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Transplant anesthesia

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https://www.readbyqxmd.com/read/27910802/near-infrared-spectroscopy-evaluated-cerebral-oxygenation-during-anesthesia
#1
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
https://www.readbyqxmd.com/read/27884494/consensus-conference-on-tips-management-techniques-indications-contraindications
#2
Stefano Fagiuoli, Raffaele Bruno, Wilma Debernardi Venon, Filippo Schepis, Francesco Vizzutti, Pierluigi Toniutto, Marco Senzolo, Paolo Caraceni, Francesco Salerno, Paolo Angeli, Roberto Cioni, Alessandro Vitale, Maurizio Grosso, Andrea De Gasperi, Gennaro D'Amico, Alfredo Marzano
The trans jugular intrahepatic Porto systemic shunt (TIPS) is no longer viewed as a salvage therapy or a bridge to liver transplantation and is currently indicated for a number of conditions related to portal hypertension with positive results in survival. Moreover, the availability of self-expandable polytetrafluoroethylene (PTFE)-covered endoprostheses has dramatically improved the long-term patency of TIPS. However, since the last updated International guidelines have been published (year 2009) new evidence have come, which have open the field to new indications and solved areas of uncertainty...
October 29, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27870736/lidocaine-administration-controls-micrornas-alterations-observed-after-lung-ischemia-reperfusion-injury
#3
Lisa Rancan, Carlos Simón, Emmeline Marchal-Duval, Javier Casanova, Sergio Damian Paredes, Alberto Calvo, Cruz García, David Rincón, Agustín Turrero, Ignacio Garutti, Elena Vara
BACKGROUND: Ischemia-reperfusion injury (IRI) is associated with morbidity and mortality. MicroRNAs (miRNAs) have emerged as regulators of IRI, and they are involved in the pathogenesis of organ rejection. Lidocaine has proven anti-inflammatory activity in several tissues but its modulation of miRNAs has not been investigated. This work aims to investigate the involvement of miRNAs in lung IRI in a lung auto-transplantation model and to investigate the effect of lidocaine. METHODS: Three groups (sham, control, and Lidocaine), each comprising 6 pigs, underwent a lung autotransplantation...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27861947/recurrent-laryngeal-nerve-regeneration-using-an-oriented-collagen-scaffold-containing-schwann-cells
#4
Shun-Ichi Chitose, Kiminori Sato, Mioko Fukahori, Shintaro Sueyoshi, Takashi Kurita, Hirohito Umeno
OBJECTIVES/HYPOTHESIS: Regeneration of the recurrent laryngeal nerve (RLN), which innervates the intrinsic laryngeal muscles such that they can perform complex functions, is particularly difficult to achieve. Synkinesis after RLN neogenesis leads to uncoordinated movement of laryngeal muscles. Recently, some basic research studies have used cultured Schwann cells (SCs) to repair peripheral nerve injuries. This study aimed to regenerate the RLN using an oriented collagen scaffold containing cultured SCs...
November 15, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27853736/transplantation-of-epidermal-cell-sheets-by-endoscopic-balloon-dilatation-to-avoid-esophageal-re-strictures-initial-experience-in-a-porcine-model
#5
Shinichiro Kobayashi, Nobuo Kanai, Nobuyuki Tanaka, Masanori Maeda, Takahiro Hosoi, Fumio Fukai, Susumu Eguchi, Masayuki Yamato
Background and study aims: Epidermal cell sheet (ECS) transplantation immediately after aggressive endoscopic submucosal dissection (ESD) has been shown to be safe and effective in the prevention of esophageal strictures. This study evaluated the feasibility of ECS transplantation after endoscopic balloon dilation (EBD) in a porcine model. Methods: Six pigs underwent circumferential esophageal ESD under general anesthesia. Two weeks later, two pigs underwent EBD and transplantation of an autologous ECS, two underwent EBD alone, and two underwent endoscopic observation only (control)...
November 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27837084/intraoperative-diagnosis-of-intracardiac-thrombus-during-orthotopic-liver-transplantation-with-transesophageal-echocardiography-a-case-series-and-literature-review
#6
Adam A Dalia, Hisham Khan, Antolin S Flores
Anesthesia for orthotopic liver transplantation (OLT) is challenging for any anesthesiologist as the patients undergoing this procedure are among the most critically ill. Adding to the underlying complexity of OLT management is the rare complication of an intracardiac thrombus (ICT). Intracardiac thrombi can present following liver allograft reperfusion resulting in high morbidity and mortality. Currently there is no consensus treatment for ICT, and the gold standard for diagnosis is intraoperative transesophageal echocardiography (TEE); these 2 factors lead to a dangerous amalgam of the difficulty in diagnosing and treating the disease...
November 10, 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27833495/postoperative-pain-management-of-liver-transplantation-in-cystic-fibrosis-is-it-time-to-start-us-guided-neuraxial-blocks
#7
M Piazza, G Martucci, A Arcadipane
Cystic fibrosis (CF) is the most common life-limiting genetic disease in Caucasians. Declining lung function is the principal cause of death, but liver involvement can lead to the need for liver transplantation. General anesthesia has detrimental effects on pulmonary function, increasing perioperative morbidity and mortality in CF patients. Regional anesthetic techniques improve outcomes by reducing anesthetic drugs and administration of opioids, and hastening extubation, awakening, and restarting respiratory of physiotherapy...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27830551/experimental-hepatocyte-transplantation-in-pigs
#8
Eiji Kobayashi, Shin Enosawa, Hiroshi Nagashima
Technical issues of experimental hepatocyte transplantation in pigs, i.e., selection of animals, anesthesia, route of transplantation, and segment-specific transplantation have described.
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27796066/decline-in-ventricular-function-as-a-result-of-general-anesthesia-in-pediatric-heart-transplant-recipients
#9
Justin J Elhoff, Shahryar M Chowdhury, Carolyn L Taylor, Marc Hassid, Andrew J Savage, Andrew M Atz, Ryan J Butts
Echocardiography is frequently performed under anesthesia during procedures such as cardiac catheterization with EMB in pediatric HTx recipients. Anesthetic agents may depress ventricular function, resulting in concern for rejection. The aim of this study was to compare ventricular function as measured by echocardiography before and during GA in 17 pediatric HTx recipients. Nearly all markers of ventricular systolic function were significantly decreased under GA, including EF (-4.2% ±1.2, P < .01) and RV FAC (-0...
October 30, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27788811/effects-of-intraoperative-magnesium-sulfate-administration-on-postoperative-tramadol-requirement-in-liver-transplantation-a-prospective-double-blind-study
#10
B Gucyetmez, H K Atalan, S Aslan, S Yazar, K Y Polat
BACKGROUND: Magnesium is an N-methyl-d-aspartate receptor blocker and is known to have analgesic effect. Hypomagnesemia can often be seen in liver transplantation and may be associated with higher morbidity and mortality. The objective of this study was to investigate the effects of intraoperative magnesium sulfate administration on postoperative tramadol requirement in liver transplant patients. METHODS: Liver transplant patients >18 years of age were screened prospectively from October 2014 to April 2015...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27766546/management-of-skin-cancer-in-the-high-risk-patient
#11
James W Behan, Adam Sutton, Ashley Wysong
Skin cancer is the most common of human cancers and outnumbers all other types of cancer combined in the USA by over threefold. The majority of non-melanoma skin cancers are easily treated with surgery or locally destructive techniques performed under local anesthesia in the cost-effective outpatient setting. However, there is a subset of "high-risk" cases that prove challenging in terms of morbidity, mortality, adjuvant treatment required, as well as overall cost to the health care system. In our opinion, the term "high risk" when applied to skin cancer can mean one of three things: a high-risk tumor with aggressive histologic and/or clinical features with an elevated risk for local recurrence or regional/distant metastasis, a high-risk patient with the ongoing development of multiple skin cancers, and a high-risk patient based on immunosuppression...
December 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27765179/from-the-laboratory-bench-to-the-operating-room-the-role-of-the-surgeon-in-cancer-prevention
#12
Terry C Lairmore
BACKGROUND: The last 200 years have seen remarkable achievements in the art and clinical practice of surgery. These advances include the introduction of antisepsis, anesthesia, vascular anastomosis, antimicrobials, organ transplantation, and the widespread application of minimally invasive operative procedures. Very recently, a surgical procedure has been shown to cure diabetes, representing the most effective treatment of a metabolic disorder by surgeons. METHODS: The author reviewed the major surgical milestones in the modern surgical era and prepared this monograph for presentation as the Claude H...
September 30, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27749293/left-ventricular-assist-device-insertion-in-a-patient-with-biventricular-noncompaction-cardiomyopathy-ebstein-anomaly-and-a-left-atrial-mass-anesthesia-management-and-challenges
#13
Nikhil Kumar, Christopher A Troianos, Joshua S Baisden
In this report, we present the case of a patient with biventricular noncompaction cardiomyopathy, Ebstein anomaly, and a left atrial mass who required emergent placement of a left ventricular assist device. The noncompaction cardiomyopathy complicated the left ventricular assist device implantation procedure because the thickened, trabeculated myocardium made it difficult to place the inflow cannula. We discuss our perioperative management strategy, in which transesophageal echocardiography was used, to help the surgical team identify the proper cannula placement and provide a bridge to transplantation...
October 5, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27746573/anesthesia-for-bench-surgery
#14
S Sachin, M C Rajesh, E K Ramdas
Surgical removal of the kidney tumor outside the body, (ex vivo renal bench surgery) followed by auto transplantation is an emerging and often done procedure to reconstruct the urinary tract. It possesses immense challenges to both the anesthesiologists and the surgeons. The risks are multiplied if you are performing the surgery on a solitary functioning kidney. Here, we are describing the anesthetic management of 70-year-old male post nephrectomy patient undergoing renal auto transplantation by bench surgery...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27742300/n-acetylcysteine-use-in-hepatic-ischemia-reperfusion-in-rats-minimizing-bowel-injury
#15
S H Lauz Medeiros, A de Oliveira Menezes, L Zogbi, E Frasson de Souza Montero
BACKGROUND: The ischemia/reperfusion (I/R) phenomenon can cause the dysfunction of some transplanted organs and other distant organs. Liver surgery success, including transplantations, may depend on the adverse effects of intestinal mucosa injury arising from temporary porta triad occlusion. The study objective was to examine I/R liver effects on the small intestine in rats after N-acetylcysteine (NAC) treatment. METHODS: Twenty-four male Wistar rats were randomly divided into 2 groups...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27740465/perioperative-management-of-a-bilateral-forearm-allograft
#16
M Clerc, J Prothet, T Rimmelé
Composite tissue allotransplantation (CTA) is a complex procedure requiring a multidisciplinary collaboration between surgeons, anesthetists, and transplantation specialists. We will describe the perioperative management of a bilateral forearm allograft performed at our facility. A 40-year-old man who lost both forearms was registered on the transplant waiting list; a suitable graft was available 11months later. Anesthesia required planning for vascular access, hemodynamic monitoring, fluid therapy management and prevention of deep vein thrombosis...
June 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27729704/esmolol-corrects-severe-hypoxemia-in-patients-with-femoro-femoral-venoarterial-extracorporeal-life-support-for-lung-transplantation
#17
Mohamed Ghalayini, Pierre-Yves Brun, Pascal Augustin, Elise Guivarch, Marie Pierre Dilly, Sophie Provenchere, Pierre Mordant, Yves Castier, Philippe Montravers, Dan Longrois
Competitive flows syndrome result in severe regional hypoxemia when the deoxygenated flow from the native left ventricle (LV) competes with oxygenated flow from extracorporeal life support (ECLS) pump with potentially severe consequences for the cerebral and coronary circulations. Fast correction of hypoxemia could be obtained by decreasing native LV flow by infusion of a short-acting beta-blocker (esmolol). Our purpose was to retrospectively review the efficacy of esmolol in this situation and hypothesize on the potential mechanisms of action and the associated risks...
September 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27648689/hyperoxia-induces-inflammation-and-cytotoxicity-in-human-adult-cardiac-myocytes
#18
Christina Hafner, Jing Wu, Akos Tiboldi, Moritz Hess, Goran Mitulovic, Christoph Kaun, Konstantin Alexander Krychtiuk, Johann Wojta, Roman Ullrich, Eva Verena Tretter, Klaus Markstaller, Klaus Ulrich Klein
Supplemental oxygen (O2) is used as adjunct therapy in anesthesia, emergency and intensive care medicine. We hypothesized that excessive O2 levels (hyperoxia) can directly injure human adult cardiac myocytes (HACMs). HACMs obtained from the explanted hearts of transplantation patients were exposed to constant hyperoxia (95% O2), intermittent hyperoxia (alternating 10 min exposures to 5% and 95% O2), constant normoxia (21% O2), or constant mild hypoxia (5% O2) using a bioreactor. Changes in cell morphology, viability as assessed by lactate dehydrogenase (LDH) release and trypan blue (TB) staining, and secretion of vascular endothelial growth factor (VEGF), macrophage migration inhibitory factor (MIF), and various pro-inflammatory cytokines (interleukin, IL; chemokine C-X-C motif ligand, CXC; granulocyte-colony stimulating factor, G-CSF; intercellular adhesion molecule, ICAM; chemokine C-C motif ligand, CCL) were compared among treatment groups at baseline (0 h) and after 8 h, 24 h, and 72 h of treatment...
September 19, 2016: Shock
https://www.readbyqxmd.com/read/27622549/practical-use-of-thromboelastometry-in-the-management-of-perioperative-coagulopathy-and-bleeding
#19
Brittney Williams, John McNeil, Andrew Crabbe, Kenichi A Tanaka
Achieving hemostasis after complex cardiovascular and transplant surgical procedures is one of the greatest challenges anesthesiologists face. Preoperative coagulation disturbances due to underlying disease or antithrombotic therapy are common, and they are worsened by intraoperative blood loss and fluid replacement. The coagulation reactions in vivo are incredibly complex interactions among blood cells, proteins, and vasculature, standing in sharp contrast to rather simple treatment options including transfusion of platelets, plasma, and cryoprecipitate...
August 27, 2016: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/27595667/the-next-10-years-innovations-transforming-outcomes-in-liver-transplantation-advances-in-anesthesia-and-critical-care
#20
Helge Eilers
No abstract text is available yet for this article.
September 6, 2016: Liver Transplantation
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