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https://www.readbyqxmd.com/read/29280097/current-treatment-paradigms-in-pediatric-short-bowel-syndrome
#1
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...
December 26, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29273999/distal-duodenogastrostomy-or-proximal-jejunogastrostomy-in-the-management-of-ultra-short-bowel
#2
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...
December 22, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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/29184909/gut-permeability-and-glucose-absorption-are-affected-at-early-stages-of-graft-rejection-in-a-small-bowel-transplant-rat-model
#5
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/29170900/the-challenges-of-closing-an-ileostomy-in-patients-with-total-intestinal-aganglionosis-after-small-bowel-transplant
#6
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
#7
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
#8
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/29046035/-laboratorial-alteration-preceding-staphylococcal-infection-clinical-manifestations-after-intestinal-transplantation
#9
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/28944322/advances-in-small-bowel-transplantation
#10
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/28755968/surgical-and-medical-approach-to-patients-requiring-total-small-bowel-resection-managing-the-no-gut-syndrome
#11
Ruy J Cruz, Laurie Butera, Kristine Poloyac, Jenee McGurgan, William Stein, David Binion, Abhinav Humar
BACKGROUND: Total resection of the jejunum and ileum, a rarely performed procedure, is indicated after mesenteric vascular events, trauma, or resection of abdominal neoplasms. We describe our recent experience with the operative and medical management of patients with "no gut syndrome." METHODS: We retrospectively reviewed 341 adult patients who were referred to our center between January 2013 and December 2016. RESULTS: Thirteen patients with a mean age of 42...
October 2017: Surgery
https://www.readbyqxmd.com/read/28652655/effect-of-cxcr3-ho-1-genes-modified-bone-marrow-mesenchymal-stem-cells-on-small-bowel-transplant-rejection
#12
Ming-Li Yin, Hong-Li Song, Yang Yang, Wei-Ping Zheng, Tao Liu, Zhong-Yang Shen
AIM: To investigate whether bone marrow mesenchymal stem cells (BMMSCs) modified with the HO-1 and CXCR3 genes can augment the inhibitory effect of BMMSCs on small bowel transplant rejection. METHODS: Lewis rat BMMSCs were cultured in vitro. Third-passage BMMSCs were transduced with the CXCR3/HO-1 genes or the HO-1 gene alone. The rats were divided into six groups and rats in the experimental group were pretreated with BMMSCs 7 d prior to small bowel transplant...
June 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28601304/a-practical-guide-for-small-bowel-transplantation-in-rats-review-of-techniques-and-models
#13
REVIEW
Daniel Foell, Felix Becker, Rebecca Hadrian, Daniel Palmes, Linus Kebschull
BACKGROUND: Animal models are a central aspect in research on small bowel transplantation (SBTx). Among them, rats are the preferred species because of their widespread availability and cost effectiveness. Because the complexity of the surgical procedure could per se influence the outcome of an experiment, a standardized and comparable technique is important. Based on of the vast amount of different models and surgical techniques published to this point, a review seemed necessary to guide investigators when choosing the suitable model...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28583544/experiences-of-living-donors-for-small-bowel-transplantation
#14
H S Kim, Y S Yoo, M-D Lee, J I Kim
INTRODUCTION: Along with developments in surgical and immunosuppression techniques, the success rate of small bowel transplantation has increased. In Korea, the incidence of small bowel transplantations has increased, and the longest surviving living donor recipient has now survived for over 12 years postsurgery. The purpose of this study was to assess the experiences of living donors for small bowel transplantation before, during, and after the transplantation. METHODS: In one hospital, we conducted interviews, based on open-ended questions, with three small bowel donors...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28484466/the-st2-il-33-axis-in-immune-cells-during-inflammatory-diseases
#15
REVIEW
Brad Griesenauer, Sophie Paczesny
Il1rl1 (also known as ST2) is a member of the IL-1 superfamily, and its only known ligand is IL-33. ST2 exists in two forms as splice variants: a soluble form (sST2), which acts as a decoy receptor, sequesters free IL-33, and does not signal, and a membrane-bound form (ST2), which activates the MyD88/NF-κB signaling pathway to enhance mast cell, Th2, regulatory T cell (Treg), and innate lymphoid cell type 2 functions. sST2 levels are increased in patients with active inflammatory bowel disease, acute cardiac and small bowel transplant allograft rejection, colon and gastric cancers, gut mucosal damage during viral infection, pulmonary disease, heart disease, and graft-versus-host disease...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28437160/meeting-report-of-the-xiv-international-small-bowel-transplant-symposium-summary-of-presentations-workshops-and-debates-from-a-comprehensive-meeting-on-intestinal-failure-rehabilitation-and-transplantation-buenos-aires-argentina-june-10-13-2015
#16
Gabriel E Gondolesi, Adriana Fernandez, Karolina M Burghardt, Scott Nowakowski, Stuart S Kaufman, Andreas Pascher, Diana Florescu, Phillip Ruiz, Rodrigo Vianna, Sara Clarke, Mihai Oltean, Martin Rumbo, George Mazariegos, Debra L Sudan, Douglas G Farmer
The 2015 meeting of the Intestinal Transplant Association was held in Buenos Aires, Argentina. This was the 14th International Small Bowel Transplant Symposium, and it was the first meeting organized as a joint venture of the Transplantation Society, the Intestinal Transplant Association, and the Argentinean Transplant Society (Sociedad Argentina de Trasplantes). Innovative aspects of the classic meeting format included workshops sessions, debates, and multicenter studies. This report highlights the most prominent scientific contributions and results of the first such symposium in a Latin American country...
April 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28369932/successful-management-of-passenger-lymphocyte-syndrome-in-an-abo-compatible-nonidentical-isolated-bowel-transplant-a-case-report-and-review-of-the-literature
#17
REVIEW
Daniel Foell, Sabina Glasmeyer, Norbert Senninger, Heiner Wolters, Daniel Palmes, Ralf Bahde
BACKGROUND: Passenger lymphocyte syndrome (PLS), a subtype of graft-versus-host disease, is a rare disorder encountered mainly in ABO-mismatched hematopoietic stem cell transplantation and infrequently in all types of ABO-mismatched solid organ transplantation. We here report the fifth case of PLS in small bowel transplantation (SBTx) and the first one describing the successful management of PLS in a cadaveric, isolated SBTx. CASE REPORT: A 60-year-old Caucasian female with blood group A D+ suffering from short bowel syndrome received a small bowel transplant from a 32-year-old Caucasian female with blood group O D+ (HLA mismatch 2/6)...
June 2017: Transfusion
https://www.readbyqxmd.com/read/28282321/intestinal-transplantation-a-review
#18
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...
May 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28281234/portomesenteric-vein-thrombosis-post-laparoscopic-sleeve-gastrectomy-case-series-and-literature-review
#19
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...
September 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28159115/william-hunter-harridge-lecture-the-changing-face-of-short-gut-syndrome-management
#20
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
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