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"Intestinal transplant"

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https://www.readbyqxmd.com/read/29622402/vascular-invasion-and-survival-after-liver-transplantation-for-hepatocellular-carcinoma-a-study-from-the-european-liver-transplant-registry
#1
Hans-Christian Pommergaard, Andreas A Rostved, René Adam, Lau C Thygesen, Mauro Salizzoni, Miguel A Gómez Bravo, Daniel Cherqui, Franco Filipponi, Karim Boudjema, Vincenzo Mazzaferro, Olivier Soubrane, Juan C García-Valdecasas, Joan F Prous, Antonio D Pinna, John O'Grady, Vincent Karam, Christophe Duvoux, Allan Rasmussen
BACKGROUND: Studies suggest that vascular invasion may be a superior prognostic marker compared with traditional selection criteria, e.g. Milan criteria. This study aimed to investigate the prognostic value of micro and macrovascular invasion in a large database material. METHODS: Patients liver transplanted for HCC and cirrhosis registered in the European Liver Transplant Registry (ELTR) database were included. The association between the Milan criteria, Up-to-seven criteria and vascular invasion with overall survival and HCC specific survival was investigated with univariate and multivariate Cox regression analyses...
April 2, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29610163/recanalization-of-occluded-central-veins-in-a-parenteral-nutrition-dependent-child-with-no-access
#2
Patrick M Sullivan, Russell Merritt, Juan Carlos Pelayo, Frank F Ing
Central venous thromboses are common and pose challenges in the care of chronically ill pediatric patients. Among patients with intestinal failure (most commonly because of short bowel syndrome) who depend on parenteral nutrition, progressive loss of central venous access sites is a potentially fatal complication. We present the case of a 5-year-old girl with parenteral nutrition-dependent short bowel syndrome and no remaining standard central venous access sites despite medical anticoagulation, in whom angioplasty and stent implantations were used to reconstruct chronically occluded central veins...
April 2018: Pediatrics
https://www.readbyqxmd.com/read/29605022/posttransplant-complications-in-adult-recipients-of-intestine-grafts-without-bowel-decontamination
#3
Jared W Clouse, Chandrashekhar A Kubal, Jonathan A Fridell, Richard S Mangus
BACKGROUND: Selective digestive decontamination is commonly used to decrease lumenal bacterial flora. Preoperative bowel decontamination may be associated with a lower wound infection rate but has not been shown to decrease risk of intra-abdominal abscess or lower leak rate for enteric anastomoses. Alternatively, the decontamination disrupts the normal flora of the gastrointestinal tract and may affect normal physiology, including immunologic function. This study reports complication rates of an intestine transplant program that has never used bowel decontamination...
May 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29596174/chapter-5-2-4-intestinal-transplantation-on-a-long-and-uneven-road-from-the-past-to-the-future
#4
Florence Lacaille, Girish Gupte, Olivier Goulet
No abstract text is available yet for this article.
April 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29570554/paediatric-intestinal-pseudo-obstruction-evidence-and-consensus-based-recommendations-from-an-espghan-led-expert-group
#5
Nikhil Thapar, Efstratios Saliakellis, Marc A Benninga, Osvaldo Borrelli, Joe Curry, Christophe Faure, Roberto De Giorgio, Girish Gupte, Charles H Knowles, Annamaria Staiano, Yvan Vandenplas, Carlo Di Lorenzo
OBJECTIVES: Chronic intestinal pseudo-obstructive (CIPO) conditions are considered the most severe disorders of gut motility. They continue to present significant challenges in clinical care despite considerable recent progress in our understanding of pathophysiology, resulting in unacceptable levels of morbidity and mortality. Major contributors to the disappointing lack of progress in paediatric CIPO include a dearth of clarity and uniformity across all aspects of clinical care from definition and diagnosis to management...
March 22, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29543344/graft-versus-host-disease-after-multivisceral-transplantation-a-uk-center-experience-and-update-on-management
#6
Lisa M Sharkey, Sarah Peacock, Neil K Russell, Stephen J Middleton, Andrew J Butler
Graft versus host disease (GVHD) following transplantation of an intestine-containing graft occurs more frequently than with other solid organ transplants and is known to have a poor outcome. The presentation differs from other solid organ transplants, as the gastrointestinal tract is not involved following intestinal transplant. Diagnosis is based on clinical symptoms arising due to native tissue damage and the detection of donor T lymphocytes in circulating blood (T cell chimerism). The ideal treatment strategy has not been defined, with advocates for both increased or decreased immunosuppression...
March 15, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29534292/prevalence-evolution-and-risk-factors-for-advanced-liver-fibrosis-in-adults-undergoing-intestinal-transplantation
#7
Geneviève Huard, M Isabel Fiel, Jang Moon, Kishore Iyer, Thomas D Schiano
INTRODUCTION: Intestinal failure-associated liver disease (IFALD) occurs commonly in intestinal transplant (ITx) candidates receiving parenteral nutrition (PN). The aim of this study is to establish the prevalence and risk factors for advanced liver fibrosis in adults at the time of ITx. METHODS: Retrospective chart review of all ITx was performed in adults between January 2000 and May 2014. Advanced liver fibrosis was defined as stage 3 or stage 4 fibrosis. RESULTS: Fifty-three patients met the inclusion criteria...
March 13, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29528830/imaging-of-intestinal-and-multivisceral-transplantation
#8
Mitchell A Rees, Nikhil B Amesur, Ruy J Cruz, Amir A Borhani, Kareem M Abu-Elmagd, Guilherme Costa, Anil K Dasyam
Intestinal transplantation has evolved from its experimental origins in the mid-20th century to its status today as an established treatment option for patients with end-stage intestinal failure who cannot be sustained with total parenteral nutrition. The most common source of intestinal failure in both adults and children is short-bowel syndrome, but a host of other disease processes can lead to this common end-point. The development of intestinal transplantation has presented multiple hurdles for the transplant community, including technical challenges, immunologic pitfalls, and infectious complications...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29511548/citrulline-as-a-marker-of-intestinal-function-and-absorption-in-clinical-settings-a-systematic-review-and-meta-analysis
#9
REVIEW
Konstantinos C Fragkos, Alastair Forbes
Background: Citrulline has been described as a marker of intestinal function or absorption but evidence varies according to clinical settings. Objective: The objective of this article is to examine the evidence of plasma citrulline as a marker of intestinal function and absorption in various clinical settings. Methods: Studies were examined for p values, means and standard deviations, correlation coefficients or other metrics depicting the association of citrulline with intestinal function...
March 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29509288/myeloid-derived-suppressor-cells-increase-and-inhibit-donor-reactive-t-cell-responses-to-graft-intestinal-epithelium-in-intestinal-transplant-patients
#10
Shinji Okano, Kareem Abu-Elmagd, Danielle D Kish, Karen Keslar, William M Baldwin, Robert L Fairchild, Masato Fujiki, Ajai Khanna, Mohammed Osman, Guilherme Costa, John Fung, Charles Miller, Hiroto Kayashima, Koji Hashimoto
Recent advances in immunosuppressive regimens have decreased acute cellular rejection (ACR) rates and improved intestinal transplant (ITx) recipient survival. We investigated the role of myeloid-derived suppressor cells (MDSCs) in ITx. We identified MDSCs as CD33+ CD11b+ lineage(CD3/CD56/CD19)- HLA-DR-/low cells with 3 subsets, CD14- CD15- (e-MDSC), CD14+ CD15- (M-MDSC), and CD14- CD15+ (PMN-MDSC), in peripheral blood mononuclear cells (PBMCs) and mononuclear cells in the grafted intestinal mucosa. Total MDSC numbers increased in PBMCs following ITx; among MDSC subsets, M-MDSC numbers were maintained at high level after 2 months following ITx...
March 6, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29505674/outcomes-of-left-split-graft-transplantation-in-europe-report-from-the-european-liver-transplant-registry-eltr
#11
Roberta Angelico, Alessandra Nardi, René Adam, Silvio Nadalin, Wojciech G Polak, Vincent Karam, Roberto Troisi, Paolo Muiesan
BACKGROUND: Split liver transplantation(SLT) has been widely adopted across Europe resulting in remarkable reduction of the paediatric waiting-list mortality. Left split graft(LSG) are commonly used for paediatric recipients, however deceased donor criteria selection aren't universal. METHOD: The aim of this study was to analyse the LSG outcome from the European Liver Transplant Registry and to identify risk factors of graft failure. Data from 1500 children transplanted in 2006-2014 with LSG from deceased donors were retrospectively analysed...
March 5, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29498797/visceral-transplantation-in-patients-with-intestinal-failure-associated-liver-disease-evolving-indications-graft-selection-and-outcomes
#12
REVIEW
Jason S Hawksworth, Chirag S Desai, Khalid M Khan, Stuart S Kaufman, Nada Yazigi, Raffaele Girlanda, Alexander Kroemer, Thomas M Fishbein, Cal S Matsumoto
Intestinal failure (IF)-associated liver disease (IFALD) is widely recognized as a lethal complication of long-term parenteral nutrition. The pathophysiology of IFALD is poorly understood but appears to be multifactorial and related to the inflammatory state in the patient with IF. Visceral transplant for IFALD includes variants of intestine, liver, or combined liver-intestine allografts. Graft selection for an individual patient depends on the etiology of IF, abdominal and vascular anatomy, severity of IFALD, and potential for intestinal rehabilitation...
March 2, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29498160/complications-in-pediatric-intestine-transplantation-in-the-absence-of-peri-operative-donor-or-recipient-bowel-decontamination
#13
Jared W Clouse, Chandrashekhar A Kubal, Jonathan A Fridell, Richard S Mangus
This study reports the clinical complication and infection rates of an active pediatric IT program that has never utilized bowel decontamination in either the donor or the recipient. All patients undergoing IT from 2003 to 2015 at a single pediatric IT center were reviewed. Post-transplant surgical, infectious, and immunosuppressive complications are reported. There were 52 patients who underwent IT during the study period. Among these patients, 4% developed a postoperative abscess, one developed an enteric fistula (2%), and one had an enteric or anastomotic leak (2%)...
March 2, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29485511/small-for-size-syndrome-does-not-occur-in-intestinal-transplantation-without-liver-containing-grafts
#14
Jang I Moon, Thomas D Schiano, Alyssa Burnham, Kwai Lam, Kishore R Iyer
BACKGROUND: The ideal donor in intestinal transplantation is generally considered to be 50 - 70% of recipient body weight. This may be due to concerns for "small for size" syndrome as seen in liver transplantation. We report our experience using smaller donors (donor-recipient weight ratio, DRWR < 50%) in intestinal transplantation (ITX) recipients. METHODS: We studied a group of ITX recipients with DRWR ≤ 50% to unmatched controls who received intestinal allografts with DRWR > 50%...
February 26, 2018: Transplantation
https://www.readbyqxmd.com/read/29479440/liver-inclusive-intestinal-transplantation-results-in-decreased-alloimmune-mediated-rejection-but-increased-infection
#15
Guosheng Wu, Ruy J Cruz
Background and aims: A co-transplanted liver allograft has been thought to protect other organs from rejection-mediated injury; however, detailed analyses of co-transplanted liver on intestinal allograft outcomes have not been conducted to date. The aim of the study was to compare immune-mediated injury, causes of graft failure and clinical outcomes between recipients who underwent either a liver-inclusive intestinal transplant (LITx) or liver-exclusive intestinal transplant (LETx). Methods: Between May 2000 and May 2010, 212 adult patients undergoing LITx ( n  =76) and LETx ( n  =136) were included...
February 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29478887/long-term-outcomes-of-intestinal-rehabilitation-in-children-with-neonatal-very-short-bowel-syndrome-parenteral-nutrition-or-intestinal-transplantation
#16
Lorenzo Norsa, Solene Artru, Cecile Lambe, Cecile Talbotec, Benedicte Pigneur, Frank Ruemmele, Virginie Colomb, Carmen Capito, Christophe Chardot, Florence Lacaille, Olivier Goulet
BACKGROUND & AIMS: Intestinal rehabilitation is the preferred treatment for children with short bowel syndrome (SBS) whatever the residual bowel length, and depends on the accurate management of long-term parenteral nutrition (PN). If nutritional failure develops, intestinal transplantation (ITx) should be discussed and may be life-saving. This study aimed to evaluate survival, PN dependency and nutritional status in children with neonatal very SBS on PN or after ITx, in order to define indications and timing of both treatments...
February 15, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29465439/intestinal-re-transplantation-indications-techniques-and-outcomes
#17
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...
April 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
#18
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
#19
Nimisha Sulejmani, Shunji Nagai, Mohamed Safwan, Michael D Rizzari, Mohammad Raoufi, Marwan S Abouljoud, Mayur Ramesh
BACKGROUND: 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 U.S. Food and Drug Administration-approved medications exist for the treatment of adenovirus disease...
April 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29427406/risk-factors-for-clostridium-difficile-infection-in-intestinal-transplant-recipients-during-the-first-year-post-transplant
#20
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
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