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Heart transplantation AND gastrointestinal complication

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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/28244293/epidemiology-of-biliary-atresia-in-korea
#2
Kyung Jae Lee, Ju Whi Kim, Jin Soo Moon, Jae Sung Ko
Biliary atresia (BA) is the major cause of cholestasis and the leading indication for liver transplantation (LT). However, the incidence of BA in Korea has not been reported. The aim of this study was to investigate the incidence and clinical outcomes of BA in Korea. We used the Korean universal health insurance database and extracted data regarding BA patients younger than 18 years of age admitted between 2011 and 2015. The incidence of BA was calculated by dividing the number of BA patients by the number of live births...
April 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28043445/a-decade-of-experience-with-continuous-flow-left-ventricular-assist-devices
#3
Ranjit John, Christopher T Holley, Peter Eckman, Samit S Roy, Rebecca Cogswell, Laura Harvey, Sara Shumway, Kenneth Liao
The use of continuous-flow left ventricular assist devices (CF-LVADs) has revolutionized the landscape of mechanical circulatory support for patients with heart failure. Clinical trials are already testing the next generation of CF-LVADs. In this study, our objective was to review our long-term experience with the current generation of CF-LVADs, specifically, the HeartMate (HM) II (Thoratec Corp, Pleasanton, CA). In this single-center retrospective analysis, we evaluated the records of 278 consecutive patients who underwent a total of 302 HM II placements from June 2005 through June 2014...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27645810/the-emergency-medicine-approach-to-transplant-complications
#4
REVIEW
Brit Long, Alex Koyfman
INTRODUCTION: Organ transplantation provides improved quality of life and longevity in patients with end-organ disease. These patients have significant physiological and anatomical modifications, and with new immunosuppressive agents, many of these patients will present to the emergency department with complications. OBJECTIVE: The objective was to provide emergency physicians with a review of transplant complications, including infection, rejection, medication adverse effects, and specific complications related to the transplant...
November 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27582783/emergency-abdominal-surgery-after-solid-organ-transplantation-a-systematic-review
#5
REVIEW
Nicola de'Angelis, Francesco Esposito, Riccardo Memeo, Vincenzo Lizzi, Aleix Martìnez-Pérez, Filippo Landi, Pietro Genova, Fausto Catena, Francesco Brunetti, Daniel Azoulay
AIMS: Due to the increasing number of solid organs transplantations, emergency abdominal surgery in transplanted patients is becoming a relevant challenge for the general surgeon. The aim of this systematic review of the literature is to analyze morbidity and mortality of emergency abdominal surgery performed in transplanted patients for graft-unrelated surgical problems. METHODS: The literature search was performed on online databases with the time limit 1990-2015...
2016: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/27569963/outcomes-and-readmissions-after-continuous-flow-left-ventricular-assist-device-heartmate-ii-versus-heartware-ventricular-assist-device
#6
COMPARATIVE STUDY
O N Tuncer, C Kemaloğlu, O Erbasan, I Gölbaşı, C Türkay, Ö Bayezid
INTRODUCTION: Donor organ shortage is still a problem for heart transplantation. Only 10% of patients in waiting list undergo heart transplantation. Over the last 5 years, 2 different continuous flow pumps, the HeartMate II and the HeartWare, have been successful clinically in the alternative treatment of patients with end-stage heart disease. METHODS: Fifty-five patients underwent left ventricular assist device implantation between 2011 and 2014. Patients were followed on pump support for complications and intraoperative outcomes...
July 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27569941/bone-disease-and-serum-fibroblast-growth-factor-23-levels-in-renal-transplant-recipients
#7
Y Coskun, S Paydas, M Balal, S Soyupak, E Kara
BACKGROUND: Posttransplantation bone disease develops commonly and results in important complications. In this study, we aimed to investigate the relationship between bone diseases and serum fibroblast growth factor-23 (FGF-23) in renal transplant recipients. METHODS: This study was conducted in 106 kidney transplant recipients (KTrs; group G1) and 30 patients with chronic kidney disease (group G2). Patients with fever, heart failure, angina pectoris, acute renal failure, malignant disease, or any gastrointestinal disease were excluded...
July 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27342573/mechanical-circulatory-assist-devices-a-primer-for-critical-care-and-emergency-physicians
#8
REVIEW
Ayan Sen, Joel S Larson, Kianoush B Kashani, Stacy L Libricz, Bhavesh M Patel, Pramod K Guru, Cory M Alwardt, Octavio Pajaro, J Christopher Farmer
Mechanical circulatory assist devices are now commonly used in the treatment of severe heart failure as bridges to cardiac transplant, as destination therapy for patients who are not transplant candidates, and as bridges to recovery and "decision-making". These devices, which can be used to support the left or right ventricles or both, restore circulation to the tissues, thereby improving organ function. Left ventricular assist devices (LVADs) are the most common support devices. To care for patients with these devices, health care providers in emergency departments (EDs) and intensive care units (ICUs) need to understand the physiology of the devices, the vocabulary of mechanical support, the types of complications patients may have, diagnostic techniques, and decision-making regarding treatment...
June 25, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27173072/outcomes-on-continuous-flow-left-ventricular-assist-devices-a-single-institutional-9-year-experience
#9
Jeffrey A Morgan, Pauline H Go, Linnea Xuereb, Babbaljeet Kaur, Silvy Akrawe, Hassan W Nemeh, Jamil Borgi, David E Lanfear, Celeste T Williams, Gaetano Paone
BACKGROUND: Continuous-flow left ventricular assist devices (LVADs) have become the standard of care for patients with advanced heart failure. The goal of this study was to review our 9-year institutional experience. METHODS: From March 2006 through May 2015, 231 patients underwent implantation of 240 CF LVADs, HeartMate II LVAD (Thoratec Corp., Pleasanton, CA; n = 205) or HVAD (HeartWare Inc., Framingham, MA; n = 35). Of these, 127 devices (52.9%) were implanted as bridge to transplantation (BTT) and 113 (47...
October 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27132122/parenteral-nutrition-improves-nutritional-status-autonomic-symptoms-and-quality-of-life-in-transthyretin-amyloid-polyneuropathy
#10
Massimo Russo, Gian Luca Vita, Claudia Stancanelli, Anna Mazzeo, Giuseppe Vita, Sonia Messina
Transthyretin familial amyloid polyneuropathy (TTR-FAP) is an inherited amyloidosis, leading to death in about ten years in most cases due to cardiac failure or wasting syndrome. Previous studies showed that modified body mass index was related to time before death, duration of gastrointestinal disturbances, malabsorption and functional capacity. We report two patients in whom nutritional status worsened despite diet modification, hypercaloric supplement and two relevant therapeutic approaches such as liver transplant and tafamidis meglumine, respectively...
June 2016: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/27022892/the-future-of-mechanical-circulatory-support-for-advanced-heart-failure
#11
REVIEW
Karolina K Marinescu, Nir Uriel, Sirtaz Adatya
PURPOSE OF REVIEW: Mechanical circulatory support (MCS) has become the main focus of heart replacement therapy for end stage heart failure patients. Advances in technology are moving towards miniaturization, biventricular support devices, complete internalization, improved hemocompatibility profiles, and responsiveness to cardiac loading conditions. This review will discuss the recent advances and investigational devices in MCS for advanced heart failure. RECENT FINDINGS: The demand for both short-term and long-term durable devices for advanced heart failure is increasing...
May 2016: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27017225/gastrointestinal-bleeding-following-lvad-placement-from-top-to-bottom
#12
REVIEW
Kelly Cushing, Vladimir Kushnir
BACKGROUND: Left ventricular assist devices (LVADs) are an increasingly prevalent form of mechanical support for patients with end-stage heart failure. These devices can be implanted both as a bridge to transplant and as definitive/destination therapy. Gastrointestinal (GI) bleeding is one of the most common and recalcitrant long-term complications following LVAD implantation, with an incidence approaching 30 %. AIMS: This review will discuss what is known about the pathophysiology of GI bleeding in LVADs and the currently available options for medical and/or endoscopic management...
June 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27011917/pentamidine-in-pneumocystis-jirovecii-prophylaxis-in-heart-transplant-recipients
#13
REVIEW
Adem Ilkay Diken, Ozlem Erçen Diken, Onur Hanedan, Seyhan Yılmaz, Ata Niyazi Ecevit, Emir Erol, Adnan Yalçınkaya
Despite advances in transplantation techniques and the quality of post-transplantation care, opportunistic infections remain an important cause of complications. Pneumocystis jirovecii (P. jirovecii) is an opportunistic organism, represents an important cause of infections in heart transplantation patients. Almost 2% to 10% of patients undergoing cardiac transplantation have Pneumocystis pneumonia. Prophylaxis is essential after surgery. Various prophylaxis regimes had been defined in past and have different advantages...
March 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/26592377/transfusion-strategy-in-hematological-intensive-care-unit-study-protocol-for-a-randomized-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
Sylvain P Chantepie, Jean-Baptiste Mear, Lydia Guittet, Benoît Dervaux, Jean-Pierre Marolleau, Fabrice Jardin, Jean-Jacques Dutheil, Jean-Jacques Parienti, Jean-Pierre Vilque, Oumedaly Reman
BACKGROUND: Packed red blood cell (PRBC) transfusion is required in hematology patients treated with chemotherapy for acute leukemia, autologous (auto) or allogeneic (allo) hematopoietic stem cell transplantation (HSCT). In certain situations like septic shock, hip surgery, coronary disease or gastrointestinal hemorrhage, a restrictive transfusion strategy is associated with a reduction of infection and death. A transfusion strategy using a single PRBC unit has been retrospectively investigated and showed a safe reduction of PRBC consumption and costs...
November 23, 2015: Trials
https://www.readbyqxmd.com/read/26455245/ventricular-assist-devices-in-patients-with-chemotherapy-induced-cardiomyopathy-new-modalities
#15
Omer Ali Sayin, Cenk Ozpeker, Michael Schoenbrodt, Fahrettin Oz, Jochen Borgermann, Jan Gummert, Michiel Morshuis
INTRODUCTION: Cardiotoxicity is a fatal complication of chemotherapeutic agents in which the implantation of a mechanical circulatory support system (MCS) can be a life-saving modality. The aim of this article is to analyse this available therapeutic option for patients with cardiotoxicity induced by treatment of malignancy in the light of current literature. We analysed our recent experience with MCS implantations in patients who have advanced heart failure associated with chemotherapy-induced cardiotoxicity...
August 2015: Acta Cardiologica
https://www.readbyqxmd.com/read/26209034/-graft-versus-host-disease-a-rare-complication-of-lung-transplantation
#16
REVIEW
H Morisse-Pradier, R Nove-Josserand, F Philit, A Senechal, F Berger, E Callet-Bauchu, A Traverse-Glehen, J-M Maury, R Grima, F Tronc, J-F Mornex
Graft-versus-host disease (GVHD) is a classic and frequent multisystemic complication of bone marrow allografts. It has also been reported after the transplantation of solid organs such as the liver or gut. Recent cases of GVHD have been reported after lung and heart-lung transplant. Skin, liver, gastrointestinal tract and bone marrow are the organ preferentially affected by GVHD. Corticosteroid is the first line treatment of GVHD. The prognosis reported in solid organ transplants is poor with infectious complications favoured by immunosuppressive therapy...
February 2016: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/25894265/-physical-activity-in-patients-with-microvascular-complications-of-diabetes
#17
Martin Matoulek
Physical activity is often underestimated and little used in the treatment of diabetes. The fear of damage, especially in patients with diabetes complications is one of the reasons why it occurs. Physical activity plays an important role in prevention of the progression of peripheral neuropathy and its impact is primarily on the development of muscle strength and the ability to replace the function of nerve fibers damaged disabilities. Demonstrable effect on neuropathy is already recorded a few weeks of regular exercise, long-term programs then demonstrate the safety of occurrence of ulcers in compliance with basic foot care...
April 2015: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/25866336/cytomegalovirus-appendicitis-in-solid-organ-transplant-patients-two-cases-and-a-review
#18
REVIEW
Todd P McCarty, Rachael A Lee, Barbara M Herfel, Peter G Pappas
Cytomegalovirus (CMV) disease is a common complication following solid organ transplantation with a variety of gastrointestinal (GI) tract manifestations. CMV appendicitis, however, is a rare complication in a solid organ transplant patient, having been reported only once previously. We have recently seen two cases in solid organ transplant recipients at our institution, one a liver recipient and the other a heart recipient. Both patients underwent surgical resection. Pathologic evaluation of both resected appendices as well as polymerase chain reaction (PCR) amplification for CMV from the serum revealed the virus as the etiology...
May 2015: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/25770405/gastrointestinal-bleeding-in-recipients-of-the-heartware-ventricular-assist-system
#19
MULTICENTER STUDY
Daniel J Goldstein, Keith D Aaronson, Antone J Tatooles, Scott C Silvestry, Valluvan Jeevanandam, Robert Gordon, David R Hathaway, Kevin B Najarian, Mark S Slaughter
OBJECTIVES: This study evaluated gastrointestinal bleeding (GIB) in patients receiving the HeartWare HVAD System (HeartWare Inc., Framingham, Massachusetts) in the pivotal BTT (Bridge to Transplant) trial and under the continued access protocol (CAP). BACKGROUND: GIB has become a significant problem for recipients of continuous flow device left ventricular assist devices (CF-LVAD). The need for anticoagulation and antiplatelet therapies complicates the management of GIB...
April 2015: JACC. Heart Failure
https://www.readbyqxmd.com/read/25692442/surgical-management-of-perforated-gastrointestinal-posttransplantation-lymphoproliferative-disorder-after-heart-transplantation
#20
Hideki Osawa, Mamoru Uemura, Junichi Nishimura, Taishi Hata, Ichiro Takemasa, Tsunekazu Mizushima, Hirofumi Yamamoto, Yuichiro Doki, Masaki Mori
Posttransplantation lymphoproliferative disorder (PTLD) is a relatively rare and life-threatening complication after organ transplantation. From 1999 to 2012, 45 adult patients underwent heart transplantation at our hospital. Two of the patients developed PTLD after transplantation and required emergency surgery due to intestinal perforation. These cases were informative regarding the adequate surgical management of such cases. Both cases revealed Epstein-Barr virus-related PTLD. The optimal treatment of PTLD remains controversial, and PTLD with gastrointestinal perforation could be critical because the patients are already debilitated and immunocompromised after transplantation...
February 2015: International Surgery
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