共查询到20条相似文献，搜索用时 31 毫秒
1.
C. Karaca C. Yilmaz R. Ferecov Z. Iakobadze K. Kilic L. Caglayan S. Aydogdu M. Kilic 《Transplantation proceedings》2017,49(8):1841-1847
Background
Venous reconstruction in living-donor liver transplantation for Budd-Chiari syndrome (BCS) has challenges because the grafts from living donors lack vena cava, and hepatic venous anastomosis must be performed on an already-thrombosed and/or stenosed inferior vena cava. Several techniques are described to overcome this problem, and we represent our experience with 22 patients.Methods
Medical recordings of 22 patients were retrospectively collected, and disease-specific data as well as recordings about surgical technique were analyzed.Results
Creation of a wide, triangular de novo orifice was the main method used for venous drainage, which was used in 19 patients. The remaining 3 patients had totally thrombosed vena cava; thus, direct anastomosis to the supra-hepatic portion of the vena cava was used in 2 patients and an anastomosis to the right atrium was used in 1 patient.Conclusions
Venous reconstruction in BCS can be achieved without the use of patch-plasty, and the inferior vena cava can be safely resected in selected patients. Living-donor liver transplantation is a feasible option for the treatment of BCS, considering the scarcity of cavaderic donors. 相似文献2.
Objective
The objectives of this study were to analyze the potential correlation between post–liver transplantation survival interval and CD4+ T-cell intracellular ATP (iATP) levels, and to describe the distribution of CD4+ T-cell iATP levels in liver transplant recipients.Methods
This was a retrospective analysis of clinical data of 273 patients who underwent liver transplantation from July 2010 to October 2012 in our center and achieved long-term stable survival. CD4+ T-cell iATP level was detected using Cylex ImmuKnow assay. Post–liver transplantation survival was analyzed.Results
CD4+ T-cell iATP level significantly differed among patients with different post–liver transplantation survival intervals. The peak CD4+ T-cell iATP levels typically occurred within the first 3 postoperative months.Conclusions
Post–liver transplantation survival interval is correlated with CD4+ T-cell iATP levels. 相似文献3.
R. Nakano M. Ohira K. Ishiyama K. Ide T. Kobayashi H. Tahara S. Shimizu K. Arihiro M. Imamura K. Chayama Y. Tanaka H. Ohdan 《Transplantation proceedings》2017,49(7):1634-1638
Background
We report a case of acute rejection of a liver graft, together with the occurrence of de novo donor-specific antibodies (DSAs), in a 53-year-old Japanese man who had undergone deceased-donor liver transplantation.Methods
The graft rejection was triggered by low cyclosporine levels and pegylated interferon treatment for the recurrence of hepatitis C virus (HCV) infection 18 months after transplantation. Although the graft was ABO-compatible, pre-formed DSA B51 was detected; therefore, total plasma exchange was performed and intravenous rituximab (500 mg/body) was administered before transplantation.Results
DSA was absent 6 months after transplantation. HCV recurrence was treated with pegylated interferon-α-2a. Renal function deteriorated with this anti-HCV therapy, with serum cyclosporine levels decreasing to 50 ng/mL. A rapid virologic response was achieved, but liver function deteriorated after 3 months of anti-HCV therapy, with histologic evidence of acute cellular rejection and formation of de novo DSAs. Anti-thymocyte globulin was administered for 5 days, which led to immediate improvement in liver function. However, renal function declined, warranting hemodialysis. The patient recovered 2 months after acute rejection, although de novo DSAs persisted.Conclusions
Careful immunologic monitoring may be required for patients receiving interferon therapy for HCV infection to maintain sufficient blood levels of immunosuppressive agents and to prevent acute liver graft rejection. 相似文献4.
M. Lejman K. Drabko B. Styka D. Winnicka M. Babicz I. Jaszczuk J.R. Kowalczyk 《Transplantation proceedings》2017,49(8):1903-1910
Background
In the light of an increasing number of hematopoietic stem cell transplantations and more frequent use of reduced-intensity conditioning as preparative regimens for hematopoietic stem cell transplantation, post-transplant cell chimera monitoring is considered a necessity.Methods
The quantitative fluorescence polymerase chain reaction method, along with the commercial AmpFSTR SGMPlus kit, was applied in research on hematopoietic chimeras.Results
The total of 102 patients who had undergone allogenic transplantations were investigated. Chimerism monitoring was commenced on the seventh day after transplantation and lasted up to 12 years in some cases, according to the instituted schedule.Conclusions
The kit has been shown to be fully sufficient for determining genetic profiles of recipients and donors and selecting informative markers. The method has been proven effective and satisfactory for assessing quantitative chimeras. 相似文献5.
Background
The global rise in infectious disease has led the Center for Disease Control and Prevention and the World Health Organization to release new guidelines for the prevention of surgical site infection.Methods
In this article, we summarize current recommendations based on level of evidence, review unresolved and unaddressed issues, and supplement them with new literature.Results
Although the guidelines discuss major issues in reducing surgical site infection, many questions remain unanswered.Conclusion
These guidelines will hopefully help in setting a standard of care based on best evidence available and focus investigators on areas where evidence is lacking. 相似文献6.
E.C. Ataide S.R. Perales M.G. Silva F.C. Filho A.C. Sparapani P.F. Latuf Filho R.S.B. Stucchi J. Vassallo C.A.F. Escanhoela I.F.S.F. Boin 《Transplantation proceedings》2017,49(4):858-862
Background
Hepatocellular carcinoma (HCC) is the 6th leading cause of cancer worldwide. Its recurrence ranges from 6% to 26%. In the literature, many factors are associated with higher risk of recurrence, without a clear definition of the best method that could predict this highly lethal event.Objective
The aim of this study was to evaluate the immunoexpression of immunohistochemical markers: HSP70, glypican 3, glutamine synthetase, and beta-catenin, as well as studying their association with tumor characteristics and prognosis of patients undergoing liver transplantation for HCC.Methods
We studied 90 patients who underwent liver transplantation from 1998 to 2012. Afterwards we evaluated factors related to survival, tumor recurrence, and the correlation of expression of the immunohistochemical markers.Results
Immunohistochemical marker glutamine synthetase showed a positive trend toward better survival. HSP70-positive patients had a higher prevalence of histologic grade III. Patients with positive glypican 3 showed larger lesions and a higher number with AFP >200 ng/mL. Patients with positive beta-catenin showed larger nodules and more with histologic grade III. The association between beta-catenin and glypican 3 showed positive association with larger nodules.Conclusions
Most of the markers studied had a correlation with at least one of the variables studied, confirming our hypothesis that these markers can indeed assist in assessing the prognosis of patients undergoing liver transplantation for HCC. 相似文献7.
Z. Wu S. Zhang L. Zhou J. Cai J. Tan X. Gao Z. Zeng D. Li 《Transplantation proceedings》2017,49(7):1656-1658
Objective
To investigate the thromboembolism induced by blood-mediated inflammatory reactions against infused cells during the clinical application of stem cells.Methods
Two patients with renal transplantation and chronic kidney disease, respectively, experienced thromboembolism after umbilical cord mesenchymal stem cell (UCMSC) infusion. The clinical manifestations and the laboratory test results were collected and analyzed.Results
The patients received stem cell infusion through the peripheral veins and presented with a swollen and painful forearm postinfusion. Doppler ultrasound showed venous clots at the proximal end of the puncture site. Urokinase and warfarin were used for thrombolytic therapy. The swelling and pain were relieved and cured.Conclusion
Safety concerns are still a primary hurdle for stem cell therapy, and thromboembolism as a critical complication should be prevented appropriately. 相似文献8.
C.-H. Shen K.-R. Dong Y.-F. Tao G. Chen R.-D. Li Q.-B. Zhang X.-F. Zhang S. Zheng Z.-X. Wang 《Transplantation proceedings》2017,49(1):185-187
Background
Liver transplantation in combination with chemotherapy in postoperative biliary rhabdomyosarcoma recurrence of children was evaluated.Methods
An 8-year-old girl with biliary rhabdomyosarcoma underwent pancreatico-duodenectomy with postoperative vincristine (VCR), adriamycin (Act-D), and cyclophosphamide (CTX) (VAC chemotherapy) (VCR, 1 mg; Act-D, 0.7 mg; CTX, 1500 mg). Two years later, liver metastasis in the left and right lobes was found and was followed by VAC chemotherapy (CTX, 1800 mg; Act-D, 0.9 mg; VCR, 1.2 mg), with no change of the tumor size. One and a half years later, liver transplantation performed with postoperative pathology confirmed embryonal rhabdomyosarcoma recurrence and was followed by VAC chemotherapy (CTX, 1400 mg; Act-D, 0.7 mg; VCR, 1.9 mg) and immunosuppression treatment.Results
The liver transplantation went well, with no major complications. At the time of this report, the patient had survived for 6 months, with a good quality of life and no tumor recurrence.Conclusions
For unresectable biliary rhabdomyosarcoma without extra-hepatic metastases, liver transplantation could be an effective treatment. Liver transplantation completely removes the tumor and reduces the long-term side effects of chemotherapy drugs. 相似文献9.
I.R.C. Brasil J. Custodio-Lima R.L. Sampaio A.M.M. Pierre T.M. Esmeraldo R.V.C. Lima L.F.A. Lima R.M. Esmeraldo 《Transplantation proceedings》2017,49(4):871-873
Intoduction
Infection by cytomegalovirus (CMV) is a major cause of morbidity among immunosuppressed patients, especially after solid organ transplantation. The risk of CMV after organ transplantation is strongly related to the serology of the donor and the recipient. The objective of this study was to analyze the outcomes and costs of pre-emptive therapy in patients after liver transplantation with donor-positive/recipient-negative (D+/R?) serostatus.Methods
This retrospective study analyzed all patients who underwent liver transplantation with CMV serostatus D+/R? between January 2012 and December 2015. The service protocol adopts pre-emptive therapy. The outcomes and costs of this therapy are described.Results
Of the 119 patients undergoing liver transplantation, 19 were D+/R? and entered the main analysis. Of these, 7 had positive polymerase chain reaction (PCR) results, and 1 developed CMV disease. Of the 6 patients who received no treatment, none developed CMV disease. Analyzing costs, pre-emptive therapy for these patients generated service savings of R$32,346.00.Conclusions
Although outcomes of universal prophylaxis and pre-emptive therapy are similar, pre-emptive therapy save on costs and have to be considered in patients with high-risk CMV disease after liver transplantation. 相似文献10.
M. Kono J. Hasegawa S. Wakai A. Ishiwatari Y. Abe M. Endo T. Sakoma K. Miyake T. Tokumoto K. Tanabe H. Shirakawa 《Transplantation proceedings》2017,49(5):1183-1186
Background
Sarcoidosis is a chronic systemic disease that is characterized by the formation of noncaseating granuloma and whose etiology is unclear. It is unclear whether patients with sarcoidosis are suitable organ donors.Case
We treated a 56-year-old woman with pulmonary sarcoidosis who donated her kidney. She was previously in good health and was diagnosed with pulmonary sarcoidosis during her preoperative examination. Because she presented with no symptoms and was otherwise in good condition, donor nephrectomy was performed.Results
Baseline biopsy examination showed no evidence of sarcoidosis. One year after transplantation, both the donor and the recipient had not developed kidney dysfunction or recurrence of sarcoidosis.Conclusion
This is a rare case in which a patient with pulmonary sarcoidosis donated a kidney for transplantation, and both the recipient and the donor were clinically healthy. A patient with sarcoidosis and no kidney lesion can donate a living kidney, because transplantation appears to be safe for both the recipient and the donor. 相似文献11.
P. Dedhia A. Govil G. Mogilishetty R.R. Alloway E.S. Woodle B.G. Abu Jawdeh 《Transplantation proceedings》2017,49(1):188-192
Background
Atypical hemolytic uremic syndrome (aHUS) is associated with significant morbidity and mortality and occurs due to genetic or acquired abnormalities that result in the dysregulation of the alternative complement pathway.Case Report
We report a case of post-living kidney transplantation de novo aHUS in a setting of heterozygous deletion in the complement factor H-related protein (CFHR)3-CFHR1 gene. The aHUS episode was possibly triggered by antibody-mediated rejection or tacrolimus. The patient responded well to eculizumab and substituting belatacept for tacrolimus. Her serum creatinine level was stable at 1.5 mg/dL after 2.5 years of follow-up.Conclusion
This case highlights the success of using a strategy that combines eculizumab and belatacept, as an alternative to calcineurin inhibitors, in treating aHUS in a patient with heterozygous deletion in the CFHR3-CFHR1 gene. 相似文献12.
L. Haddad K. Andrade L. Mendes L. Ducatti L.A. D&#x;Albuquerque W. Andraus 《Transplantation proceedings》2017,49(2):330-337
Objective
To measure the association between readmission after liver transplantation and corresponding adverse drug reactions.Methods
A total of 48 patients undergoing liver transplantation were prospectively followed for 1 year. Of these, 23 were readmitted and evaluated by a pharmacist for causes of adverse drug reaction. The detection of adverse drug reactions was based on a combination of clinical interviews and physical and laboratory exams. Adverse reactions were defined in accordance with the Naranjo algorithm.Results
A total of 67.6% of all readmissions were related to adverse drug reactions, with tacrolimus accounting for 80% of the drug reactions. The most common cause of readmission was infection (48.6%), followed by procedure-related reasons (29.7%). Of all patients requiring admission, 39.1% had Model for End-stage Liver Disease (MELD) scores below 21 at the time of transplantation, 17.4% had MELD scores between 21 and 29, and 43.5% had MELD scores above 29. Most (66.7%) of those readmitted more than twice had MELD scores above 29.Conclusion
Adverse drug reactions related to immunosuppressants frequently lead to readmission among liver transplant patients, and in our series tacrolimus was the most frequently associated drug. 相似文献13.
W.M. Bennett E.L. Simonich A.M. Garre K.M. McEvoy M.A. Farinola T.D. Batiuk 《Transplantation proceedings》2017,49(8):1779-1782
Introduction
Between January 2013 and September 2015, 135 consecutive renal transplant patients were screened prospectively with ultrasound for renal cell carcinoma (RCC).Results
Eighteen ultrasound abnormalities were identified with 4 solid lesions detected. Fifty-six other patients were screened retrospectively by referring nephrology groups, with 6 additional malignancies found.Conclusion
As a result of our data, we recommend and have instituted annual ultrasound screening of native kidneys in all renal transplant patients. 相似文献14.
V. Aliyev K. Yasuchika A. Hammad A. Badawy Y. Nigmet T. Tajima K. Fukumitsu S. Yagi K. Hata H. Okajima S. Uemoto 《Transplantation proceedings》2017,49(7):1649-1651
Background
Colon cancer accompanying decompensated liver cirrhosis is a rare clinical condition. Usually, treatment of colon cancer is prioritized, with cirrhosis dealt with later.Case report
We present a case of end-stage liver disease due to nonalcoholic steatohepatitis evaluated for living donor liver transplant. During the pretransplant examination, an ascending colon cancer was detected. Liver function was too poor to perform colon resection first. Simultaneous living donor liver transplant and colonic resection were carried out. The patient developed left lung metastasis at 2 different times during the first postoperative year, and both of them were resected. The patient received the standard chemoradiotherapy. Now, the patient is alive at 42 months postprocedure and recurrence-free at 31 months postoperatively.Conclusion
Simultaneous liver transplantation and colon resection are possible with acceptable long-term outcomes. Immunosuppressive therapy after transplantation increases the risk for cancer recurrence. So the patient should undergo close surveillance. 相似文献15.
H. Aktas A. Ozer O.S. Guner E. Gurluler R. Emiroglu 《Transplantation proceedings》2017,49(8):1820-1823
Background
Despite technical developments in transplantation surgery, complete portal vein thrombosis still remains a challenge for restoration of adequate portal vein inflow. Renoportal or varicoportal anastomosis provides an effective alternative solution for patients with complete portal vein thrombosis. This study describes our experience with renoportal and varicoportal anastomosis during liver transplantation.Patients and methods
Between January 2014 and May 2016, 5 patients with complete portal vein thrombosis underwent extra-anatomic portal anastomosis. In 3 cases, varicoportal anastomosis was performed and for the others, end-to-end renoportal anastomosis. We used iliac cryopreserved vein grafts to restore portal anastomosis in 3 cases. Epidemiology, risk factors, surgical techniques, complications, and outcomes of these procedures were evaluated over short- and long-term follow-ups.Results
The follow-up time is 3 years for our first renoportal case, which was performed in a cadaveric liver transplantation; it was also first nationwide case. The other renoportal anastomosis was practiced in a living donor liver transplantation and the follow-up time is 8 months. The patient and graft survival rates were 100% at the last follow-up. The follow-up times are 10.9 and 4 months for the patients with varicoportal anastomosis. One of these patients died due to recurrence of hepatocellular carcinoma. The other two patients are alive with good graft functions.Conclusion
Our experience suggests that reno-varicoportal anastomosis is a useful technique for patients with complete portal vein thrombosis and cryopreserved grafts may be safely used. 相似文献16.
Y. Oya Y. Sugawara M. Honda D. Yoshii K. Isono S. Hayashida H. Yamamoto Y. Inomata 《Transplantation proceedings》2017,49(5):1123-1125
Background
Progressive familial intrahepatic cholestasis type 1 (PFIC1) is an inherited disease characterized by cholestatic features. We report two patients with PFIC1 who underwent liver retransplantation.Case Report
One patient was a 3-year-old female who underwent liver transplantation for PFIC1. She presented with severe diarrhea and fatty liver, and went into liver failure. She therefore underwent liver retransplantation and external biliary diversion 8 years after the initial liver transplantation. The explanted liver was histologically diagnosed with chronic rejection. Her intractable diarrhea stopped after the retransplantation. She was diagnosed with a fatty liver 8 months after the retransplantation and died 4 years after retransplantation due to bleeding from an ileostomy. The other patient was a 3-year-old male. This patient underwent liver retransplantation due to liver cirrhosis caused by steatohepatitis 9 years after the initial liver transplantation. The biliary tract was not diverted. He also experienced severe diarrhea after the retransplantation and requires home parenteral nutrition due to an eating disorder.Conclusions
Liver transplantation is the only treatment to resolve life-threatening issues due to PFIC1, but requires further improvement as a therapeutic modality. 相似文献17.
Background
Post-operative respiratory failure is common in liver transplant patients, with a direct effect on graft and recipient outcomes. We present a case of successful treatment for a patient who had acute respiratory distress syndrome combined with septic shock after living-donor liver transplantation with veno-arterial–venous hybrid mode of extracorporeal membrane oxygenation (ECMO) support.Methods
A 49-year-old male patient underwent successful emergency living-donor liver transplantation for acute-on-chronic liver failure associated with alcoholic liver cirrhosis. The patient was diagnosed with concurrent active pulmonary tuberculosis and tuberculosis peritonitis just before emergency liver transplantation. Intermittent post-operative small-bowel obstruction caused by adhesions from tuberculosis peritonitis was nonresponsive to conservative management.Results
On post-operative day 114, we performed emergency adhesio-lysis because of bowel ischemia signs. However, the patient had progressive deterioration of arterial oxygenation despite conventional ventilatory support and nitric oxide gas inhalation, and septic shock resulted from aspiration pneumonia. Therefore, we decided to administer ECMO. After initiation of ECMO support, hemodynamic status, pneumonic consolidation, and oxygenation status gradually improved, and the patient was weaned from ECMO on the 11th day. Finally, the patient was discharged on post-transplant day 204.Conclusions
ECMO can be a beneficial rescue option for the management of refractory cardiopulmonary failure in liver transplant recipients. In addition, the hybrid mode of ECMO is a helpful salvage option when conventional modes of ECMO are inadequate. 相似文献18.
Objectives
In renal transplant recipients, the risk of developing bladder cancer and rate of diagnosis of advanced staged bladder cancer are generally higher than the general population. Also, it is more challenging to treat renal transplant recipients than the regular patient population. We aimed to evaluate the efficacy and safety of radical cystectomy (RC) and urinary diversion with ileal conduit in renal transplant recipients.Methods
We identified 2 patients with prior history of renal transplantation who underwent RC and ileal conduit urinary diversion for bladder cancer. Preoperative clinical and demographic data were presented and outcomes were assessed.Results
The RC and ileal conduit urinary diversion were performed in the first patient 56 months after renal transplantation and in the second patient 64 months after renal transplantation. Clinical staging was high-grade T2 transitional cell cancer of the bladder for patient 1 and T2 with pure squamous cell cancer of the bladder for patient 2. No perioperative or postoperative complication and no graft dysfunction occurred in either patient.Conclusion
Our experience demonstrated that RC with ileal conduit reconstruction in renal transplant recipients is safe and feasible. 相似文献19.
G.S. Wu Q.C. Zhao Z.S. Li Y. Wu W.Z. Wang M.B. Li H. Shi M. Wang D.L. Chen J.Y. Zheng X. Wang D.M. Fan 《Transplantation proceedings》2017,49(1):232-236
Background
Antibody-mediated rejection (ABMR) has recently surfaced as a potential form of graft dysfunction after intestinal transplantation.Methods
We present a case of an intestinal transplant recipient who developed late-onset ABMR 12 years after living-donor transplantation. An 18-year-old male recipient with a history of extensive intestinal resection secondary to acute bowel volvulus exhibited an excellent baseline immune profile for transplantation, including ABO-identical and HLA-haploidentical to the donor; a negative cross-match with a panel reactive antibody of 3.0%.Results
Post-transplantation immunosuppression consisted of tacrolimus, mycophenolate mofetil (MMF), and prednisone within the first year, followed by tacrolimus and MMF in the second year, and maintenance with tacrolimus monotherapy thereafter. The recipient experienced a single episode of indetermined acute cellular rejection 3 months after transplantation. Since then, he did not require any parenteral nutrition and had completely reintegrated with society. Twelve years later, the patient developed persistent diarrhea associated with transplant biopsy diffuse C4d deposition and circulating donor-specific antibodies. After the use of rituximab and intravenous immunoglobulin, the recipient stabilized 17 years after transplantation with complete recovery of intestinal mucosal damage.Conclusion
Late-onset ABMR can emerge after transplantation and must be considered a possible cause of graft dysfunction in long-term intestinal transplantation survivors. 相似文献20.
T. Bessede Y. Hammoudi D. Bedretdinova B. Parier H. Francois A. Durrbach G. Benoit 《Transplantation proceedings》2017,49(9):2018-2024