共查询到20条相似文献，搜索用时 10 毫秒
1.
Ester De Marco Daniela Corona Flavio Origlio Giuseppe Giuffrida Rossella Gioco Chiara Palermo Francesca Privitera Alessia Giaquinta Alba Ilari Sara D’Errico Flavia Pinto Fausto Carbone Anna Carbonaro Pierfrancesco Veroux Massimiliano Veroux 《Transplantation proceedings》2019,51(9):2906-2909
BackgroundA careful assessment of a living donor is mandatory to minimize the short- and long-term risk related to kidney donation. In this study, we evaluated the incidence of incidental findings (IFs) in a large population of potential living kidney donors. Moreover, this study evaluated if the presence of IFs could influence the chance of living kidney donation and post-transplant outcomes.MethodsOne hundred and sixty consecutive potential prospective living kidney transplant donors, who underwent a multidetector computed tomography angiography (MDCTA), were included in the study. An IF was defined as an incidentally discovered mass or lesion, detected by computed tomography angiography during the imaging evaluation of potential living donors. Clinical outcomes of living donors with IF were compared with those without IF.ResultsIn 10 patients (6.2%) an incidental finding was detected at MDCTA assessment. Among the 10 patients presenting with an IF, 7 patients (4.3%) were excluded from the living donation: 2 patients with an adrenal lesion, 3 patients with cancer, and 2 patients with a large (>8 cm) renal cyst. Graft and patient survival of kidney transplant recipients of donors with IFs were not significantly different to those receiving a kidney from living donors without IFs.ConclusionsIncidental findings are frequently discovered during living kidney donor evaluation. Whereas most are asymptomatic or not clinically relevant, predonation screening could identify potentially life-threatening diseases at an earlier stage, allowing for a more radical treatment. 相似文献
2.
An unusual case of blunt injury with double disruption of an innominate artery is presented. The surgical management of the problem was complicated by the fact that both common carotid arteries originated from the innominate artery. The literature contains 33 cases of innominate artery injuries secondary to blunt trauma and is discussed in terms of cerebral protection by means of carotid shunts, moderate hypothermia, deep hypothermia with circulatory arrest, and no cerebral protection. 相似文献
3.
4.
J R Skinner C Rasak C Kongtahworn S J Phillips R H Zeff R S Toon V B Solomon 《The Annals of thoracic surgery》1984,38(1):42-45
Forty-one patients underwent resection of a postinfarction ventricular aneurysm. Thirty-seven of them had associated saphenous vein grafting procedures (average, 2.3 grafts per patient). Thirty-five patients sustained left ventricular dysfunction preoperatively. Forty patients were followed until death or for a minimum of five years (1 was lost to follow-up), and functional status was evaluated. Hospital mortality was 12%. Twenty-four patients survived five years or longer, and 20 patients were alive after a mean follow-up of 84 months. Eighty percent of the nonsurvivors died of atherosclerosis-related events. Forty-nine percent of the patients who survived the operation sustained severe atherosclerotic events postoperatively. Only 2 of 15 nonsurvivors ever regained functional status as judged by return to work. Twelve of the 20 long-term survivors returned to work. Of those patients less than 50 years old at operation, only 17% returned to work. Preoperative left ventricular function was a significant predictor of long-term functional results of aneurysmectomy and saphenous vein grafting. All patients remained at high risk for continued events related to atherosclerotic cardiovascular disease, and only 37% returned to full-time, preoperative work status. Return to productive status was especially disappointing in patients less than 50 years old. 相似文献
5.
Carpal tunnel decompression in spite of normal electromyography 总被引：6，自引：0，他引：6
A B Grundberg 《The Journal of hand surgery》1983,8(3):348-349
6.
7.
8.
James R. Skinner Robert H. Zeff Chamnahn Kongtahworn Richard S. Toon C. David Smith Steven J. Phillips 《The Annals of thoracic surgery》1984,38(3):296-297
Intraaortic balloon pump counterpulsation is well established as a lifesaving measure. Aortic counterpulsation may be achieved externally as well as internally. A simple technique for manual external aortic counterpulsation during cardiovascular surgical procedures is presented. This technique is available on immediate demand and identical in effect to intraaortic balloon pumping, and it may be lifesaving in patients with acute cardiovascular decompensation since it allows time for institution of necessary emergency therapy. 相似文献
9.
10.
R H Zeff L A Iannone C Kongtahworn T M Brown D F Gordon M Benson S J Phillips R E Alley 《The Annals of thoracic surgery》1982,34(2):196-200
Coronary artery spasm is a well-documented phenomenon in patients undergoing medial treatment. We describe coronary artery spasm occurring in the immediate postoperative period following coronary artery bypass operation. The spasm occurred in a vessel that was not operated on and that had no apparent lesion. The diagnosis of spasm was made by coronary angiography immediately after operation. Complications associated with this spasm are discussed. Emphasis is placed on early postoperative angiography for patients whose condition is inexplicably unstable after operation. 相似文献
11.
A newly designed arterial monitoring and perfusion cannula for cardiopulmonary bypass eliminates the need for cannulation of a peripheral artery for pressure monitoring. The double-lumen cannula is designed as follows: the large central lumen (12 to 26F) acts as the arterial inflow conduit from the pump oxygenator, while a second, smaller lumen (18 gauge) constructed in the wall of the first cannula acts as the pressure-monitoring port and the source for blood sampling and drug infusion. This monitoring/perfusion cannula has been used successfully in more than 250 clinical patients in a variety of settings—total cardiopulmonary bypass, left heart bypass, and when multiple arterial inflow lines were necessary (as in aortic arch replacement). Use of this cannula is advantageous in the infant and pediatric patient or in the emergency setting, when insertion of a peripheral arterial line can be difficult. Used in conjunction with a Doppler system, the cannula provides accurate, dependable blood pressure monitoring. 相似文献
12.
S.H.E. Ceuppens H.J.A.N. Kimenai J.I. Roodnat I.R.A.M. Mertens zur Borg J.C. Duipmans J.N.M. IJzermans R.C. Minnee 《Transplantation proceedings》2019,51(9):3074-3076
Severe recessive dystrophic epidermolysis bullosa is a very rare inherited disease with excessive blisters forming starting at birth. Surgical intervention in this population creates a challenge: preventing formation of new lesions while managing previously scarred tissues.We present a case of a 27-year-old patient with end-stage renal disease caused by rapidly progressive IgA nephropathy. Living donor kidney transplantation was performed under local, spinal and epidural anesthesia.Living kidney transplantation in epidermolysis bullosa patients with end-stage renal disease should not be a contraindication for transplantation and should be considered as a viable and feasible option after careful preparation. 相似文献
13.
M.L. Pistorio M. Veroux C. Trigona M. Patanè S. Lo Bianco G. Cirincione P. Veroux A. Giaquinta C. De Pasquale 《Transplantation proceedings》2019,51(1):124-127
Background
The decision to resort to living donor transplantation determines a particular condition characterized by a strong mental and emotional anguish, both for the patients and their families.The purpose of the study was to correlate the relational dynamics between donor-recipient, donor/recipient couple with the health team, and the family support perceived by the couple with the quality of life 6 months before transplant and 12 months after transplant and compare the data between the 2 time points after participating in the psychotherapy program of counseling about behavioral change.Patients and Methods
Twenty-seven donor and recipient pairs consented to participate. The quality of life was studied through the Complete Form Health Survey (SF-36). All subjects completed a questionnaire that investigated the 3 types of fundamental relationships (donor-recipient, donor/recipient with the health team, and family support perceived by the couple). All participants were involved in an 18-month psychotherapy program in the pre- and post-transplant phase.Results
The quality of the donor-recipient relationship significantly positively influences the subjective perception of psychophysical well-being before and after transplant. Post-transplant family support is crucial in ensuring a good perception of psychological and emotional health in donors and recipients. The relationship with the health team is important in ensuring a good perception of psychophysical health only in recipients after transplant.Conclusions
This study suggests that patients should be assisted by a multidisciplinary health care team and receive continuous support from relatives during the post-transplant adaptation process. This facilitates the donor and recipient postoperative quality of life. 相似文献14.
M. Gregorini V. Martinelli E. Ticozzelli M. Canevari G. Fasoli E.F. Pattonieri F. Erasmi M. Valente P. Esposito A. Contardi M.A. Grignano A. Pietrabissa M. Abelli T. Rampino 《Transplantation proceedings》2019,51(1):120-123
Background
Living donor kidney transplantation (LDKT) is the best therapy for patients with chronic renal failure. Its advantages, compared with cadaveric transplantation, include the possibility of avoiding dialysis, the likelihood of best outcome, and donor pool expansion. Careful assessment of potential donors is important to minimize the risks and ensure success. However, the proportion of donors disqualified has been poorly investigated. The aim of this work is to describe our experience and present the main reasons for missed donation.Methods
This was a single-center, retrospective study of all potential donors and recipients evaluated for LDKT between January 2008 and December 2017.Results
During the period of study, 81 donor-recipient pairs were evaluated. Of these, 45.7% were disqualified and 37 LDKTs were carried out. LDKT was the first choice in 68% of cases and preemptive in 20%; 60% of transplants were among family members. Sex distribution revealed a prevalence of females in the donor group (69%) and males in the recipient group (70%). The mean living donor age was 53 ± 9.5 years; the mean recipient age was lower in recipients listed in the living transplant program than those listed for cadaver transplantation (45.8 ± 13.4 vs 54.2 ± 11.08; P < .0001). Reasons for denial included hypertension (18.9%), deceased donor transplant performed during the study period (16.2%), urologic pathology (13.5%), incompatibility (13.5%), withdrawal of consent by donor or recipient (13.5%), psychological unsuitability (8.1%), donor cancer (5.4%), and reduced renal clearance (2.7%).Conclusion
LDKT is considered an option especially for younger recipients. Of the potential kidney living donors, 45.7% were disqualified during the evaluation, with medical reasons being the primary cause. 相似文献15.
S. Sekito K. Nishikawa S. Masui Y. Hasegawa H. Kanda K. Arima Y. Sugimura 《Transplantation proceedings》2018,50(8):2431-2435
Background
The frequency of renal transplants from elderly living donors has increased because of a shortage of donors. However, the results of renal transplantation using aged kidney grafts have yet to be determined conclusively.Methods
We evaluated 45 patients who underwent living donor kidney transplantation at our institution. The patients were categorized according to donor age at the time of the transplant: ≥?60 years (elderly donor group, n = 21) and <60 years (young donor group, n = 24). We reviewed the renal function of the recipients and pathologic findings of the graft including interstitial fibrosis score, tubular atrophy score, tubular atrophy and interstitial fibrosis grades, and arteriosclerosis up to 2 years posttransplantation.Results
Significant differences were observed in the preoperative creatinine clearance of the donor, prevalence of hypertension in the donor, and age of the recipient. Serum creatinine levels in the elderly donor group were significantly higher from 2 months to 1 year posttransplantation, and the estimated glomerular filtration rate was significantly lower from 7 days to 1 year posttransplantation. However, the decline in estimated glomerular filtration rate from 14 days to up to 2 years posttransplantation was similar in the 2 groups. There was no significant difference in the renal biopsy findings between the 2 groups except for arteriosclerosis 1 year posttransplantation.Conclusion
Kidney grafts from elderly living donors were not associated with a deterioration in renal function, and their pathologic findings were comparable with those of young donors for up to 2 years posttransplantation. 相似文献16.
N.L. Mendelson A. Fitzgerald A. Kumar J.A. Pineda J. MacDougall R.J. Solomon P.C. Gibson M. Prikis C.E. Marroquin 《Transplantation proceedings》2017,49(10):2411-2414
Using kidneys from deceased donors whose demise was secondary to ethylene glycol (EG) toxicity requires considerable thought and planning. The exact impact that kidneys from these donors could have is unclear. The shortage of viable organs and growing wait list mortality should lead us to consider these allografts as potential life-saving transplants. Because it is crucial for the transplant community to use every available allograft, we need to develop processes that optimize each possible scenario. This article is a discussion of the viability of kidneys from a donor with EG-induced brain death and a proposed algorithm for encouraging the use of renal allografts after EG toxicity. 相似文献
17.
Y.E. Yoon H.H. Lee J.C. Na K.H. Huh M.S. Kim S.I. Kim Y.S. Kim W.K. Han 《Transplantation proceedings》2018,50(4):1029-1033
Background
Smoking is known to result in a decline in renal allograft function and survival of recipients; however, the effect of smoking on living kidney donors remains unknown. In this study we evaluated the impact of cigarette smoking on renal function of kidney donors.Methods
Among 1056 donors who underwent nephrectomy, 612 completed the 6-month follow-up protocol and were enrolled in the study. The association of smoking status, including pack-years smoking history, and postoperative renal function was evaluated.Results
Among donors, 68.1% had never smoked, 8% were former smokers, and 23.9% were current smokers. Donors who never smoked were older than former and current smokers (42.3 ± 11.8, 41.9 ± 11.1, and 38.3 ± 10.9 years, respectively; P < .001). There was no difference in preoperative renal function between groups; however, postoperative estimated glomerular filtration rate (eGFR) was lower in former and current smokers than in those who never smoked (64.6 ± 13.8, 64.7 ± 12.3, and 67.8 ± 13.1 mL/min/1.73 m2, respectively; P = .023). In former and current smokers, pack-years smoking history was negatively associated with pre- and postoperative eGFR (r = -0.305 and -0.435, P < .001), and correlated with postoperative percent eGFR decline (r = 0.248, P < .001). Smoking history was associated with postoperative development of chronic kidney disease (CKD). Especially in former smokers, a smoking history of more than 12 pack-years was strongly associated with development of CKD (odds ratio = 7.5, P = .003).Conclusion
Even if they no longer smoke, donors with a smoking history require close observation due to increased risk of CKD development after kidney donation. A detailed pack-years smoking history should be obtained, and smoking cessation strategies should be implemented in kidney donors. 相似文献18.
Background
The Kidney Donor Risk Index (KDRI) scoring system for deceased donors has been widely introduced for postoperative evaluation of graft function. We analyzed the usefulness of the KDRI in deceased donors with acute kidney injury (AKI).Methods
Forty-nine recipients from deceased donors with AKI between January 2009 and December 2014 were reviewed retrospectively. Data collected from donor medical records included age, height, weight, hypertension or diabetes history, cause of death, serum creatinine (sCr), and donation after cardiac death. Graft function data including sCr, estimated glomerular filtration rate (eGFR), and acute rejection episodes were monitored for 1 year. Correlations between KDRI score and factors indicating graft function were analyzed. A cutoff value for KDRI score was calculated using a receiver operating characteristic (ROC) curve for significant graft function.Results
The mean ages of donors and recipients were 46.81 ± 13.13 and 47.69 ± 11.43, respectively. The mean KDRI score was 1.24 ± 0.40. Univariable analysis of KDRI score and factors indicating graft function indicated that sCr at 6 to 12 months, eGFR at 1 year, and slow graft function (SGF) had statistical significance. The ROC curve of KDRI score for SGF showed an optimal cutoff value of 1.20, with sensitivity of 69.2% and specificity of 69.4% (area under the curve = 0.75) in deceased donors with AKI.Conclusions
KDRI score in deceased donors with AKI was correlated with postoperative graft values including eGFR and SGF. KDRI could be used as a predictor for the short-term clinical outcome after kidney transplant from deceased donor with AKI. 相似文献19.
C.-H. Wang K.-A. Chang C.-L. Chen K.-W. Cheng S.-C. Wu C.-J. Huang T.-H. Shih S.C. Yang S.-E. Juang C.-E. Huang B. Jawan Y.-E. Lee 《Transplantation proceedings》2018,50(9):2654-2656
Objective
Right lobe living donor hepatectomy poses a greater risk for the donor in relation to blood loss. The aims of this study were to compare anesthetic and intraoperative fluid management in right and left lateral segment living donor hepatectomy.Patients and Methods
The anesthesia records of living donor hepatectomy patients were retrospectively reviewed. Donor age and weight, anesthesia time, central venous pressure, blood loss, blood product transfusion, intravenous fluids used, doses of furosemide, and urine output were compared and analyzed between groups using the Mann Whitney U test.Results
Forty-six patients underwent living donor left lateral segment hepatectomy (Group I); while 31 patients underwent right lobe hepatectomy (Group II). The mean blood loss in Group II was significantly higher compared to Group I (118 ± 81 mL vs 68 ± 64 mL), but clinically such amount of blood loss was not high enough to affect the hemodynamics. The fluid management was therefore not meaningfully different between the two groups. No blood transfusions or colloid infusions were required for either group. Urine output, hemoglobin changes, blood urea nitrogen, and serum creatinine pre- and postoperatively were not significantly different between groups.Conclusions
As long as blood loss is minimal, we found no difference in the anesthetic management and fluid replacements between right and left lateral segment living donor hepatectomy. 相似文献20.
T. Wakiya K. Ishido D. Kudo N. Kimura K. Sato Y. Mitsuhashi T. Kagiya C. Uchida S. Umetsu T. Yoshida Y. Wakasa Y. Toyoki K. Hakamada 《Transplantation proceedings》2018,50(9):2593-2596