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Transplant anesthesia

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https://www.readbyqxmd.com/read/28219273/noteworthy-literature-published-in-2016-for-thoracic-organ-transplantation-anesthesiologists
#1
Kathirvel Subramaniam, Soheyla Nazarnia
This article is first in the series to review the published literature on perioperative issues in patients undergoing thoracic solid organ transplantations. We present recent literature from 2016 on preoperative considerations, organ preservation, intraoperative anesthesia management, surgical techniques, postoperative complications, and the impact of perioperative management on short- and long-term outcomes that are pertinent to thoracic transplantation anesthesiologists.
March 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28216199/the-evolution-of-anesthesia-for-lung-transplantation
#2
REVIEW
Daniel Sellers, Wilfred Cassar-Demajo, Shaf Keshavjee, Peter Slinger
No abstract text is available yet for this article.
November 22, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28183558/frequency-of-inadequate-neuromuscular-blockade-during-general-anesthesia
#3
Timur Dubovoy, Amy M Shanks, Scott Devine, Sachin Kheterpal
STUDY OBJECTIVE: We used electronic health record data to define frequency of inadequate intraoperative neuromuscular blockade (NMB). DESIGN: Retrospective observational study using electronic health record data. SETTING: Operating room in a tertiary care academic hospital. PATIENTS: A total of 129,209 adult patients with American Society of Anesthesiologists physical status 1 to 5 undergoing general anesthesia in an outpatient or inpatient setting who received nondepolarizing NMB...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28162930/a-randomized-study-of-autologous-bone-marrow-derived-stem-cells-in-pediatric-cardiomyopathy
#4
E Sian Pincott, Deborah Ridout, Margaret Brocklesby, Angus McEwan, Vivek Muthurangu, Michael Burch
BACKGROUND: Bone marrow mononuclear cell fraction has been used as therapy for dilated cardiomyopathy in adults. Although case series are reported, there are no randomized controlled studies in children. METHODS: We designed a randomized, crossover, controlled pilot study to determine safety and feasibility of intracoronary stem cell therapy in children. The primary safety end-point was freedom from death and transplantation or any complication that could be considered related to bone marrow injection or anesthesia (e...
January 5, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28152572/safety-and-efficacy-of-transhepatic-and-transsplenic-access-for-endovascular-management-of-portal-vein-complications-after-liver-transplantation-1
#5
Joon-Young Ohm, Gi-Young Ko, Kyu-Bo Sung, Dong-Il Gwon, Heung-Gyu Koh
OBJECTIVE: To evaluate and compare the safety and efficacy of endovascular management of the portal vein (PV) via percutaneous transsplenic access versus percutaneous transhepatic access in liver transplant recipients. METHODS: Eighteen patients who underwent endovascular management of PV via percutaneous transhepatic (n = 8) and transsplenic (n = 10) access were enrolled. Transsplenic access was chosen if the spleen was located in a normal position, the splenic vein was preserved, and the target lesion did not involve confluence of the superior mesenteric and splenic veins...
February 2, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28138266/pregnancy-after-allogeneic-hematopoietic-stem-cell-transplantation-in-a-fanconi-anemia-patient
#6
Simin Atashkhoei, Solmaz Fakhari, Eissa Bilehjani, Haleh Farzin
Pregnancy in patients with Fanconi anemia (FA) is rare. However, there are reports of successful pregnancy in Fanconi patients after bone marrow transplantation (BMT, hematopoietic stem cell transplantation). We describe the case of a term pregnant woman with FA who was treated with BMT 2 years earlier. She underwent successful delivery with cesarean section using spinal anesthesia without any complications.
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/28133947/serious-gaming-for-orthotopic-liver-transplant-anesthesiology-a-randomized-control-trial
#7
Daniel Katz, Jeron Zerillo, Sang Kim, Bryan Hill, Ryan Wang, Andrew Goldberg, Samuel DeMaria
: Anesthetic management of orthotopic liver transplantation (OLT) is complex. Given the unequal distributions of liver transplant surgeries performed at different centers, anesthesiology providers receive relatively uneven OLT training and exposure. One well-suited modality for OLT training is the "serious game", an interactive application created for the purpose of imparting knowledge or skills, while leveraging the self-motivating elements of video games. We therefore developed a serious game designed to teach best practices for the anesthetic management of a standard OLT and determined if the game would improve resident performance in a simulated OLT...
January 30, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28117792/murine-full-thickness-skin-transplantation
#8
Chih-Hsien Cheng, Chen-Fang Lee, Madeline Fryer, Georg J Furtmüller, Byoungchol Oh, Jonathan D Powell, Gerald Brandacher
Murine full-thickness skin transplantation is a well-established in vivo model to study alloimmune response and graft rejection. Despite its limited application to humans, skin transplantation in mice has been widely employed for transplantation research. The procedure is easy to learn and perform, and it does not require delicate microsurgical techniques nor extensive training. Moreover, graft rejection in this model occurs in a very reproducible immunological reaction and is easily monitored by direct inspection and palpation...
January 2, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28107803/the-society-for-the-advancement-of-transplant-anesthesia-sata
#9
Ernesto A Pretto, Tetsuro Sakai, Jeron Zerillo, M Susan Mandell
No abstract text is available yet for this article.
January 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28072739/risk-factors-and-outcomes-associated-with-a-higher-use-of-inotropes-in-kidney-transplant-recipients
#10
Jae Moon Choi, Jun-Young Jo, Jae-Won Baik, Sooyoung Kim, Chan Sik Kim, Sung-Moon Jeong
Preservation of adequate perfusion pressures to the graft is a main focus of intraoperative management during kidney transplantation. We undertook this study to investigate the incidence of the higher use of inotropes in kidney transplant recipients and identify the patient outcomes and preoperative and intraoperative variables related to this.We retrospectively analyzed 1053 patients who underwent kidney transplantation at Asan Medical Center between January 2006 and February 2012, stratified by their inotropic score ([dopamine] + [dobutamine] + [epinephrine × 100] + [norepinephrine × 100]) <7 versus ≥7, wherein all doses are expressed as μg/kg/min...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28067880/a-phase-i-ii-trial-of-intrabone-marrow-cord-blood-transplantation-and-comparison-of-the-hematological-recovery-with-the-japanese-nationwide-database
#11
N Kurita, M Gosho, Y Yokoyama, T Kato, N Obara, M Sakata-Yanagimoto, Y Hasegawa, N Uchida, S Takahashi, Y Kouzai, Y Atsuta, M Kurata, T Ichinohe, S Chiba
Intrabone marrow cord blood transplantation (IB-CBT) was proposed as a promising treatment modality to improve hematological recovery. However, clinical advantages of IB-CBT over conventional IV CBT have been unclear. We conducted a prospective single-center trial of IB-CBT to evaluate its safety and superiority in terms of hematological recovery. Fifteen adults with hematological malignancies were enrolled. A thawed and unwashed single cord blood unit was injected into the bilateral superior-posterior iliac crests under local anesthesia...
January 9, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28053610/evaluation-of-stability-and-biocompatibility-of-phema-pmma-keratoprosthesis-by-penetrating-keratoplasty-in-rabbits
#12
Yawon Hwang, Gonhyung Kim
Artificial corneas have been developed as an alternative to natural donor tissue to replace damaged or diseased corneas. This study was conducted to evaluate the stability and biocompatibility of PHEMA-PMMA [poly (2-hydroxyl methacrylate)-poly (methyl methacrylate)] keratoprostheses in rabbits following penetrating keratoplasty. Sixteen male New Zealand White rabbits aged 16 weeks were divided into three groups. Group I and group II contained six rabbits each, while the control group had four rabbits. Experimental surgery was conducted under general anesthesia...
December 2016: Laboratory Animal Research
https://www.readbyqxmd.com/read/27990829/-islet-transplantation-as-a-treatment-for-hypoglycemia-unawareness-syndrome-evaluation-of-the-pilot-program-and-comparison-with-pancreas-transplantation
#13
Martina Zahradnická, Peter Girman, Jan Kříž, Zuzana Berková, Tomáš Koblas, Ema Vávrová, Lucie Kosinová, David Habart, Eva Fábryová, Eva Dovolilová, Tomáš Neškudla, Jan Peregrin, Jozef Kováč, Květoslav Lipár, Matěj Kočík, Lenka Németová, Jiří Svoboda, František Saudek
Islet transplantation (ITx) started in 2005 in IKEM as a potentially safer alternative to pancreas transplantation (PTx), which so far had represented the method of choice in type-1 diabetic patients with conservatively intractable hypoglycemia unawareness syndrome. The aim of the study was to compare these two methods with regard to severe hypoglycemia elimination and to frequency of complications.Up to November 2015 a total number of 48 patients underwent ITx. The results from 22 patients with hypoglycemia unawareness were statistically analyzed...
2016: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/27984210/hypertensive-crisis-from-the-aquamantys-bipolar-sealing-system
#14
Brian C Hardy, Christopher R Giordano
Hypertension is a common occurrence during general anesthesia. Apart from pathological causes of hypertension, it is rarely extreme enough to be classified as a hypertensive crisis (systolic blood pressure >180 mm Hg or diastolic blood pressure >120 mm Hg). There is literature concerning the unintentional electrocauterization of the adrenal gland leading to hypertensive crisis, but to date, no reports have been made of adrenal stimulation from the use of an Aquamantys for hemostasis. Here, we report such a case when a hypertensive crisis (systolic blood pressure >300 mm Hg) occurred while using an Aquamantys during a liver transplant after unintentional stimulation of the adrenal glands...
December 15, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27977542/early-diagnosis-of-labial-fusion-in-women-after-allogeneic-hematopoietic-cell-transplant-enables-outpatient-treatment
#15
Claire Scrivani, Melissa A Merideth, Tajana Klepac Pulanic, Steven Pavletic, Richard W Childs, Matthew M Hsieh, Pamela Stratton
OBJECTIVE: The aim of the study was to describe the presentation and successful treatment of labial fusion in women after allogeneic hematopoietic cell transplantation (HCT). MATERIALS AND METHODS: During routine posttransplant gynecologic evaluation, labial fusion was identified in 5 female patients. Clinical data were collected regarding underlying disease, transplant regimen, genital symptoms, systemic sites of chronic graft-versus-host disease (cGvHD) and treatment, and follow-up...
December 13, 2016: Journal of Lower Genital Tract Disease
https://www.readbyqxmd.com/read/27932181/use-of-terlipressin-in-an-elderly-patient-with-moderate-aortic-valve-stenosis-accompanied-by-episodic-atrial-fibrillation-during-liver-transplantation-a-case-report
#16
Y J Won, B G Lim, D Chung, E Park, H Kim, I O Lee, M H Kong
Anesthesia for patients with moderate aortic stenosis accompanied by atrial fibrillation during high-risk surgery such as liver transplantation remains a challenge in maintaining control of heart rate and maintenance of cardiac output. The action of terlipressin on vasopressin receptors (mainly V1 receptors) leads to splanchnic vasoconstriction and is the key mechanism responsible for increasing systemic vascular resistance and reducing heart rate. We report successful anesthetic management using low-dose terlipressin infusion in an elderly patient who had moderate aortic stenosis with atrial fibrillation during urgent deceased-donor liver transplantation...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932148/low-dose-spinal-block-with-continuous-epidural-infusion-for-renal-transplantation-in-a-patient-with-alport-syndrome-a-case-report
#17
F Gobbi, G Sales, P Bretto, P P Donadio, L Brazzi
OBJECTIVE: We aim to describe management of a patient receiving renal transplantation for chronic renal failure due to Alport syndrome with low dose of intrathecal bupivacaine and continuous epidural infusion of local anesthetic. CASE REPORT: A 38-years-old man with chronic renal failure secondary to Alport syndrome underwent kidney transplantation. Because of a high risk of respiratory and cardiovascular complications related to the patient's baseline lung disease and abnormalities in heart conduction, we selected combined spinal-epidural anesthesia...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931574/effects-of-the-hypnotic-agent-on-primary-graft-dysfunction-after-liver-transplantation
#18
L Gajate Martín, C González, I Ruiz Torres, C Fernández Martín, A Martín Grande, E Elías Martín, D Parise Roux, J M Del Rey Sánchez
BACKGROUND: Morbidity and mortality rates in orthotopic liver transplantation have decreased in the past few years. Risk factors related to severe postoperative complications, such as primary graft dysfunction, still need to be analyzed. We evaluated the influence of the hypnotic agent used during anesthesia on primary graft dysfunction. METHODS: We performed a retrospective analysis of 419 consecutive patients who received a liver transplant between 2005 and 2013 in a single center...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27930598/the-anhepatic-phase-extended-by-temporary-portocaval-shunt-does-not-affect-anesthetic-sensitivity-and-postoperative-cognitive-function-a-case-control-study
#19
COMPARATIVE STUDY
Young Gon Son, Sung Hye Byun, Jong Hae Kim
Temporary portocaval shunt (TPCS) prolongs the duration of the anhepatic phase, during which anesthetic sensitivity is highest among the 3 phases of living donor liver transplantation (LDLT). Cognitive dysfunction has been associated with increased anesthetic sensitivity and poor hepatic function. Therefore, we assessed anesthetic sensitivity to desflurane and perioperative cognitive function in patients undergoing LDLT, in whom the duration of the anhepatic phase was extended by TPCS to test the hypothesis that the prolonged anhepatic phase increases anesthetic sensitivity and causes postoperative cognitive decline...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27910802/near-infrared-spectroscopy-evaluated-cerebral-oxygenation-during-anesthesia
#20
Henrik Sørensen
Likely, maintained organ and notably cerebral perfusion, secures rapid recovery following anesthesia. To secure cerebral blood flow (CBF) at least mean arterial pressure (MAP) and the arterial carbon dioxide tension (PaCO2) need to be considered. CBF is "autoregulated", i.e. stays more or less stable within a MAP of 50-150 mmHg, but the lower limit appears to depend on the central blood volume and/or cardiac output, illustrated by a decrease in CBF at a MAP of 80 mmHg with a compromised central blood volume, while CBF remains constant with a MAP < 40 mmHg, if the central blood volume is maintained...
December 2016: Danish Medical Journal
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