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"Multivisceral transplant"

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https://www.readbyqxmd.com/read/28538578/total-abdominal-wall-transplantation-an-anatomical-study-and-classification-system
#1
David Light, Neilendu Kundu, Risal Djohan, Cristiano Quintini, Namita Gandhi, Brian R Gastman, Richard Drake, Maria Siemionow, James E Zins
BACKGROUND: Candidates for multivisceral transplantation present with complex defects often beyond traditional reconstructive options. In this study, the authors describe a dissection technique for a total abdominal wall vascularized composite flap. In addition, the authors suggest a classification system for complex abdominal wall defects. METHODS: Forty fresh, cadaveric hemiabdomens were dissected, with care taken to preserve the iliofemoral, deep circumflex iliac, superficial circumflex iliac, deep inferior epigastric, and superficial inferior epigastric arteries and corresponding veins...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28481070/-negative-pressure-system-in-the-treatment-of-enterocutaneous-fistulas-in-the-pediatric-population
#2
V Núñez Cerezo, M I Romo Muñoz, M V Amesty Morello, A Vilanova Sánchez, M Dore Reyes, M Gómez Cervantes, A M Andrés Moreno, E Martínez-Ojinaga Nodal, L Martínez Martínez, M López Santamaría
AIM OF THE STUDY: The management of children with enterocutaneous fistulas (EF) along with large abdominal wall defects secondary to multiple surgical interventions can be difficult and sometimes lead to intestinal failure (IF). The aim of this study is to present the results of negative pressure systems and their properties (edema reduction angiogenesis promotion and granulation tissue formation) in children with enterocutaneous fistulas (EF) and their prognosis. MATERIALS AND METHODS: A retrospective analysis of children with refractory, high output EF treated with NPS between 2008-2014...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28434656/an-overview-of-eu-and-usa-intestinal-transplant-current-activity
#3
A Lauro, F Panaro, K R Iyer
AIM OF THE STUDY: To report the current activity of intestinal transplantation in Europe (EU) and Unites States of America (USA), underlining outcomes in the last 5 years and discussing possible trends. PATIENTS AND METHODS: Data review of results was performed through analysis of ITR and UNOS registries, Eurotransplant and newsletter transplant reports, congress abstracts, international published literature, personal communications and hospital web sites. RESULTS: The absence in Europe of a sole organization collecting donors and the presence of many low-volume centers (less than 5 cases/year) makes the difference with USA: in the last 5 years (2010-2014), 222 intestinal/multivisceral transplants have been performed in EU countries (most of them in the UK), while in USA, the number of transplants achieved 634 procedures in the same period of time...
April 20, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28422396/a-simplified-multivisceral-transplantation-procedure-for-patients-with-combined-end-stage-liver-disease-and-type-2-diabetes-mellitus
#4
Xiao-Shun He, Shun-Jun Fu, Qiang Zhao, Xiao-Feng Zhu, Dong-Ping Wang, Ming Han, Wei-Qiang Ju, Yi Ma, Jiao Xing-Yuan, Xiao-Peng Yuan, An-Bin Hu, Zhi-Yong Guo
In liver transplant patients with type 2 diabetes mellitus (DM), the disease worsens after transplantation because of long-term use of diabetogenic immunosuppressive drugs, making management of those patients a great challenge. The objective of our study was to evaluate the safety and efficacy of a simplified multivisceral transplantation (SMT) procedure for the treatment of patients with end-stage liver disease and concurrent type 2 DM. Forty-four patients who had pretransplant type 2 DM were included. Twenty-three patients received SMT and 21 patients received orthotopic liver transplantation (OLT)...
April 19, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28393434/multivisceral-transplantation-for-abdominal-tumors-in-children-a-single-center-experience-and-review-of-the-literature
#5
Eliza Lee, Nicole Hodgkinson, Rima Fawaz, Khashayar Vakili, Heung Bae Kim
Standard management of intra-abdominal pediatric solid tumors requires complete resection. However, tumors with multiple organ and vascular involvement present a unique surgical challenge. We conducted a retrospective chart review of four patients, aged 2-14 years, undergoing MVT for intra-abdominal tumors with significant involvement of the visceral arteries and/or portomesenteric venous system at our institution. Indications for MVT included hepatocellular carcinoma, inflammatory myofibroblastic tumor, and two cases of hepatoblastoma...
April 9, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28362060/maintenance-immunosuppression-for-adults-undergoing-liver-transplantation-a-network-meta-analysis
#6
REVIEW
Manuel Rodríguez-Perálvarez, Marta Guerrero-Misas, Douglas Thorburn, Brian R Davidson, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy
BACKGROUND: As part of liver transplantation, immunosuppression (suppressing the host immunity) is given to prevent graft rejections resulting from the immune response of the body against transplanted organ or tissues from a different person whose tissue antigens are not compatible with those of the recipient. The optimal maintenance immunosuppressive regimen after liver transplantation remains uncertain. OBJECTIVES: To assess the comparative benefits and harms of different maintenance immunosuppressive regimens in adults undergoing liver transplantation through a network meta-analysis and to generate rankings of the different immunosuppressive regimens according to their safety and efficacy...
March 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28273399/clinical-presentation-and-outcomes-of-norovirus-infection-in-intestinal-allograft-compared-to-native-intestine
#7
Diana F Florescu, Jessica L Sonderup, Wendy Grant, Pearlie P Chong, David van Duin, Andre C Kalil
BACKGROUND: No data are available on clinical manifestations and course of norovirus gastroenteritis (NVE) in intestinal allograft (from intestinal and multivisceral transplant recipients, ITR) compared to native intestine (from other allograft recipients, nITR). METHODS: This was a retrospective study of solid organ transplant recipients with NVE at two centers from January 1, 2010 to April 1, 2014. Chi-square, t-test, linear and logistic regression analyses were done to compare NVE in ITR vs nITR patients...
March 8, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28151808/techniques-for-abdominal-wall-reconstruction-in-intestinal-transplantation
#8
Gabriel E Gondolesi, Nicolás F Aguirre
PURPOSE OF REVIEW: One of the most important challenges in the intestinal (ITx) and multivisceral transplant (MVTx) is to achieve a successful abdominal wall closure. RECENT FINDINGS: A tension-free primary closure should be our aim. In most of the cases, we need to perform a component separation technique, alone or combined, to the use of a synthetic mesh. If those options are not feasible, the abdominal wall composite vascularized allograft transplant (AW-CVA) utilizing direct orthotopic vascularization can be considered...
February 1, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28130374/current-status-of-intestinal-and-multivisceral-transplantation
#9
REVIEW
Shishira Bharadwaj, Parul Tandon, Tushar D Gohel, Jill Brown, Ezra Steiger, Donald F Kirby, Ajai Khanna, Kareem Abu-Elmagd
Clinical-nutritional autonomy is the ultimate goal of patients with intestinal failure (IF). Traditionally, patients with IF have been relegated to lifelong parenteral nutrition (PN) once surgical and medical rehabilitation attempts at intestinal adaptation have failed. Over the past two decades, however, outcome improvements in intestinal transplantation have added another dimension to the therapeutic armamentarium in the field of gut rehabilitation. This has become possible through relentless efforts in the standardization of surgical techniques, advancements in immunosuppressive therapies and induction protocols and improvement in postoperative patient care...
January 26, 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/27932149/portal-vein-inflow-from-enlarged-coronary-vein-in-liver-transplantation-surgical-approach-and-technical-tips-a-case-report
#10
M Safwan, S Nagai, M S Abouljoud
Portal vein thrombosis is common in patients with end-stage liver disease, with an incidence as high as 26% in liver transplant candidates. It is known to be associated with a high risk of morbidity and mortality posttransplantation, and its management can be challenging. The management options range from a simple thrombendvenectomy to multivisceral transplantation in cases with diffuse portomesenteric thrombosis. We report a case of liver transplantation in which we performed a rare reconstruction of the portal vein...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27788782/could-sentinel-skin-transplants-have-some-utility-in-solid-organ-transplantation
#11
J M Ali, P Catarino, J Dunning, H Giele, G Vrakas, J Parmar
Accurate diagnosis of allograft rejection can be hazardous and challenging. A strategy that has emerged from experience with vascularized composite allografts (VCAs) is the use of sentinel skin transplants (SSTs)-portions of donor skin transplanted synchronously to an allograft. Work in nonhuman animal models and experience with VCAs suggest concordance between rejection occurring in the primary allograft and the SST, and that appearance of rejection in the SST may precede rejection in the primary allograft, permitting early therapeutic intervention that may improve outcomes with lower rates of chronic rejection...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27569969/hospital-readmissions-after-intestinal-and-multivisceral-transplantation
#12
Y K Kwon, K Etesami, A L Sharp, C S Matsumoto, T M Fishbein, R Girlanda
BACKGROUND: Intestinal transplant recipients require frequent hospital readmission after a successful transplantation, but the reasons for readmission have not been characterized in detail. METHODS: We reviewed our single-center experience to characterize the patterns of readmissions and to identify preventable causes. Among 87 adult patients who received an intestinal or multivisceral transplant, 65 patients (35 males, 30 females; median age, 42 years [range, 19-66]) with a follow-up of at least 1 year were included in this study...
July 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27495916/the-abdominal-wall-transplant-as-a-sentinel-skin-graft
#13
James Barnes, Fadi Issa, Georgios Vrakas, Peter Friend, Henk Giele
PURPOSE OF REVIEW: Abdominal wall transplantation is a technique used to achieve abdominal closure after intestinal and multivisceral transplantation. This review focuses on whether there are additional benefits for the skin component as an immune-monitoring tool. RECENT FINDINGS: The largest series of abdominal wall transplants has recently been published. Alongside the physiological advantage gained in abdominal closure, the authors describe the immunological insight that the skin component can provide and how this contributes to the management of patients...
October 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27495766/non-hla-antibodies-may-accelerate-immune-responses-after-intestinal-and-multivisceral-transplantation
#14
Undine Ariane Gerlach, Nils Lachmann, Giuseppina Ranucci, Birgit Sawitzki, Constanze Schoenemann, Johann Pratschke, Duska Dragun, Andreas Pascher
BACKGROUND: Non-HLA alloantibodies and autoantibodies are involved in allograft rejection in kidney and heart transplantation. Their role in intestinal transplantation has not yet been described. We examined the development of antiangiotensin II type I receptor antibodies (anti-AT1R) and antiendothelin type A receptor antibodies associated with the clinical course and histopathological findings of intestinal transplantation recipients. METHODS: Thirty-seven patients underwent intestinal or multivisceral transplantation...
January 2017: Transplantation
https://www.readbyqxmd.com/read/27149335/scleromatous-changes-in-an-abdominal-wall-graft-graft-versus-graft-disease-or-chronic-graft-rejection
#15
Nicholas J Olson, Daniel B Wimmer, Daniel P Croitoru, Dorothea T Barton, Gregory D Seidel, M Shane Chapman, Konstantinos Linos
Abdominal wall transplants are relatively new procedures that are frequently performed in conjunction with multivisceral transplants. The skin of the abdominal wall transplant is often the first site for graft rejection to manifest itself. Prompt recognition can lead to appropriate treatment before the involvement of the underlying viscera. However, the signs of graft rejection are nonspecific and can overlap with other entities. We present a case of a patient who received a multivisceral and abdominal wall transplant from 2 different donors, who presented with acute and eventually chronic graft rejection of the abdominal wall graft...
January 2017: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/27140671/skype-clinics-after-intestinal-transplantation-follow-up-beyond-post-codes
#16
Undine A Gerlach, Georgios Vrakas, Lydia Holdaway, Marion O'Connor, Rubens Macedo, Srikanth Reddy, Peter J Friend, Henk Giele, Anil Vaidya
The follow-up after intestinal transplantation (ITX) is complex and limited to specialized centers. ITX recipients often travel all over the country to be seen in the outpatient clinic of specialized centers which is costly and time-consuming. Videoconferences through Skype have been implemented to eliminate travel time, costs, and to improve patient compliance without jeopardizing safety. Eighteen of 19 patients followed up after ITX or modified multivisceral transplantation (MMVTX) in conventional outpatient clinics in Oxford agreed to attend additional Skype clinics...
July 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27113513/urgent-multivisceral-transplantation-for-widespread-splanchnic-ischemia
#17
Lisa M Sharkey, Neil K Russell, Charlotte S Rutter, Stephen J Middleton, J Andrew Bradley, Neville V Jamieson, Andrew J Butler
BACKGROUND: Multivisceral transplantation (transplantation of the stomach, intestine, liver, and pancreas) is usually undertaken as a semi-elective procedure after thorough assessment in patients who have intestinal failure with cirrhosis, cirrhosis with portomesenteric venous thrombosis, or tumors such as desmoids involving the liver and mesentery. STUDY DESIGN: Data were collected prospectively from the time of referral and held in a central database. We used it to report the first cases of urgent multivisceral transplantation (MVT) in patients with widespread splanchnic ischemia (occlusion of the celiac axis and superior mesenteric artery) resulting in small bowel infarction and hepatic failure...
May 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27109998/case-report-spleen-preserving-multivisceral-transplant-for-peutz-jeghers-syndrome
#18
L Moulin, N Pedraza, J Padin, S Niveyro, G Tuhay, C Rumbo, P Barros Schelotto, A Crivelli, H Solar Muñiz, D Ramisch, G Gondolesi
CASE REPORT: A 24-year-old man diagnosed with Peutz-Jeghers syndrome as a child underwent multiple surgeries owing to intussusception. Pretransplant workup showed >150 polyps along the gastrointestinal (GI) tract, some of them with high-grade dysplasia. Despite having intestinal sufficiency, a modified multivisceral transplantation was offered. PROCEDURE: An 18-year-old donor was procured using University of Wisconsin solution. The recipient's surgery started with a midline incision...
March 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27109997/case-report-multivisceral-transplantation-for-an-extensive-cystic-lymphangioma-of-the-mesenteric-root
#19
L Moulin, C Rumbo, P Romero, N Pedraza, D Garcia Hervá, G Orce, J Trentadue, D Ramisch, G Gondolesi
BACKGROUND: We report the case of a 7-year-old girl with intestinal failure owing to a cystic lymphangioma compromising the root of the mesentery, not amenable to resection, leading to intestinal failure. Oncologic treatment was attempted to reduce tumor size with no response; therefore, she was listed for multivisceral transplantation. PROCEDURE: Resection of the tumor required resection of all abdominal organs with vascular inflow and outflow. A multivisceral graft (liver, stomach, duodenum-pancreas and spleen complex, small bowel, and right colon) was implanted...
March 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27109996/aortic-graft-mycotic-pseudoaneurysm-as-a-severe-complication-after-multivisceral-transplantation-a-case-report
#20
J Calvo Pulido, M Manrique Municio, C Loinaz Segurola, I Justo Alonso, O Caso Maestro, A García-Sesma, F Cambra Molero, R San-Juan Garrido, M Abradelo de Usera, A Marcacuzco Quinto, E Moreno González, C Jiménez Romero
BACKGROUND: Surgical complications in multivisceral transplantation (MVT) are frequent and always severe. Those related to technical issues are relevant as they have implications not only on the graft but also on patient survival. The aim of this study was to review our case-based data and experience with 5 MVT performed since December 2004. CASE REPORT: A 38 year-old woman presented with ultra-short bowel syndrome due to massive ischemia also affecting the celiac trunk...
March 2016: Transplantation Proceedings
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