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Transplant Surgery

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https://www.readbyqxmd.com/read/28817752/technical-refinements-and-outcomes-of-the-modified-anterior-septal-transplant
#1
Myriam Loyo, Jeffrey D Markey, Deniz Gerecci, Edward El Rassi, Ryan J Li, C Blake Sullivan, Tom D Wang
Importance: Severe anterior septal deviation and resultant nasal obstruction represent a difficult surgical task to correct. The goal of surgery is to straighten the anterior dorsal and caudal struts, while maintaining nasal tip and midvault support. This study presents a novel extracorporeal septoplasty technique to straighten the crooked anterior septum. Objective: To describe the novel anterior septal transplant technique, which consists of complete resection of the caudal septum and reconstruction with extended spreader grafts and a columellar strut, without a separate caudal septal replacement graft...
August 17, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28816969/immediate-breast-reconstruction-with-omental-flap-for-luminal-breast-cancer-patients-ten-clinical-case-reports
#2
Nanlin Li, Zhao Zheng, Jipeng Li, Jing Fan, Ting Wang, Juliang Zhang, Hui Wang, Jianghao Chen, Yonggang Lv, Jun Yi, Meiling Huang, Rui Ling
RATIONALE: Luminal subtype breast cancer, accounting for 70 to 80% of all breast cancers, has been reported to be associated with good prognosis. However, for the patients with large mass or worse mass position, omental flap transplantation may provide a new option for breast reconstruction. PATIENT CONCERNS: Ten patients (6 luminal B1, 2 luminal B2, 2 luminal A), were enrolled into the study, between January 23, 2015 and August 22, 2016. The mean age was 34.6 ± 6...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28810564/clinical-efficacy-of-conjunctival-flap-surgery-in-the-treatment-of-refractory-fungal-keratitis
#3
Honorine Nizeyimana, Dan-Dan Zhou, Xiu-Fen Liu, Xiao-Tao Pan, Cong Liu, Cheng-Wei Lu, Ji-Long Hao
The aim of the present study was to investigate the use and effectiveness of a selective, partial, pedunculated (tongue-shaped) conjunctival flap (CF) for the treatment of refractory fungal keratitis (FK) with or without perforation. A total of 31 cases of corneal diseases treated by CF surgery between April 2014 and October 2015 were evaluated. Among the 31 cases, 16 cases (male:female, 11:5) with FK were selected. Logistic regression analysis was used to investigate factors associated with complications of CF surgery...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28808947/the-sydney-heart-bank-improving-translational-research-while-eliminating-or-reducing-the-use-of-animal-models-of-human-heart-disease
#4
REVIEW
C G Dos Remedios, S P Lal, A Li, J McNamara, A Keogh, P S Macdonald, R Cooke, E Ehler, R Knöll, S B Marston, J Stelzer, H Granzier, C Bezzina, S van Dijk, F De Man, G J M Stienen, J Odeberg, F Pontén, W Linke, J van der Velden
The Sydney Heart Bank (SHB) is one of the largest human heart tissue banks in existence. Its mission is to provide high-quality human heart tissue for research into the molecular basis of human heart failure by working collaboratively with experts in this field. We argue that, by comparing tissues from failing human hearts with age-matched non-failing healthy donor hearts, the results will be more relevant than research using animal models, particularly if their physiology is very different from humans. Tissue from heart surgery must generally be used soon after collection or it significantly deteriorates...
August 14, 2017: Biophysical Reviews
https://www.readbyqxmd.com/read/28808225/congestive-preconditioning-by-portal-venous-clamping-a-novel-preventive-concept-for-small-intestinal-congestive-re-outflow-injury
#5
Hironori Hayashi, Hiroyuki Takamura, Ryosuke Gabata, Yoshinao Ohbatake, Shinichi Nakanuma, Tomoharu Miyashita, Hidehiro Tajima, Itasu Ninomiya, Sachio Fushida, Tetsuo Ohta
BACKGROUND Congestion of the small intestine, which induces mucosal damage via apoptosis, is a common pathophysiological change in hepato-biliary-pancreatic surgery, including liver transplantation. Small intestinal mucosal damage can trigger postoperative complications via various pathways. Therefore, we investigated the efficacy of intermittent portal venous clamping, which we named congestive preconditioning (CPC), for decreasing congestive re-outflow injury (CRoI) of the small intestine. MATERIAL AND METHODS Small intestinal CRoI was induced in rats by clamping the portal vein (PV) for 30 min, followed by re-outflow...
August 15, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28806822/-multiple-myeloma-current-status-in-diagnostic-testing-and-therapy
#6
Michael Kehrer, Sebastian Koob, Andreas Strauss, Dieter Christian Wirtz, Jan Schmolders
Background Multiple myeloma is a haematological blood cancer of the bone marrow and is classified by the World Health Organisation (WHO) as a plasma cell neoplasm. In multiple myeloma, normal plasma cells transform into malignant myeloma cells and produce large quantities of an abnormal immunoglobulin called monoclonal protein or M protein. This ultimately causes multiple myeloma symptoms such as bone damage or kidney problems. The annual worldwide incidence of multiple myeloma is estimated to be 6 - 7/100,000 and accounts for 1% of all cancer...
August 14, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28805236/comparison-of-intrathecal-morphine-and-surgical-site-infusion-of-ropivacaine-as-adjuncts-to-intravenous-patient-controlled-analgesia-in-living-donor-kidney-transplant-recipients
#7
Joo-Hyun Jun, Gaab-Soo Kim, Jeong Jin Lee, Justin S Ko, Sung Joo Kim, Pil Hyun Jeon
INTRODUCTION: This prospective observational study compared the postoperative analgesic effectiveness of intrathecal morphine (ITM) and surgical-site infusion (SSI) of ropivacaine as adjuncts to intravenous (IV) patient-controlled analgesia (PCA) (fentanyl) in living-donor kidney transplant recipients. METHODS: Patients undergoing living-donor kidney transplantation receiving ITM or SSI in addition to IV PCA were included. Rescue analgesia was achieved with IV meperidine, as required...
August 14, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28805187/changes-in-patient-characteristics-following-cardiac-transplantation-the-montreal-heart-institute-experience
#8
Nicola Vistarini, Anthony Nguyen, Michel White, Normand Racine, Louis P Perrault, Anique Ducharme, Denis Bouchard, Philippe Demers, Michel Pellerin, Yoan Lamarche, Ismaïl El-Hamamsy, Geneviève Giraldeau, Guy Pelletier, Michel Carrier
BACKGROUND: Heart transplantation is no longer considered an experimental operation, but rather a standard treatment; nevertheless the context has changed substantially in recent years owing to donor shortage. The aim of this study was to review the heart transplant experience focusing on very long-term survival (≥ 20 years) and to compare the initial results with the current era. METHODS: From April 1983 through April 1995, 156 consecutive patients underwent heart transplantation...
August 3, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28805088/the-current-therapeutic-options-for-crohn-s-disease-from-medical-therapy-to-intestinal-transplantation
#9
Augusto Lauro, Francesco D'Amico, Gabriel Gondolesi
Crohn's disease (CD) has an annual incidence per 100.000 person-year of 20.2 in North America and 12.7 in Europe, and the purpose of this review is to evaluate its medical management, from diagnosis to transplant. Pharmacologic manipulation with nutritional care aims to achieve and maintain remission, but more than half of patients will undergo an intestinal resection, very often repeated over time. They could experience short bowel syndrome (SBS) requiring total parenteral nutrition (TPN). Intestinal transplantation (ITx) represents an alternative in case of irreversible intestinal failure (IF) with life-threatening TPN complications...
August 14, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28803679/systematic-review-of-the-methods-predictive-of-the-functionality-of-kidney-transplantation
#10
E Miret Alomar, E Trilla Herrera, D Lorente Garcia, L Regis Placido, R López Del Campo, M Cuadras Solé, T Pont Castellana, F Moreso Mateos, D Serón Micas, J Morote Robles
CONTEXT: Kidney transplantation from donors with expanded criteria has increased the pool of kidneys at the cost of a higher risk of short and long-term graft dysfunction. The main issue lies in determining which kidneys will offer acceptable function and survival compared with the risk represented by surgery and subsequent immunosuppression. OBJECTIVE: The objective of our article is to review the current evidence on the tools for predicting the functionality of kidney transplantation from cadaveric donors with expanded criteria and determining the validity for their use in standard practice...
August 10, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28800919/similar-outcomes-after-osteochondral-allograft-transplantation-in-anterior-cruciate-ligament-intact-and-reconstructed-knees-a-comparative-matched-group-analysis-with-minimum-2-year-follow-up
#11
Dean Wang, Claire D Eliasburg, Tim Wang, Ryan R Fader, Francesca R Coxe, Mollyann D Pais, Riley J Williams
PURPOSE: To compare failure rates and clinical outcomes of osteochondral allograft transplantation (OCA) in anterior cruciate ligament (ACL)-intact versus ACL-reconstructed knees at midterm follow-up. METHODS: After a priori power analysis, a prospective registry of patients treated with OCA for focal chondral lesions ≥2 cm(2) in size with minimum 2-year follow-up was used to match ACL-reconstructed knees with ACL-intact knees by age, sex, and primary chondral defect location...
August 8, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28797760/effect-of-left-ventricular-dysfunction-on-utilization-of-donor-hearts
#12
David Tryon, Nahidh W Hasaniya, Brice Jabo, Anees J Razzouk, Leonard L Bailey, David G Rabkin
BACKGROUND: In this study we investigated modern, non-utilization rates of potential cardiac donors with left ventricular dysfunction (LVD) to clarify this phenomenon's magnitude and the impact of recent studies suggesting these organs can be safely transplanted. METHODS: Using the United Network for Organ Sharing transplant database, we reviewed all donors evaluated between January 1, 2007 and June 30, 2014. Exclusion criteria included lack of consent and age <13 or >59 years...
July 19, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28797737/nkt-cells-are-important-mediators-of-hepatic-ischemia-reperfusion-injury
#13
James A Richards, Stephen J Wigmore, Stephen M Anderton, Sarah E M Howie
INTRODUCTION: IRI results from the interruption then reinstatement of an organ's blood supply, and this poses a significant problem in liver transplantation and resectional surgery. In this paper, we explore the role T cells play in the pathogenesis of this injury. MATERIALS & METHODS: We used an in vivo murine model of warm partial hepatic IRI, genetically-modified mice, in vivo antibody depletion, adoptive cell transfer and flow cytometry to determine which lymphocyte subsets contribute to pathology...
August 7, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28796371/inflammatory-bowel-disease-with-primary-sclerosing-cholangitis-a-danish-population-based-cohort-study-1977-2011
#14
Jakob Ørskov Sørensen, Ole Haagen Nielsen, Mikael Andersson, Mark Andrew Ainsworth, Henriette Ytting, Erika Bélard, Tine Jess
BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) may be complicated by primary sclerosing cholangitis (PSC). We aimed to assess the characteristics of Danish PSC-IBD patients and to compare their prognosis with IBD patients without PSC. METHODS: A retrospective nationwide population-based cohort of 257 PSC-IBD patients was assessed through Danish national registries and manual scrutiny of patient files. RESULTS: For all PSC-IBD patients diagnosed after 1976 (n=222) and 8,231 IBD controls (i...
August 10, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28795141/posttransplant-outcomes-of-kidneys-donated-after-brain-death-followed-by-circulatory-death-a-cohort-study-of-128-chinese-patients
#15
Ning Na, Ke Li, Zhengyu Huang, Bin Miao, Cheng Hu, Heng Li, Dejuan Wang, Jianguang Qiu
BACKGROUND: Donation after brain death followed by circulatory death (DBCD) is a new class in the unique Chinese donor classification system. Currently, in China, the organ transplantation of DBCD is rising. However, there is a dearth of research on the characteristics and outcomes of DBCD kidney transplantation. METHOD: We collected 128 DBCD renal transplant patients who underwent surgery between June 2013 and May 2016 at our center to analyze clinical outcomes and to share our experience to enhance perioperative management in DBCD kidney transplantation...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28795136/renal-autotransplantation-and-extracorporeal-nephron-sparing-surgery-for-de-novo-renal-cell-carcinoma-in-a-kidney-allograft
#16
Shinichiro Ono, Takashi Kenmochi, Taihei Ito, Naohiro Aida, Kazunori Otsuki, Naotake Akutsu, Michihiro Maruyama, Mamoru Kusaka, Ryoichi Shiroki, Kiyotaka Hoshinaga
De novo renal cell carcinoma (RCC) rarely occurs in kidney allografts; however, the risk of RCC in these patients is 100-fold that of the general healthy population. Although total nephrectomy has been the standard treatment for kidney allograft RCC, several authors have reported that early-stage RCC in kidney allografts was successfully treated with nephron-sparing surgery. We herein describe a new procedure involving renal autotransplantation and extracorporeal nephron-sparing surgery, which was performed to treat de novo RCC near the hilum of a transplanted kidney...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28791580/the-role-of-bariatric-surgery-in-abdominal-organ-transplantation-the-next-big-challenge
#17
REVIEW
Tomasz Dziodzio, Matthias Biebl, Robert Öllinger, Johann Pratschke, Christian Denecke
Obesity is linked to inferior transplant outcome. Bariatric surgery (BS) is an established treatment of morbid obesity. We provide an overview on BS in the field of kidney (KT) and liver transplantation (LT). In end-stage renal disease (ESRD) and KT patients, BS seems safe and feasible. Complication rates were slightly higher compared to the non-transplant population, whereas weight loss and improvement of comorbidities were comparable. Sleeve gastrectomy (SG) was the preferred procedure before KT and superior to gastric bypass (GB) in regard to mortality and morbidity...
August 8, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28791352/establishment-of-a-murine-pancreatic-cancer-pain-model-and-microarray-analysis-of-pain%C3%A2-associated-genes-in-the-spinal-cord-dorsal-horn
#18
Liqin Wang, Huihong Xu, Yanhu Ge, Hai Zhu, Dawei Yu, Weifeng Yu, Zhijie Lu
There is emerging evidence on the mechanisms of pancreatic cancer pain. Following the establishment of an orthotropic transplantation model of pancreatic cancer, microarray analysis was performed to identify changes in the expression levels of pain‑associated genes in the spinal cord. A mouse model of pancreatic cancer‑induced pain was established by implanting SW 1990 cells into the pancreases of female BALB/c‑nu mice. The survival rate and body weight were measured following orthotropic transplantation...
August 4, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28790783/hydrogen-peroxide-test-for-intraoperative-bile-leak-detection
#19
V Trehan, Pankaj P Rao, C S Naidu, Anuj K Sharma, A K Singh, Sanjay Sharma, Amit Gaur, S V Kulkarni, N Pathak
BACKGROUND: Bile leakage (BL) is a common complication following liver surgery, ranging from 3 to 27% in different series. To reduce the incidence of post-operative BL various BL tests have been applied since ages, but no method is foolproof and every method has their own limitations. In this study we used a relatively simpler technique to detect the BL intra-operatively. Topical application of 1.5% diluted hydrogen peroxide (H2O2) was used to detect the BL from cut surface of liver and we compared this with conventional saline method to know the efficacy...
July 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28782907/sclerosing-peritonitis-post-liver-transplantation-a-rare-condition-where-surgery-is-an-important-treatment-option
#20
Yvonne X Kong, Simone I Strasser, Geoffrey W McCaughan, Michael Crawford, Deborah J Verran
BACKGROUND: Sclerosing peritonitis (SP) is a rare but potentially fatal complication following orthotopic liver transplantation (OLT). The definitive surgical management is via a laparotomy peritonectomy and enterolysis procedure, but this carries risks particularly in the immunosuppressed transplant patient population. The natural history of SP is known from a handful of case reports and series, which mostly report de novo cases arising early on following OLT. The aim of this study was to identify all cases of de novo SP following OLT and the outcomes of management...
August 7, 2017: ANZ Journal of Surgery
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