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Small bowel transplant

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https://www.readbyqxmd.com/read/28299353/safety-and-efficacy-of-single-balloon-enteroscopy-in-management-of-gastrointestinal-bleeding-in-patients-with-a-left-ventricular-assist-device
#1
Abhinav Koul, Donald M Pham, Arjun Nanda, Kevin E Woods, Steven D Keilin
Background and study aims Left ventricular assist devices (LVADs) are currently the standard of care in treatment of patients with end-stage heart failure waiting for heart transplant as well as destination therapy for non-transplant candidates. However, patients with LVADs are at increased risk of gastrointestinal bleeding due to the device's unique effects on hemodynamics. A major source of gastrointestinal bleeding in these patients are gastrointestinal angioectasias located within the small bowel that can only be reached with deep enteroscopy...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28282321/intestinal-transplantation-a-review
#2
Larry Loo, Georgio Vrakas, Srikanth Reddy, Philip Allan
PURPOSE OF REVIEW: The purpose of this article is to review the existing literature on the current indications, surgical techniques, immunosuppressive therapy and outcomes following intestinal transplantation (ITx). RECENT FINDINGS: Over recent years, ITx has become a more common operation with approximately 2500 procedures carried out worldwide by 2014. It is reserved for patients with intestinal failure and who have developed complications of home parenteral nutrition or who have a high risk of dying from their underlying disease...
March 9, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28281234/portomesenteric-vein-thrombosis-post-laparoscopic-sleeve-gastrectomy-case-series-and-literature-review
#3
S Alman AlSabah, Mohammed AlRuwaished, Sulaiman Almazeedi, Eliana Al Haddad, Elie Chouillard
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is today one of the leading procedures in bariatric surgery, and portomesenteric vein thrombosis (PMVT) has been reported as one of its rare complications. The purpose of this study is to determine the prevalence, clinical presentation, and outcomes of PMVT in patients undergoing LSG. METHODS: A retrospective study of a database of all post-LSG patients was conducted on the patients who developed PMVT post-LSG from July 2011 to March 2016, at Amiri Hospital, Kuwait...
March 9, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28280702/mycophenolate-mofetil-toxicity-mimicking-acute-cellular-rejection-in-a-small-intestinal-transplant
#4
Ross Apostolov, Khashayar Asadi, Julie Lokan, Ning Kam, Adam Testro
Mycophenolate mofetil (MMF) is an important medication used for maintenance immunosuppression in solid organ transplants. A common gastrointestinal (GI) side effect of MMF is enterocolitis, which has been associated with multiple histological features. There is little data in the literature describing the histological effects of MMF in small intestinal transplant (SIT) recipients. We present a case of MMF toxicity in a SIT recipient, with histological changes in the donor ileum mimicking persistent acute cellular rejection (ACR)...
February 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28274849/patient-age-sex-and-inflammatory-bowel-disease-phenotype-associate-with-course-of-primary-sclerosing-cholangitis
#5
Tobias J Weismüller, Palak J Trivedi, Annika Bergquist, Mohamad Imam, Henrike Lenzen, Cyriel Y Ponsioen, Kristian Holm, Daniel Gotthardt, Martti A Färkkilä, Hanns-Ulrich Marschall, Douglas Thorburn, Rinse K Weersma, Johan Fevery, Tobias Mueller, Olivier Chaouillères, Kornelius Schulze, Konstantinos N Lazaridis, Sven Almer, Stephen P Pereira, Cynthia Levy, Andrew Mason, Sigrid Naess, Christopher L Bowlus, Annarosa Floreani, Emina Halilbasic, Kidist K Yimam, Piotr Milkiewicz, Ulrich Beuers, Dep K Huynh, Albert Pares, Christine N Manser, George N Dalekos, Bertus Eksteen, Pietro Invernizzi, Christoph P Berg, Gabi I Kirchner, Christoph Sarrazin, Vincent Zimmer, Luca Fabris, Felix Braun, Marco Marzioni, Brian D Juran, Karouk Said, Christian Rupp, Kalle Jokelainen, Maria Benito de Valle, Francesca Saffioti, Angela Cheung, Michael Trauner, Christoph Schramm, Roger W Chapman, Tom H Karlsen, Erik Schrumpf, Christian P Strassburg, Michael P Manns, Keith D Lindor, Gideon M Hirschfield, Bettina E Hansen, Kirsten M Boberg
BACKGROUND & AIMS: Primary sclerosing cholangitis (PSC) is an orphan hepatobiliary disorder associated with inflammatory bowel disease (IBD). We aimed to estimate the risk of disease progression based on distinct clinical phenotypes in a large, international cohort of patients with PSC. METHODS: We performed a retrospective outcome analysis of patients diagnosed with PSC from 1980 through 2010 at 37 centers in Europe, North America, and Australia. For each patient, we collected data on sex, clinician-reported age at and date of PSC and IBD diagnoses, phenotypes of IBD and PSC, and date and indication of IBD-related surgeries...
March 5, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28267037/intravenous-lipid-emulsions-in-pediatric-patients-with-intestinal-failure
#6
Olivier Goulet, Cécile Lambe
The incidence of cholestatic liver disease (CLD) in pediatric patients suffering intestinal failure (IF) is not well established. Due to persistent portal inflammation, about 20% of these patients will progress to end-stage intestinal failure associated liver disease (IFALD) leading to liver transplant or death. PURPOSE OF REVIEW: Premature babies as well as infants with short bowel syndrome (SBS) and repeated sepsis (catheter or small intestinal bacterial overgrowth related) are at risk of developing CLD...
April 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28266040/ex-vivo-porcine-organ-perfusion-models-as-a-suitable-platform-for-translational-transplant-research
#7
Rohan Kumar, Wen Yuan Chung, Ashley Robert Dennison, Giuseppe Garcea
In transplantation surgery, extending the criteria for organ donation to include organs that may have otherwise been previously discarded has provided the impetus to improve organ preservation. The traditional method of cold static storage (CS) has been tried and tested and is suitable for organs meeting standard criteria donation. Ex vivo machine perfusion is, however, associated with evidence suggesting that it may be better than CS alone and may allow for organ donation criteria to be extended. Much of our knowledge of organ preservation is derived from animal studies...
March 6, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28168199/safety-and-efficacy-of-small-bowel-examination-by-capsule-endoscopy-for-patients-before-liver-transplantation
#8
Kawano Seiji, Takaki Akinobu, Iwamuro Masaya, Yasunaka Tetsuya, Kono Yoshiyasu, Miura Kou, Inokuchi Toshihiro, Kawahara Yoshiro, Umeda Yuzo, Yagi Takahito, Okada Hiroyuki
Background and Aims. Gastrointestinal surveillance is a requirement prior to liver transplantation (LT), but small intestine examination is not generally undertaken. The aim of the present study was to evaluate the safety and efficacy of capsule endoscopy (CE) for patients with end-stage liver disease. Methods. 31 patients who needed LT were enrolled, and 139 patients who underwent CE over the same period of time acted as controls. Results. Frequency of successful achievement of evaluation of the full length of the small bowel, the mean gastric transit time, and the mean small bowel transit time were not significantly different between the two groups...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28159115/william-hunter-harridge-lecture-the-changing-face-of-short-gut-syndrome-management
#9
REVIEW
John J Fung
The evolution of managing short gut syndrome optimizes management and decision making of intestinal failure by way of a multidisciplinary team utilizing the latest advances in therapeutic options. Only the minority of patients referred for small bowel transplantation will actually need a transplant. Many of these patients can be rehabilitated without the need for transplant, by way of early referral, and thus the likelihood of medical therapy increases. On the other hand, in those patients with little likelihood of success with medical therapy, early referral decreases the morbidity and mortality associated with long-term total parenteral nutrition and associated complications and will improve their overall survival outcomes...
March 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28147371/crohn-s-disease-and-intestinal-transplantation
#10
Pavel Drastich, Martin Oliverius
BACKGROUND: Most patients with Crohn's disease (CD) require one or more operations during their lifetime. Repeated resections and surgical complications may result in short gut in a subset of patients, typically those with extensive small bowel disease or a penetrating CD phenotype. The effects of short bowel syndrome (SBS) can range in seriousness from mild to life-threatening advanced intestinal failure. Worldwide, CD is the second leading indication for intestinal transplantation (ITx) in SBS, but the overall incidence of ITx is quite low...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/28139856/epidemiological-investigation-of-candida-species-causing-bloodstream-infection-in-paediatric-small-bowel-transplant-recipients
#11
Mallory J Suhr, João Carlos Gomes-Neto, Nabaraj Banjara, Diana F Florescu, David F Mercer, Peter C Iwen, Heather E Hallen-Adams
Small bowel transplantation (SBT) can be a life-saving medical procedure. However, these recipients experience high risk of bloodstream infections caused by Candida. This research aims to characterise the SBT recipient gut microbiota over time following transplantation and investigate the epidemiology of candidaemia in seven paediatric patients. Candida species from the recipients' ileum and bloodstream were identified by internal transcribed spacer sequence and distinguished to strain by multilocus sequence typing and randomly amplified polymorphic DNA...
January 31, 2017: Mycoses
https://www.readbyqxmd.com/read/28134688/progress-with-treating-the-microbial-dysbiosis-associated-with-irritable-bowel-syndrome
#12
James S Pearson, Peter J Whorwell
PURPOSE OF REVIEW: Microbial dysbiosis is receiving increasing attention as possibly being important in the pathophysiology of irritable bowel syndrome. This review will summarize the most recent literature addressing attempts to explore and target the microbiome in patients with irritable bowel syndrome. RECENT FINDINGS: Manipulation of the intestinal microbiota in irritable bowel syndrome is receiving increasing attention. Traditionally, dietary manipulation has been utilized...
January 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28130374/current-status-of-intestinal-and-multivisceral-transplantation
#13
REVIEW
Shishira Bharadwaj, Parul Tandon, Tushar D Gohel, Jill Brown, Ezra Steiger, Donald F Kirby, Ajai Khanna, Kareem Abu-Elmagd
Clinical-nutritional autonomy is the ultimate goal of patients with intestinal failure (IF). Traditionally, patients with IF have been relegated to lifelong parenteral nutrition (PN) once surgical and medical rehabilitation attempts at intestinal adaptation have failed. Over the past two decades, however, outcome improvements in intestinal transplantation have added another dimension to the therapeutic armamentarium in the field of gut rehabilitation. This has become possible through relentless efforts in the standardization of surgical techniques, advancements in immunosuppressive therapies and induction protocols and improvement in postoperative patient care...
January 26, 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28122648/microbiota-transfer-therapy-alters-gut-ecosystem-and-improves-gastrointestinal-and-autism-symptoms-an-open-label-study
#14
Dae-Wook Kang, James B Adams, Ann C Gregory, Thomas Borody, Lauren Chittick, Alessio Fasano, Alexander Khoruts, Elizabeth Geis, Juan Maldonado, Sharon McDonough-Means, Elena L Pollard, Simon Roux, Michael J Sadowsky, Karen Schwarzberg Lipson, Matthew B Sullivan, J Gregory Caporaso, Rosa Krajmalnik-Brown
BACKGROUND: Autism spectrum disorders (ASD) are complex neurobiological disorders that impair social interactions and communication and lead to restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. The causes of these disorders remain poorly understood, but gut microbiota, the 10(13) bacteria in the human intestines, have been implicated because children with ASD often suffer gastrointestinal (GI) problems that correlate with ASD severity. Several previous studies have reported abnormal gut bacteria in children with ASD...
January 23, 2017: Microbiome
https://www.readbyqxmd.com/read/28109015/a-single-centre-experience-of-roux-en-y-enteric-drainage-for-pancreas-transplantation
#15
Irum Amin, Andrew J Butler, Gail Defries, Neil K Russell, Simon J F Harper, Asif Jah, Kourosh Saeb-Parsy, Gavin J Pettigrew, Christopher J E Watson
Exocrine drainage following pancreas transplantation can be achieved by drainage into the bladder or bowel, the latter typically by direct duodeno-jejunostomy; the use of Roux-en-Y enteric drainage is uncommon. We report a retrospective analysis of a single-centre experience of Roux-en-Y enteric drainage following pancreas transplantation. Over a 14-year period (2001-2015), 204 consecutive adult pancreas transplants were performed (96.6% simultaneous pancreas and kidney transplants), of which 26.0% were from donors after circulatory death (DCD)...
January 21, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28104934/an-unusual-sigmoid-phytobezoar-in-a-patient-with-a-transplanted-kidney-a-case-report
#16
Paola Milillo, Angelo Pio Moffa, Vincenzo Bertozzi, Roberta Vinci, Luca Macarini
Bezoars are masses formed by the concretion of stomach contents or debris within the gastrointestinal tract. Bezoars are rare and account for only 0.4-4% of all cases of gastrointestinal obstruction and mainly occur in the stomach or small intestine. Intestinal obstruction caused by colonic bezoars is extremely rare. A 39-year-old man with a transplanted kidney came to the hospital because of abdominal pain, constipation, and distension. We performed an abdominal computed tomography scan and found an ovoid intraluminal mass with a mottled gas pattern in the distal sigmoid colon...
October 2016: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28104139/a-renal-paratransplant-hernia-causing-complete-small-bowel-obstruction-a-case-report-and-review-of-the-literature
#17
T Zingg, H Teixeira Farinha, N Demartines, M Pascual, M Matter
A rare type of acquired internal hernia, the renal paratransplant hernia (RPTH), of which only 11 cases have been reported in the literature so far, can follow renal transplantation. We report a patient who presented with acute abdominal pain and vomiting 6 weeks after renal transplantation in the right iliac fossa. A noncontrast abdominal computed tomography scan showed signs of small bowel obstruction. The patient was taken to the operating room for a midline laparotomy, and RPTH with incarcerated small bowel was diagnosed...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104121/liver-failure-from-ultra-short-bowel-syndrome-on-the-intestinal-transplant-waiting-list-a-retrospective-study
#18
Y Noguchi, T Ueno, R Matsuura, T Kodama, K Deguchi, S Umeda, T Yamamichi, K Nakahata, M Zenitani, Y Takama, H Yamanaka, Y Tazuke, H Okuyama
BACKGROUND: Patients with intestinal failure (IF) are candidates for intestinal transplantation (ITx). In Japan, these patients have few opportunities to undergo cadaveric ITx because of low rates of organ donation. The donor criteria and recipient priority for ITx are still unknown. We reviewed our cases of IF to investigate which patients should be prioritized for ITx. METHODS: Patients with IF who were registered as candidates for cadaveric ITx between January 2010 and November 2015 in our institute were included in this retrospective study...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28067296/gut-microbiota-mediates-protection-against-enteropathy-induced-by-indomethacin
#19
Xue Xiao, Geicho Nakatsu, Ye Jin, Sunny Wong, Jun Yu, James Y W Lau
Non-steroidal anti-inflammatory drugs (NSAIDs) can cause significant small bowel injuries. The role of gut microbiota in this NSAID-induced enteropathy is poorly understood. We studied the dynamic changes in gut microbiota following indomethacin administration in mice, and investigated the effects of these adaptive changes on subsequent NSAID-induced enteropathy. The changes in gut microbiota were studied using 16S rRNA sequencing, and the effects of such changes were investigated using antibiotics and a faecal transplantation model...
January 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28062420/jejunal-perforation-an-unusual-presentation-of-metastatic-cutaneous-squamous-cell-carcinoma-scc-in-an-immunosuppressed-patient
#20
N Hitchen, D Warnapala, R M Fisher, J Dua, P Pratsou, A Freebairn
We report the rare occurrence of a small bowel perforation secondary to a metastatic cutaneous squamous cell carcinoma (cSCC). A 70-year-old woman, who had previously undergone renal transplantation, presented with severe, sudden-onset abdominal pain. She was peritonitic on initial examination, with evidence of free intra-abdominal air on radiographic imaging. During an exploratory laparotomy, she was found to have a perforated jejunum secondary to disseminated metastases seen throughout her peritoneum. Following histopathological analysis, as well as further imaging studies, the primary malignancy was eventually identified as a cSCC on her upper back...
January 6, 2017: BMJ Case Reports
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