease, angiodysplasia, and gastrointestinal arteriovenous malformations, as well as additional risk factors such as history of GIB and increased age...
August 22, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28804516/the-role-of-sebelipase-alfa-in-the-treatment-of-lysosomal-acid-lipase-deficiency
#5
REVIEW
Angelika L Erwin
Lysosomal acid lipase deficiency (LALD) is a lysosomal storage disorder (LSD) characterized either by infantile onset with fulminant clinical course and very poor prognosis or childhood/adult-onset disease with an attenuated phenotype. The disorder is often misdiagnosed or remains undiagnosed in children and adults due to a rather unspecific clinical presentation with dyslipidemia and steatohepatitis. Until recently, no good treatment options were available for LALD. Despite supportive and symptomatic therapies, death occurred before 1 year of age in patients with infantile-onset disease and patients with childhood/adult-onset LALD suffered from significant complications, such as liver cirrhosis, requiring liver transplantation and early-onset cardiovascular disease...
July 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28803487/a-mechanism-based-approach-to-management-of-children-with-end-stage-liver-disease
#6
Allah B Haafiz
Due to parallel advances in surgical and acute care disciplines, liver transplantation (LT) has revolutionized the outlook for children with end-stage liver disease (ESLD). Contrary to advances in technical aspects of LT and the peri-operative care, pre-transplant management of ESLD remains quite a formidable challenge. Areas covered: This review provides mechanisms based management strategies to address common complications of ESLD including malnutrition, amended metabolic pathways, gastrointestinal dysfunction, and development of ascites...
August 28, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28795840/a-complete-histologic-approach-to-gastrointestinal-biopsy-from-hematopoietic-stem-cell-transplant-patients-with-evidence-of-transplant-associated-gastrointestinal-thrombotic-microangiopathy
#7
Mikako Warren, Sonata Jodele, Christopher Dandoy, Kasiani C Myers, Gregory Wallace, Adam Nelson, Javier El-Bietar
CONTEXT: - Transplant-associated thrombotic microangiopathy is a serious complication of hematopoietic stem cell transplant that may progress to multi-organ dysfunction. Transplant-associated thrombotic microangiopathy may involve the intestinal vasculature (intestinal transplant-associated thrombotic microangiopathy [iTMA]), causing patients to experience debilitating symptoms of ischemic colitis, including disproportionately severe abdominal pain and gastrointestinal bleeding, requiring heavy narcotic use and frequent transfusion support...
August 10, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28753218/a-review-of-late-complications-of-allogeneic-hematopoietic-stem-cell-transplantations
#8
REVIEW
Erden Atilla, Pinar Ataca Atilla, Selami Kocak Toprak, Taner Demirer
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective and curative treatment of different malignant and non-malignant diseases. Early transplant-related mortality after allo-HSCT has decreased with reduced-intensity conditioning regimens and effective anti-infectious treatments, but late transplant-related mortality is still a problem. Physicians are now paying more attention to late complications that may worsen the quality of life of many transplant recipients. Chronic graft versus host disease (cGVHD) is one of the major causes of late transplant-related mortality after allo-HSCT...
July 28, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28744150/radiofrequency-ablation-using-barrx-%C3%A2-for-the-endoscopic-treatment-of-gastric-antral-vascular-ectasia-a-series-of-three-cases-and-a-review-of-the-literature-on-treatment-options
#9
Anish Patel, Sunil Patel, Prasanna C Wickremesinghe, Deepak Vadada
Gastric antral vascular ectasia (GAVE), also known as "watermelon stomach", is an uncommon condition, which can cause gastrointestinal bleeding due to rupture of blood vessels that line the stomach. The pathogenesis of GAVE remains unclear; however it is thought that hemodynamic changes, mechanical stress, and autoimmune factors all have a part to play. A range of conditions are also commonly associated with the syndrome, such as portal hypertensive gastropathy, liver cirrhosis, and autoimmune disorders. Less commonly, chronic renal failure, cardiac diseases, and bone marrow transplantation have coexisted with GAVE...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28711168/surgical-treatment-of-intestinal-complications-of-graft-versus-host-disease-in-the-pediatric-population-case-series-and-review-of-literature
#10
REVIEW
Camille A Gutierrez, Mehul V Raval, Hannah R Vester, Sonali Chaudhury, Daniel von Allmen, David H Rothstein
BACKGROUND/PURPOSE: Intestinal complications of acute graft-versus-host disease (aGVHD) include hemorrhage and perforation in the short-term, and stricture with bowel obstruction in the long-term. As medical management of severe aGVHD has improved, more patients are surviving even advanced stages of intestinal aGVHD. This review summarizes the available pediatric literature on surgical treatment of complications of intestinal GVHD. METHODS: A systematic review was performed using PubMed, Cochrane, Embase, and Scopus databases...
June 28, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28688917/real-world-economic-burden-associated-with-transplantation-related-complications
#11
Miguel-Angel Perales, Machaon Bonafede, Qian Cai, Phillip M Garfin, Donna McMorrow, Neil C Josephson, Akshara Richhariya
Approximately 20,000 hematopoietic cell transplantation (HCT) procedures are performed annually in the United States. Real-world data on the costs associated with post-transplantation complications are limited. Patients with hematologic malignancies aged ≥18 years undergoing autologous HCT (auto-HCT) or allogeneic HCT (allo-HCT) between January 1, 2011, and June 30, 2014, were identified in the Truven Health MarketScan Research Databases. Patients were required to have 12 months of continuous medical and pharmacy enrollment before and after HCT; patients who experience inpatient death within 12 months post-HCT were also included...
July 5, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28688097/b-lymphocyte-chemoattractant-cxcl13-is-an-indicator-of-acute-gastrointestinal-gvhd-in-murine-model
#12
Yigeng Cao, Xiaoyi Qin, Na Wang, Erlie Jiang, Mingzhe Han, Yongyong Ma, Bin Liang, Kaiyan Yang, Kang Yu, Haige Ye
Gastrointestinal acute graft-vs.-host disease (GI aGVHD) remains a significant obstacle to the success of allogeneic hematopoietic cell transplantation and is a major cause of morbidity and mortality. In addition, GI aGVHD is often clinically indistinguishable from other causes of GI dysfunction such as conditioning regimen toxicity, infections, or medications, which complicates the diagnosis. Thus, specific biomarkers are needed to help improve diagnosis and obtain a deeper understanding of the cytokine changes in GI aGVHD...
July 7, 2017: Inflammation
https://www.readbyqxmd.com/read/28680375/tlr-myd88-mediated-innate-immunity-in-intestinal-graft-versus-host-disease
#13
REVIEW
Young-Kwan Lee, Myungsoo Kang, Eun Young Choi
Graft-versus-host disease (GHVD) is a severe complication after allogeneic hematopoietic stem cell transplantation. The degree of inflammation in the gastrointestinal tract, a major GVHD target organ, correlates with the disease severity. Intestinal inflammation is initiated by epithelial damage caused by pre-conditioning irradiation. In combination with damages caused by donor-derived T cells, such damage disrupts the epithelial barrier and exposes innate immune cells to pathogenic and commensal intestinal bacteria, which release ligands for Toll-like receptors (TLRs)...
June 2017: Immune Network
https://www.readbyqxmd.com/read/28676511/absence-of-post-transplantation-encapsulating-peritoneal-sclerosis-after-relatively-short-exposure-to-peritoneal-dialysis-prospective-analysis-using-repeated-abdominal-ct-scanning
#14
Alferso C Abrahams, Maaike K van Gelder, Jan Willem van der Veer, Pim A de Jong, Maarten S van Leeuwen, Walther H Boer
BACKGROUND: Encapsulating peritoneal sclerosis (EPS) is the most severe complication of peritoneal dialysis (PD). Several retrospective reports published between 2007 and 2009 have suggested an increasing incidence of EPS occurring after kidney transplantation. We conducted a prospective observational study to determine the incidence of post-transplantation EPS and identify possible risk factors. METHODS: Consecutive PD patients undergoing kidney transplantation between 2009 and 2013 were included...
July 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28665827/cessation-of-continuous-flow-left-ventricular-assist-device-related-gastrointestinal-bleeding-after-heart-transplantation
#15
Snehal R Patel, Kyung Taek Oh, Tolulope Ogriki, Daniel Sims, J Julia Shin, Shivank Madan, Omar Saeed, Daniel J Goldstein, Ulrich P Jorde
Gastrointestinal bleeding (GIB) is a major complication of continuous flow left ventricular assist device (CF LVAD) therapy. The precise pathophysiology of CF LVAD-related bleeding remains poorly understood, and the effect of pump removal at the time of transplantation on actual bleeding frequency has not previously been studied. A single-center retrospective review was conducted on patients who received CF LVAD and subsequently developed GIB. Baseline demographics and markers of pulsatility (aortic valve opening and the HeartMate II [HM2] pulse index) were compared between those with and without GIB...
June 28, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28653858/transplantation-of-a-human-tissue-engineered-bowel-in-an-athymic-rat-model
#16
Elie Zakhem, Riccardo Tamburrini, Giuseppe Orlando, Kenneth L Koch, Khalil N Bitar
Intestinal failure is a serious clinical condition characterized by loss of motility, absorptive function, and malnutrition. Current treatments do not provide the optimal solution for patients due to the numerous resulting complications. A bioengineered bowel that contains the necessary cellular components provides a viable option for patients. In this study, human tissue-engineered bowel (hTEB) was developed using a technique, whereby human-sourced smooth muscle cells were aligned and neoinnervated using human-sourced neural progenitor cells, resulting in the formation of intrinsically innervated smooth muscle sheets...
June 27, 2017: Tissue Engineering. Part C, Methods
https://www.readbyqxmd.com/read/28652649/bleeding-with-the-artificial-heart-gastrointestinal-hemorrhage-in-cf-lvad-patients
#17
EDITORIAL
Grigoriy E Gurvits, Elena Fradkov
Continuous-flow left ventricular assist devices (CF-LVADs) have significantly improved outcomes for patients with end-stage heart failure when used as a bridge to cardiac transplantation or, more recently, as destination therapy. However, its implantations carries a risk of complications including infection, device malfunction, arrhythmias, right ventricular failure, thromboembolic disease, postoperative and nonsurgical bleeding. A significant number of left ventricular assist devices (LVAD) recipients may experience recurrent gastrointestinal hemorrhage, mainly due to combination of antiplatelet and vitamin K antagonist therapy, activation of fibrinolytic pathway, acquired von Willebrand factor deficiency, and tendency to develop small intestinal angiodysplasias due to increased rotary speed of the pump...
June 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28581444/altered-homeostatic-regulation-of-innate-and-adaptive-immunity-in-lower-gastrointestinal-tract-gvhd-pathogenesis
#18
REVIEW
James Lm Ferrara, Christopher M Smith, Julia Sheets, Pavan Reddy, Jonathan S Serody
Lower gastrointestinal (GI) tract graft-versus-host disease (GVHD) is the predominant cause of morbidity and mortality from GVHD after allogeneic stem cell transplantation. Recent data indicate that lower GI tract GVHD is a complicated process mediated by donor/host antigenic disparities. This process is exacerbated by significant changes to the microbiome, and innate and adaptive immune responses that are critical to the induction of disease, persistence of inflammation, and a lack of response to therapy. Here, we discuss new insights into the biology of lower GI tract GVHD and focus on intrinsic pathways and regulatory mechanisms crucial to normal intestinal function...
June 30, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28577653/nutritional-status-and-hyperglycemia-in-the-peritransplant-period-a-review-of-associations-with-parenteral-nutrition-and-clinical-outcomes
#19
Marina Verdi Schumacher, Gustavo Adolpho Moreira Faulhaber
Hematopoietic stem cell transplantation is an established treatment option for various hematological diseases. This therapy involves complex procedures and is associated with several systemic complications. Due to the toxic effects of the conditioning regimen used in allogeneic transplantations, patients frequently suffer from severe gastrointestinal complications and are unable to feed themselves properly. This complex clinical scenario often requires specialized nutritional support, and despite the increasing number of studies available, many questions remain regarding the best way to feed these patients...
April 2017: Revista Brasileira de Hematologia e Hemoterapia
https://www.readbyqxmd.com/read/28576435/-encapsulating-peritoneal-sclerosis
#20
Jean-Philippe Ryckelynck, Clémence Béchade, Nicolas Bouvier, Maxence Ficheux, Bruno Hurault de Ligny, Thierry Lobbedez
Encapsulating peritoneal sclerosis is a rare but devastating complication of long-term peritoneal dialysis with a high mortality rate. The incidence is between 0.5 and 2.5%, decreasing with time. PSE is defined as a clinical syndrome with signs of gastrointestinal obstruction, inflammation parameters, radiological and macroscopic changes. The duration of treatment and the cessation of peritoneal dialysis are the main risks. About 75% occured in patients on hemodialysis or after kidney transplantation. Morphological alterations are disappearance of mesothelial layer, submesothelial fibrosis, interstitial sclerosis and vasculopathy...
May 30, 2017: Néphrologie & Thérapeutique
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