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"Intestinal transplant"

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https://www.readbyqxmd.com/read/29046035/-laboratorial-alteration-preceding-staphylococcal-infection-clinical-manifestations-after-intestinal-transplantation
#1
Wilma Carvalho Neves Forte, Alliny Oliveira Carvalho Galvan, Pedro Salem Molino, Thais Roque, Tainá Mosca, Wangles Soler
BACKGROUND: Hospital-acquired infection, often with Staphylococcus aureus, is an important complication in intestinal transplant. CLINICAL CASE: A 2-year-old girl underwent small bowel transplantation owing to a small bowel volvulus. On the first postoperative day, lymphocyte phenotypes, serum immunoglobulins and chemotactic and phagocytic activity of neutrophils were assessed in peripheral blood. A decrease in the ingestion phase of phagocytosis by neutrophils was identified, in comparison with the results of 20 healthy children...
July 2017: Revista Alergia Mexico: Organo Oficial de la Sociedad Mexicana de Alergia e Inmunología, A.C
https://www.readbyqxmd.com/read/29039892/step-by-step-male-to-female-transsexual-surgery
#2
Rodrigo Uliano Moser da Silva, Fernando Jahn da Silva Abreu, Gabriel M V da Silva, João Vitor Quadra Vieira Dos Santos, Nelson Sivonei da Silva Batezini, Brasil Silva, Tiago Elias Rosito
INTRODUCTION: After the diagnosis of transsexualism is confirmed therapy commences with psychotherapeutic preparation for the conversion, and after conversion, long-term patient rehabilitation is maintained for at least two years. The indication for surgery is chronic discomfort caused by discord with the patient's natural gender, intense dislike of developing secondary sex characteristics and the onset of puberty. The surgical conversion of transsexuals is the main step in the complex care of these problematic patients (1)...
October 17, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29026878/robotic-assisted-live-donor-ileal-segmentectomy-for-intestinal-transplantation
#3
Guosheng Wu, Qianjing Li, Qingchuan Zhao, Weizhong Wang, Hai Shi, Mian Wang, Jianyong Zheng, Mengbing Li, Daiming Fan
BACKGROUND: Every effort should be made to optimize surgical techniques and to minimize potential morbidity rates associated with live donor operations. Advances in a minimally invasive approach by robotic surgery to donor nephrectomy have raised the possibility of applying this technique to live donor bowel resections for intestinal transplantation. METHODS: We report the first 5 consecutive cases of a robotic-assisted live donor ileal segmentectomy. We describe the technical aspects of the procedure, discuss the rationale for considering this option, and evaluate potential advantages of this approach...
October 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28987256/liver-disease-in-patients-on-total-parenteral-nutrition
#4
REVIEW
Arnab Mitra, Joseph Ahn
Parenteral nutrition-associated liver disease (PNALD) spectrum ranges from liver enzyme abnormalities to steatosis to fibrosis, and, eventually, cirrhosis from total parenteral nutrition (TPN). The pathophysiology is postulated to be multifactorial. Diagnosis in adults is primarily by exclusion, eliminating other causes of chronic liver disease or cirrhosis, and other factors seen in critically ill or postoperative patients on TPN. Principal treatment is avoiding TPN. If this is not feasible, research supports fish oil-based lipid emulsions in TPN formulations to reduce risk and progression of PNALD...
November 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28964480/pediatric-intestinal-transplantation
#5
Kyle A Soltys, Geoff Bond, Rakesh Sindhi, Sara K Rassmussen, Armando Ganoza, Ajai Khanna, George Mazariegos
The field of intestinal transplantation has experienced dramatic growth since the first reported cases 3 decades ago. Improvements in operative technique, donor assessment and immunosuppressive protocols have afforded children who suffer from life-threatening complications of intestinal failure a chance at long-term survival. As experience has grown, newer diseases, with more systemic manifestations have arisen as potential indications for transplant. After discussing the historical developments of intestinal transplant as a backdrop, this review focuses on the specific pre-operative indications for transplant as well as the great success that intestinal rehabilitation has witnessed over the past decade...
August 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28944322/advances-in-small-bowel-transplantation
#6
REVIEW
Alp Gürkan
Small bowel transplantation is a life-saving surgery for patients with intestinal failure. The biggest problem in intestinal transplantation is graft rejection. Graft rejection is the main reason for morbidity and mortality. Rejection has a negative effect on the survival of the graft. While 50%-75% of small bowel transplantation patients experience acute rejection, chronic rejection occurs in approximately 15% of patients. Immune monitoring is crucial after small bowel transplantation. Unlike other types of transplantation, there are no non-invasive or reliable markers to predict rejection in small bowel transplantation...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28937976/tissue-engineering-for-the-treatment-of-short-bowel-syndrome-in-children
#7
REVIEW
Laura Y Martin, Mitchell R Ladd, Adam Werts, Chhinder P Sodhi, John C March, David J Hackam
Short bowel syndrome is a major cause of morbidity and mortality in children. Despite decades of experience in the management of short bowel syndrome, current therapy is primarily supportive. Definitive treatment often requires intestinal transplantation, which is associated with significant morbidity and mortality. In order to develop novel approaches to the treatment of short bowel syndrome, we and others have focused on the development of an artificial intestine, by placing intestinal stem cells on a bioscaffold that has an absorptive surface resembling native intestine, and taking advantage of neovascularization to develop a blood supply...
September 22, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28918445/pre-emptive-intestinal-transplant-the-surgeon-s-point-of-view
#8
REVIEW
Augusto Lauro, Ignazio R Marino, Kishore R Iyer
Pre-emptive transplantation is a well-established practice for certain types of end-organ failure such as in the use of kidney transplantation. For irreversible intestinal failure, total parenteral nutrition (TPN) remains the gold standard, due to the suboptimal long-term results of intestinal transplantation. As such, the only role for pre-emptive transplantation, if at all, will be for patients identified to be at high risk of complications and mortality while on definitive long-term TPN. In these patients, the timing of early listing and transplantation could become life-saving, taking into account that mortality on the waiting list is still the highest for intestinal candidates...
September 16, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28866623/epidemiology-management-and-outcome-of-ultrashort-bowel-syndrome-in-infancy
#9
REVIEW
Akshay Batra, Simon Charlie Keys, Mark John Johnson, Robert A Wheeler, Robert Mark Beattie
Ultrashort bowel syndrome (USBS) is a group of heterogeneous disorders where the length of small bowel is less than 10 cm or 10% of expected for the age. It is caused by massive loss of the gut which in the neonatal period can be a result of vanishing gastroschisis or surgical resection following mid-gut volvulus, jejunoileal atresia and/or extensive necrotising enterocolitis. The exact prevalence of USBS is not known although there is a clear trend towards increasing numbers because of increased incidence and improved survival...
September 2, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28854959/hemophagocytic-lymphohistiocytosis-presenting-in-a-pediatric-patient-with-near-total-colonic-and-small-bowel-aganglionosis-a-case-report
#10
Brittany Badal, Michael J Wilsey, Sara Karjoo
BACKGROUND: Total colonic and small bowel aganglionosis is a rare condition typically requiring intestinal transplant for long-term survival. There have not been any previously reported cases of near total intestinal aganglionosis complicated by concerns for hemophagocytic lymphohistiocytosis and need for both multivisceral organ transplant and hematopoietic stem cell transplant. CASE PRESENTATION: Our patient is a 35-month-old Egyptian boy who presented with bilious emesis and failure to pass meconium shortly after birth...
August 31, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28845319/diagnostic-lessons-from-a-complex-case-of-postintestinal-transplantation-enteropathy
#11
Cian Wade, Philip Allan, Elena Collantes, Srikanth R Reddy, Peter J Friend, Georgios Vrakas
Recent advances in the field of intestinal transplantation have been mitigated by the incidence of allograft rejection. In such events, early identification and appropriate timing of antirejection therapy are crucial in retaining graft function. We present the case of a patient who suffered severe postintestinal transplantation allograft enteropathy, primarily characterized by extensive mucosal ulcerations, and was refractory to all conventional therapy. This progressed as chronic rejection; however crucially this was not definitively diagnosed until allograft function had irreversibly diminished...
2017: Case Reports in Transplantation
https://www.readbyqxmd.com/read/28843648/5-gene-differential-expression-predicts-stability-of-human-intestinal-allografts
#12
Paloma Talayero, Lola Alonso-Guirado, Guillermo Padilla, Haydee Artaza, Ana Dopazo, Fátima Sánchez-Cabo, Sarbelio Rodríguez-Muñoz, Jorge Calvo-Pulido, Esther Mancebo, Mario García de Lacoba, Estela Paz-Artal
In intestinal allografts, endoscopy and histology detect the injury once changes in the bowel wall architecture have occurred. We aimed to identify a molecular signature that could predict early deterioration, within histologically indistinguishable biopsies with "minimal changes" (MC) pathology. Sixty biopsies from 12 adult recipients were longitudinally taken during 8years post-transplant. They were classified as either stable (STA) or non-stable (NSTA) according to the prospectively recorded number, frequency and severity of rejection events of the allograft...
August 24, 2017: Experimental and Molecular Pathology
https://www.readbyqxmd.com/read/28837507/clinical-report-intestinal-rehabilitation-programs-in-the-management-of-pediatric-intestinal-failure-and-short-bowel-syndrome
#13
Russell J Merritt, Valeria Cohran, Bram P Raphael, Timothy Sentongo, Diana Volpert, Brad W Warner, Praveen S Goday
Intestinal failure is a rare, debilitating condition that presents both acute and chronic medical management challenges. The condition is incompatible with life in the absence of the safe application of specialized and individualized medical therapy that includes surgery, medical equipment, nutritional products, and standard nursing care. Intestinal rehabilitation (IR) programs are best suited to provide such complex care with the goal of achieving enteral autonomy and oral feeding with or without intestinal transplantation...
August 23, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28807200/a-sequential-assessment-of-the-preservation-injury-in-porcine-intestines
#14
Mihai Oltean, Lucian Jiga, Mats Hellström, John Söfteland, Marius Papurica, Teodora Hoinoiu, Mihai Ionac, Anna Casselbrant
BACKGROUND: Clinical and experimental evidence strongly suggest that ischemia-reperfusion injury after intestinal transplantation has deleterious short- and long-term effects and finding means to reduce ischemia-reperfusion injury is a major research area. The anatomical and physiological similarities between the human and porcine digestive tract favor its use as a preclinical model for translational research. Intriguingly, no systematic appraisal of the development of the intestinal preservation injury in pigs is available...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28805088/the-current-therapeutic-options-for-crohn-s-disease-from-medical-therapy-to-intestinal-transplantation
#15
Augusto Lauro, Francesco D'Amico, Gabriel Gondolesi
Crohn's disease (CD) has an annual incidence per 100.000 person-year of 20.2 in North America and 12.7 in Europe, and the purpose of this review is to evaluate its medical management, from diagnosis to transplant. Pharmacologic manipulation with nutritional care aims to achieve and maintain remission, but more than half of patients will undergo an intestinal resection, very often repeated over time. They could experience short bowel syndrome (SBS) requiring total parenteral nutrition (TPN). Intestinal transplantation (ITx) represents an alternative in case of irreversible intestinal failure (IF) with life-threatening TPN complications...
August 21, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28801969/anesthetic-management-for-intestinal-transplantation-a-decade-of-experience
#16
Jeron Zerillo, Sang Kim, Bryan Hill, David Shapiro, Hung-Mo Lin, Alyssa Burnham, Jang Moon, Kishore Iyer, Samuel DeMaria
BACKGROUND: Intestinal transplantation (ITx) is the definitive therapy for patients suffering from intestinal failure. Previously published reports suggest that these cases should be managed perioperatively with the same intensive monitors and techniques as in liver transplantation. METHODS: We retrospectively reviewed the anesthetic management of 67 isolated intestinal, intestinal-pancreas, and intestinal-kidney transplants over the previous decade (2005-2015) in our tertiary care institution...
August 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28795840/a-complete-histologic-approach-to-gastrointestinal-biopsy-from-hematopoietic-stem-cell-transplant-patients-with-evidence-of-transplant-associated-gastrointestinal-thrombotic-microangiopathy
#17
Mikako Warren, Sonata Jodele, Christopher Dandoy, Kasiani C Myers, Gregory Wallace, Adam Nelson, Javier El-Bietar
CONTEXT: - Transplant-associated thrombotic microangiopathy is a serious complication of hematopoietic stem cell transplant that may progress to multi-organ dysfunction. Transplant-associated thrombotic microangiopathy may involve the intestinal vasculature (intestinal transplant-associated thrombotic microangiopathy [iTMA]), causing patients to experience debilitating symptoms of ischemic colitis, including disproportionately severe abdominal pain and gastrointestinal bleeding, requiring heavy narcotic use and frequent transfusion support...
August 10, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28707991/a-case-study-of-intractable-diarrhea-due-to-neonatal-microvillous-inclusion-disease
#18
Ozgul Bulut, Bulent Ahishali, Mine Gulluoglu, Sertac Arslanoglu
BACKGROUND: Microvillous inclusion disease (MVID) is one of the most severe congenital diarrhea disorders, caused by a genetic defect in enterocyte differentiation and polarization. CASE REPORT: We describe a neonate who presented with severe weight loss, hypernatremic dehydration and metabolic acidosis due to intractable diarrhea due to MVID, confirmed by electron microscopy. CONCLUSION: MVID can present with severe weight loss, hypernatremic dehydration and metabolic acidosis that is life threatening...
August 2017: Fetal and Pediatric Pathology
https://www.readbyqxmd.com/read/28701261/five-year-survival-and-causes-of-death-in-patients-on-home-parenteral-nutrition-for-severe-chronic-and-benign-intestinal-failure
#19
Francisca Joly, Janet Baxter, Michael Staun, Darlene G Kelly, Yi Lisa Hwa, Olivier Corcos, Antonella De Francesco, Federica Agostini, Stanislaw Klek, Lidia Santarpia, Franco Contaldo, Cora Jonker, Geert Wanten, Luisa Chicharro, Rosa Burgos, Andre Van Gossum, Cristina Cuerda, Nuria Virgili, Loris Pironi
BACKGROUND & AIM: Home parenteral nutrition (HPN) is the primary treatment for chronic intestinal failure (IF). Intestinal transplantation (ITx) is indicated when there is an increased risk of death due to HPN complications or to the underlying disease. Age, pathophysiologic conditions and underlying disease are known predictors of HPN dependency and overall survival. Although the cause of death on HPN is mostly related to underlying disease in these patients, the relationship between mortality and duration of HPN use remains unclear...
June 19, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28670855/medication-adherence-among-adolescent-solid-organ-transplant-recipients-a-survey-of-healthcare-providers
#20
Pooja Mehta, Elizabeth A Steinberg, Sarah L Kelly, Cindy Buchanan, Alana Resmini Rawlinson
The aim of this study was to assess healthcare provider perspectives on barriers to medication adherence and to discover recommendations for interventions among providers of pediatric solid-organ transplant patients. An anonymous online survey was administered to a multidisciplinary pool of pediatric transplant providers from February 2015 to March 2016. It consisted of 15 questions regarding transplant providers' attitudes, clinical practice, and beliefs pertaining to medication adherence among teenage solid-organ transplant recipients...
November 2017: Pediatric Transplantation
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