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Transplant anesthesiology

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https://www.readbyqxmd.com/read/27744725/management-of-patients-with-colorectal-liver-metastasis-in-eleven-questions-and-answers
#1
Axel Andres, Pietro Majno, Sylvain Terraz, Philippe Morel, Arnaud Roth, Laura Rubbia-Brandt, Eduardo Schiffer, Frederic Ris, Christian Toso
Colorectal liver metastasis (CRLM) is the most frequent indication for liver resection in many centers. Recent improvements in oncology, surgery, interventional radiology, pathology and anesthesiology allow curative treatment in a larger proportion of patients with CRLM. Areas covered: We illustrate the various aspects of the management of CRLM through 11 questions that summarize the topic, from the current obtained survival to future perspectives such as transplantation. The limits of a curative treatment are also presented from different angles, such as the benefits of pathology, the surgical options for extreme resections, the available chemotherapies and their efficacy, or the non-surgical ablative treatments...
November 7, 2016: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/27496437/hrv-influence-during-renal-transplantation-procedure-on-long-term-mortality
#2
J Biernawska, K Kotfis, M Kaczmarczyk, W Błaszczyk, E Barnik, M Żukowski
BACKGROUND: The autonomic nervous system plays an important role in heart function regulation. One of the most acknowledged methods for noninvasive measurement of autonomic system activity is to determine heart rate variability (HRV). Reduced HRV parameters-heart rate rigidity/stiffness-are an independent prognostic factor of sudden cardiac death risk because of arrhythmia. Renal transplantation is an important factor in HRV changes because of hemodynamic and ion disturbances. The main purpose of this study was to determine the influence of HRV disturbances during renal transplantation procedures on long-term mortality in patients with chronic kidney disease...
June 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27466988/anaesthesiological-strategies-to-improve-outcome-in-liver-transplantation-recipients
#3
V Perilli, P Aceto, T Sacco, C Modesti, P Ciocchetti, F Vitale, A Russo, G Fasano, A Dottorelli, L Sollazzi
Graft and patients survival are the main goal of anesthesiological management in patients undergoing liver transplantation (LT). Even if anesthesiological practice sustained major developments over time, some evidence-based intraoperative strategies have not yet been widely applied. The aim of this review was to summarize intraoperative anesthesiological strategies which could have the potential to improve LT graft and/or recipient survival. Monitoring must be as accurate as possible in order to manage intraoperative hemodynamic changes...
July 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27129535/donor-derived-tuberculosis-in-an-anesthetist-after-short-term-exposure-an-old-demon-transplanted-from-the-past-to-the-present
#4
I Freytag, J Bucher, M Schoenberg, M Stangl, G Schelling
We report a case of a 27-year-old anesthetist who acquired tuberculosis (TB) while performing general anesthesia in a renal transplant (RTX) patient who had donor-derived contagious TB. The anesthetist developed pleural TB 6 months after exposure. Contact investigations (CIs) did not include health care workers (HCWs) of the Department of Anesthesiology, thereby missing the opportunity for the early diagnosis and treatment of TB. Genomic fingerprinting revealed identical Mycobacterium tuberculosis (MT) isolates in the anesthetist and in the RTX patient...
May 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/26951450/anesthetic-management-of-the-first-pediatric-bilateral-hand-transplant
#5
Harshad G Gurnaney, John E Fiadjoe, L Scott Levin, Benjamin Chang, Heather Delvalle, Jorge Gálvez, Mohamed A Rehman
PURPOSE: The purpose of this case report is to describe the anesthetic and case management of the first vascularized composite allograft pediatric bilateral hand transplant. CLINICAL DETAILS: Our patient was an eight-year-old male with a medical history of Staphylococcus aureus sepsis at one year of age that resulted in end-stage renal disease as well as bilateral upper and lower extremity amputations. After referral for bilateral hand transplantation, the transplantation team, with expertise in all aspects of perioperative care (surgery, anesthesiology, nephrology, renal transplantation, pediatric intensive care, and therapeutic pharmacy), was consulted to help develop anesthetic and other perioperative protocols for surgery...
June 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/26813115/systematic-review-and-meta-analysis-of-the-impact-of-computed-tomography-assessed-skeletal-muscle-mass-on-outcome-in-patients-awaiting-or-undergoing-liver-transplantation
#6
REVIEW
J L A van Vugt, S Levolger, R W F de Bruin, J van Rosmalen, H J Metselaar, J N M IJzermans
Liver transplant outcome has improved considerably as a direct result of optimized surgical and anesthesiological techniques and organ allocation programs. Because there remains a shortage of human organs, strict selection of transplant candidates remains of paramount importance. Recently, computed tomography (CT)-assessed low skeletal muscle mass (i.e. sarcopenia) was identified as a novel prognostic parameter to predict outcome in liver transplant candidates. A systematic review and meta-analysis on the impact of CT-assessed skeletal muscle mass on outcome in liver transplant candidates were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines...
August 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/26640924/endoscopic-retrograde-cholangiopancreatography-in-kidney-transplant-patients-results-from-a-single-center
#7
Serkan Öcal, Özgür Harmancı, Fatih Ensaroğlu, Murat Korkmaz, Haldun Selçuk, Fatih Hilmioğlu, Gökhan Moray, Mehmet Haberal
OBJECTIVES: We report the outcomes of endoscopic retrograde cholangiopancreatography procedures performed for diagnostic and therapeutic purposes in patients who had undergone kidney transplant. MATERIALS AND METHODS: We retrospectively evaluated the records of kidney transplant patients for January 1993 to December 2014. Endoscopic retrograde cholangiopancreatography was carried out using an Olympus JF240 duodenoscope (tip outer diameter 12.6 mm, working channel diameter 3...
November 2015: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/26442265/viscoelastic-methods-of-blood-clotting-assessment-a-multidisciplinary-review
#8
REVIEW
Jan Benes, Jan Zatloukal, Jakub Kletecka
Viscoelastic methods (VEM) made available the bedside assessment of blood clotting. Unlike standard laboratory tests, the results are based on the whole blood coagulation and are available in real time at a much faster turnaround time. In combination with our new knowledge about pathophysiology of the trauma-induced coagulopathy, the goal-oriented treatment protocols have been recently proposed for the initial management of bleeding in trauma victims. Additionally, the utility of viscoelastic monitoring devices has been proved even outside this setting in cardiosurgical patients or those undergoing liver transplantation...
2015: Frontiers in Medicine
https://www.readbyqxmd.com/read/26015088/preoperative-arterial-embolization-facilitates-multivisceral-transplantation-for-portomesenteric-thrombosis
#9
L J Ceulemans, I Jochmans, D Monbaliu, M Verhaegen, W Laleman, F Nevens, S Heye, G Maleux, J Pirenne
Multivisceral transplantation (MvTx) for diffuse venous portomesenteric thrombosis is a surgically and anesthesiologically challenging procedure, partly because of the risk of massive bleeding during visceral exenteration. Preoperative visceral artery embolization might reduce this risk. In three consecutive MvTx, the celiac trunk (CT) and superior mesenteric artery (SMA) were embolized immediately pretransplant. We analyzed demographics, serum D-lactate, pH, base excess, hemoglobin, blood pressure, transfused packed cell (PC) units, intervention time and outcome...
November 2015: American Journal of Transplantation
https://www.readbyqxmd.com/read/25985819/editorial-pharmacological-considerations-in-anesthesiology-from-organ-failure-to-transplantation
#10
EDITORIAL
Chris Giordano
No abstract text is available yet for this article.
2015: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/25875549/the-impact-of-exposure-to-liver-transplantation-anesthesia-on-the-ability-to-treat-intraoperative-hyperkalemia-a-simulation-experience
#11
Dung Nguyen, Shira Gurvitz-Gambrel, Paul A Sloan, Jeremy S Dority, Amy DiLorenzo, Zaki-Udin Hassan, Annette Rebel
The objective of this study was to assess whether resident exposure to liver transplantation anesthesia results in improved patient care during a simulated critical care scenario. Our hypothesis was that anesthesia residents exposed to liver transplantation anesthesia care would be able to identify and treat a simulated hyperkalemic crisis after reperfusion more appropriately than residents who have not been involved in liver transplantation anesthesia care. Participation in liver transplantation anesthesia is not a mandatory component of the curriculum of anesthesiology training programs in the United States...
April 2015: International Surgery
https://www.readbyqxmd.com/read/25769593/comparison-of-antioxidant-effects-of-isoflurane-and-propofol-in-patients-undergoing-donor-hepatectomy
#12
RANDOMIZED CONTROLLED TRIAL
M Ucar, U Ozgül, A Polat, H I Toprak, M A Erdogan, M S Aydogan, M Durmus, M O Ersoy
BACKGROUND: The safety of healthy volunteer donors is one of the most important issues in living-donor liver transplantation. Use of the Pringle maneuver during donor hepatectomy can result in liver ischemia-reperfusion (IR) injury. The objective of this study was to examine the effects of isoflurane and propofol on IR injury caused by the Pringle maneuver during donor hepatectomy. METHODS: A total of 70 American Society of Anesthesiology I-II donors aged 18-65 years who underwent hepatectomy were included in the study...
March 2015: Transplantation Proceedings
https://www.readbyqxmd.com/read/25741432/distribution-of-yeast-like-fungi-at-a-university-hospital-in-turkey
#13
Gulfem Ece
BACKGROUND: The increased life span has led to application of more invasive procedures for diagnosis and treatment of particularly immunosuppressed individuals. This situation drew more attention to fungal infections due to existence of yeast-like fungi. Candida infections have increased due to transplant in patients, prolonged intensive care unit (ICU) stays, and invasive procedures. Recently, identification of yeast-like fungi as well as antifungal susceptibility test has been gaining more importance...
December 2014: Jundishapur Journal of Microbiology
https://www.readbyqxmd.com/read/25211170/cell-based-therapy-for-acute-organ-injury-preclinical-evidence-and-ongoing-clinical-trials-using-mesenchymal-stem-cells
#14
REVIEW
Antoine Monsel, Ying-Gang Zhu, Stephane Gennai, Qi Hao, Jia Liu, Jae W Lee
Critically ill patients often suffer from multiple organ failures involving lung, kidney, liver, or brain. Genomic, proteomic, and metabolomic approaches highlight common injury mechanisms leading to acute organ failure. This underlines the need to focus on therapeutic strategies affecting multiple injury pathways. The use of adult stem cells such as mesenchymal stem or stromal cells (MSC) may represent a promising new therapeutic approach as increasing evidence shows that MSC can exert protective effects following injury through the release of promitotic, antiapoptotic, antiinflammatory, and immunomodulatory soluble factors...
November 2014: Anesthesiology
https://www.readbyqxmd.com/read/25187754/replacement-of-anesthesia-machines-improves-intraoperative-ventilation-parameters-associated-with-the-development-of-acute-respiratory-distress-syndrome
#15
James M Blum, Victor Davila, Michael J Stentz, Ronald Dechert, Elizabeth Jewell, Milo Engoren
BACKGROUND: The impact of anesthetic equipment on clinical practice parameters associated with development of acute respiratory distress syndrome (ARDS) has not been extensively studied. We hypothesized a change in anesthesia machines would be associated with parameters associated with lower rates of ARDS. METHODS: We performed a retrospective cohort study on a subset of data used to evaluate intraoperative ventilation. Patients included adults receiving a non-cardiac, non-thoracic, non-transplant, non-trauma, general anesthetic between 2/1/05, and 3/31/09 at the University of Michigan...
2014: BMC Anesthesiology
https://www.readbyqxmd.com/read/24981063/-noncardiological-surgical-procedure-for-patients-implanted-with-a-ventricular-assist-device-anesthesiological-management-concepts
#16
F E Blum
BACKGROUND: The implantation of a ventricular assist device (VAD) is more frequently used as destination therapy of end-stage heart failure compared to the use of the device as bridge-to-transplantation, this results in an increasing number of noncardiac surgical procedures for patients implanted with a VAD. OBJECTIVE: For these procedures, the anesthesia provider faces various device-related complications, such as an increased risk for bleeding complications, thromboembolism, hypotension, infections, mechanical device limitations, and right heart failure...
April 2015: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/24628275/hepatic-artery-complications-following-liver-transplantation-does-preoperative-chemoembolization-impact-the-postoperative-course
#17
Fabrizio Panaro, Jeanne Ramos, Benoit Gallix, Grégoire Mercier, Astrid Herrero, Halidou Niampa, Georges-Philippe Pageaux, Francis Navarro
BACKGROUND: Transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) may cause damage to the hepatic artery (HA) and impact the postoperative course of the liver transplantation (LT). We aim to describe the relationship between preoperative TACE and the occurrence of histological and radiological hepatic artery complications (HAC). METHODS: All cirrhotic patients with HCC undergoing LT between January 2009 and October 2012 were included and divided in two groups: TACE (group 1) and No TACE (group 2)...
May 2014: Clinical Transplantation
https://www.readbyqxmd.com/read/24497441/fate-of-abstracts-presented-at-the-2004-2008-international-liver-transplantation-society-meetings
#18
Patrick J Hackett, Marina Guirguis, Nozomi Sakai, Tetsuro Sakai
Only 20.5% to 61.6% of abstracts presented at biomedical meetings are subsequently published as full-length articles. The aim of this study was to analyze the abstract-to-publication rate of International Liver Transplantation Society (ILTS) meeting abstracts. Abstracts presented at 5 consecutive annual ILTS meetings (2004-2008) were included to ensure a minimum follow-up period of 4 years. For each abstract, a PubMed Central search was conducted with the first author's name and affiliation along with keywords from the title...
March 2014: Liver Transplantation
https://www.readbyqxmd.com/read/24447499/united-states-practice-patterns-in-the-use-of-transesophageal-echocardiography-during-adult-liver-transplantation
#19
Wayne Soong, Saadia S Sherwani, Michael L Ault, Andrew M Baudo, Joshua C Herborn, Andre M De Wolf
OBJECTIVE: To characterize contemporary practice patterns in the use of transesophageal echocardiography during adult liver transplantation and to identify factors preventing more frequent use. DESIGN: Online questionnaire. SETTING: Liver transplantation centers in the United States performing 12 or more adult liver transplants in 2011. PARTICIPANTS: One representative from each qualifying center: The transplant anesthesiology director, a transplant anesthesiologist personally known to the authors, or the department of anesthesiology chair...
June 2014: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/24409054/early-respiratory-complications-after-liver-transplantation
#20
REVIEW
Paolo Feltracco, Cristiana Carollo, Stefania Barbieri, Tommaso Pettenuzzo, Carlo Ori
The poor clinical conditions associated with end-stage cirrhosis, pre-existing pulmonary abnormalities, and high comorbidity rates in patients with high Model for End-Stage Liver Disease scores are all well-recognized factors that increase the risk of pulmonary complications after orthotopic liver transplantation (OLT) surgery. Many intraoperative and postoperative events, such as fluid overload, massive transfusion of blood products, hemodynamic instability, unexpected coagulation abnormalities, renal dysfunction, and serious adverse effects of reperfusion syndrome, are other factors that predispose an individual to postoperative respiratory disorders...
December 28, 2013: World Journal of Gastroenterology: WJG
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