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https://www.readbyqxmd.com/read/29218832/necrotizing-enterocolitis-in-the-setting-of-milk-allergy-after-pediatric-living-donor-liver-transplantation
#1
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...
December 7, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29209121/fatal-gastrointestinal-histoplasmosis-15-years-after-orthotopic-liver-transplantation
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/29198676/case-report-primary-de-novo-sarcoma-in-transplant-pancreas-allograft
#5
S Nagaraju, S J Grethlein, S Vaishnav, A A Sharfuddin, J A Powelson, J A Fridell
BACKGROUND: The majority of malignancies after transplantation appear to be virally mediated and of recipient origin. Donor-derived neoplasms occur early, whereas recipient-origin tumors typically occur many years after transplantation. Sarcomas are a relatively rare form of cancer. The etiology of sarcomas remains largely unknown, although some are linked to viruses, familial cancer syndromes, or therapeutic radiation exposure. Primary sarcomas are extremely rare, accounting for <0...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29184909/gut-permeability-and-glucose-absorption-are-affected-at-early-stages-of-graft-rejection-in-a-small-bowel-transplant-rat-model
#6
Pablo Stringa, David Romanin, Natalia Lausada, Rodrigo Papa Gobbi, Carolina Zanuzzi, Pedro Martín, Juan Cruz Abate, Ana Cabanne, Nathalie Arnal, Leandro Vecchio, Verónica Milesi, Enrique Portiansky, Gabriel Gondolesi, Martin Rumbo
Background: Intestinal transplantation (ITx) faces many challenges due to the complexity of surgery and to the multiple immunological reactions that lead to the necessity of rigorous follow-up for early detection of acute cellular rejection (ACR). Our aim was to determine the kinetics of ACR using an experimental ITx model, with emphasis in the characterization of the process using different approaches, including the use of functional assays of absorptive and barrier function. Methods: ITx in rats conducting serial sampling was performed...
November 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29182898/reconnection-surgery-in-adult-post-operative-short-bowel-syndrome-100-cm-is-colonic-continuity-sufficient-to-achieve-enteral-autonomy-without-autologous-gastrointestinal-reconstruction-report-from-a-single-center-and-systematic-review-of-literature
#7
A Lauro, R Cirocchi, N Cautero, A Dazzi, D Pironi, F M Di Matteo, A Santoro, L Pironi, A D Pinna
A systematic bibliographic research concerning patients operated on for SBS was performed: inclusion criteria were adult age, reconnection surgery and SBS < 100 cm. Autologous gastrointestinal reconstruction represented an exclusion criteria. The outcomes of interest were the rate of total parenteral nutrition (TPN) independence and the length of follow-up (minimum 1 year) after surgery. We reviewed our experience from 2003 to 2013 with minimum 1-year follow-up, dealing with reconnection surgery in 13 adults affected by < 100 cm SBS after massive small bowel resection: autologous gastrointestinal reconstruction was not feasible...
July 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29170900/the-challenges-of-closing-an-ileostomy-in-patients-with-total-intestinal-aganglionosis-after-small-bowel-transplant
#8
Fereshteh Salimi Jazi, Tiffany J Sinclair, Chad M Thorson, Ricardo Castillo, Andrew C Bonham, Carlos O Esquivel, Matias Bruzoni
We present the case of a 14-year-old male with a history of small bowel transplantation for long segment Hirschsprung's disease who underwent Duhamel ileorectal pull-through procedure. In post-transplant, the patient had no restrictions and was not TPN-dependent. To improve his quality of life, he and his family were interested in closing the ileostomy and undergoing pull-through surgery. The complexity of the case includes the presence of an aganglionic rectal segment-a short root of the mesentery due to the small bowel transplant-and significant immunosuppression...
November 23, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/29150964/de-novo-donor-specific-hla-antibodies-after-combined-intestinal-and-vascularised-composite-allotransplantation
#9
Annemarie Weissenbacher, Georgios Vrakas, Mian Chen, Srikanth Reddy, Philip Allan, Henk Giele, Martin Cnm Barnardo, Anil Vaidya, Peter J Friend, Susan V Fuggle
Combining vascularised composite allotransplantation (VCA) with intestinal transplantation to achieve primary abdominal closure has become a feasible procedure. Besides facilitating closure, the abdominal wall can be used to monitor intestinal rejection. As the inclusion of a VCA raises the possibility of an enhanced alloimmune response, we investigated the incidence and clinical effect of de novo donor specific HLA antibodies (dnDSA) in a cohort of patients receiving an intestinal transplant with or without a VCA...
November 18, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29139621/paneth-and-intestinal-stem-cells-preserve-their-functional-integrity-during-worsening-of-acute-cellular-rejection-in-small-bowel-transplantation
#10
M Pucci Molineris, V Gonzalez Polo, F Perez, D Ramisch, M Rumbo, G E Gondolesi, D Meier
Graft survival after small bowel transplantation remains impaired due to acute cellular rejection (ACR), the leading cause of graft loss. Although it was shown that the number of enteroendocrine progenitor cells in intestinal crypts was reduced during mild ACR, no results of Paneth and intestinal stem cells localized at the crypt bottom have been shown so far. Therefore, we wanted to elucidate integrity and functionality of the Paneth and stem cells during different degrees of ACR, and to assess whether these cells are the primary targets of the rejection process...
November 15, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29123002/peritoneal-dialysis-catheter-removal-post-transplant-a-rare-case-of-delayed-bowel-perforation
#11
Andrew P Maxted, Brian Davies, Daniel Colliver, Alun Williams, Andrew Lunn
Peritoneal dialysis (PD) is a well-established form of renal replacement therapy and the practice of leaving catheters in situ post-transplantation widely accepted. We present a rare complication: a child presenting with anal protrusion of the PD catheter.The patient is an 11-year-old boy with a background of renal dysplasia and congenital cutis laxa. Twenty-three weeks after dialysis was commenced, the patient underwent a renal transplant. Thirteen weeks post-transplant, the patient felt an unusual sensation after defecation...
November 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29083037/review-article-the-gut-microbiome-as-a-therapeutic-target-in-the-pathogenesis-and-treatment-of-chronic-liver-disease
#12
REVIEW
C A Woodhouse, V C Patel, A Singanayagam, D L Shawcross
BACKGROUND: Mortality from chronic liver disease is rising exponentially. The liver is intimately linked to the gut via the portal vein, and exposure to gut microbiota and their metabolites translocating across the gut lumen may impact upon both the healthy and diseased liver. Modulation of gut microbiota could prove to be a potential therapeutic target. AIM: To characterise the changes in the gut microbiome that occur in chronic liver disease and to assess the impact of manipulation of the microbiome on the liver...
October 30, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29081901/role-of-reduced-size-liver-bowel-grafts-in-the-abdominal-wall-transplantation-era
#13
REVIEW
Augusto Lauro, Anil Vaidya
The evolution of multi-visceral and isolated intestinal transplant techniques over the last 3 decades has highlighted the technical challenges related to the closure of the abdomen at the end of the procedure. Two key factors that contribute to this challenge include: (1) Volume/edema of donor graft; and (2) loss of abdominal domain in the recipient. Not being able to close the abdominal wall leads to a variety of complications and morbidity that range from complex ventral hernias to bowel perforation. At the end of the 90's this challenge was overcome by graft reduction during the donor operation or bench table procedure (especially reducing liver and small intestine), as well as techniques to increase the volume of abdominal cavity by pre-operative expansion devices...
September 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29064957/an-evaluation-of-the-safety-and-efficacy-of-simultaneous-bilateral-nephrectomy-and-renal-transplantation-for-polycystic-kidney-disease-a-20-year-experience
#14
COMPARATIVE STUDY
Elliot I Grodstein, Nathan Baggett, Shawn Wayne, Glen Leverson, Anthony M D'Alessandro, Luis A Fernandez, David P Foley, Joshua D Mezrich, Jon S Odorico, Robert R Redfield, Hans W Sollinger, Dixon B Kaufman
BACKGROUND: Many strategies regarding timing of native nephrectomies exist for patients with symptomatic polycystic kidney disease (PCKD). METHODS: This is a single-center, retrospective study of 594 adults with PCKD who had renal transplants from 1994 to 2014. Three groups were analyzed: renal transplant-only recipients (tx alone), recipients of simultaneous bilateral nephrectomies and transplant (simultaneous), and recipients with pretransplant bilateral nephrectomies (pre)...
November 2017: Transplantation
https://www.readbyqxmd.com/read/29046035/-laboratorial-alteration-preceding-staphylococcal-infection-clinical-manifestations-after-intestinal-transplantation
#15
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/29024228/de-novo-hepatocellular-carcinoma-post-multivisceral-transplantation-in-a-child
#16
P Tran, S Zhou, L Wang, M Finegold, L Mascarenas, S Alexopolous, Y Genyk, N Kerkar
De novo hepatocellular carcinoma (HCC) post-transplantation in patients without viral hepatitis is extremely rare, with only three reported adult cases in the English literature. Here, we present a case of de novo HCC that developed in a 7-year-old female, who at 8 months of age received a liver, small bowel, spleen, and pancreas transplantation 6.5 years ago for gastroschisis and total parenteral nutrition (TPN)-related cirrhosis. The post-transplant course was complicated by Epstein-Barr virus (EBV) infection, post-transplant lymphoproliferative disease, and subsequent development of multifocal EBV-associated post-transplant smooth muscle tumors (EBV-PTSMT) in the small bowel 1 year and 10 months after transplantation, respectively...
November 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28989997/diaphragmatic-hernia-following-liver-resection-case-series-and-review-of-the-literature
#17
Francesco Esposito, Chetana Lim, Chady Salloum, Michael Osseis, Eylon Lahat, Philippe Compagnon, Daniel Azoulay
BACKGROUNDS/AIMS: Postoperative diaphragmatic hernia, following liver resection, is a rare complication. METHODS: Data of patients who underwent major hepatectomy for liver tumors, between 2011 and 2015 were retrospectively reviewed. The literature was searched for studies reporting the occurrence of diaphragmatic hernia following liver resection. RESULTS: Diaphragmatic hernia developed in 2.3% of patients (3/131) with a median delay of 14 months (4-31 months)...
August 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28977113/primary-sclerosing-cholangitis-in-children-and-adolescents
#18
Eleonora Druve Tavares Fagundes, Alexandre Rodrigues Ferreira, Caroline Caldeira Hosken, Thaís Costa Nascentes Queiroz
BACKGROUND: Primary sclerosing cholangitis is a rare disease, but its prevalence has been underestimated in children and adolescents due to broad variation in clinical presentation as well as diagnostic challenges in this life period. OBJECTIVE: To evaluate children and adolescents with primary sclerosing cholangitis and to describe their clinical, laboratorial, histopathological, and cholangiography conditions. METHODS: This is an observational descriptive research that took place from 2005 to 2016 and included all the patients seen in the Outpatient Unit for Pediatric Hepatology of Hospital das Clinicas of UFMG who had been diagnosed with primary sclerosing cholangitis before the age of 18...
October 2, 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28944322/advances-in-small-bowel-transplantation
#19
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: Turkish Journal of Surgery
https://www.readbyqxmd.com/read/28923630/use-of-nonvascularized-abdominal-rectus-fascia-after-liver-small-bowel-and-multiorgan-transplantation-long-term-follow-up-of-a-single-center-series
#20
P A Farinelli, J S Rubio, J M Padín, C Rumbo, H Solar, D Ramisch, G E Gondolesi
BACKGROUND: The abdominal wall may be severely compromised in the vast majority of intestinal and multiorgan transplant candidates, and sometimes as a consequence of complex liver transplantation. Multiple options have been described to overcome this problem, varying from component separation to the extreme need of performing an abdominal wall transplantation. The aim of the present paper is to report the largest and longest-term results of patients that received an abdominal rectus fascia (ARF) after liver, intestinal, or multiorgan transplantation at a single transplant center...
October 2017: Transplantation Proceedings
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