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Transplant anesthesia

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https://www.readbyqxmd.com/read/29303422/use-training-and-opinions-about-effectiveness-of-transesophageal-echocardiography-in-adult-liver-transplantation-among-anesthesiologists-in-the-united-states
#1
Jeron Zerillo, Bryan Hill, Sang Kim, Samuel DeMaria, M Susan Mandell
STUDY OBJECTIVE: Describe transesophageal echocardiography (TEE) use, preparatory training and opinions about clinical importance, and future training pathways in a sample of liver transplant anesthesiologists. DESIGN: Online survey questionnaire. SETTING: Liver Transplant Centers in the United States. PARTICIPANTS: Director of Liver Transplant Anesthesia or designated alternate respondent. RESULTS: A total of 79 Directors or alternates from 111 (71%) centers were identified...
January 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29289367/characterizing-predictors-and-severity-of-vasoplegia-syndrome-after-heart-transplantation
#2
Joshua L Chan, Jon A Kobashigawa, Tamar L Aintablian, Sadia J Dimbil, Paul A Perry, Jignesh K Patel, Michelle M Kittleson, Lawrence S Czer, Parham Zarrini, Angela Velleca, Jenna Rush, Francisco A Arabia, Alfredo Trento, Fardad Esmailian
BACKGROUND: Vasoplegia is characterized as a severe vasodilatory shock after cardiac surgery, and can be associated with substantial morbidity. Increased systemic inflammation and endothelial dysfunction, often related to prolonged cardiopulmonary bypass times, anesthesia, or mechanical circulatory support have been shown to be associated with the development of vasoplegia. We sought to identify risk factors and the impact of various degrees of vasoplegia after heart transplantation. METHODS: A retrospective review was conducted of 244 consecutive patients who underwent heart transplantation over a 3-year period...
December 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29276852/organ-donor-management-part-1-toward-a-consensus-to-guide-anesthesia-services-during-donation-after-brain-death
#3
Michael J Souter, E Eidbo, James Y Findlay, Daniel J Lebovitz, Marina Moguilevitch, Nikole A Neidlinger, Gerhard Wagener, Anil S Paramesh, Claus U Niemann, Pamela R Roberts, Ernesto A Pretto
Worldwide 715 482 patients have received a lifesaving organ transplant since 1988. During this time, there have been advances in donor management and in the perioperative care of the organ transplant recipient, resulting in marked improvements in long-term survival. Although the number of organs recovered has increased year after year, a greater demand has produced a critical organ shortage. The majority of organs are from deceased donors; however, some are not suitable for transplantation. Some of this loss is due to management of the donor...
December 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29276090/anesthesia-for-lung-transplantation-in-cystic-fibrosis-retrospective-review-from-the-irish-national-transplantation-centre
#4
Martin Lenihan, Darren Mullane, Donal Buggy, Georgina Flood, Michael Griffin
Cystic fibrosis (CF) is an autosomal recessive disorder affecting approximately 1 in 2,500 live births worldwide, with double this estimated frequency in Ireland. CF is characterized by a genetic defect of the CF transmembrane regulator protein, causing impairment of chloride ion transportation. This has multisystem consequences, particularly in the lungs, where it results in intensely mucoid secretions, which increases susceptibility to infection. Lung transplantation is indicated in CF when there is progressive decline in a patient's functional reserve...
November 23, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29260110/surgical-treatment-outcome-of-medically-refractory-huge-giant-papillary-conjunctivitis
#5
Yien Lai, Gangadhara Sundar, Manotosh Ray
Purpose: To compare the surgical outcome of excision of giant papillae with and without amniotic membrane in a patient with bilateral medically refractory giant papillary conjunctivitis (GPC). Observations: 27-year-old Chinese lady presented with bilateral itchy eyes, discomfort and fullness of upper lids for past two years. She was a long-term contact lens user but stopped completely 2 years ago. Not a known atopic, she had unusually large giant papillae involving both upper tarsal conjunctiva...
December 2017: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29235211/pre-transplant-serum-procalcitonin-level-for-prediction-of-early-post-transplant-sepsis-in-living-donor-liver-transplantation
#6
Takanobu Hara, Akihiko Soyama, Masaaki Hidaka, Koji Natsuda, Tomohiko Adachi, Shinichiro Ono, Satomi Okada, Takashi Hamada, Mitsuhisa Takatsuki, Susumu Eguchi
AIM: Infections are frequent causes of in-hospital mortality after liver transplantation (LT). Elimination of possible risks in the pre-transplant period, early diagnosis of post-transplant sepsis, and prompt administration of antimicrobial agents are important. The objectives of this study were to analyze the impact of early post-transplant sepsis on outcomes and to clarify the value of predictive factors for early post-transplant sepsis. METHODS: The study included 136 patients who underwent initial living donor LT (LDLT) at our institute from April 2009 to December 2016...
December 13, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29229261/preliminary-experience-in-combined-somatic-and-cerebral-oximetry-monitoring-in-liver-transplantation
#7
Tina Hu, Yves Collin, Réal Lapointe, François Martin Carrier, Luc Massicotte, Annik Fortier, Jean Lambert, Franck Vandenbroucke-Menu, André Y Denault
OBJECTIVE: The use of cerebral near-infrared spectroscopy (NIRS) has become widespread in cardiac surgery after research demonstrated an association between perioperative cerebral desaturations and postoperative complications. Somatic NIRS desaturation also is associated with an increased risk of postoperative complications and mortality. The objective of this study was to explore the trends of both somatic and cerebral NIRS during liver transplantation. DESIGN: A prospective, single-site, observational case series...
July 20, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29221922/pediatric-percutaneous-nephrostomy-a-multicenter-experience
#8
Sphoorti Shellikeri, Robert Daulton, Madeleine Sertic, Bairbre Connolly, Mark Hogan, Francis Marshalleck, Anne Marie Cahill
PURPOSE: To analyze technique, outcomes, and complications of a large series of pediatric percutaneous nephrostomy (PCN) procedures performed at 4 tertiary pediatric centers. MATERIALS AND METHODS: Retrospective multicenter study of PCNs performed during an 11-year period. Six hundred seventy-five PCNs were performed on 441 patients (median age: 4 y, range: 1 d-18 y, median weight: 17 kg, range: 0.7-112 kg); 31% were younger than 1 year. The most frequent indications for PCN procedures included hydronephrosis (57%), calculus (14%), and infection (12%)...
December 5, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29189286/epidural-anesthesia-to-facilitate-organ-blood-flow-during-the-first-penile-transplantation-in-the-united-states-a-case-report
#9
Katarina J Ruscic, Grettel J Zamora-Berridi, Francis J McGovern, Curtis Cetrulo, Jonathan M Winograd, Kyle R Eberlin, Branko Bojovic, Dicken S Ko, T Anthony Anderson
Regional anesthesia has been used to help create local sympathectomy and improve blood flow in plastic surgery procedures involving tissue grafts and flaps. However, anesthetic techniques that reduce systemic vascular resistance must be used with caution in patients with aortic stenosis (AS). Combined neuraxial and general anesthesia with careful titration of the local anesthetic dose can be a safe approach for patients with AS undergoing microvascular procedures. We present the anesthetic management of the first North American penile transplant, on an obese patient with moderate AS...
November 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29174749/takotsubo-cardiomyopathy-following-induction-of-anesthesia-for-lung-transplantation-an-unexpected-complication
#10
Gary Duclos, Alexandre Mignon, Laurent Zieleskiewicz, Charlotte Kelway, Jean-Marie Forel, Franck Thuny, Pascal-Alexandre Thomas, Marc Leone
No abstract text is available yet for this article.
October 16, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29174123/intraoperative-anesthetic-management-of-lung-transplantation-center-specific-practices-and-geographic-and-centers-size-differences
#11
Roland Tomasi, David Betz, Sophie Schlager, Tobias Kammerer, Dominik J Hoechter, Thomas Weig, Peter Slinger, Laura V Klotz, Bernhard Zwißler, Nandor Marczin, Vera von Dossow
OBJECTIVE: Although increasing evidence in lung transplantation (LTx) suggests that intraoperative management could influence outcomes, there are no guidelines available regarding intraoperative management of LTx. The overall goal of the study was to assess geographic and center volume-specific clinical practices in perioperative management. DESIGN: Prospective data analysis. SETTING: Online survey from a single-center university hospital...
May 17, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29168236/a-prospective-multicenter-phase-ii-study-of-intrabone-marrow-transplantation-of-unwashed-cord-blood-using-reduced-intensity-conditioning
#12
Masaya Okada, Taizo Tasaka, Kazuhiro Ikegame, Nobuyuki Aotsuka, Takeshi Kobayashi, Yuho Najima, Yoshiko Matsuhashi, Hideho Wada, Hirotoshi Tokunaga, Shinichi Masuda, Yoshikazu Utsu, Satoshi Yoshihara, Katsuji Kaida, Takashi Daimon, Hiroyasu Ogawa
Cord blood transplantation (CBT) is associated with delayed hematopoietic recovery and graft failure. To overcome these problems, we conducted a prospective, multicenter phase II study of intrabone marrow transplantation in which patients received reduced-intensity conditioning without anti-thymocyte globulin. The primary endpoint was the probability of full donor engraftment. Forty patients with hematologic malignancies were enrolled. CB cells were injected without washing into 4 iliac bone sites (2 at each hemipelvis), at which approximately 6 mL of CB was administered at one site with local anesthesia...
November 23, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/29156640/clinical-beneficial-effects-of-using-crystalloid-only-in-recipients-of-living-donor-liver-transplantation
#13
Chia-Jung Huang, Kwok-Wai Cheng, Chao-Long Chen, Shao-Chun Wu, Tsung-Hsiao Shih, Sheng-Chun Yang, Sin-Ei Juang, Ying-En Lee, Chiu-En Huang, Bruno Jawan, Chih-Hsien Wang
OBJECTIVE: Liver transplantation (LT) is a major surgery associated with intraoperative massive fluid shift, which is usually replaced by crystalloid, 5% albumin (colloid) and blood products. We studied 15 patients from 477 consecutive recipients of adult living donor liver transplantation. Each patient received crystalloid only during LT. Whether LT provides any clinical benefit is not clear and must be determined. METHODS AND PATIENTS: The anesthesia records of 477 adult LDLT were reviewed retrospectively...
November 20, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29149949/attitudes-toward-organ-donation-among-relatives-of-the-patients-who-are-being-followed-up-in-intensive-care-and-dialysis-units
#14
B Kahveci, K Topal, Ç Gereklioglu, H Aksoy
INTRODUCTION: This study sought to investigate attitudes toward organ donation (OD) among the relatives of patients who are being followed up in intensive care units (ICU) and dialysis units. MATERIALS AND METHODS: This cross-sectional study was conducted with relatives of the patients who were being followed up in hemodialysis (HD) and peritoneal dialysis (PD) units and Neurosurgery, Neurology, Anesthesia, and Reanimation ICUs of Adana Numune Research and Training Hospital...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29131005/a-review-of-anesthetic-effects-on-renal-function-potential-organ-protection
#15
Negar Motayagheni, Sheshanna Phan, Crystal Eshraghi, Ala Nozari, Anthony Atala
BACKGROUND: Renal protection is a critical concept for anesthesiologists, nephrologists, and urologists, since anesthesia and renal function are highly interconnected and can potentially interfere with one another. Therefore, a comprehensive understanding of anesthetic drugs and their effects on renal function remains fundamental to the success of renal surgeries, especially transplant procedures. Some experimental studies have shown that some anesthetics provide protection against renal ischemia/reperfusion (IR) injury, but there is limited clinical evidence...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29110788/worldwide-trends-in-heart-and-lung-transplantation-guarding-the-most-precious-gift-ever
#16
REVIEW
Vera von Dossow, Joseph Costa, Frank D'Ovidio, Nandor Marczin
Transplantation is sadly a therapy to die for. The survival of a recipient with end-stage heart or lung disease requires the demise of a human being through brain death or cessation of circulation, with the noblest final act of offering one's organs to another. However, transplantation is constrained by severe hemodynamic, regulatory, inflammatory, and metabolic stresses in the donor, rendering the majority of offered organs unsuitable for transplantation. Coupled with our inability to acquire exact molecular and cellular information and missed opportunities for effectively modulating deteriorations of donors and allografts, anesthesia and critical care contributes to ongoing organ shortages...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29103962/corneal-stroma-enhancement-with-decellularized-stromal-laminas-with-or-without-stem-cell-recellularization-for-advanced-keratoconus
#17
Jorge L Alió Del Barrio, Mona El Zarif, Albert Azaar, Nehman Makdissy, Charbel Khalil, Walid Harb, Ibrahim El Achkar, Ziad Abdul Jawad, María P de Miguel, Jorge L Alió
PURPOSE: Phase-1 study to preliminarily evaluate the safety and efficacy of decellularized human corneal stromal lamina transplantation with or without autologous adipose derived adult stem cells (ADASC) recellularization within the corneal stroma of patients with advanced keratoconus. DESIGN: Phase one clinical trial METHODS: Femtosecond-assisted 120μm-thickness and 9mm-diameter laminas were obtained from the anterior stroma of human donor corneas and decellularized with a sodium dodecyl sulfate solution...
November 2, 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29099537/use-of-peripherally-inserted-central-venous-catheters-piccs-in-children-receiving-autologous-or-allogeneic-stem-cell-transplantation
#18
Stefano Benvenuti, Rosanna Ceresoli, Giovanni Boroni, Filippo Parolini, Fulvio Porta, Daniele Alberti
INTRODUCTION: The aim of our study was to present our experience with the use of peripherally inserted central catheters (PICCs) in pediatric patients receiving autologous or allogenic blood stem-cell transplantation. The insertion of the device in older children does not require general anesthesia and does not require a surgical procedure. METHODS: From January 2014 to January 2017, 13 PICCs were inserted as a central venous device in 11 pediatric patients submitted to 14 autologous or allogeneic stem-cell transplantation, at the Bone Marrow Transplant Unit of the Children's Hospital of Brescia...
October 31, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29067599/legislative-enforcement-of-nonconsensual-determination-of-neurological-brain-death-in-muslim-patients-a-violation-of-religious-rights
#19
Mohamed Y Rady, Joseph L Verheijde
Death is defined in the Quran with a single criterion of irreversible separation of the ruh (soul) from the body. The Quran is a revelation from God to man, and the primary source of Islamic knowledge. The secular concept of death by neurological criteria, or brain death, is at odds with the Quranic definition of death. The validity of this secular concept has been contested scientifically and philosophically. To legitimize brain death for the purpose of organ donation and transplantation in Muslim communities, Chamsi-Pasha and Albar (concurring with the US President's Council on Bioethics) have argued that irreversible loss of capacity for consciousness and breathing (apneic coma) in brain death defines true death in accordance with Islamic sources...
October 24, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/29050500/prophylactic-fibrinogen-decreases-postoperative-bleeding-but-not-acute-kidney-injury-in-patients-undergoing-heart-transplantation
#20
Alireza Jahangirifard, Z H Ahmadi, Farah Naghashzadeh, Babak Sharif-Kashani, Farin Rashid-Farokhi, Ali Afshar, Reyhaneh Yamini-Sharif, Yousef Rezaei
The present study is the premier clinical attempt to scrutinize the practicability of prophylactic fibrinogen infusion in patients undergoing heart transplantation (HT). A total of 67 consecutive patients who had undergone HT between January 2012 and December 2014 were assessed. After exclusion of some patients, 23 patients were given preoperative 2 g fibrinogen concentrate over a period of 15 minutes after the termination of cardiopulmonary bypass pump and complete reversal of heparin, and 30 patients were not given...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
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