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Renal transplant hernia

Stephen H Phillips, Sharon K Hill, Lorie D Lipscomb, Joseph B Africa
OBJECTIVE: To retrospectively analyze the wound issues for obese renal transplant patients, as well as post-transplant outcomes including graft and patient survival, hypothesizing improvement over the standard approach. As the obese population has expanded, minimally invasive renal transplant techniques have attempted to improve the issues of complications related to wounds and hernias. The anterior rectus sheath approach, which facilitates a minimal incision, has been adopted at our center for all renal transplants, including obese patients...
March 31, 2017: Urology
Giovanni Vennarecci, Gianluca Mascianà, Edoardo De Werra, Giovanni Battista Levi Sandri, Daniele Ferraro, Mirco Burocchi, Giovanni Tortorelli, Nicola Guglielmo, Giuseppe Maria Ettorre
AIM: To emphasize the effectiveness and versatility of prosthesis, and good tolerance by patients with incisional hernia (IH). METHODS: From December 2001 to February 2016, 270 liver transplantations were performed at San Camillo Hospital. IH occurred in 78 patients (28.8%). IH usually appeared early within the first year post-orthotopic liver transplantation. In the first era, fascial defect was repaired by primary closure for defects smaller than 2.5 cm or with synthetic mesh for greater defects...
February 24, 2017: World Journal of Transplantation
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
Niyati Lobo, Fiona McCaig, Jonathon Olsburgh
Ipsilateral inguinal herniation of the transplanted ureter has been reported as a rare cause of obstructive uropathy in renal transplant recipients. A 73-year-old man presented with acute renal failure 29 years after receiving a deceased donor renal transplant. Radiological investigations demonstrated marked hydronephrosis of the left iliac fossa transplant kidney and herniation of the distal transplant ureter and bladder into the right inguinal canal. The patient underwent placement of a nephrostomy and antegrade stent followed by definitive hernia repair with return of graft function to baseline level...
January 6, 2017: BMJ Case Reports
D Moris, J Bokos, M Vailas, K Kakavia, E Spartalis, A Athanasiou, D Schizas, S Vernadakis
BACKGROUND: Renal paratransplant hernia (RPH) is an uncommon variant of internal hernias developed in renal transplant recipients. The aim of this review is to meticulously present and analyze all data coming mainly from case reports or short-case studies on this very uncommon surgical entity. MATERIALS AND METHODS: The MEDLINE/PubMed database was searched for publications with the medical subject heading ''renal paratransplant hernia''. All the references from the identified articles were searched for relevant information...
November 19, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
E Broggi, F Bruyère, F Gaudez, F Desgrandchamps
PURPOSE: The aim of this study was to analyze the incidence of severe incisional hernias and find their specific risk factors in renal transplant patients. METHODS: This retrospective multicentric case-control study focused on 225 kidney transplant patients among 4348 patients transplanted during this period within two French university hospitals (Saint-Louis/Lariboisière in Paris and Tours, Loire Valley) from 2000 to 2014 and from 1995 to 2014, respectively. Forty-five patients developed a severe incisional hernia after renal transplantation...
November 15, 2016: World Journal of Urology
Arvind U Gowda, Colton H L McNichols, Ishan Asokan, Jamil A Matthews, E Bryan Buckingham, Jennifer Sabino, John S Maddox, Sheri Slezak, Yvonne Rasko, Devinder P Singh
PURPOSE: The purpose of this study was to compare clinical outcomes of incisional hernia repair in solid organ transplant patients using non-cross-linked porcine acellular dermal matrix (PADM), human derived acellular dermal matrix (HADM) and synthetic mesh. METHODS: A retrospective review of patients who underwent hernia repair with PADM after pancreas and/or renal transplant at the University of Maryland Medical Center from 2008 to 2012 was conducted. Repair type, postoperative infection, hernia recurrence, mesh removal, and length of follow-up were recorded...
December 2016: Annals of Plastic Surgery
M Gastaca, I Bilbao, M Jimenez, J Bustamante, C Dopazo, R Gonzalez, R Charco, J Santoyo, J Ortiz de Urbina
Our aim was to study the safety and efficacy of immunosuppression with everolimus (EVL) within the 1st month after orthotopic liver transplantation (LT) when calcineurin inhibitors are not recommended. For this purpose, 28 recipients who had been treated with EVL within the 1st month after adult LT were eligible to enter in a retrospective multicenter study. Patients were followed up for 12 months after LT. EVL therapy was initiated at a median of 14 days (range, 4-24) after LT. The reason for early EVL was neurotoxicity in 14 cases, renal dysfunction in 12, and acute cellular rejection combined with renal impairment in 2...
September 2016: Transplantation Proceedings
T du Toit, L Kaestner, E Muller, D Kahn
We report the first documented case of an inguinal hernia containing bladder, resulting in contralateral allograft hydroureteronephrosis. A 39-year-old male patient presented with allograft dysfunction, a contralateral inguinoscrotal hernia, and marked hydroureteronephrosis on ultrasound (US). Percutaneous nephrostogram and a retrograde cystogram suggested bladder herniation with incorporation of the contralateral ureteroneocystostomy into the hernia. Paraperitoneal bladder herniation was confirmed at surgery and hernioplasty was performed...
February 2017: American Journal of Transplantation
Joel B Durinka, Afshin Parsikia, Farah Karipineni, Stalin Campos, Khamran Khanmoradi, Radi Zaki, Amit R T Joshi, Jorge Ortiz
OBJECTIVES: Incisional hernias can occur after any abdominal operation, including after renal transplant. Several risk factors have been identified in nonimmunosuppressed surgical patients. We aimed to identify whether specific risk factors correlated with the development of incisional hernias after renal transplant. The existence of associations between these risk factors and postoperative complications was also reviewed. MATERIALS AND METHODS: We reviewed 969 kidney transplants performed between February 2000 and January 2011...
February 2017: Experimental and Clinical Transplantation
Masaki Honda, Seisuke Sakamoto, Rieko Sakamoto, Shirou Matsumoto, Tomoaki Irie, Koushi Uchida, Keita Shimata, Seiichi Kawabata, Kaori Isono, Shintaro Hayashida, Hidekazu Yamamoto, Fumio Endo, Yukihiro Inomata
We herein present the case of a four-yr-old boy with PA who developed AMR after ABO-incompatible LDLT despite undergoing B cell desensitization using rituximab. Although the CD19+ lymphocyte count decreased to 0.1% nine days after the administration of rituximab, he developed a high fever which was accompanied by arthralgia due to a streptococcal infection 13 days after rituximab prophylaxis. After the clearance of the infection, he underwent ABO-incompatible LDLT 36 days after the administration of rituximab...
September 2016: Pediatric Transplantation
Yener Koc, Taner Basturk, Tamer Sakaci, Zuhal Atan Ucar, Elbis Ahbap, Mustafa Sevinc, Ayse Sinangil, Ekrem Kara, Arzu Ozdemir Kayalar, Feyza Bayraktar Caglayan, Tuncay Sahutoglu, Nuri Baris Hasbal, Abdulkadir Ünsal
BACKGROUND: Peritoneal dialysis (PD) is often avoided for patients with polycystic kidney disease (PKD) because of increased risk of complications and technique failure due to limited intra-abdominal space. In this study, we have aimed to determine clinical outcomes, patient and technique survivals in patients with PKD performing PD and to define whether PD is appropriate for these patients. METHODS: Totally 99 patients: 33 with PKD and 66 with diseases other than PKD were included in this retrospective study...
July 2016: Néphrologie & Thérapeutique
Felix Cheung, Merrit Marion Debartolo, Leonard Michael Copertino, April Adams Szafran, Chelsea Caron Estrada, Patrick Gerard Lynch, Frank Sam Darras
Ureteral obstruction secondary to an inguinal hernia with transplant ureteral component is an extremely rare entity with only several case reports found in literature. In all previously reported cases, management of the obstruction involved temporary drainage with ureteral stenting or nephrostomy tube placements followed by delayed definitive repair. We present two case reports, here one being the first one managed by immediate definitive repair via ureteral reimplant and herniorrhaphy and a second case by delayed definitive repair after percutaneous nephrostomy tube placement...
2016: Case Reports in Transplantation
B Rao, M C Segovia, M Kazimi, R Parekh, M Raoufi, S-M Jafri
Inhibitors of mechanistic target of rapamycin are used in solid organ transplant procedures to avoid calcineurin inhibitor complications, including nephrotoxicity and malignancy. We present 2 cases of multivisceral transplantation for neuroendocrine tumor (NET) for which everolimus was implemented for its potential to prevent NET recurrence as well as preserve renal function. The first case was complicated by NET recurrence in the liver before initiation of everolimus. After initiation of everolimus, the patient developed a ventral hernia and elevated aminotransferase levels with nonspecific biopsy findings...
March 2016: Transplantation Proceedings
Massimiliano Veroux, Vincenzo Ardita, Domenico Zerbo, Pietro Caglià, Stefano Palmucci, Nunziata Sinagra, Alessia Giaquinta, Pierfrancesco Veroux
Acute renal failure due to ureter compression after a mesh-plug inguinal repair in a kidney transplant recipient has not been previously reported to our knowledge. A 62-year-old man, who successfully underwent kidney transplantation from a deceased donor 6 years earlier, was admitted for elective repair of a direct inguinal hernia. The patient underwent an open mesh-plug repair of the inguinal hernia with placement of a plug in the preperitoneal space. We did not observe the transplanted ureter and bladder during dissection of the inguinal canal...
March 2016: Medicine (Baltimore)
Valentina Vigo, Luigi Rossi, Piero Lisi, Maurizio Antonelli, Carlo Lomonte, Carlo Basile
Inguinal herniation of the ureter in a kidney transplantation is a rare cause of late distal ureteral obstruction. Herniation is usually secondary to the implant of a long redundant ureter and to its course on the spermatic cord. This clinical condition can worsen graft function in the presence of ipsilateral hydroureteronephrosis. In this review, we describe the case of an asymptomatic 51-year-old man with a history of right iliac renal allotransplantation 12 years before. Kidney ultrasound showed moderate hydroureteronephrosis and ureteral kneeling at the upper third of the inguinal canal...
January 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Hugo Coelho, Pedro Nunes, Carolina Canhoto, Paulo Temido
A 77-year-old man presented with acute graft dysfunction 25 years after a renal transplant in the left iliac fossa. He also had an asymptomatic left inguinal hernia. Renal ultrasound showed a significant pyelocalicial dilation of the kidney graft and the patient was submitted to a percutaneous nephrostomy. An antegrade nephrostogram was performed, which showed a dilated ureter and the bladder included in the left inguinal hernia that caused the obstructive uropathy. Concomitant retrograde cystography also showed a significant portion of the bladder in the hernia sac...
February 24, 2016: BMJ Case Reports
Uta Herden, Antonio Galante, Lutz Fischer, Sven Pischke, Jun Li, Eike Achilles, Martina Koch, Bjoern Nashan, Martina Sterneck
BACKGROUND: Evidence relating to early everolimus use after liver transplantation remains limited. MATERIAL AND METHODS: Ninety-one adult patients undergoing liver transplantation at our center during 2007-2012 in whom everolimus therapy was initiated <3 months post-transplant were analyzed retrospectively. Everolimus was started on days 1-5 in 50 patients (group 1) and after day 5 in 41 patients (group 2). Most patients continued to receive low-dose cyclosporine (59...
February 4, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Ignacio Puche-Sanz, José Miguel Molina-Hernández, Manrique Pascual-Geler, José Manuel Cózar-Olmo
We present the case of a 60-year-old male diagnosed with end stage renal disease due to polycystic kidney disease (urinary flow rate between 100-150mL/24h) in the study to enter renal transplantation waiting list. The patient complained of a right inguinoscrotal bulky mass, first noticed several years before. Physical examination suggested an irreducible inguinoscrotal hernia and surgical repair was offered before transplantation.
November 2015: Archivos Españoles de Urología
David Faraoni, Viviane G Nasr, James A DiNardo, Ravi R Thiagarajan
OBJECTIVE: To assess the characteristics associated with high hospital cost for patients receiving extracorporeal membrane oxygenation (ECMO) to identify a cohort of high-resource users. STUDY DESIGN: Cost for hospitalization, during which ECMO support was used, was calculated from hospital charges reported in the 2012 Health Care Cost and Use Project Kid's Inpatient Database. Patients were categorized into 6 diagnostic groups: (1) cardiac surgery; (2) nonsurgical heart disease; (3) congenital diaphragmatic hernia; (4) neonatal respiratory failure; (5) pediatric respiratory failure; and (6) sepsis...
February 2016: Journal of Pediatrics
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