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Primary graft dysfunction

Marcos Vinícius Zanchet, Larissa Luvison Gomes da Silva, Jorge Eduardo Fouto Matias, Júlio Cezar Uili Coelho
Background: The outcome of the patients after liver transplant is complex and to characterize the risk for complications is not always easy. In this context, the hepatic post-reperfusion biopsy is capable of portraying alterations of prognostic importance. Aim: To compare the results of liver transplantation, correlating the different histologic features of the hepatic post-reperfusion biopsy with graft dysfunction, primary non-function and patient survival in the first year after transplantation...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Seung-Ah Lee, Yeonyee E Yoon, Jung-Eun Kim, Jin Joo Park, Il-Young Oh, Chang-Hwan Yoon, Jung-Won Suh, Jun-Sung Kim, Eun Ju Chun, Young-Suk Cho, Tae-Jin Youn, Cheong Lim, Goo-Young Cho, In-Ho Chae, Kay-Hyun Park, Dong-Ju Choi, Sang Il Choi
The value of late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI) for the prediction of functional recovery after surgical revascularization has been previously established. However, the impact of LGE-MRI on the long-term prognosis after coronary artery bypass grafting (CABG) remains incompletely understood. Therefore, we aimed to evaluate the long-term prognostic value of LGE-MRI, based on the presence or absence of left ventricular (LV) dysfunction, in patients with coronary artery disease undergoing CABG...
August 30, 2016: American Journal of Cardiology
M E Gámez Córdoba, B Sánchez Pérez, J Santoyo Santoyo, J L Fernández Aguilar, M A Suárez Muñoz, J A Pérez Daga, F J León Díaz, C Montiel Casado
BACKGROUND: The Andalusian community has a specific management model of liver transplantation with a common waiting list, forcing transportation of 45% of hepatic grafts. These trips within the community have been made exclusively via expressway since 2012, sometimes surpassing 400 km in distance. The objective of this study was to analyze the effect of graft transportation on our community regarding postoperative results, primary dysfunction, and short-term graft survival. METHODS: This was a retrospective observational cohort study that included 110 patients recipients of liver transplants from 2009 to 2012...
September 2016: Transplantation Proceedings
J H Kang, B H Choi, K M Moon, Y M Park, K H Yang, J H Ryu, C W Chu
It is well known that the quality of organs retrieved from brain-dead donors (DBDs) is better than those retrieved from circulatory death donors. However, in situations of organ retrieval from marginal DBDs, who are unstable despite intensive care, transplantation outcomes are not good. Organ ischemia is the most important determining factor in decreased organ quality in circulatory death donors and in some DBDs. Extracorporeal membrane oxygenation (ECMO) for management of DBDs can be an emergency countermeasure...
September 2016: Transplantation Proceedings
Panagiotis M Kitrou, Stavros Spiliopoulos, Panagiotis Papadimatos, Nicolaos Christeas, Theodoros Petsas, Konstantinos Katsanos, Dimitris Karnabatidis
PURPOSE: To investigate the safety and effectiveness of lutonix paclitaxel-coated balloon (PCB) for the treatment of dysfunctional dialysis access. MATERIALS AND METHODS: This was a single-center, single-arm, retrospective analysis of 39 patients (23 male, 59 %) undergoing 61 interventions using 69 PCBs in a 20-month period. There was a balance between arteriovenous fistulae (AVF) and grafts (AVG) (20 AVFs, 19AVGs), and the majority of lesions were restenotic (25/39, 64...
October 14, 2016: Cardiovascular and Interventional Radiology
A A Abbas, J M Diamond, C Chehoud, B Chang, J J Kotzin, J C Young, I Imai, A R Haas, E Cantu, D J Lederer, K Meyer, R K Milewski, K M Olthoff, A Shaked, J D Christie, F D Bushman, R G Collman
Primary graft dysfunction (PGD) is a principal cause of early morbidity and mortality after lung transplantation, but its pathogenic mechanisms are not fully clarified. Thus far, studies using standard clinical assays have not linked microbial factors to PGD. We previously used comprehensive metagenomic methods to characterize viruses in lung allografts >1 month post-transplant and found that levels of Anellovirus, mainly Torque teno viruses (TTV), were significantly higher than in non-transplant healthy controls...
October 12, 2016: American Journal of Transplantation
V Gómez-Dos Santos, V Díez-Nicolás, L Martínez-Arcos, J J Fabuel-Alcañiz, I Laso-García, S Álvarez-Rodríguez, F de Asís Donis-Canet, V Hevia-Palacios, M Ruiz-Hernández, F J Burgos-Revilla
: Mayor urological complications, fistulae and stenosis, mainly affect the vesicoureteral anastomosis and present in the early post-transplant period. The systematic use of ureteral catheters keeps selecbeing controversial with many groups using them only selectively depending on the existence of pretransplant or intraoperative risk factors. METHODS: We performed a bibliographic review through automatized search in the Medline bibliographic database, as the main bibliographic source, and also in Clinical Key...
October 2016: Archivos Españoles de Urología
Dipesh K Shah, Salil V Deo, Andrew D Althouse, Jeffery J Teuteberg, Soon J Park, Robert L Kormos, Harold M Burkhart, Victor O Morell
BACKGROUND: Adults with congenital heart disease may present with end-stage heart failure necessitating orthotopic heart transplant (OHT). We sought to review the United Network for Organ Sharing (UNOS) experience with this unique cohort focusing on surgical outcomes and survival. METHODS: From the UNOS registry, 737 adult congenital heart disease recipients (ACHDR) out of 26,993 OHT patients (2.7%) who underwent OHT were studied to analyze early and late outcomes and compared to non-congenital recipients (NCR) over a 15-year period (2000-2014)...
October 5, 2016: Journal of Cardiac Surgery
Mohamed Zeriouh, Anton Sabashnikov, Prashant N Mohite, Bartlomiej Zych, Nikhil P Patil, Diana García-Sáez, Achim Koch, Alexander Weymann, Simona Soresi, Jens Wippermann, Thorsten Wahlers, Fabio De Robertis, Aron-Frederik Popov, André R Simon
OBJECTIVE: Zonal organ allocation system comprises organ procurement by teams within a specific geographical area of each retrieval team. Therefore, in a substantial number of cases organs are retrieved by 'foreign' teams and are sent for transplantation to the implanting centre. The aim of this study was to assess the impact of zonal organ allocation system on early- and long-term outcomes after lung transplantation (LTx). METHODS: Included were 331 consecutive patients who underwent LTx performed at Harefield Hospital between January 2007 and January 2015...
October 2, 2016: European Journal of Cardio-thoracic Surgery
Thibault Voron, Morgan Anyla, Helene Corte, Eric Roland, Nicolas Munoz-Bongrand, Emile Sarfati, Pierre Cattan, Mircea Chirica
OBJECTIVE: The study purpose was to report the indications, technical aspects, and outcomes of cervicosternolaparotomy during revision surgery after esophageal reconstruction for caustic injuries. METHODS: Patients who underwent cervicosternolaparotomy during revision surgery for graft dysfunction between 1999 and 2015 were included. Cervicosternolaparotomy was performed to mobilize and pull up the primary conduit during surgery for strictures (rescue cervicosternolaparotomy) or to allow retrosternal access for management of other graft-related complications (exposure cervicosternolaparotomy)...
November 2016: Journal of Thoracic and Cardiovascular Surgery
Garry R Thomas, Michael A McDonald, Jennifer Day, Heather J Ross, Diego H Delgado, Filio Billia, Jagdish W Butany, Vivek Rao, Eitan Amir, Philippe L Bedard, Paaladinesh Thavendiranathan
Anthracycline-induced cardiomyopathy (AIC) may progress to end-stage heart failure requiring mechanical circulatory support or orthotopic heart transplantation (OHT). Previous studies have described important clinical differences between AIC and nonischemic cardiomyopathy (NIC) cohorts requiring these advanced interventions. Therefore, we sought to extend this literature by comparing echocardiographic parameters, treatment strategies, and the prognosis between matched patients from these cohorts. This is a retrospective matched cohort study...
August 23, 2016: American Journal of Cardiology
Barbara Geeroms, Wim Laleman, Annouschka Laenen, Sam Heye, Chris Verslype, Schalk van der Merwe, Frederik Nevens, Geert Maleux
PURPOSE: To retrospectively analyse long-term patency and overall survival of cirrhotic patients treated with TIPSS using e-PTFE-covered stents. Additionally, prognostic factors for better patency and survival were analysed. MATERIALS AND METHODS: Two hundred and eighty-five consecutive cirrhotic patients with severe portal hypertension-related symptoms were included. Follow-up, including clinical assessment and duplex ultrasound, was analysed up to end of study, patient's death, liver transplantation or TIPSS-reduction...
September 15, 2016: European Radiology
Anne Olland, Jérémie Reeb, Marc Puyraveau, Sandrine Hirschi, Joseph Seitlinger, Nicola Santelmo, Olivier Collange, Paul-Michel Mertes, Romain Kessler, Pierre-Emmanuel Falcoz, Gilbert Massard
BACKGROUND: After lung transplantation, bronchial complications are one of the major concerns for surgeons and physicians. In the era of evolving immunosuppressive regimens and surgical approaches, we have reassessed risk factors for bronchial complications after lung transplantation. METHODS: We undertook a retrospective study of all consecutive lung transplantations performed at a single center from 2004 to 2014. We monitored the incidence of symptomatic bronchial complications...
August 17, 2016: Journal of Heart and Lung Transplantation
Cécile Picard, Guillaume Thouvenin, Caroline Kannengiesser, Jean-Christophe Dubus, Nadia Jeremiah, Frédéric Rieux-Laucat, Bruno Crestani, Alexandre Belot, Françoise Thivolet-Béjui, Véronique Secq, Christelle Ménard, Martine Reynaud-Gaubert, Philippe Reix
We report three cases of pulmonary disease suggesting fibrosis in two familial and one sporadic case. Pulmonary symptoms were associated with various clinical features of systemic inflammation and vasculitis involving the skin, and appeared at different ages. A strong interferon signature was found in all three cases. Disease was not responsive to corticosteroids, and lung transplantation was considered for all three subjects at an early age. One of them underwent double-lung transplantation, but she immediately experienced a primary graft dysfunction and died soon after...
September 2016: Chest
Hilary F Armstrong, David J Lederer, Matthew Bacchetta, Matthew N Bartels
BACKGROUND: Adults with primary graft dysfunction (PGD) after lung transplantation are at increased risk for pulmonary and functional impairment. No prior studies have described the long-term (within 1.5 years of transplant) cardiopulmonary exercise testing (CPET) results in adults with grade 3 PGD. The objective of this study was to compare the functional outcomes of lung transplant patients with and without grade 3 PGD via CPET and six-minute talk tests (6MWD). METHODS: 243 adults underwent lung transplantation between 2003 and 2010, 128 (53%) of whom underwent CPET and 6MWD within 12-18 months of transplantation...
September 1, 2016: Heart & Lung: the Journal of Critical Care
Jun Zhai, Guidong Yao, Fangli Dong, Zhiqin Bu, Yuan Cheng, Yorino Sato, Linli Hu, Yingying Zhang, Jingyuan Wang, Shanjun Dai, Jing Li, Jing Sun, Aaron J Hsueh, Kazuhiro Kawamura, Yingpu Sun
CONTEXT: Recently, two Primary ovarian insufficiency (POI) patients delivered healthy babies after IVA (In Vitro Activation) treatment followed by auto-transplantation of frozen-thawed ovarian tissues. OBJECTIVE: To report the first case of live birth after IVA treatment following fresh ovarian tissue grafting in POI patients, together with monitoring of follicle development and serum hormonal changes. DESIGN: Prospective observational cohort study...
August 29, 2016: Journal of Clinical Endocrinology and Metabolism
R A Quintana-Quezada, I Rajapreyar, A Postalian-Yrausquin, Y C Yeh, S Choi, B Akkanti, A Sieg, P Weeks, M Patel, J Patel, S Nathan, B Kar, P Loyalka, I Gregoric
BACKGROUND: Primary graft dysfunction (PGD) is a frequent complication after cardiac transplantation and remains one of the leading causes of mortality in these patients. The objective of this case-control study is to identify donor and surgical procedure's factors associated with PGD, and further guide possible strategies to prevent PGD. METHODS: Retrospective analysis of the medical records of patients who underwent cardiac transplantation at Memorial Hermann Hospital at Texas Medical Center between October 2012 and February 2015...
July 2016: Transplantation Proceedings
Kelvin Henrique Vilalva, Fabrícia Teixeira Mumic, Marina Rodrigues Garcia Silveira, Enio David Mente, Paulo Roberto Barbosa Evora, Orlando Castro E Silva
A 57-year-old female patient received elective liver transplant due to nonalcoholic steatohepatitis complicated by hepatocellular carcinoma. Her preoperative Model for End-Stage Liver Disease score was 11. The total transplant ischemic time was 10 hours and 35 minutes, and the warm ischemic time was 35 minutes. Even with aggressive fluid overload and use of high concentrations of vasoactive amines, the patient developed possible primary graft dysfunction with poor response to fluids and vasopressor support, suggesting vasoplegic syndrome...
August 24, 2016: Experimental and Clinical Transplantation
Isabel Roberti, Shefali Vyas
IMN contribute to ESRD in 13% children with renal transplant (txp). Recurrent or de novo IMN can cause graft dysfunction and/or failure, but the details regarding incidence, therapy, and outcome remain poorly understood. Retrospective single-center study of all pediatric kidney txp was carried out since 1998. Clinical presentation, pathology, therapy, and graft outcomes of children with recurrent or de novo IMN were reviewed. IMN was the primary etiology of ESRD in 28 of the 149 txp recipients. Eleven children had biopsy-proven post-txp IMN-six were recurrent and five had de novo...
August 25, 2016: Pediatric Transplantation
Renato Braulio, Marcelo Dias Sanches, Antonio Lúcio Teixeira Junior, Paulo Henrique Nogueira Costa, Maria da Consolação Vieira Moreira, Monaliza Angela Rocha, Silvio Amadeu de Andrade, Cláudio Léo Gelape
INTRODUCTION: Primary graft dysfunction is a major cause of mortality after heart transplantation. OBJECTIVE: To evaluate correlations between donor-related clinical/biochemical markers and the occurrence of primary graft dysfunction/clinical outcomes of recipients within 30 days of transplant. METHODS: The prospective study involved 43 donor/recipient pairs. Data collected from donors included demographic and echocardiographic information, noradrenaline administration rates and concentrations of soluble tumor necrosis factor receptors (sTNFR1 and sTNFR2), interleukins (IL-6 and IL-10), monocyte chemoattractant protein-1, C-reactive protein and cardiac troponin I...
April 2016: Brazilian Journal of Cardiovascular Surgery
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