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Small bowel transplantation

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https://www.readbyqxmd.com/read/27909438/donor-specific-regulatory-t-cells-acquired-from-tolerant-mice-bearing-cardiac-allograft-promote-mixed-chimerism-and-prolong-intestinal-allograft-survival
#1
Xiao-Fei Shen, Jin-Peng Jiang, Jian-Jun Yang, Wei-Zhong Wang, Wen-Xian Guan, Jun-Feng Du
The induction of donor-specific transplant tolerance has always been a central problem for small bowel transplantation (SBT), which is thought to be the best therapy for end-stage bowel failure. With the development of new tolerance-inducing strategies, mixed chimerism induced by co-stimulation blockade has become most potent for tolerance of allografts, such as skin, kidney, and heart. However, a lack of clinically available co-stimulation blockers has hindered efficient application in humans. Furthermore, unlike those for other types of solid organ transplantation, strategies to induce robust mixed chimerism for intestinal allografts have not been fully developed...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27891750/epidemiology-and-outcomes-of-primary-sclerosing-cholangitis-with-and-without-inflammatory-bowel-disease-in-an-australian-cohort
#2
Ken Liu, Ruoxi Wang, Viraj Kariyawasam, Mark Wells, Simone I Strasser, Geoff McCaughan, Crispin Corte, Rupert W Leong
BACKGROUND&AIMS: Epidemiological data on primary sclerosing cholangitis (PSC) outside the Northern hemisphere is limited. Similarly, the impact of inflammatory bowel disease (IBD) on PSC outcomes remains unclear. We aimed to study the epidemiology and outcomes of PSC patients with and without IBD in an Australian cohort. METHODS: We retrospectively studied PSC patients attending two tertiary referral hospitals over 20years. Diagnosis of PSC was made according to international guidelines by positive cholangiography and/or liver biopsy (for small duct PSC) with supporting clinical and laboratory evidence RESULTS: 208 PSC patients (61% male) were studied (2,271patient-years follow-up)...
November 28, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27889929/twenty-eight-years-of-intestinal-transplantation-in-paris-experience-of-the-oldest-european-centre
#3
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/27867410/closed-gastroschisis-vanishing-midgut-and-extreme-short-bowel-syndrome-case-report-and-review-of-the-literature
#4
F A Dennison
Gastroschisis alone has excellent survival rates. Occasionally reported is closed gastroschisis, leading to vanishing small bowel and extreme short bowel syndrome. It is believed that the abdominal wall defect can contract or close in utero, which leads to strangulation of the eviscerated bowel and the rare "vanishing gut syndrome." This has a very poor prognosis with mortality as high as 70%. An 18-year-old primigravid patient's 13 week scan diagnosed a large gastroschisis affecting the fetus. After counselling, she decided to continue with the pregnancy...
August 2016: Ultrasound: Journal of the British Medical Ultrasound Society
https://www.readbyqxmd.com/read/27866474/heme-oxygenase-1-transduced-bone-marrow-mesenchymal-stem-cells-in-reducing-acute-rejection-and-improving-small-bowel-transplantation-outcomes-in-rats
#5
Yang Yang, Hong Li Song, Wen Zhang, Ben Juan Wu, Nan Nan Fu, Chong Dong, Zhong Yang Shen
BACKGROUND: We determined whether bone marrow mesenchymal stem cells (BMMSCs) transduced with heme oxygenase-1 (HO-1), a cytoprotective and immune-protective factor, could improve outcomes for small bowel transplantation (SBTx) in rats. METHODS: We performed heterotopic SBTx from Brown Norway rats to Lewis rats, before infusing Ad/HO-1-transduced BMMSCs (Ad/HO-1/BMMSCs) through the superficial dorsal veins of the penis. Respective infusions with Ad/BMMSCs, BMMSCs, and normal saline served as controls...
November 20, 2016: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/27849440/use-of-cidofovir-for-cytomegalovirus-disease-refractory-to-ganciclovir-in-solid-organ-recipients
#6
Hugo Bonatti, Costi D Sifri, Clara Larcher, Stefan Schneeberger, Camille Kotton, Christian Geltner
BACKGROUND: Solid organ transplantation (SOT) frequently is complicated by cytomegalovirus (CMV) infections. Cidofovir (CDV) is active against CMV, including many ganciclovir (GCV)-resistant mutants, but often is considered to be too nephrotoxic for use after organ transplantation. PATIENTS AND METHODS: Seven males and two females (median age 50.1 years), including two kidney/pancreas, four lung, one small bowel, and two hand recipients, received CDV for refractory CMV disease...
November 16, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27849236/treatment-of-short-bowel-syndrome-in-children-value-of-the-intestinal-rehabilitation-program
#7
Uenis Tannuri, Fabio de Barros, Ana Cristina Aoun Tannuri
The main cause of acute intestinal failure is short bowel syndrome, generally as a result of resection of extensive segments of small intestine. As a result, the main symptoms are watery diarrhea, malabsorption syndrome, chronic malnutrition, and death, if the patient is not properly treated. If the length of the remaining intestine is greater than 30 cm, complete adaptation is possible and the patient may not require parenteral nutrition. The currently recommended treatment includes the use of prolonged parenteral nutrition and enteral nutrition, always aimed at constant weight gain, in conjunction with surgeries aimed at elongating the dilated bowel...
September 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27828601/remote-ischemic-preconditioning-and-tacrolimus-in-the-fetal-small-bowel-transplant-in-mice
#8
Ricardo José Morello, Marcia Kiyomi Koike, Marcos de Souza Abrahão, Karen Ruggeri Saad, Paulo Fernandes Saad, Edna Frasson de Souza Montero
PURPOSE: To evaluate the effect of remote ischemic preconditioning (IPC-R) in the fetal small bowel transplantation model. METHODS: Two groups were constituted: The Isogenic transplant (ISO, C57BL/6 mice, n=24) and the allogenic transplant (ALO, BALB/c mice, n=24). In each group, the animals were distributed with and without IPC-R. It was obtained the following subgroups: Tx, IPC-R, Fk, IPC-Fk, in both strains. Intestinal grafts were stained with hematoxylin and eosin and immunohistochemically...
October 2016: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/27818866/influence-of-repeated-measurements-on-small-bowel-length
#9
Servet Karagul, Cuneyt Kayaalp, Serdar Kirmizi, Ali Tardu, Ismail Ertugrul, Kerem Tolan, Fatih Sumer
PURPOSE: Measurement of small bowel length (SBL) is a common procedure in gastrointestinal surgery. When required, repeated SBL measurements can be done during surgery. Our aim was to evaluate whether these repeated measurements differ in SBL results. METHODS: Small bowel length was measured during laparotomy in 28 patients between ligament of Treitz and caecum, using a standard measure, two times in each patient consecutively by two different surgeons from the anti-mesenteric border of the bowel...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27816208/absent-ileocecal-valve-predicts-the-need-for-repeated-step-in-children
#10
Tomas Wester, Helene Engstrand Lilja, Pernilla Stenström, Mikko Pakarinen
BACKGROUND: Serial transverse enteroplasty facilitates weaning from parenteral support in selected patients with short bowel syndrome, although repeated procedure is frequently required. Our aim was to evaluate the outcome of a series of patients after serial transverse enteroplasty and define predictors of repeated serial transverse enteroplasty and weaning off parenteral support. METHODS: All children who underwent serial transverse enteroplasty at 4 Nordic pediatric surgery centers from 2004-2015 were included in this observational study...
November 3, 2016: Surgery
https://www.readbyqxmd.com/read/27782890/pediatric-small-bowel-transplantation-a-single-center-experience-from-turkey
#11
Cem Tuğmen, Maşallah Baran, İsmail Sert, Ayşe Berna Anıl, Eyüp Kebapçı, Sait Murat Doğan, Selçuk Kılınç, Gaye Aydın, Ayşe Gülden Diniz, Mustafa Ölmez, İbrahim Pirim, Cezmi Karaca
BACKGROUND/AIMS: Small bowel transplantation (SBTx) is a treatment option for patients with serious parenteral nutrition-related problems in intestinal failure. İzmir Tepecik Training Research Hospital Organ Transplantation Center is still the only pediatric intestinal transplant center in Turkey. MATERIAL AND METHODS: This study was approved by the local ethics committee. Patients' data were analyzed from the medical charts and the hospital digital database. Seven isolated SBTxs were performed in six children between 2010 and 2016...
September 2016: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/27742300/n-acetylcysteine-use-in-hepatic-ischemia-reperfusion-in-rats-minimizing-bowel-injury
#12
S H Lauz Medeiros, A de Oliveira Menezes, L Zogbi, E Frasson de Souza Montero
BACKGROUND: The ischemia/reperfusion (I/R) phenomenon can cause the dysfunction of some transplanted organs and other distant organs. Liver surgery success, including transplantations, may depend on the adverse effects of intestinal mucosa injury arising from temporary porta triad occlusion. The study objective was to examine I/R liver effects on the small intestine in rats after N-acetylcysteine (NAC) treatment. METHODS: Twenty-four male Wistar rats were randomly divided into 2 groups...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27722100/toxoplasmosis-in-organ-transplant-recipients-evaluation-implication-and-prevention
#13
Sumeeta Khurana, Nitya Batra
Toxoplasmosis in organ transplant patients can be a result of donor-transmitted infection, or reactivation of latent infection, or de novo infection. Solid organ transplants including heart, liver, kidney, pancreas and small bowel, and hematogenous stem cell transplants have been implicated in the risk of acquiring infection. In contrast to a benign course in immunocompetent individuals, the spectrum of illness is severe in transplant recipients. Clinical manifestations usually occur within the first 3 months of transplant and may present as encephalitis, pneumonitis, chorioretinitis, meningitis, and disseminated toxoplasmosis with multi-organ involvement...
July 2016: Tropical Parasitology
https://www.readbyqxmd.com/read/27623481/predictors-of-persistent-diarrhea-in-norovirus-enteritis-after-solid-organ-transplantation
#14
Pearlie P Chong, David van Duin, Jessica L Sonderup, Wendy J Grant, Andre C Kalil, Diana F Florescu
Solid organ transplant (SOT) recipients may develop protracted diarrheal illness from norovirus. We performed a retrospective chart review between January 2010 and April 2014 to identify predictors of persistent diarrhea in transplant recipients with norovirus enteritis. A total of 152 SOT recipients with mean age of 31.5 years (SD 23.1) were included: 43.4% male, 34.2% pediatric patients. Allograft types were abdominal 136 (89.5%) (kidney [39.5%], liver-small bowel [23%], other [27%]) and thoracic 16 (10...
October 6, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27582783/emergency-abdominal-surgery-after-solid-organ-transplantation-a-systematic-review
#15
REVIEW
Nicola de'Angelis, Francesco Esposito, Riccardo Memeo, Vincenzo Lizzi, Aleix Martìnez-Pérez, Filippo Landi, Pietro Genova, Fausto Catena, Francesco Brunetti, Daniel Azoulay
AIMS: Due to the increasing number of solid organs transplantations, emergency abdominal surgery in transplanted patients is becoming a relevant challenge for the general surgeon. The aim of this systematic review of the literature is to analyze morbidity and mortality of emergency abdominal surgery performed in transplanted patients for graft-unrelated surgical problems. METHODS: The literature search was performed on online databases with the time limit 1990-2015...
2016: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/27582272/allograft-biopsy-findings-in-patients-with-small-bowel-transplantation
#16
Jamie Koo, David W Dawson, Sarah Dry, Samuel W French, Bita V Naini, Hanlin L Wang
In this study, we sought to determine the incidence of posttransplant complications including acute cellular rejection (ACR), infection, and posttransplant lymphoproliferative disease (PTLD) in mucosal allograft biopsies in patients with small bowel transplant at our institution. We retrospectively reviewed pathology reports from 5675 small bowel allograft biopsies from 99 patients and analyzed the following: indications for biopsy, frequency and grade of ACR, presence of infectious agents, results of work-up for potential PTLD, results of C4d immunohistochemistry (IHC), features of chronic mucosal injury, and findings in concurrent native bowel biopsies...
September 1, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27580384/fecal-microbiota-transplantation-is-safe-and-efficacious-for-recurrent-or-refractory-clostridium-difficile-infection-in-patients-with-inflammatory-bowel-disease
#17
Monika Fischer, Dina Kao, Colleen Kelly, Aishwarya Kuchipudi, Syed-Mohammed Jafri, Mark Blumenkehl, Douglas Rex, Mark Mellow, Nirmal Kaur, Harry Sokol, Gwen Cook, Matthew J Hamilton, Emmalee Phelps, Brian Sipe, Huiping Xu, Jessica R Allegretti
BACKGROUND: New treatments are needed as Clostridium difficile infection (CDI) is becoming increasingly formidable. Fecal microbiota transplantation (FMT) has a 90% success rate in the treatment of recurrent CDI. However, evidence regarding its safety, efficacy, and effect on disease activity in patients with inflammatory bowel disease (IBD) is lacking. METHODS: This cohort study used data from 8 national and international academic centers. Patients with established IBD who underwent FMT for recurrent CDI were followed for a minimum of 3 months...
October 2016: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/27565072/harvest-tissue-source-does-not-alter-the-protective-power-of-stromal-cell-therapy-after-intestinal-ischemia-and-reperfusion-injury
#18
Amanda R Jensen, Morenci M Manning, Sina Khaneki, Natalie A Drucker, Troy A Markel
BACKGROUND: Transplantation of mesenchymal stromal cells (MSCs) may be a novel treatment for intestinal ischemia. The optimal stromal cell source that could yield maximal protection after injury, however, has not been identified. We hypothesized that (1) MSCs would increase survival and mesenteric perfusion, preserve intestinal histologic architecture, and limit inflammation after intestinal ischemia and reperfusion (I/R) injury, and (2) MSCs harvested from different sources of tissue would have equivalent protective properties to the intestine after I/R inury...
August 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27543980/edta-treatment-of-serum-unmasks-complement-mediated-prozone-inhibition-in-human-leukocyte-antigen-antibody-testing
#19
Waseem Q Anani, Adriana Zeevi, John G Lunz
OBJECTIVES: Luminex-based single-antigen bead human leukocyte antigen (HLA) antibody testing is widely used to define HLA antibodies for transplant compatibility. False-negative results can occur with complement-mediated prozone inhibition. This study assessed the effect of EDTA on the assay background reactivity and fluctuations in antibody mean fluorescent intensity. METHODS: Serum specimens were retrospectively tested using Luminex-based single-antigen beads with and without EDTA...
September 2016: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/27479158/cyclooxygenase-inhibitors-as-a-new-therapeutic-strategy-in-small-bowel-transplantation
#20
Frank A Schildberg, Bin Liu, Mamdouh Afify, Julia Steitz, Pascal Paschenda, Nico Schäfer, Jörg C Kalff, Thomas Minor, René H Tolba
BACKGROUND: The long-term outcome of intestinal transplantations is still not favorable, which is partly due to the intestinal susceptibility to ischemia. There are several indications that the inflammatory response to ischemia-reperfusion injury is mediated by cyclooxygenases and that their inhibition may be associated with improved organ function. The aim of this study was to analyze if COX inhibitors could improve the early posttransplant outcome after orthotopic small bowel transplantation (SBTx)...
July 29, 2016: Transplantation
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