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Small bowel transplantation

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https://www.readbyqxmd.com/read/28168199/safety-and-efficacy-of-small-bowel-examination-by-capsule-endoscopy-for-patients-before-liver-transplantation
#1
Kawano Seiji, Takaki Akinobu, Iwamuro Masaya, Yasunaka Tetsuya, Kono Yoshiyasu, Miura Kou, Inokuchi Toshihiro, Kawahara Yoshiro, Umeda Yuzo, Yagi Takahito, Okada Hiroyuki
Background and Aims. Gastrointestinal surveillance is a requirement prior to liver transplantation (LT), but small intestine examination is not generally undertaken. The aim of the present study was to evaluate the safety and efficacy of capsule endoscopy (CE) for patients with end-stage liver disease. Methods. 31 patients who needed LT were enrolled, and 139 patients who underwent CE over the same period of time acted as controls. Results. Frequency of successful achievement of evaluation of the full length of the small bowel, the mean gastric transit time, and the mean small bowel transit time were not significantly different between the two groups...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28159115/william-hunter-harridge-lecture-the-changing-face-of-short-gut-syndrome-management
#2
REVIEW
John J Fung
The evolution of managing short gut syndrome optimizes management and decision making of intestinal failure by way of a multidisciplinary team utilizing the latest advances in therapeutic options. Only the minority of patients referred for small bowel transplantation will actually need a transplant. Many of these patients can be rehabilitated without the need for transplant, by way of early referral, and thus the likelihood of medical therapy increases. On the other hand, in those patients with little likelihood of success with medical therapy, early referral decreases the morbidity and mortality associated with long-term total parenteral nutrition and associated complications and will improve their overall survival outcomes...
January 25, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28147371/crohn-s-disease-and-intestinal-transplantation
#3
Pavel Drastich, Martin Oliverius
BACKGROUND: Most patients with Crohn's disease (CD) require one or more operations during their lifetime. Repeated resections and surgical complications may result in short gut in a subset of patients, typically those with extensive small bowel disease or a penetrating CD phenotype. The effects of short bowel syndrome (SBS) can range in seriousness from mild to life-threatening advanced intestinal failure. Worldwide, CD is the second leading indication for intestinal transplantation (ITx) in SBS, but the overall incidence of ITx is quite low...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/28139856/epidemiological-investigation-of-candida-species-causing-bloodstream-infection-in-paediatric-small-bowel-transplant-recipients
#4
Mallory J Suhr, João Carlos Gomes-Neto, Nabaraj Banjara, Diana F Florescu, David F Mercer, Peter C Iwen, Heather E Hallen-Adams
Small bowel transplantation (SBT) can be a life-saving medical procedure. However, these recipients experience high risk of bloodstream infections caused by Candida. This research aims to characterise the SBT recipient gut microbiota over time following transplantation and investigate the epidemiology of candidaemia in seven paediatric patients. Candida species from the recipients' ileum and bloodstream were identified by internal transcribed spacer sequence and distinguished to strain by multilocus sequence typing and randomly amplified polymorphic DNA...
January 31, 2017: Mycoses
https://www.readbyqxmd.com/read/28134688/progress-with-treating-the-microbial-dysbiosis-associated-with-irritable-bowel-syndrome
#5
James S Pearson, Peter J Whorwell
PURPOSE OF REVIEW: Microbial dysbiosis is receiving increasing attention as possibly being important in the pathophysiology of irritable bowel syndrome. This review will summarize the most recent literature addressing attempts to explore and target the microbiome in patients with irritable bowel syndrome. RECENT FINDINGS: Manipulation of the intestinal microbiota in irritable bowel syndrome is receiving increasing attention. Traditionally, dietary manipulation has been utilized...
January 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28130374/current-status-of-intestinal-and-multivisceral-transplantation
#6
REVIEW
Shishira Bharadwaj, Parul Tandon, Tushar D Gohel, Jill Brown, Ezra Steiger, Donald F Kirby, Ajai Khanna, Kareem Abu-Elmagd
Clinical-nutritional autonomy is the ultimate goal of patients with intestinal failure (IF). Traditionally, patients with IF have been relegated to lifelong parenteral nutrition (PN) once surgical and medical rehabilitation attempts at intestinal adaptation have failed. Over the past two decades, however, outcome improvements in intestinal transplantation have added another dimension to the therapeutic armamentarium in the field of gut rehabilitation. This has become possible through relentless efforts in the standardization of surgical techniques, advancements in immunosuppressive therapies and induction protocols and improvement in postoperative patient care...
January 26, 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28122648/microbiota-transfer-therapy-alters-gut-ecosystem-and-improves-gastrointestinal-and-autism-symptoms-an-open-label-study
#7
Dae-Wook Kang, James B Adams, Ann C Gregory, Thomas Borody, Lauren Chittick, Alessio Fasano, Alexander Khoruts, Elizabeth Geis, Juan Maldonado, Sharon McDonough-Means, Elena L Pollard, Simon Roux, Michael J Sadowsky, Karen Schwarzberg Lipson, Matthew B Sullivan, J Gregory Caporaso, Rosa Krajmalnik-Brown
BACKGROUND: Autism spectrum disorders (ASD) are complex neurobiological disorders that impair social interactions and communication and lead to restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. The causes of these disorders remain poorly understood, but gut microbiota, the 10(13) bacteria in the human intestines, have been implicated because children with ASD often suffer gastrointestinal (GI) problems that correlate with ASD severity. Several previous studies have reported abnormal gut bacteria in children with ASD...
January 23, 2017: Microbiome
https://www.readbyqxmd.com/read/28109015/a-single-centre-experience-of-roux-en-y-enteric-drainage-for-pancreas-transplantation
#8
Irum Amin, Andrew J Butler, Gail Defries, Neil K Russell, Simon J F Harper, Asif Jah, Kourosh Saeb-Parsy, Gavin J Pettigrew, Christopher J E Watson
Exocrine drainage following pancreas transplantation can be achieved by drainage into the bladder or bowel, the latter typically by direct duodeno-jejunostomy; the use of Roux-en-Y enteric drainage is uncommon. We report a retrospective analysis of a single centre experience of Roux-en-Y enteric drainage following pancreas transplantation. Over a 14-year period (2001- 2015), 204 consecutive adult pancreas transplants were performed (96.6% simultaneous pancreas and kidney transplants), of which 26.0% were from donors after circulatory death (DCD)...
January 21, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28104934/an-unusual-sigmoid-phytobezoar-in-a-patient-with-a-transplanted-kidney-a-case-report
#9
Paola Milillo, Angelo Pio Moffa, Vincenzo Bertozzi, Roberta Vinci, Luca Macarini
Bezoars are masses formed by the concretion of stomach contents or debris within the gastrointestinal tract. Bezoars are rare and account for only 0.4-4% of all cases of gastrointestinal obstruction and mainly occur in the stomach or small intestine. Intestinal obstruction caused by colonic bezoars is extremely rare. A 39-year-old man with a transplanted kidney came to the hospital because of abdominal pain, constipation, and distension. We performed an abdominal computed tomography scan and found an ovoid intraluminal mass with a mottled gas pattern in the distal sigmoid colon...
October 2016: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28104139/a-renal-paratransplant-hernia-causing-complete-small-bowel-obstruction-a-case-report-and-review-of-the-literature
#10
T Zingg, H Teixeira Farinha, N Demartines, M Pascual, M Matter
A rare type of acquired internal hernia, the renal paratransplant hernia (RPTH), of which only 11 cases have been reported in the literature so far, can follow renal transplantation. We report a patient who presented with acute abdominal pain and vomiting 6 weeks after renal transplantation in the right iliac fossa. A noncontrast abdominal computed tomography scan showed signs of small bowel obstruction. The patient was taken to the operating room for a midline laparotomy, and RPTH with incarcerated small bowel was diagnosed...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104121/liver-failure-from-ultra-short-bowel-syndrome-on-the-intestinal-transplant-waiting-list-a-retrospective-study
#11
Y Noguchi, T Ueno, R Matsuura, T Kodama, K Deguchi, S Umeda, T Yamamichi, K Nakahata, M Zenitani, Y Takama, H Yamanaka, Y Tazuke, H Okuyama
BACKGROUND: Patients with intestinal failure (IF) are candidates for intestinal transplantation (ITx). In Japan, these patients have few opportunities to undergo cadaveric ITx because of low rates of organ donation. The donor criteria and recipient priority for ITx are still unknown. We reviewed our cases of IF to investigate which patients should be prioritized for ITx. METHODS: Patients with IF who were registered as candidates for cadaveric ITx between January 2010 and November 2015 in our institute were included in this retrospective study...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28067296/gut-microbiota-mediates-protection-against-enteropathy-induced-by-indomethacin
#12
Xue Xiao, Geicho Nakatsu, Ye Jin, Sunny Wong, Jun Yu, James Y W Lau
Non-steroidal anti-inflammatory drugs (NSAIDs) can cause significant small bowel injuries. The role of gut microbiota in this NSAID-induced enteropathy is poorly understood. We studied the dynamic changes in gut microbiota following indomethacin administration in mice, and investigated the effects of these adaptive changes on subsequent NSAID-induced enteropathy. The changes in gut microbiota were studied using 16S rRNA sequencing, and the effects of such changes were investigated using antibiotics and a faecal transplantation model...
January 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28062420/jejunal-perforation-an-unusual-presentation-of-metastatic-cutaneous-squamous-cell-carcinoma-scc-in-an-immunosuppressed-patient
#13
N Hitchen, D Warnapala, R M Fisher, J Dua, P Pratsou, A Freebairn
We report the rare occurrence of a small bowel perforation secondary to a metastatic cutaneous squamous cell carcinoma (cSCC). A 70-year-old woman, who had previously undergone renal transplantation, presented with severe, sudden-onset abdominal pain. She was peritonitic on initial examination, with evidence of free intra-abdominal air on radiographic imaging. During an exploratory laparotomy, she was found to have a perforated jejunum secondary to disseminated metastases seen throughout her peritoneum. Following histopathological analysis, as well as further imaging studies, the primary malignancy was eventually identified as a cSCC on her upper back...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28052307/ultrashort-bowel-syndrome-outcome-in-children-treated-in-a-multidisciplinary-intestinal-rehabilitation-unit
#14
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...
February 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28039510/surgical-strategies-in-short-bowel-syndrome
#15
REVIEW
Michael E Höllwarth
Extensive loss of small bowel in all age groups has significant morbidity and mortality consequences. Despite the astonishing ability of the small bowel to compensate for an extensive loss, long-term parenteral nutrition and enteral nutrition, tailored to the need of the patients in relation to the missing intestinal regions is needed. Organ-preserving surgical intervention becomes necessary in patients with a very short intestinal transit time and in an other group of patients with impaired propulsive peristalsis...
December 30, 2016: Pediatric Surgery International
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
#16
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
#17
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
#18
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
#19
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
#20
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
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