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https://www.readbyqxmd.com/read/29888807/clinical-characteristics-and-outcomes-of-ptld-following-intestinal-transplantation
#1
Laura J Wozniak, Tian L Mauer, Robert S Venick, Jonathan W Said, Roy L Kao, Pamela Kempert, Elizabeth A Marcus, Vilayphone Hwang, Elaine Y Cheng, Ronald W Busuttil, Sue V McDiarmid, Douglas G Farmer
Post-transplant lymphoproliferative disease (PTLD) has the highest incidence following intestinal transplantation (ITx). Our center has seen a recent increase in PTLD. Our aim was to review a single-center PTLD experience with a focus on clinical characteristics and outcomes. We completed a retrospective review of biopsy-proven PTLD cases using a prospectively maintained database of 115 ITx recipients transplanted between 1991-2014. Nineteen (17%) ITx recipients developed 25 PTLD cases during a median follow-up time of 6...
June 11, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29882922/prevention-and-treatment-of-intestinal-failure-associated-liver-disease-in-children
#2
REVIEW
Lorenzo Norsa, Emanuele Nicastro, Angelo Di Giorgio, Florence Lacaille, Lorenzo D'Antiga
Intestinal failure-associated liver disease (IFALD) is a threatening complication for children on long-term parenteral nutrition because of intestinal failure. When progressive and intractable, it may jeopardize intestinal rehabilitation and lead to combined liver and intestinal transplantation. The institution of dedicated intestinal failure centers has dramatically decreased the incidence of such complication. IFALD may rapidly fade away if very early management aimed at preventing progression to end-stage liver disease is provided...
May 24, 2018: Nutrients
https://www.readbyqxmd.com/read/29850987/the-hepatobiliary-complications-of-malnutrition-and-nutritional-support-in-adults
#3
Andrew McNeice, Ryan Scott, Gerard Patrick Rafferty, William Jonathan Cash, Graham Blake Turner
Hepatobiliary complications of hypoalimentation and parenteral nutrition (PN) are widely recognised. Hypoalimentation includes conditions such as anorexia nervosa (AN), obesity malnutrition and liver disease following bariatric surgery. Treatment of the underlying condition causing hypoalimentation can result in an improvement in liver dysfunction. Liver function test abnormalities are also commonly found in patients on PN, with the three main complications being steatosis, cholestasis and biliary system sludge/stones...
May 31, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29782661/comparable-outcomes-in-intestinal-retransplantation-single-center-cohort-study
#4
Burcin Ekser, Chandrashekhar A Kubal, Jonathan A Fridell, Richard S Mangus
BACKGROUND: Graft loss in intestinal transplantation (ITx) is close to 25% in the first year and 50% at 5-year post-transplantation. Although technically and immunologically challenging, intestinal retransplantation is now the 4th most common indication for ITx. METHODS: The aim of this study is to review and compare the outcomes of intestinal retransplantation with primary ITx, which included isolated ITx, modified multivisceral transplantation (mMVTx), and full MVTx, between 2003-2014 at Indiana University...
May 21, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29770706/intestinal-transplants-review-of-normal-imaging-appearance-and-complications
#5
Bashir Hakim, Daniel T Myers, Todd R Williams, Shunji Nagai, John Bonnett
Intestinal transplant (IT) is one of the least common forms of organ transplant but is increasing both in volume of cases and number of centers performing intestinal transplants, with the busiest centers in North America and Europe. IT can be performed in isolation or as part of a multivisceral transplant (MVT). Intestinal failure either in the form of short gut syndrome or functional bowel problems is the primary indication for IT. The normal post-surgical anatomy can be variable due to both recipient anatomy in regard to amount of residual bowel and status of native vasculature as well as whether the transplant is isolated or part of an multivisceral transplant...
May 17, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29755021/a-single-center-experience-of-post-transplant-lymphoproliferative-disorder-ptld-cases-after-pediatric-liver-transplantation-incidence-outcomes-and-association-with-food-allergy
#6
Zeren Barış, Figen Özçay, Özlem Yılmaz Özbek, Nihan Haberal, Faik Sarıalioğlu, Mehmet Haberal
BACKGROUND/AIMS: We evaluated our 16-year single-center experience of pediatric post-transplant lymphoproliferative disorder (PTLD) cases who underwent liver transplantation between 2001 and 2017. MATERIALS AND METHODS: Of the 236 pediatric patients who underwent liver transplantation between 2001 and 2017, the clinical and laboratory data of eight patients diagnosed with PTLD were reviewed. The pre-transplant Epstein-Barr virus (EBV) status of 172 patients was also recorded...
May 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/29752972/urologic-phenotype-and-patterns-of-care-in-patients-with-megacystis-microcolon-intestinal-hypoperistalsis-syndrome-presenting-to-a-major-pediatric-transplantation-center
#7
Lee A Hugar, Rajeev Chaudhry, Thomas W Fuller, Glenn M Cannon, Francis X Schneck, Michael C Ost, Heidi A Stephany
OBJECTIVES: To describe the phenotype, referral pattern, and trends of urologic management for children with megacystis microcolon intestinal hypoperistalsis syndrome. METHODS: We performed a retrospective review of all patients with megacystis microcolon intestinal hypoperistalsis syndrome treated at a large tertiary children's medical center over a 14-year period. Our primary outcomes included the rate of urology referral, urodynamic characteristics of bladder function, and the proportion of patients managed with clean intermittent catheterization...
May 9, 2018: Urology
https://www.readbyqxmd.com/read/29750389/delisting-hcv-infected-liver-transplant-candidates-who-improved-after-viral-eradication-outcome-2-years-after-delisting
#8
Giovanni Perricone, Christophe Duvoux, Marina Berenguer, Paolo A Cortesi, Carmen Vinaixa, Rita Facchetti, Chiara Mazzarelli, Susanne Rasoul-Rockenschaub, Silvia Martini, Cristina Morelli, Sara Monico, Riccardo Volpes, Georges-Philippe Pageaux, Stefano Fagiuoli, Luca S Belli
BACKGROUNDS AND AIMS: Treating patients with decompensated cirrhosis with direct-acting antiviral (DAA) therapy while on the waiting list for liver transplantation, results in substantial improvement of liver function allowing one in four patients to be removed from the waiting list or delisted, as reported in a previous study promoted by the European Liver and Intestine Transplant Association (ELITA). Aim of this study was to report on clinical outcomes of delisted patients, including mortality risk, hepatocellular-carcinoma development, and clinical de-compensation requiring relisting...
May 11, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29746380/one-year-incidence-of-infection-in-pediatric-intestine-transplantation
#9
Jared W Clouse, Chandrashekhar A Kubal, Jonathan A Fridell, Richard S Mangus
BACKGROUND: This study reports the infection rate, location of infection, and pathogen causing bacterial, fungal, or viral infections in intestine transplant recipients at a pediatric transplant center. METHODS: Records from a pediatric center were reviewed for patients receiving an intestine transplant. Positive cultures and pathology reports were used to diagnose bacterial, fungal, and viral infections and also to determine location and infectious agent. Risk for infection was assessed based on liver or colon inclusion, and immunosuppression induction, as part of the intestine transplant...
May 9, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29745058/post-transplant-lymphoproliferative-disorder-in-pediatric-intestinal-transplant-recipients-a-literature-review
#10
REVIEW
Kaitlin Stanley, Erika Friehling, Sarangarajan Ranganathan, George Mazariegos, Linda M McAllister-Lucas, Rakesh Sindhi
Intestinal transplantation is a successful treatment for children with intestinal failure, but has many potential complications. PTLD, a clinically and histologically diverse malignancy, occurs frequently after intestinal transplantation and can be fatal. The management of this disease is particularly challenging. The rejection-prone intestinal allograft requires high levels of immunosuppression, a precondition for PTLD. While EBV infection clearly plays a role in disease pathogenesis, the relatively naïve immune system of children is another likely contributor...
May 10, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29739826/luminal-polyethylene-glycol-alleviates-intestinal-preservation-injury-irrespective-of-molecular-size
#11
Anna Casselbrant, John Mackay Softeland, Mats Hellstrom, Mantas Malinauskas, Mihai Oltean
Intestinal preservation injury (IPI) and the resulting mucosal injury raise several serious challenges early after intestinal transplantation (ITx). The current clinical approach using only vascular perfusion allows the shortest preservation period among the abdominal organs. The experimental addition of luminal polyethylene glycol (PEG) solutions has been repeatedly suggested to alleviate preservation injury, improve graft quality and prolong the preservation time. We investigated if the size of PEG in the solution influences the development of intestinal preservation injury...
May 8, 2018: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/29735031/endoscopic-follow-up-of-intestinal-transplant-recipients
#12
REVIEW
Robert E Carroll
The growing population of intestinal transplant recipients present a unique challenge to the gastroenterologists responsible for their support and evaluation. Improvements in patient and graft survival are largely attributed to surgical advancements, refined antirejection therapy, and enhanced endoscopic surveillance protocols that better perceive rejection and other complications. This article reviews the endoscopic management and interventions provided for transplant recipients at the University of Illinois Hospital with complications, such as acute rejection, ischemia, bleeding, fistula, post-transplant lymphoproliferative disorder, and gastroparesis...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735030/living-donor-intestinal-transplantation
#13
REVIEW
Ivo G Tzvetanov, Kiara A Tulla, Giuseppe D'Amico, Enrico Benedetti
Living donor intestinal transplantation (LDIT) has been improved leading to results comparable to those obtained with deceased donors. LDIT should be limited to specific indications and patient selection. The best indication is combined living donor intestinal/liver transplantation in pediatric recipients with intestinal and hepatic failure; the virtual elimination of waiting time may avoid the high mortality experienced by candidates on the deceased waiting list. Potentially, LDIT could be used in highly sensitized recipients to allow the application of de-sensitization protocols...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735029/pediatric-intestinal-transplantation
#14
REVIEW
Neslihan Celik, George V Mazariegos, Kyle Soltys, Jeffrey A Rudolph, Yanjun Shi, Geoffrey J Bond, Rakesh Sindhi, Armando Ganoza
Pediatric intestinal transplantation has moved from the theoretic to an actual therapy for children with irreversible intestinal failure who are suffering from complications of total parenteral nutrition. Owing to significant advancement in the management of intestinal failure and prevention of parenteral nutrition-related complications that have led to reduction in incidence of parenteral nutrition-associated liver disease and have improved intestinal adaptation, the indications for intestinal transplantation are evolving...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29735028/adult-intestinal-transplantation
#15
REVIEW
Cal S Matsumoto, Sukanya Subramanian, Thomas M Fishbein
Adult intestinal transplantation differs significantly from pediatric intestinal transplantation. While indications have remained largely consistent since 2000, indications for adults have expanded over the last two decades to include motility disorders and desmoid tumors. Graft type in adult recipients depends on the distinct anatomic characteristics of the adult recipient. Colonic inclusion, while initially speculated to portend unfavorable outcomes due to complex host-bacterial interactions has increased over the past two decades with superior graft survival and improved patient quality of life...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29701871/pediatric-intestinal-failure-the-key-outcomes-for-the-first-100-patients-treated-in-a-national-tertiary-referral-center-during-1984-2017
#16
Laura Merras-Salmio, Annika Mutanen, Elisa Ylinen, Risto Rintala, Antti Koivusalo, Mikko P Pakarinen
BACKGROUND: Pediatric-onset intestinal failure (IF) remains a severe illness with life-threatening consequences. In this study, we analyzed a single center's outcomes of IF over 3 decades. METHODS: All children with IF who required parenteral nutrition (PN) >2 months or small-intestinal resection ≥50% managed since 1984 were included for retrospective outcome analyses. RESULTS: In total, 100 patients with median PN duration of 1.2 (interquartile range, 0...
April 27, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29622402/vascular-invasion-and-survival-after-liver-transplantation-for-hepatocellular-carcinoma-a-study-from-the-european-liver-transplant-registry
#17
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
#18
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
#19
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
#20
Florence Lacaille, Girish Gupte, Olivier Goulet
No abstract text is available yet for this article.
April 2018: Journal of Pediatric Gastroenterology and Nutrition
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