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https://www.readbyqxmd.com/read/29465439/intestinal-re-transplantation-indications-techniques-and-outcomes
#1
Armando Ganoza, Neslihan Celik, George V Mazariegos
PURPOSE OF REVIEW: The field of intestinal transplantation has shown significant growth and has become the gold standard therapy for patients that suffer from the complications of total parenteral nutrition due to irreversible intestinal failure. In the early years of intestinal transplant, retransplantation was associated with extremely high morbidity and mortality. The purpose of this review is to summarize recent encouraging reports, showing significant improvement in outcomes after intestinal retransplantation...
February 19, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29461274/long-term-results-of-intestinal-transplantation-in-children-survival-after-10-years-intestinal-function-quality-of-life
#2
Robert S Venick
PURPOSE OF REVIEW: The review aims to describe in detail contemporary medical, nutritional, and psychosocial results in pediatric intestinal transplant (ITx) recipients greater than 10 years removed from their transplant, and to highlight significant long-term post-ITx challenges and complications. The review will draw from recent publications in the field, the ITx registry as well as detailed unpublished data from a large, well established single center. RECENT FINDINGS: The majority of long-term ITx survivors are off parenteral nutrition altogether, but a significant number require supplemental tube feeds to gain weight and grow properly...
February 15, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29457839/brincidofovir-as-salvage-therapy-for-adenovirus-disease-in-intestinal-transplant-recipients
#3
Nimisha Sulejmani, Shunji Nagai, Mohamed Safwan, Michael D Rizzari, Mohammad Raoufi, Marwan S Abouljoud, Mayur Ramesh
Adenoviruses are double-stranded DNA viruses that typically cause mild self-limiting respiratory, ocular, and gastrointestinal infections. In immunocompromised patients, especially transplant recipients, the infection can be severe, with dissemination and multiorgan failure. In intestinal transplant recipients, the incidence is as high as 57%. To our knowledge, no standardized guidelines or United States Food and Drug Administration-approved medications exist for the treatment of adenovirus disease. We describe two isolated intestinal transplant recipients who developed adenovirus disease (viremia with viral enteritis) that was managed with a new experimental drug, brincidofovir (an oral lipid conjugate prodrug of cidofovir), as salvage therapy...
February 19, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29427406/risk-factors-for-clostridium-difficile-infection-in-intestinal-transplant-recipients-during-the-first-year-post-transplant
#4
Luis Guzman, Fang Qiu, Andre C Kalil, David F Mercer, Alan Langnas, Diana F Florescu
BACKGROUND: C. difficile is the most common cause of healthcare-associated infectious diarrhea. Risk factors for C. difficile infections (CDI) in intestinal transplant recipients (ITR) are not well defined. The aim of our study was to assess specific risk factors for CDI in ITR. METHODS: This is a 1:3 case-control study that included 29 ITR who developed CDI (cases) and 87 ITR without CDI (controls) observed during the first year post transplantation. Wilcoxon rank sum and Fisher's exact tests were used to compare variables...
February 10, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29413013/nutritional-interventions-in-chronic-intestinal-pseudoobstruction
#5
REVIEW
Donald F Kirby, Sulieman Abdal Raheem, Mandy L Corrigan
Although chronic intestinal pseudo-obstruction (CIPO) is a rare disorder, it presents a wide spectrum of severity that ranges from abdominal bloating to severe gastrointestinal dysfunction. In the worst cases, patients may become dependent upon artificial nutrition via parenteral nutrition or choose to have an intestinal transplant. However, whatever the severity, a patient's quality of life can be seriously compromised. This article defines the disorder and discusses the spectrum of disease and challenges to providing adequate nutrition to help improve a patient's quality of life...
March 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29411474/epidemiology-and-outcome-of-chronic-high-epstein-barr-viral-load-carriage-in-pediatric-kidney-transplant-recipients
#6
Masaki Yamada, Christina Nguyen, Paul Fadakar, Armando Ganoza, Abhinav Humar, Ron Shapiro, Marian G Michaels, Michael Green
The development of EBV infection and PTLD is normally associated with a high EBV viral load in peripheral blood. Observations have previously identified existence of a CHL carrier state that demonstrated variable outcomes based upon the organ which was transplanted. Data defining the incidence and outcome of CHL in pediatric KTx are not well described. The charts of children undergoing isolated KTx at Children's Hospital of Pittsburgh between January 2000 and December 2014 were retrospectively reviewed. EBV loads in the peripheral blood were routinely measured as part of surveillance protocols at our center...
February 6, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29406608/the-optimal-timing-of-hepatitis-c-therapy-in-liver-transplant-eligible-patients-cost-effectiveness-analysis-of-new-opportunities
#7
Paolo A Cortesi, Luca S Belli, Rita Facchetti, Chiara Mazzarelli, Giovanni Perricone, Stella De Nicola, Giancarlo Cesana, Christophe Duvoux, Lorenzo G Mantovani, Mario Strazzabosco
Different strategies of DAAs treatment are currently possible both pre and post liver-transplantation (LT). Clinical and economic consequences of these strategies still need to be adequately investigated; this study aims at assessing their cost-effectiveness. A decision-analytical model was created to simulate the progression of HCV-infected patients listed for decompensated cirrhosis (DCC) or for Hepatocellular carcinoma (HCC). Three DAAs treatment strategies were compared: (i) a 12-week course of DAAs prior to transplantation (PRE-LT), (ii) a 4-week course of DAAs starting at the time of transplantation (PERI-LT), and (iii) a 12-week course of DAAs administered at disease recurrence (POST-LT)...
February 6, 2018: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/29406449/long-term-results-of-surgery-for-bowel-lengthening-how-many-transplants-are-avoided-for-which-patients
#8
Francisco Hernandez, Ane M Andres, Manuel Lopez-Santamaria
PURPOSE OF REVIEW: One of the biggest successes of intestinal rehabilitation programs is that more patients achieve enteral autonomy without transplantation. Many factors are responsible of this accomplishment including new parenteral formulas, better catheter management, surgical management, and the experience of the teams. The purpose of this review is to analyze recent published papers regarding intestinal lengthening procedures trying to find out how many transplantations are avoided and for which patients...
February 5, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29402878/challenges-with-intestine-and-multivisceral-re-transplantation-importance-of-timing-of-re-transplantation-and-optimal-immunosuppression
#9
Chandrashekhar A Kubal, Catherine Pennington, Jonathan Fridell, Burcin Ekser, Plamen Muhaylov, Richard Mangus
BACKGROUND Patients undergoing re-transplantation often receive high doses of immunosuppression, which may lead to an immunocompromised status of the recipient. This study investigates the outcomes after intestine/multivisceral re-transplantation. MATERIAL AND METHODS Clinical outcomes of 23 patients undergoing 24 re-transplantations at a single intestine transplant center were reviewed. Bone marrow suppression was used as a surrogate marker of immunocompromised status, and was defined as platelet count <50 k/mm3 and absolute lymphocyte count <200/mm³...
February 6, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29400258/noteworthy-literature-published-in-2017-for-abdominal-organ-transplantation
#10
Jeron Zerillo, Natalie K Smith, Tetsuro Sakai
In 2017, we identified more than 400 peer reviewed publications on the topic of pancreas transplantation, more than 500 on intestinal transplantation, more than 4000 on renal transplantation, and more than 4700 on liver transplantation. This annual review highlights the most pertinent literature for anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation. We explore a wide range of topics, including risk for and prediction of perioperative complications, recommendations on perioperative management, economic analyses, and education of the trainees in abdominal transplantation anesthesia and critical care...
March 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29399329/intestinal-failure-a-review
#11
REVIEW
Philip Allan, Simon Lal
Intestinal failure (IF) is the inability of the gut to absorb necessary water, macronutrients (carbohydrate, protein, and fat), micronutrients, and electrolytes sufficient to sustain life and requiring intravenous supplementation or replacement. Acute IF (types 1 and 2) is the initial phase of the illness and may last for weeks to a few months, and chronic IF (type 3) from months to years. The challenge of caring for patients with IF is not merely the management of the underlying condition leading to IF or the correct provision of appropriate nutrition or both but also the prevention of complications, whether thromboembolic phenomenon (for example, venous occlusion), central venous catheter-related bloodstream infection, IF-associated liver disease, or metabolic bone disease...
2018: F1000Research
https://www.readbyqxmd.com/read/29397036/antibody-mediated-rejection-in-pediatric-small-bowel-transplantation-capillaritis-is-a-major-determinant-of-c4d-positivity-in-intestinal-transplant-biopsies
#12
Marion Rabant, Maud Racapé, Laetitia-Marie Petit, Jean Luc Taupin, Olivier Aubert, Julie Bruneau, Patrick Barbet, Olivier Goulet, Christophe Chardot, Caroline Suberbielle, Florence Lacaille, Danielle Canioni, Jean-Paul Duong Van Huyen
The diagnostic criteria for antibody-mediated rejection (ABMR) after small bowel transplantation (SBT) are not clearly defined, although the presence of Donor Specific Antibodies (DSA) has been reported to be deleterious for graft survival. We aimed to determine the incidence and prognostic value of DSA and C4d in pediatric SBT and to identify the histopathological features associated with C4d positivity. We studied all intestinal biopsies (IBx) obtained in the first year post-transplantation (n=345) in a prospective cohort of 23 children...
February 3, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29389823/thirty-years-after-the-first-intestinal-transplantation-in-1987-which-indications-are-left-in-2018
#13
Florence Lacaille
No abstract text is available yet for this article.
January 30, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29380442/locoregional-treatments-before-liver-transplantation-for-hepatocellular-carcinoma-a-study-from-the-european-liver-transplant-registry
#14
Hans-Christian Pommergaard, Andreas Arendtsen Rostved, René Adam, Lau Caspar Thygesen, Mauro Salizzoni, Miguel Angel Gómez Bravo, Daniel Cherqui, Paolo De Simone, Karim Boudjema, Vincenzo Mazzaferro, Olivier Soubrane, Juan Carlos García-Valdecasas, Joan Fabregat Prous, Antonio D Pinna, John O'Grady, Vincent Karam, Christophe Duvoux, Allan Rasmussen
INTRODUCTION: Locoregional treatment while on the waiting list for liver transplantation (Ltx) for hepatocellular carcinoma (HCC) has been shown to improve survival. However, the effect of treatment type has not been investigated. We investigate the effect of locoregional treatment type on survival after Ltx for HCC. METHODS: We investigated patients registered in the European Liver Transplant Registry (ELTR) database using multivariate Cox regression survival analysis...
January 30, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29377289/kidney-allograft-survival-outcomes-in-combined-intestinal-kidney-transplant-an-analysis-of-the-unos-optn-database-2000-2014
#15
Irfan Moinuddin, Muhammad Sohail Yaqub, Tim Taber, Muhammad Mujtaba, Asif Sharfuddin
BACKGROUND AND OBJECTIVES: Intestinal transplants carry a high morbidity/mortality. Kidney allograft outcomes after combined intestinal (IT) with kidney transplant (CIKT) remain largely uninvestigated. MATERIALS AND METHODS: The UNOS STAR database was queried to identify all such combined organ transplants from 2000-2015. RESULTS: Out of a total 2,215 (51.4% peds vs 48.6% adults) intestinal transplants, 111 (5.0%) CIKT were identified (32...
January 27, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29356317/the-use-of-vascular-homografts-in-pediatric-small-bowel-transplantation-single-center-experience-over-a-decade
#16
Yong K Kwon, Nathaly Llore, Stuart S Kaufman, Cal S Matsumoto, Thomas M Fishbein, Raffaele Girlanda
Intestinal transplantation in children has evolved with more isolated small intestine transplants being performed compared to combined liver-intestine transplants. Consequently, surgical techniques have changed, frequently requiring the use of vascular homografts of small caliber to revascularize the isolated small intestine, the impact of which on outcomes is unknown. Among 106 pediatric intestine and multivisceral transplants performed at our center since 2003, 33 recipients of an isolated small intestine graft were included in this study...
January 22, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29351131/quality-of-life-on-long-term-parenteral-nutrition-can-it-be-an-indication-for-intestinal-transplantation
#17
Yaron Avitzur, Mar Miserachs
PURPOSE OF REVIEW: Long-term outcomes in patients with intestinal failure and following intestine transplantation have improved significantly over the last decade. With these improvements, listing criteria for intestine transplantation are reevaluated and the role of quality of life (QoL) in patients' outcome is increasingly studied and emphasized. Here, we review the recent literature on QoL before and after intestine transplantation and discuss whether QoL should be considered as a listing criterion for intestine transplantation...
January 17, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29349849/the-optimal-intestinal-segment-length-for-experimental-size-mismatched-intestinal-transplantation-defining-the-maximum-length-with-the-lowest-blood-flow-needs-in-a-porcine-model
#18
Giovanni Frongia, Ali Majlesara, Arash Saffari, Golnaz Emami, Mohammad Golriz, Patrick Günther, Arianeb Mehrabi
Transplanted Intestinal Segments (IS) must match the perfusion capacities of the recipient. This can be challenging during a size-mismatched SBTX. In this study, we defined the maximum IS length with lowest blood flow needs in a porcine model by evaluating the physiological perfusion rates of different IS lengths. Blood flow in the SMA, aorta segment four, and general circulatory parameters were monitored before and after sequential intestinal resection. IS lengths of 30 cm, 60 cm, 120 cm, and 300 cm (n = 8 each) were compared...
January 18, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29334565/reversal-of-intestinal-failure-in-children-with-tufting-enteropathy-supported-with-parenteral-nutrition-at-home
#19
Iona Ashworth, Alexander Wilson, Samuel Aquilina, Raymond Parascandalo, Victor Mercieca, Jurgen Gerada, Sarah Macdonald, Venetia Simchowitz, Susan Hill
OBJECTIVES: To review long-term outcome of Intestinal Epithelial Dysplasia(IED)/tufting enteropathy(TE) patients treated with parenteral nutrition(PN) at home managed by an intestinal failure(IF) rehabilitation service METHODS:: Infants presenting from 1986-2010 with IF, and TE histology were retrospectively reviewed for up to 30 years. Data collected included: outcome, presentation, nutrition(parenteral/enteral), country of residence, race, EpCAM gene, growth, bone age, occupation. RESULTS: 13 patients (6 male) in Malta and the UK with TE histology were established on home PN...
January 13, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29333883/simultaneous-intestinal-and-kidney-transplantation-in-adults
#20
Irum Amin, Charlotte Rutter, Adam Barlow, Neil K Russell, J Andrew Bradley, Andrew Jackson, Andrew J Butler
AIM OF THE STUDY: Intestinal transplantation (IT) is a life-saving procedure for carefully selected patients with intestinal failure. We evaluated patients who had undergone simultaneous intestinal and kidney transplantation (SIKT) to determine whether UK guidelines for inclusion of a renal allograft (dialysis dependent or estimated glomerular filtration rate ((eGFR)) < 45 ml/min/1.73 m2) are justified. METHODS: A single centre analysis was undertaken of adults undergoing IT at the Cambridge Transplant Centre between December 2007 and January 2016...
January 15, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
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