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Transplant anesthesia

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https://www.readbyqxmd.com/read/29768341/the-plethysmographic-variability-index-does-not-predict-fluid-responsiveness-estimated-by-esophageal-doppler-during-kidney-transplantation-a-controlled-study
#1
Morgan Le Guen, Arnaud Follin, Etienne Gayat, Marc Fischler
Research is ongoing to find a noninvasive method of monitoring, which can predict fluid responsiveness in patients undergoing kidney transplantation.To compare the responses to fluid challenges with the Pleth Variability Index, a noninvasive dynamic index derived from plethysmographic variability (Radical 7 pulse oximeter; Masimo Corporation, Irvine, CA), and the esophageal Doppler, the criterion standard.Observational study.University hospital; study from May 2011 and May 2012.Forty-eight patients with end-renal function were included and 44 analyzed...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29764373/a-subclinical-high-tricuspid-regurgitation-pressure-gradient-independent-of-the-mean-pulmonary-artery-pressure-is-a-risk-factor-for-the-survival-after-living-donor-liver-transplantation
#2
Yosuke Saragai, Akinobu Takaki, Yuzo Umeda, Takashi Matsusaki, Tetsuya Yasunaka, Atsushi Oyama, Ryuji Kaku, Kazufumi Nakamura, Ryuichi Yoshida, Daisuke Nobuoka, Takashi Kuise, Kosei Takagi, Takuya Adachi, Nozomu Wada, Yasuto Takeuchi, Kazuko Koike, Fusao Ikeda, Hideki Onishi, Hidenori Shiraha, Shinichiro Nakamura, Hiroshi Morimatsu, Hiroshi Ito, Toshiyoshi Fujiwara, Takahito Yagi, Hiroyuki Okada
BACKGROUND: Portopulmonary hypertension (POPH) is characterized by pulmonary vasoconstriction, while hepatopulmonary syndrome (HPS) is characterized by vasodilation. Definite POPH is a risk factor for the survival after orthotopic liver transplantation (OLT), as the congestive pressure affects the grafted liver, while subclinical pulmonary hypertension (PH) has been acknowledged as a non-risk factor for deceased donor OLT. Given that PH measurement requires cardiac catheterization, the tricuspid regurgitation pressure gradient (TRPG) measured by echocardiography is used to screen for PH and congestive pressure to the liver...
May 15, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29725794/cardiac-output-measurement-in-liver-transplantation-patients-using-pulmonary-and-transpulmonary-thermodilution-a-comparative-study
#3
Luigi Vetrugno, Elena Bignami, Federico Barbariol, Nicola Langiano, Francesco De Lorenzo, Carola Matellon, Giuseppe Menegoz, Giorgio Della Rocca
During liver transplantation surgery, the pulmonary artery catheter-despite its invasiveness-remains the gold standard for measuring cardiac output. However, the new EV1000 transpulmonary thermodilution calibration technique was recently introduced into the market by Edwards LifeSciences. We designed a single-center prospective observational study to determine if these two techniques for measuring cardiac output are interchangeable in this group of patients. Patients were monitored with both pulmonary artery catheter and the EV1000 system...
May 3, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29708917/epidural-anesthesia-to-facilitate-organ-blood-flow-during-the-first-penile-transplantation-in-the-united-states-a-case-report
#4
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...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29701620/use-of-nitrous-oxide-in-dermatology-a-systematic-review
#5
Erica A Brotzman, Laura F Sandoval, Jonathan Crane
BACKGROUND: Many dermatologic procedures are painful and can be distressing to patients. OBJECTIVE: To determine whether nitrous oxide has been used in dermatology and whether literature supports its use in terms of providing analgesia and anxiety associated with dermatologic procedures. METHODS: A search of PubMed and Cochrane databases was conducted through July 15, 2016, to identify studies involving nitrous oxide use in dermatology. RESULTS: Eight studies were identified and reviewed...
May 2018: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/29701539/an-update-in-abdominal-organ-transplantation-anesthesia-in-2018-society-for-the-advancement-of-transplant-anesthesia-sata
#6
Jeron Zerillo, Michael Ramsay, M Susan Mandell, Tetsuro Sakai
No abstract text is available yet for this article.
June 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29699477/effects-of-bacterial-translocation-on-hemodynamic-and-coagulation-parameters-during-living-donor-liver-transplant
#7
Heba A Moharem, Fawzia Aboul Fetouh, Hamed M Darwish, Doaa Ghaith, Mohamed Elayashy, Amr Hussein, Riham Elsayed, Mohammad M Khalil, Amr Abdelaal, Mahmoud ElMeteini, Ahmed Mukhtar
BACKGROUND: Bacterial translocation (BT) has been proposed as a trigger for stimulation of the immune system with consequent hemodynamic alteration in patients with liver cirrhosis. However, no information is available regarding its hemodynamic and coagulation consequences during liver transplantation. METHODS: We screened 30 consecutive adult patients undergoing living-donor liver transplant for the presence of BT. Bacterial DNA, Anti factor Xa (aFXa), thromboelastometry, tumor necrosis factor-α TNF-α, and interleukin-17 (IL-17) values were measured in sera before induction of anesthesia...
April 25, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29690758/hyperthermia-associated-with-biliary-obstruction-during-living-donor-liver-transplantation
#8
Hyeryung Kang, Joohyun Park, Jeong Jin Lee, Gaab-Soo Kim
Intraoperative hypothermia occurs frequently, but hyperthermia is relatively rare during general anesthesia. We experienced a case of hyperthermia during living donor liver transplantation that appeared to be significantly associated with biliary obstruction. A 65-year-old male patient was diagnosed with intrahepatic cholangiocarcinoma, and living donor liver transplantation was planned after confirmation of no metastasis via intraoperative frozen biopsy. Following resection of a segment of common bile duct for frozen biopsy, the surgeon clamped the common bile duct, and the patient's body temperature increased gradually to 39...
April 25, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29661451/ischemia-with-preconditioning-in-wistar-rats-maintains-mitochondrial-respiration-even-with-mild-hepatocellular-disturbance
#9
R R Tártaro, G L Jorge, A H Dianin, C A F Escanhoela, I F S F Boin
INTRODUCTION: In hepatectomy or liver transplantation, preconditioning is a procedure indicated to protect the organ from ischemia-reperfusion injury (I-R). OBJECTIVE: Evaluate the effect of preconditioning after hepatic I-R in Wistar rats, through mitochondrial respiration, liver histology, and profile. METHOD: Twenty male Wistar rats, weighing on average 307.1 g, were anesthetized with sodium thiopental (25 mg/kg) intravenously and xylazine hydrochloride (30 mg/kg) intramuscularly...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29630119/intramuscular-islet-allotransplantation-in-type-1-diabetes-mellitus
#10
F Bertuzzi, G Colussi, A Lauterio, L De Carlis
OBJECTIVE: Alternative sites to the liver for islet transplantation have been studied for a long time. Intramuscular islet transplantation appears to be an alternative site to the liver because of the ease of access. First islet autotransplantations were reported in patients after total pancreatectomies. The transplanted islets showed a proper revascularization and their function was observed for up to 2 years after the implant. However, only a few cases of autotransplantation and no allotransplantation have been performed...
March 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29621960/experimental-uterus-transplant-in-various-models-review-of-surgical-techniques
#11
Jalal Arvin, Maryam Ashrafi, Saeedeh Lotfi, Arash Dadvand Meshgin Shahr, Elvira Schomann, Kristina Scheerer, Elke Schulmeyer
Uterus transplantation may become the surgical therapeutic modality of choice for uterine factor infertility. However, this procedure still faces technical, therapeutic, and immunologic challenges that limit its success and clinical application. Experimental studies are therefore still needed to address various challenges in the field of uterus transplantation. Among various laboratory animals, small animals are ideal models for the purpose of experimental uterus transplant. However, clinical success in small animal models is not generalizable to clinical application and treatment for uterine factor infertility in humans...
April 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29605864/robotic-kidney-autotransplantation-in-a-porcine-model-a-procedure-specific-training-platform-for-the-simulation-of-robotic-intracorporeal-vascular-anastomosis
#12
Ho Yee Tiong, Benjamin Yen Seow Goh, Edmund Chiong, Lincoln Guan Lim Tan, Anatharaman Vathsala
Robotic-assisted kidney transplantation (RKT) with the Da Vinci (Intuitive, USA) platform has been recently developed to improve outcomes by decreasing surgical site complications and morbidity, especially in obese patients. This potential paradigm shift in the surgical technique of kidney transplantation is performed in only a few centers. For wider adoption of this high stake complex operation, we aimed to develop a procedure-specific simulation platform in a porcine model for the training of robotic intracorporeal vascular anastomosis and evaluating vascular anastomoses patency...
March 31, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29605279/epstein-barr-virus-associated-smooth-muscle-tumor-involving-the-spine-of-an-hiv-infected-patient-case-report-and-review-of-the-literature
#13
Jeffrey S Ehresman, A Karim Ahmed, Doreen N Palsgrove, Zachary Pennington, C Rory Goodwin, Daniel M Sciubba
Within the last two decades, there have been multiple reports of Epstein-Barr virus (EBV)-associated smooth muscle tumors in immunocompromised patients. This includes HIV-infected patients, post-transplant patients, and patients with congenital defects of their immune systems. Here we report the case of a 24-year-old African American female with congenital HIV presenting with progressive lower extremity weakness, constipation, aching pain in her shoulders, and subcostal anesthesia. Magnetic resonance imaging (MRI) revealed a large circumferential lesion extending from T1-T3 and a smaller left paraspinal lesion at C6-C7...
March 28, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29603862/intraoperative-hypoxia-secondary-to-pneumothorax-the-role-of-lung-ultrasound
#14
Cristian Mirabile, Sophie Malekzadeh-Milani, Tran Quang Vinh, Ayman Haydar
Intraoperative pneumothorax during general anesthesia is a dangerous event. It is a possible cause of sudden intraoperative hypoxia, which can be critical especially in high-risk patients such as those with end-stage heart failure. Early diagnosis and effective treatment are essential. We describe the case of a pneumothorax during cardiac transplantation, diagnosed by ultrasound and immediately treated. A good skill in lung ultrasound is advantageous in the management of intraoperative hypoxia, particularly for prompt diagnosis of pneumothorax...
March 30, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29593185/effectiveness-of-using-non-invasive-continuous-arterial-pressure-monitoring-with-clearsight-in-hemodynamic-monitoring-during-living-renal-transplantation-in-a-recipient-a-case-report
#15
Nami Kakuta, Yasuo M Tsutsumi, Chiaki Murakami, Yoko Sakai, Takuro Oyama, Asuka Kasai, Katsuyoshi Kume, Katsuya Tanaka
We investigated the effectiveness of the ClearSight system for hemodynamic management during kidney transplantation for a recipient. The recipient was to receive a kidney transplant from his mother under general anesthesia. We used continuous noninvasive finger-cuff-based monitoring of blood pressure, provided by the ClearSight system, and stroke volume variation to predict fluid responsiveness. We used of a balanced anesthetic technique and stringent monitoring standards to ensure a successful outcome for the patient...
2018: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/29567039/corrigendum-to-extracorporeal-support-during-bilateral-sequential-lung-transplantation-in-patients-with-pulmonary-hypertension-risk-factors-and-outcomes-journal-of-cardiothoracic-and-vascular-anesthesia-volume-31-2-2017-418-425
#16
Pranav R Shah, Michael L Boisen, Daniel G Winger, Jose Marquez, Christian A Bermudez, Jay K Bhama, Norihisa Shigemura, Jonathan D'Cunha, Kathirvel Subramaniam
No abstract text is available yet for this article.
March 19, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29566216/micro-autologous-fat-transplantation-for-treating-a-gummy-smile
#17
Shu-Hung Huang, Yu-Hao Huang, Yun-Nan Lin, Su-Shin Lee, Chih-Kang Chou, Tsung-Ying Lin, Hidenobu Takahashi, Yur-Ren Kuo, Chung-Sheng Lai, Sin-Daw Lin, Tsai-Ming Lin
Background: A gummy smile is treated using a number of techniques, including botulinum toxin injection and various surgical interventions. Micro-autologous fat transplantation (MAFT) is a potentially advantageous alternative approach that has not been previously evaluated. Objective: This study sought to determine the long-term results of MAFT in patients with a gummy smile. Methods: Seven patients with gummy smiles were evaluated for MAFT treatment between October 2015 and April 2017...
March 16, 2018: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29538210/comparison-of-postoperative-coagulation-profiles-and-outcome-for-sugammadex-versus-pyridostigmine-in-992-living-donors-after-living-donor-hepatectomy
#18
Young-Jin Moon, Sung-Hoon Kim, Jae-Won Kim, Yoon-Kyung Lee, In-Gu Jun, Gyu-Sam Hwang
Donor safety is the major concern in living donor liver transplantation, although hepatic resection may be associated with postoperative coagulopathy. Recently, the use of sugammadex has been gradually increased, but sugammadex is known to prolong prothrombin time (PT) and activated partial thromboplastin time (aPTT). We compared the postoperative coagulation profiles and outcomes of sugammadex versus pyridostigmine group in donors receiving living donor hepatectomy.Consecutive donor hepatectomy performed between September 2013 and August 2016 was retrospectively analyzed...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29534703/a-novel-quick-transendoscopic-enteral-tubing-in-mid-gut-technique-and-training-with-video
#19
Chuyan Long, Yan Yu, Bota Cui, Sabreen Abdul Rahman Jagessar, Jie Zhang, Guozhong Ji, Guangming Huang, Faming Zhang
BACKGROUND: This study aimed to evaluate the feasibility, safety, and value of a quick technique for transendoscopic enteral tubing (TET) through mid-gut. METHODS: A prospective interventional study was performed in a single center. A TET tube was inserted into mid-gut through the nasal orifice and fixed on the pylorus wall by one tiny titanium endoscopic clip under anesthesia. The feasibility, safety, success rate, and satisfaction with TET placement were evaluated for enteral nutrition or fecal microbiota transplantation...
March 13, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29527745/galt-ko-pig-lungs-are-highly-susceptible-to-acute-vascular-rejection-in-baboons-which-may-be-mitigated-by-transgenic-expression-of-hcd47-on-porcine-blood-vessels
#20
Hironosuke Watanabe, Hisashi Sahara, Shunichiro Nomura, Tatsu Tanabe, Dilrukshi K Ekanayake-Alper, Lennan K Boyd, Nathan J Louras, Arsenoi Asfour, Makenzie A Danton, Siu-Hong Ho, Scott J Arn, Robert J Hawley, Akira Shimizu, Takeshi Nagayasu, David Ayares, Marc I Lorber, Megan Sykes, David H Sachs, Kazuhiko Yamada
BACKGROUND: Despite recent progress in survival times of xenografts in non-human primates, there are no reports of survival beyond 5 days of histologically well-aerated porcine lung grafts in baboons. Here, we report our initial results of pig-to-baboon xeno-lung transplantation (XLTx). METHODS: Eleven baboons received genetically modified porcine left lungs from either GalT-KO alone (n = 3), GalT-KO/humanCD47(hCD47)/hCD55 (n = 3), GalT-KO/hD47/hCD46 (n = 4), or GalT-KO/hCD39/hCD46/hCD55/TBM/EPCR (n = 1) swine...
March 12, 2018: Xenotransplantation
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