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Small bowel transplant

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https://www.readbyqxmd.com/read/29602547/ostomy-in-continuity-a-novel-approach-for-the-management-of-children-with-complex-short-bowel-syndrome
#1
Sona Sehgal, Anthony D Sandler, A Alfred Chahine, Parvati Mohan, Clarivet Torres
INTRODUCTION: Despite medical and surgical management, a subset of children with short bowel syndrome (SBS) who have discrepancy between proximal small bowel and distal colon have persistent feeding intolerance. We propose the use of an Ostomy in Continuity (OIC) (Bishop-Koop or Santulli) as a salvage procedure to decompress the proximal bowel while still maintaining maximal intestinal length, in these patients. METHODS: A retrospective chart review of 104 SBS patients identified sixteen patients who underwent an OIC...
March 4, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29600975/highly-activated-carbon-enterosorbent-mediates-the-suppression-of-paraneoplastic-syndrome-associated-with-lewis-lung-carcinoma-in-mice
#2
V V Sarnatskaya, L Sakhno, L M Paziuk, L A Yushko, N K Rodionova, V N Maslenniy, A S Sidorenko, V Nikolaev
AIM: To investigate the effect of enterosorption on the development of paraneoplastic syndrome in mice with Lewis lung carcinoma (LLC). MATERIALS AND METHODS: The study was performed on male С57/ВL6 mice with transplanted LLC. As an enterosorbent, highly activated powder fraction of HSGD was administered per os daily at a dose of 0.625 g/kg for two weeks starting from the 7th day after tumor cell transplantation. Analysis of hemo- and myelograms, morphological alterations in vital organs, the activities of catalase and superoxide dismutase, biochemical analysis of blood and quantitative analysis of hydroperoxides, malonic dialdehyde, аdvanced oxidation protein products was carried out by standard methods after completing the course of enterosorption...
March 2018: Experimental Oncology
https://www.readbyqxmd.com/read/29571064/spontaneous-migration-of-thrombosed-synthetic-vascular-graft-to-the-duodenum-after-living-donor-liver-transplantation-a-case-report
#3
Ahmed Mohamed Sultan, Ahmed Shehta, Tarek Salah, Mohamed Elshoubary, Mohamed Abdel Wahab
INTRODUCTION: Spontaneous migration of synthetic grafts had been described after abdominal vascular procedures into the duodenum and small bowel. In the setting of liver transplantation, synthetic grafts are commonly used for overcoming shortened or poor-quality vasculatures. We describe a case of spontaneous migration of thrombosed synthetic vascular graft after living-donor liver transplantation (LDLT). PRESENTATION: A 59 years male patient with end stage liver disease underwent LDLT utilizing a right hemi-liver graft...
March 15, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29532509/successful-placement-of-nasointestinal-feeding-tubes-using-electromagnetic-sensor-guided-enteral-access-systems-in-patients-with-left-ventricular-assist-devices
#4
Kay Lash, Rachelle Oppel, Jeanette Hasse
Technology advances have made it possible to prolong life for patients with heart failure who are not transplant candidates or while awaiting transplant. Many different cardiac devices are available that can be used as a bridge to transplant (temporary support) or as a destination therapy (permanent support). Placement of these devices can cause complications that, if not addressed, could negatively impact the nutrition status of patients. Placement of nasointestinal feeding tubes using an electromagnetic sensor-guided enteral access system (EMS-EAS) has been difficult in patients with implantable devices because of the potential for interference with the EMS-EAS and the left ventricular assist device (LVAD)...
March 12, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29524068/gut-microbiota-and-its-implications-in-small-bowel-transplantation
#5
REVIEW
Chenyang Wang, Qiurong Li, Jieshou Li
The gut microbiota is mainly composed of a diverse population of commensal bacterial species and plays a pivotal role in the maintenance of intestinal homeostasis, immune modulation and metabolism. The influence of the gut microbiota on solid organ transplantation has recently been recognized. In fact, several studies indicated that acute and chronic allograft rejection in small bowel transplantation (SBT) is closely associated with the alterations in microbial patterns in the gut. In this review, we focused on the recent findings regarding alterations in the microbiota following SBTand the potential roles of these alterations in the development of acute and chronic allograft rejection...
March 9, 2018: Frontiers of Medicine
https://www.readbyqxmd.com/read/29511548/citrulline-as-a-marker-of-intestinal-function-and-absorption-in-clinical-settings-a-systematic-review-and-meta-analysis
#6
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/29500650/mimics-of-malrotation-on-pediatric-upper-gastrointestinal-series-a-pictorial-review
#7
REVIEW
Anilawan Smitthimedhin, Angela Suarez, Ryan L Webb, Hansel J Otero
Intestinal malrotation is a continuum of congenital anomalies due to lack of rotation or incomplete rotation of the fetal intestine around the superior mesenteric artery axis. The abnormal bowel fixation (by mesenteric bands) or absence of fixation of portions of the bowel increases the risk of bowel obstruction, acute or chronic volvulus, and bowel necrosis. The clinical presentation of patients with malrotation without, with intermittent, or with chronic volvulus can be problematic, with an important minority presenting late or having atypical or chronic symptoms, such as intermittent vomiting, abdominal pain, duodenal obstruction, or failure to thrive...
March 3, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29491050/update-on-surgical-management-of-small-bowel-neuroendocrine-tumors
#8
REVIEW
Demetrios Moris, Ioannis Ntanasis-Stathopoulos, Diamantis I Tsilimigras, Stylianos Vagios, Andreas Karamitros, Georgios Karaolanis, John Griniatsos, Alexandros Papalampros, Ioannis Papaconstantinou, Georgios K Glantzounis, Eleftherios Spartalis, Dan G Blazer, Evangelos Felekouras
The widespread use of endoscopy and imaging in combination with the continuous update of the staging systems for neuroendocrine tumors has led to an increase in the incidence of small intestinal neuroendocrine tumors (si-NENs) globally. Despite high survival rates, severe complications may occur even in early stages due to the anatomic location of the primary site and the desmoplastic reaction. Surgery plays a central role in the management of patients with si-NENs. Excision of locoregional disease along with extensive lymph node dissection should be performed in fit patients, even in the presence of metastases...
March 2018: Anticancer Research
https://www.readbyqxmd.com/read/29487492/chronic-intestinal-pseudo-obstruction
#9
REVIEW
Khalil El-Chammas, Manu R Sood
Chronic intestinal pseudo-obstruction (CIP) is defined by either continuous or intermittent symptoms of bowel obstruction in the absence of fixed lumen excluding lesion. CIP includes a heterogeneous group of disorders which result either from diseases affecting the enteric neurons and smooth muscle lining or those involving the autonomic innervation of the bowel. Symptoms associated with CIP are nonspecific, which can sometimes contribute to the delay in recognizing the condition and making the correct diagnosis...
March 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29475213/modified-multivisceral-transplantation-with-native-spleen-removal-in-rats
#10
Pablo Stringa, Nidia Monserrat Arreola, Ane M Andres Moreno, Carlota Largo, Martín Rumbo, Francisco Hernandez
BACKGROUND:  Modified multivisceral transplantation (MMVTx) refers to the use of a graft that includes all abdominal organs except the liver. The use of this type of transplant in children and adults expanded over the last years with good results. However, long-term survival in experimental models has not been reported. Our aim is to describe in detail some technical modifications of MMVTx to obtain long-term survival. MATERIALS AND METHODS:  Syngeneic (Lewis-Lewis) heterotopic MMVTx was performed in 16 male rats (180-250 g)...
February 23, 2018: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29441651/invasive-pneumococcal-infections-in-pediatric-liver-small-bowel-pancreas-transplant-recipients
#11
Hanh D Vo, Diana F Florescu, Cindy R Brown, Heather E Chambers, David F Mercer, Luciano M Vargas, Wendy J Grant, Alan N Langnas, Ruben E Quiros-Tejeira
Children undergoing LSBPTx are at increased risk of IPI due to splenectomy. We aimed to describe the clinical features and outcomes of IPI in pediatric LSBPTx recipients. Between 2008 and 2016, 122 LSBPTx children at our center were retrospectively reviewed. Nine patients had 12 episodes of IPI; the median age at first infection was 3.5 years (range: 1.5-7.1 years). The median time from transplant to first infection was 3 years (range: 0.8-5.8 years). Clinical presentation included as follows: pneumonia (n = 1), bacteremia/sepsis (n = 7), pneumonia with sepsis (n = 1), meningitis with sepsis (n = 2), pneumonia and meningitis with sepsis (n = 1)...
February 13, 2018: Pediatric Transplantation
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/29356317/the-use-of-vascular-homografts-in-pediatric-small-bowel-transplantation-single-center-experience-over-a-decade
#13
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...
March 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29280097/current-treatment-paradigms-in-pediatric-short-bowel-syndrome
#14
REVIEW
Raghav Chandra, Anil Kesavan
Pediatric short bowel syndrome (SBS) is a serious condition which occurs in children with congenital or acquired reduction in length of the small intestine. SBS results in excessive fluid loss, nutrient malabsorption, electrolyte abnormalities, increased susceptibility to infections, parenteral nutrition associated complications and affects weight gain and growth. In children, SBS is debilitating and uniformly fatal without treatment. The primary goal of treatment is to restore enteral autonomy and reduce long-term dependence on parenteral support by increasing the absorptive potential of the remnant intestine...
April 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29273999/distal-duodenogastrostomy-or-proximal-jejunogastrostomy-in-the-management-of-ultra-short-bowel
#15
Tjipke Olivier Hofker, Mirjam Anna Kaijser, Vincent B Nieuwenhuijs, Johan Frederick Michel Lange, Hendrik Sijbrand Hofker
Inflammatory bowel disease, vascular disease, volvulus, adhesions, or abdominal trauma may necessitate extensive small-bowel resection resulting in an ultra-short distal duodenal or jejunal stump. If this distal duodenal or short jejunal stump is too short for stoma creation and bowel continuity restoration is hazardous or not possible at all, a distal duodenogastrostomy or proximal jejunogastrostomy in combination with drainage of the stomach is an option to prevent stump leakage. Although successful, this distal duodenogastrostomy has been described only in very few patients and in older records...
March 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29247242/myeloid-differentiation-primary-response-gene-myd-88-signalling-is-not-essential-for-intestinal-fibrosis-development
#16
C Lutz, B Weder, A Hünerwadel, S Fagagnini, B Lang, N Beerenwinkel, J B Rossel, G Rogler, B Misselwitz, M Hausmann
Dysregulation of the immune response to microbiota is associated with inflammatory bowel disease (IBD), which can trigger intestinal fibrosis. MyD88 is a key component of microbiota signalling but its influence on intestinal fibrosis has not been clarified. Small bowel resections from donor-mice were transplanted subcutaneously into the neck of recipients C57BL/6 B6-MyD88tm1 Aki (MyD88-/- ) and C57BL/6-Tg(UBC-green fluorescence protein (GFP))30Scha/J (GFP-Tg). Grafts were explanted up to 21 days after transplantation...
December 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29218832/necrotizing-enterocolitis-in-the-setting-of-milk-allergy-after-pediatric-living-donor-liver-transplantation
#17
Soichi Narumoto, Seisuke Sakamoto, Hajime Uchida, Kengo Sasaki, Takanobu Shigeta, Akinari Fukuda, Shunsuke Nosaka, Rie Irie, Takako Yoshioka, Mureo Kasahara
NEC is an idiopathic intestinal mucosal injury that may progress to transmural bowel necrosis without mesenteric ischemia. NEC usually affects 7- to 10-day-old neonates following enteral feeding. A 10-month-old girl with no history of laparotomy underwent LDLT for acute liver failure. After starting enteral feeding on postoperative day 5, she developed abdominal distention. Diffuse PVG and PI were detected by radiologic modalities. Exploratory laparotomy revealed patchy necrosis of the intestine without perforation...
February 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29209121/fatal-gastrointestinal-histoplasmosis-15-years-after-orthotopic-liver-transplantation
#18
Nikita Agrawal, David Ej Jones, Jessica K Dyson, Tim Hoare, Sharon A Melmore, Stephanie Needham, Nick P Thompson
We report a case of ileo-colonic Histoplasmosis without apparent respiratory involvement in a patient who had previously undergone an orthotopic liver transplant (OLT) for primary biliary cholangitis 15 years earlier. The recipient lived in the United Kingdom, a non-endemic region for Histoplasmosis. However, she had previously lived in rural southern Africa prior to her OLT. The patient presented with iron deficiency anaemia, diarrhoea, abdominal pain and progressive weight loss. She reported no previous foreign travel, however, it later became known that following her OLT she had been on holiday to rural southern Africa...
November 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29205184/adipose-derived-mesenchymal-stem-cells-suppress-of-acute-rejection-in-small-bowel-transplantation
#19
Yu Zhang, Qinghong Meng, Yanyan Zhang, Xiaobo Chen, Yuliang Wang
BACKGROUND/AIMS: Adipose-derived mesenchymal stem cells (ADSCs) possess immunosuppressive activity and hold promise in autologous cell-based therapies. The aim of this study was to determine whether autologous ADSCs can improve outcomes in the rat small bowel transplantation (SBT) model. MATERIALS AND METHODS: Allogeneic SBT followed by implantation of autologous ADSCs through the penile vein was conducted in Brown-Norway (BN) donor rats with Lewis (LEW) recipient rats infused with phosphate buffered solution as the control...
November 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/29198695/-snowmelt-sign-and-corkscrew-microvessels-predicting-epithelium-regeneration-after-acute-rejection-of-small-bowel-transplantation-a-case-report
#20
C-S Chung, T-H Lee, C-T Chiu, Y Chen
Intestinal failure characterized by inadequate maintenance of nutrition via normal intestinal function comprises a group of disorders with many different causes. If parenteral nutrition dependency develops, which is associated with higher mortality and complications, it is considered for intestine transplantation. However, the graft failure rate is not low, and acute cellular rejection is one of the most important reasons for graft failure. As a result, early identification of rejection and timely modification of anti-rejection medications have been considered to be associated with better graft and patient survival rates...
December 2017: Transplantation Proceedings
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