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Multivisceral transplant

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https://www.readbyqxmd.com/read/28088400/hospitalizations-for-respiratory-syncytial-virus-and-vaccine-preventable-infections-in-the-first-2-years-after-pediatric-liver-transplant
#1
Amy G Feldman, Shikha S Sundaram, Brenda L Beaty, Allison Kempe
OBJECTIVES: To examine in liver transplant recipients at centers participating in the Pediatric Health Information System dataset the number of hospitalizations for respiratory syncytial virus (RSV) and vaccine-preventable infections (VPIs) in the first 2 years after transplantation, morbidity and mortality associated with these hospitalizations, and costs associated with these hospitalizations. STUDY DESIGN: A retrospective cohort study of patients <18 years of age who underwent liver transplantation at a Pediatric Health Information System center between January 1, 2004, and December 31, 2012...
January 11, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28052307/ultrashort-bowel-syndrome-outcome-in-children-treated-in-a-multidisciplinary-intestinal-rehabilitation-unit
#2
Mariela Dore, Paloma Triana Junco, Ane Andres Moreno, Vanesa Nuñez Cerezo, Martha Romo Muñoz, Alba Sánchez Galán, Alejandra Vilanova Sánchez, Gerardo Prieto, Esther Ramos, Francisco Hernandez, Leopoldo Martínez Martínez, Manuel Lopez Santamaria
Aim Short bowel syndrome (SBS) is the leading cause of intestinal failure (IF) in the pediatric population. Our aim was to review long-term outcome of ultrashort bowel syndrome (USBS) in an Intestinal Rehabilitation Unit (IRU). Patients and Methods Retrospective study of patients with USBS (defined as < 10 cm of remnant small bowel) treated between 2000 and 2015. Demographic data, clinical, and treatment variables including parenteral nutrition (PN), surgical techniques, and intestinal transplantation (IT) were analyzed...
January 4, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27990484/initial-experience-of-video-capsule-endoscopy-after-intestinal-transplantation
#3
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/27941430/long-term-persistence-of-innate-lymphoid-cells-in-the-gut-after-intestinal-transplantation
#4
Joshua Weiner, Julien Zuber, Brittany Shonts, Suxiao Yang, Jianing Fu, Mercedes Martinez, Donna Farber, Tomoaki Kato, Megan Sykes
BACKGROUND: Little is known about innate lymphoid cell (ILC) populations in the human gut, and the turnover of these cells and their subsets after transplantation has not been described. METHODS: Intestinal samples were taken from 4 isolated intestine (ITx) and 3 multivisceral (MvTx) transplant recipients at the time of any operative resection, such as stoma closure or revision. ILCs were isolated and analyzed by flow cytometry. The target population was defined as being negative for lineage markers and double-positive for CD45/CD127...
December 8, 2016: Transplantation
https://www.readbyqxmd.com/read/27932149/portal-vein-inflow-from-enlarged-coronary-vein-in-liver-transplantation-surgical-approach-and-technical-tips-a-case-report
#5
M Safwan, S Nagai, M S Abouljoud
Portal vein thrombosis is common in patients with end-stage liver disease, with an incidence as high as 26% in liver transplant candidates. It is known to be associated with a high risk of morbidity and mortality posttransplantation, and its management can be challenging. The management options range from a simple thrombendvenectomy to multivisceral transplantation in cases with diffuse portomesenteric thrombosis. We report a case of liver transplantation in which we performed a rare reconstruction of the portal vein...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27889929/twenty-eight-years-of-intestinal-transplantation-in-paris-experience-of-the-oldest-european-centre
#6
F Lacaille, S Irtan, L Dupic, C Talbotec, F Lesage, V Colomb, N Salvi, F Moulin, F Sauvat, Y Aigrain, Y Revillon, O Goulet, C Chardot
AIM: Our aim is to describe our achievements in pediatric intestinal transplantation (ITx) and define areas for improvement. METHODS: After a period (1987-90) of 9 isolated small bowel transplants (SBTx) where only one patient survived with her graft, 110 ITx were performed on 101 children from 1994 to 2014: 60 SBTx, 45 liver-small bowel, 4 multivisceral (3 with kidneys), 1 modified multivisceral. Indications were short bowel syndrome (36), motility disorders (30), congenital enteropathies (34) and others (1)...
November 27, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27788782/could-sentinel-skin-transplants-have-some-utility-in-solid-organ-transplantation
#7
J M Ali, P Catarino, J Dunning, H Giele, G Vrakas, J Parmar
Accurate diagnosis of allograft rejection can be hazardous and challenging. A strategy that has emerged from experience with vascularized composite allografts (VCAs) is the use of sentinel skin transplants (SSTs)-portions of donor skin transplanted synchronously to an allograft. Work in nonhuman animal models and experience with VCAs suggest concordance between rejection occurring in the primary allograft and the SST, and that appearance of rejection in the SST may precede rejection in the primary allograft, permitting early therapeutic intervention that may improve outcomes with lower rates of chronic rejection...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27569969/hospital-readmissions-after-intestinal-and-multivisceral-transplantation
#8
Y K Kwon, K Etesami, A L Sharp, C S Matsumoto, T M Fishbein, R Girlanda
BACKGROUND: Intestinal transplant recipients require frequent hospital readmission after a successful transplantation, but the reasons for readmission have not been characterized in detail. METHODS: We reviewed our single-center experience to characterize the patterns of readmissions and to identify preventable causes. Among 87 adult patients who received an intestinal or multivisceral transplant, 65 patients (35 males, 30 females; median age, 42 years [range, 19-66]) with a follow-up of at least 1 year were included in this study...
July 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27495916/the-abdominal-wall-transplant-as-a-sentinel-skin-graft
#9
James Barnes, Fadi Issa, Georgios Vrakas, Peter Friend, Henk Giele
PURPOSE OF REVIEW: Abdominal wall transplantation is a technique used to achieve abdominal closure after intestinal and multivisceral transplantation. This review focuses on whether there are additional benefits for the skin component as an immune-monitoring tool. RECENT FINDINGS: The largest series of abdominal wall transplants has recently been published. Alongside the physiological advantage gained in abdominal closure, the authors describe the immunological insight that the skin component can provide and how this contributes to the management of patients...
October 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27495766/non-hla-antibodies-may-accelerate-immune-responses-after-intestinal-and-multivisceral-transplantation
#10
Undine Ariane Gerlach, Nils Lachmann, Giuseppina Ranucci, Birgit Sawitzki, Constanze Schoenemann, Johann Pratschke, Duska Dragun, Andreas Pascher
BACKGROUND: Non-HLA alloantibodies and autoantibodies are involved in allograft rejection in kidney and heart transplantation. Their role in intestinal transplantation has not yet been described. We examined the development of antiangiotensin II type I receptor antibodies (anti-AT1R) and antiendothelin type A receptor antibodies associated with the clinical course and histopathological findings of intestinal transplantation recipients. METHODS: Thirty-seven patients underwent intestinal or multivisceral transplantation...
January 2017: Transplantation
https://www.readbyqxmd.com/read/27492796/frequency-and-risks-associated-with-clostridium-difficile-associated-diarrhea-after-pediatric-solid-organ-transplantation-a-single-center-retrospective-review
#11
J Ciricillo, D Haslam, S Blum, M-O Kim, C Liu, G Paulsen, J Courter, L Danziger-Isakov
BACKGROUND: Morbidity and mortality related to Clostridium difficile infection (CDI) has increased, but epidemiology and risk factors within pediatric solid organ transplant (SOT) recipients are uncertain. METHODS: A retrospective cohort study of SOT recipients age ≤18 years at transplantation from 2010 to 2013 was performed. Patients with CDI were compared with matched CDI-negative controls with diarrhea. RESULTS: Of 202 patients, the majority were male (58%) and Caucasian (77%)...
October 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27421821/megacystis-microcolon-intestinal-hypoperistalsis-syndrome-case-series-and-updated-review-of-the-literature-with-an-emphasis-on-urologic-management
#12
REVIEW
Kevin M Wymer, Blake B Anderson, Ashley A Wilkens, Mohan S Gundeti
INTRODUCTION: Megacystis microcolon intestinal hypoperistalsis (MMIHS) is a rare disorder characterized by distended nonobstructed bladder, microcolon, and decreased intestinal peristalsis. MMIHS has a particularly poor prognosis; however, when appropriately managed, survival can be prolonged. STUDY DESIGN: A systematic review (1996-2016) was performed with the key words "megacystis microcolon intestinal hypoperistalsis syndrome." In addition, a case series of four patients is presented as well as algorithms for the diagnosis and treatment of MMIHS...
September 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27149335/scleromatous-changes-in-an-abdominal-wall-graft-graft-versus-graft-disease-or-chronic-graft-rejection
#13
Nicholas J Olson, Daniel B Wimmer, Daniel P Croitoru, Dorothea T Barton, Gregory D Seidel, M Shane Chapman, Konstantinos Linos
Abdominal wall transplants are relatively new procedures that are frequently performed in conjunction with multivisceral transplants. The skin of the abdominal wall transplant is often the first site for graft rejection to manifest itself. Prompt recognition can lead to appropriate treatment before the involvement of the underlying viscera. However, the signs of graft rejection are nonspecific and can overlap with other entities. We present a case of a patient who received a multivisceral and abdominal wall transplant from 2 different donors, who presented with acute and eventually chronic graft rejection of the abdominal wall graft...
January 2017: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/27140671/skype-clinics-after-intestinal-transplantation-follow-up-beyond-post-codes
#14
Undine A Gerlach, Georgios Vrakas, Lydia Holdaway, Marion O'Connor, Rubens Macedo, Srikanth Reddy, Peter J Friend, Henk Giele, Anil Vaidya
The follow-up after intestinal transplantation (ITX) is complex and limited to specialized centers. ITX recipients often travel all over the country to be seen in the outpatient clinic of specialized centers which is costly and time-consuming. Videoconferences through Skype have been implemented to eliminate travel time, costs, and to improve patient compliance without jeopardizing safety. Eighteen of 19 patients followed up after ITX or modified multivisceral transplantation (MMVTX) in conventional outpatient clinics in Oxford agreed to attend additional Skype clinics...
July 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27113513/urgent-multivisceral-transplantation-for-widespread-splanchnic-ischemia
#15
Lisa M Sharkey, Neil K Russell, Charlotte S Rutter, Stephen J Middleton, J Andrew Bradley, Neville V Jamieson, Andrew J Butler
BACKGROUND: Multivisceral transplantation (transplantation of the stomach, intestine, liver, and pancreas) is usually undertaken as a semi-elective procedure after thorough assessment in patients who have intestinal failure with cirrhosis, cirrhosis with portomesenteric venous thrombosis, or tumors such as desmoids involving the liver and mesentery. STUDY DESIGN: Data were collected prospectively from the time of referral and held in a central database. We used it to report the first cases of urgent multivisceral transplantation (MVT) in patients with widespread splanchnic ischemia (occlusion of the celiac axis and superior mesenteric artery) resulting in small bowel infarction and hepatic failure...
May 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27109998/case-report-spleen-preserving-multivisceral-transplant-for-peutz-jeghers-syndrome
#16
L Moulin, N Pedraza, J Padin, S Niveyro, G Tuhay, C Rumbo, P Barros Schelotto, A Crivelli, H Solar Muñiz, D Ramisch, G Gondolesi
CASE REPORT: A 24-year-old man diagnosed with Peutz-Jeghers syndrome as a child underwent multiple surgeries owing to intussusception. Pretransplant workup showed >150 polyps along the gastrointestinal (GI) tract, some of them with high-grade dysplasia. Despite having intestinal sufficiency, a modified multivisceral transplantation was offered. PROCEDURE: An 18-year-old donor was procured using University of Wisconsin solution. The recipient's surgery started with a midline incision...
March 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27109997/case-report-multivisceral-transplantation-for-an-extensive-cystic-lymphangioma-of-the-mesenteric-root
#17
L Moulin, C Rumbo, P Romero, N Pedraza, D Garcia Hervá, G Orce, J Trentadue, D Ramisch, G Gondolesi
BACKGROUND: We report the case of a 7-year-old girl with intestinal failure owing to a cystic lymphangioma compromising the root of the mesentery, not amenable to resection, leading to intestinal failure. Oncologic treatment was attempted to reduce tumor size with no response; therefore, she was listed for multivisceral transplantation. PROCEDURE: Resection of the tumor required resection of all abdominal organs with vascular inflow and outflow. A multivisceral graft (liver, stomach, duodenum-pancreas and spleen complex, small bowel, and right colon) was implanted...
March 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27109996/aortic-graft-mycotic-pseudoaneurysm-as-a-severe-complication-after-multivisceral-transplantation-a-case-report
#18
J Calvo Pulido, M Manrique Municio, C Loinaz Segurola, I Justo Alonso, O Caso Maestro, A García-Sesma, F Cambra Molero, R San-Juan Garrido, M Abradelo de Usera, A Marcacuzco Quinto, E Moreno González, C Jiménez Romero
BACKGROUND: Surgical complications in multivisceral transplantation (MVT) are frequent and always severe. Those related to technical issues are relevant as they have implications not only on the graft but also on patient survival. The aim of this study was to review our case-based data and experience with 5 MVT performed since December 2004. CASE REPORT: A 38 year-old woman presented with ultra-short bowel syndrome due to massive ischemia also affecting the celiac trunk...
March 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27109985/cytomegalovirus-infection-and-rates-of-antiviral-resistance-following-intestinal-and-multivisceral-transplantation
#19
T Ambrose, L M Sharkey, J Louis-Auguste, C S Rutter, S Duncan, S English, E Gkrania-Klotsas, A Carmichael, J M Woodward, N Russell, D Massey, A Butler, S Middleton
BACKGROUND: Cytomegalovirus (CMV) disease is a common and clinically significant complication following intestinal or multivisceral transplantation. CMV disease is more common in cases of serologic mismatch between donor and recipient. Though in some cases it may be asymptomatic, in the immunosuppressed population it often manifests with evidence of systemic infection or end-organ disease. METHODS: We conducted a retrospective review of all patients undergoing intestinal or multivisceral transplantation over 8 years at our institution...
March 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27109984/intestine-transplantation-across-a-positive-crossmatch-with-preformed-donor-specific-antibodies
#20
R Parekh, M Kazimi, S Skorupski, O Fagoaga, S Jafri, M C Segovia
BACKGROUND: We describe our experience using a modified protocol for immunosuppression for intestine transplantation across a positive crossmatch. Patients who underwent transplantation in 2013 were evaluated over a 12-month period for rejection and infectious events with comparison to procedure-matched controls on our standard protocol of immunosuppression. PATIENTS AND METHODS: We used a modified protocol for intestine and multivisceral transplantation for patients with a positive flow crossmatch...
March 2016: Transplantation Proceedings
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