共查询到20条相似文献，搜索用时 15 毫秒
1.
B. Febrero P. Ramírez L. Martínez-Alarcón C. Abete M. Galera A. Ríos R. Robles-Martínez P.M. Ramírez-Pino J. Almela G. Ramis J.A. Pons P. Parrilla 《Transplantation proceedings》2019,51(1):28-32
Background
It is well-known that there is a high incidence of depression in patients on the liver transplant (LT) waiting list. However, there have been few studies of psychological intervention on these patients.Objectives
To determine symptoms of depression in patients on the LT waiting list and the impact of group psychotherapy.Methods
Study population: patients on the LT waiting list who received group psychotherapy (n = 15). Control group: patients who did not receive psychotherapy (n = 10). Measurement instrument: Beck's depression test, which was provided before psychotherapy was initiated and after it was completed (after 6 months). The control group was given the questionnaire at the same 2 points in time as the study group. The psychotherapeutic method consisted of discussing patients' feelings, which dealt with several matters related to transplantation. Different coping strategies were considered.Results
More than half of those surveyed initially had depressive symptoms. When the second survey was administered to the study population, all the patients improved in their psychopathological assessment. When the survey was administered to the control group, a worse psychopathological assessment was obtained in all cases.Conclusions
Our data suggest an improvement in depressive symptoms in patients on the LT waiting list after receiving group psychotherapy. 相似文献2.
U. Maggi M. Iavarone M. Fabbi D. Yiu G. Fornoni E. Melada D. Dondossola P. Cantù G. Rossi 《Transplantation proceedings》2018,50(10):3105-3110
Background and aim
Liver grafts from donors with chronic and active history of alcohol abuse are usually immediately ruled out for use in liver transplantation (LT). The aim of our study is to evaluate the use of those grafts.Methods
From 2011 to 2016, a study group (Group 1) composed of 5 adult LT patients transplanted with livers from donors with alcohol abuse, was compared with a control group (Group 2) of 10 randomly matched patients who received liver transplants. Preoperative, intraoperative, and postoperative data were compared.Results
Among donors, serum gamma-glutamyl transferase values were significantly higher in Group 1. In recipients, post-LT laboratory exams showed significantly higher peak values of aspartate transaminase and alanine transaminase in Group 1; higher values of aspartate aminotransferase, alanine aminotransferase, and total bilirubin in Group 1 were also recorded on day 0. Early allograft dysfunction occurred at higher rates in Group 1 (80% vs 20%, P = .025), with no differences in early rejection episodes or early surgical repeat interventions. All patients from both groups were alive after 20 ± 10 (range 6–35) months from LT.Conclusion
Despite higher rates of early allograft dysfunction, selected liver grafts from donors with alcohol abuse can be accepted for LT with good clinical results. 相似文献3.
A. Prodromidou I.D. Kostakis N. Machairas Z. Garoufalia P. Stamopoulos A. Paspala G.C. Sotiropoulos 《Transplantation proceedings》2019,51(2):446-449
Purpose
Liver transplantation (LT) constitutes a major therapeutic option for a number of patients suffering from liver pathologies. Pregnancy outcomes in patients who have undergone LT are assessed by a number of studies. The aim of our systematic review was to present the currently available evidence concerning the results of pregnancy in patients with LT.Materials and Methods
A meticulous systematic search of the literature published before September 2017 for studies relevant in this field was conducted. All studies, which presented obstetric and maternal outcomes of patients with prior LT, were included.Results
Nineteen studies, which comprised 1290 pregnancies in 885 female LT recipients, were reviewed. A total of 1014 live births were recorded, and the incidence of spontaneous abortions ranged from 0.5% to 33.3%. Concerning live births, a proportion of 32% of pregnancies resulted in preterm births (345 preterm births in 1079 pregnancies, range 0%-39%), and in 16% of pregnancies preeclampsia was reported (188 cases from 1173 pregnancies, range 2%-33.3%). The most commonly administered immunosuppressive drugs were cyclosporine and tacrolimus alone or with steroids. Cesarean section rates ranged from 20% to 67.9% among the included studies, concerning live birth. Moreover, approximately one-third of them resulted in preterm birth. Spontaneous abortions were reported in 176 cases (range: 0.5%-33.3%), and preeclampsia occurred in 188 patients (range: 2%-33.3%).Conclusion
Pregnancy outcomes from the included studies are encouraging, nonetheless pregnant patients who have undergone LT are at high risk and therefore require close monitoring by a multidisciplinary team. 相似文献4.
A. Bertacco S. Barbieri G. Guastalla R. Boetto A. Vitale G. Zanus U. Cillo P. Feltracco 《Transplantation proceedings》2019,51(1):179-183
Background
Liver transplantation (LT) is an established treatment for patients with end-stage liver disease. The significant advances in surgical technique, immunosuppression therapy, and anesthesiological management have dramatically improved short- and long-term outcomes. The aim of this study is to correlate specific surgical and anesthesiological variables with causes of early death in LT recipients.Methods
A retrospective observational analysis of adult patients who underwent LT in the period 2012 to 2016 and died within 90 days following LT was conducted. Exclusion criteria were intraoperative death, split liver, and domino transplant. Death was considered a dependent variable and classified into 3 different groups: death by sepsis, vascular events not related to the graft, and primary non-function. Donor and recipient variables were considered and analyzed using Fisher's exact test.Results
Statistically significative associations (P value < .05) were found between renal function support, retransplantation, and the number of fresh frozen plasma units transfused in one group and early death due to sepsis in the other.Conclusions
This study identified some risk factors associated with the specific cause of early death in liver transplantation. The clinical implications of these findings are the ability to stratify patients at high risk of early death by planning more intensive and accurate management for them. 相似文献5.
Kidney Transplantation in Patients With Chronic Kidney Disease After a Previous Lung Transplantation
M. Serrano-Salazar L. Medina-Zahonero D. Janeiro-Marín C. Contreras-Lorenzo M. Aguilar-Pérez B. Sánchez-Sobrino P. López-Sánchez P. Ussetti-Gil J. Portoles-Perez 《Transplantation proceedings》2019,51(2):324-327
Background
The development of chronic kidney disease is a common complication after a lung transplantation, especially since the introduction of immunosuppressive treatments based on calcineurin inhibitors. Many of these patients reach end-stage renal disease and even need renal replacement therapy. Among the different options of renal replacement therapy, we consider kidney transplantation as a feasible option for these patients.Methods
A single center, observational retrospective study including 8 lung transplanted patients who have received a kidney transplant in the period between 2013 and 2017 with at least 1 year of follow-up was used.Results
Seven patients maintained an adequate function of the graft 1 year after kidney transplantation, and 1 patient died because of a pulmonary condition in spite of a previous kidney transplant. Two patients presented delayed graft function in the first days after surgery.Conclusions
The kidney transplantation is a technique of renal replacement therapy that should be considered in patients with previous lung transplantation. Experienced centers in double sequential lung and kidney transplantation should be established to assess and treat these types of patients. 相似文献6.
G.C. Sotiropoulos N. Machairas I. Fouzas S. Vernadakis A. Paul J. Wohlschlaeger 《Transplantation proceedings》2019,51(2):421-423
Introduction
Hepatocellular carcinoma (HCC) in cirrhosis is a widely accepted indication for liver transplantation (LT). Many scoring systems have been proposed intending to an extension of the established Milan criteria. Bridging treatments are systematically applied in order to maintain or to downstage such patients to the listing criteria. The objective of our study was to estimate the feasibility of the prediction of microvascular tumor invasion in transplant candidates.Patients and methods
Data corresponding to transplanted HCC patients were reviewed for the purposes of this study. All tumor slices were blindly re-evaluated by a single pathologist in order to score for tumor necrosis and microvascular invasion. Recipients of pediatric or split LT were excluded.Results
Eighty patients (30 women and 50 men) were included in the study. Tumor necrosis was absent in 29 of 80 liver explants (36.25%). In the majority of instances (63.75%) tumor necrosis was evident in proportions between 5% and 100%. In 58 liver explants showing 0%-60% tumor necrosis and 22 liver explants showing >?60% tumor necrosis, microvascular tumor invasion was detectable in 11 and 0 cases, respectively (P = .0385).Conclusion
In about one-fourth of the cases (27.5%) microvascular tumor invasion could not be detected due to extended areas of tumor necrosis. Preoperative detection of microvascular invasion is misleading. 相似文献7.
N. Machairas P. Stamopoulos I.D. Kostakis Z. Garoufalia A. Paspala P. Tsaparas G.C. Sotiropoulos 《Transplantation proceedings》2019,51(2):437-439
Introduction
Mixed hepatocellular cholangiocarcinoma (HCC-CC) represents a rare hepatic tumor, which demonstrates histological features of both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). HCC-CC can be an unexpected finding in patients undergoing liver transplantation (LT) for HCC. The objective of our review was to review and evaluate long-term outcomes in patients undergoing LT for mixed HCC-CC.Methods
A meticulous MEDLINE search was performed for articles referring to long-term results in patients who underwent LT and whose final pathology revealed HCC-CC.Results
A total of 7 studies, which comprised 93 patients who underwent LT and whose resected specimen revealed mixed HCC-CC, were included in our review. One-year overall survival (OS) rates ranged from 64% to 93%, 3-year OS ranged from 38% to 78%, and 5-year OS rates range from 14% to 78%. Disease-free-survival (DFS) rates at 1-year from LT ranged from 60-% to 64%, whereas both 3- and 5-year DFS rates ranged from 30% to 53.3%.Conclusions
Long-term results of LT in the setting of mixed HCC-CC are associated with fairly unfavorable overall outcomes compared to LT for other indications including HCC yet are improved compared to others such as intrahepatic CC. A stricter preoperative evaluation could potentially help identify the patients with mixed HCC-CC who are at high-risk after LT, reduce the risks of recurrence, and improve OS. 相似文献8.
Z. Garoufalia A. Prodromidou N. Machairas I.D. Kostakis P. Stamopoulos N. Zavras I. Fouzas G.C. Sotiropoulos 《Transplantation proceedings》2019,51(2):443-445
Introduction
Wilson's disease (WD) is a rare autosomal recessive disorder transmitted through a gene located on chromosome 13. Liver transplantation (LT) provides a therapeutic option for patients with WD presenting fulminant liver failure or drug resistance. LT in patients with WD has a twofold aim: to save the patient's life when the disorder has progressed to hepatic (or other organ) failure and to cure the underlying metabolic defect. The aim of our study was to investigate the indications, aspects and post-operative outcomes in pediatric patients (<?18 years old) with WD who underwent LT.Methods
A meticulous search of the literature since 1971 was performed. A retrospective analysis of all the studies, presenting cases of LT in children due to WD, was conducted. Studies that did not report patients' characteristics, transplantation indications, post-operative outcomes, and complications, as well as those with small study populations (<?10 patients), were excluded.Results
Six studies were included in the present review, which involved 290 children. The main indications for LT included chronic liver failure and fulminant liver failure. The average 1-year survival rate was 91.9%, while the average 5-year survival rate was 88.2%. Retransplantation was performed in 16 patients due to transplant rejection. In general, patients transplanted for WD displayed an excellent quality of life after LT.Conclusion
LT is a safe and efficient procedure in selected pediatric patients with WD, demonstrating excellent long-term outcomes and quality of life. 相似文献9.
R. López-Andújar J. Maupoey J. Escrig P. Granero J.J. Vila V. Ibáñez A. Boscá M. García-Eliz S. Benlloch J.F. Orbis E.M. Montalvá 《Transplantation proceedings》2019,51(1):44-49
Background and Aims
T-tube placement during choledochocholedochostomy (CCS) associated with liver transplantation (LT) remains controversial. This study was designed to validate the results of an earlier prospective randomized controlled trial (RCT) on use versus nonuse of the T-tube during CCS associated with LT.Methods
Prospective cohort study. The primary outcome was the overall incidence of biliary complications (BCs).Results
In total, 405 patients were included, and the median overall monitoring period was 29 months (interquartile range: 13–47 months). Selective use of the T-tube reduced BCs (23% vs 13%; P = .003), of which 75% were type IIIa or less in the Clavien-Dindo classification. The overall BC rate did not differ between patients with versus without T-tube placement.Conclusions
We confirmed that selective use of a rubber T-tube during CCS associated with LT, following the principles established in our prospective RCT, reduced the rate of BC by 10% without detriment, even after enrolling patients at an a priori greater risk of BCs than were the RCT patients. 相似文献10.
Mild to Moderate Intrapulmonary Shunting in Pediatric Liver Transplantation: Is Screening Necessary?
V.P. Mali A. Fukuda T. Shigeta H. Uchida H. Kanazawa Y. Hirata T. Rahayatri B. Chiaki K. Sasaki M. Kitamura S. Sakamoto M. Kasahara 《Transplantation proceedings》2018,50(10):3496-3500
Background
Despite reported associations between intrapulmonary vascular shunting (IPVS) and morbidity and mortality in pediatric liver transplantation (LT), there are no guidelines for screening.Objective
To investigate IPVS before and after pediatric LT.Methods
Retrospective records review of all pediatric LT (n = 370) from 2005 to 2015 at a single institute in Japan. All children with cirrhosis and clinical suspicion of IPVS without cardiac or pulmonary conditions were included. 99mTechnetium labelled macroaggregated albumin (99mTcMAA) scans were performed before and after LT. The severity of IPVS was graded using shunt ratios.Results
Twenty-four children fulfilled inclusion criteria and underwent Tc99MAA scans. All revealed mild (<20%) to moderate (20%-40%) grades of IPVS. Following LT, the mean shunt ratio regressed from 20.69 ± 6.26% to 15.1 ± 3.4% (P = .06). The median (range) follow-up was 17 (4–85) months. Mortality was zero. The incidence of portal vein thrombosis (4.2%) biliary strictures (12.5%) and graft loss (4.1%) in the study group was not statistically significant compared to the remainder of the 370 transplants (3.2%, 9.4% and 3%, respectively). Sub-group analysis revealed hepatopulmonary syndrome (HPS) in 2 out of 24 children. The mean shunt ratios before and after LT were 39.2 ± 0.77% and 16.2 ± 8.5%, respectively (P = .08). There was 1 complication (intra-abdominal abscess).Conclusions
HPS is less likely in mild to moderate IPVS. LT may achieve comparable results when performed in the presence of mild to moderate IPVS. 相似文献11.
A. Palleschi E. Benazzi C.F. Rossi R. Torelli S.M. Passamonti C. Pellegrini A. Lucianetti P. Tarsia F. Meloni P. Parigi M. Nosotti 《Transplantation proceedings》2019,51(1):190-193
Background
Lung transplantation is an established therapeutic option for patients with end-stage pulmonary disease. In May 2005, the lung allocation score (LAS) was introduced in the United States to maximize the benefit to the recipient population and reduce waiting list mortality. The LAS has been applied in a region of Italy since March 2016 on a provisional basis.The aims of the study were describing waiting list characteristics and short-term outcomes after lung transplantation before and after LAS introduction.Methods
All the patients who received transplants between January 1, 2011, and March 15, 2017, were included in our retrospective study. The study population was divided into 2 cohorts (historical cohort and post-LAS cohort) and a comparison among the main perioperative data was performed.Results
The historical cohort consisted of 415 patients on the waiting list with 91 deaths and 199 lung transplants; the post-LAS cohort consisted of 134 patients with 10 deaths on the waiting list and 51 transplants. Median waiting time and mortality on the list decreased from 223 to 106 days (P = .03) and from 11.2% to 7.5% (P > .05), respectively. The transplantation rate increased from 25% to 38% (P = .001) and the probability to receive a transplant in the first year in the post-LAS era increased significantly (P = .004).Conclusions
The results of the introduction of the LAS system in our region are encouraging and have not shown any adverse short-term effects. The regional coordination decided to prolong the experimental application of LAS in order to accumulate more data and to evaluate medium-term outcomes. 相似文献12.
A. Prodromidou N. Machairas Z. Garoufalia I.D. Kostakis P. Tsaparas A. Paspala P. Stamopoulos G.C. Sotiropoulos 《Transplantation proceedings》2019,51(2):440-442
Introduction
Despite their benign nature, liver hemangiomas (LH) are lesions that can cause major complications requiring intervention. Liver transplantation (LT) has been suggested as an effective treatment option in selected patients with giant LHs causing severe symptoms and cannot be treated otherwise. The aim of our study was to investigate the indications, aspects and post-operative outcomes of patients with a LH who underwent LT.Materials and methods
A meticulous search of the literature was performed. Studies presenting cases of LT due to LH were evaluated. Studies presenting patients characteristics and symptoms, aspects of the disease, transplantation indications and details were selected.Results
Fifteen studies were included in the present review that involved 16 patients. Among them, 4 were male while the remaining 12 were female with a mean age of 39.9 ± 8.7 years. The main indications for LT included respiratory distress, massive hemorrhage, Kasabach-Merritt syndrome, and unsuccessful previous treatment strategies. Four patients were transplanted from living donors and the remaining 12 from cadaveric donors. No post-operative deaths were reported and all patients returned to normal activity. No deaths during the long-term follow-up were reported.Conclusions
LH is an extremely rare indication for LT. Nevertheless, the currently available data suggest that LT is a safe and efficient treatment in the management of symptomatic or complicated LH in selected patients. 相似文献13.
M. Tondinelli M.J.Q. Galdino M.D.B. de Carvalho E.M. Dessunti P.C. Pissinati M.F.C. Barreto R.S.S. Gois M.F.L. Haddad 《Transplantation proceedings》2018,50(10):3095-3099
Background
Few studies have analyzed the results of the organ and tissue donation process for transplants.Objectives
To analyze donations of organs and tissues for transplants in the Macroregional North of Paraná.Material and Methods
Cross-sectional and retrospective study, using data from 7383 death certificates of eligible donors notified in 2015 by 16 hospitals accredited to the Organ Procurement Organization. The data were analyzed using the prevalence ratio (PR) and the Wald test.Results
Among the 934 eligible donors, the prevalence of effective donations was 23.4% (219) Among the 582 organs and tissues donated, corneas were predominant. Organs became available for donation from younger individuals (PR = 0.992), due to brain death (PR = 2.482), notified by the type III Intra-Hospital Organ and Tissue Donation Commissions for Transplants (PR = 2.016), which took place in intensive care units (PR = 1.471). The relatives interviewed were the partners and/or children (PR = 0.469), and the interviews were held by the nurse (PR = 1.324).Conclusion
Effective donations were able to take place through proper organizational structure and trained human resources, highlighting the role of the nurse in the optimization of the organ and tissue donation process for transplants. 相似文献14.
Kenji Shigemoto Takeshi Sawaguchi Kenichi Goshima Shintarou Iwai Akira Nakanishi Ken Ueoka 《Journal of orthopaedic science》2019,24(2):280-285
Background
This study aimed to report results of the multidisciplinary treatment approach for geriatric hip fractures and evaluate its effectiveness compared with conventional treatment. Patients aged 65 years and older who presented with a hip fracture at our hospital on or after 2014 were treated according to a multidisciplinary approach.Method
Two groups of patients with hip fracture were compared. Group I (n = 364) was treated according to the new multidisciplinary approach in 2014–2016, and Group II (n = 105) which received conventional treatment in 2012. Time to surgery, length of hospital stay, postoperative complications, osteoporosis treatment, functional recovery, in-hospital mortality, 90-day mortality, and 1-year mortality were evaluated. The medical costs of multidisciplinary treatment were compared with those in other hospitals every year.Results
There were no significant differences in the time to surgery between Group I and Group II, but each was considerably shorter than the average time in other Japanese hospitals. The length of hospital stay was longer in Group I. The overall postoperative complication rate was lower in Group I, but there was no significant difference for each individual complication. The rate of anti-osteoporosis pharmacotherapy administration at the time of discharge was significantly higher in Group I. Moreover, the proportion of patients who recovered to their pre-injury functional level was significantly higher in Group I. The mortality rates did not significantly differ year on year. The total hospitalization medical cost per patient for the multidisciplinary treatment was lower than other hospital costs every year.Conclusions
Multidisciplinary treatment produced no significant improvement in time to surgery, length of hospital stay, or postoperative complications. However, the use of the multidisciplinary treatment approach led to a significant increase in osteoporosis treatment rate and better functional recovery. Furthermore, the total medical costs for multidisciplinary treatment were lower than the acute care hospital costs. 相似文献15.
V. Martinelli M. Gregorini P. Politi F. Erasmi A. Contardi M. Abelli E. Ticozzelli M. Canevari A. Pietrabissa M. Chiappedi T. Rampino 《Transplantation proceedings》2019,51(1):143-146
Background
In the context of kidney transplantation (KT), multidisciplinary interventions, including assessment and management of psychosocial aspects, are important to improve transplant's outcome. The aim of this study was to describe a multidisciplinary team approach to KT, with a specific focus on early detection and treatment of psychological distress and psychopathologic conditions in the early phase postsurgery.Methods
The multidisciplinary team in kidney transplantation was implemented in January 2016. In this team approach, all transplant recipients are invited to 3 scheduled appointments for a multidisciplinary evaluation at 1, 3, and 6 months posttransplant, including a psychiatric interview, with the aim to assess the patient's adjustment after transplantation and provide support when necessary.Results
This pilot study involved all 41 KT recipients consecutively referred for the first multidisciplinary appointment after transplantation. Five subjects (12% of the study sample) presented with a current psychiatric diagnosis. Psychopharmacologic treatment was confirmed or introduced for all these patients. Further psychological support was suggested to 4 other patients (10%).Conclusion
KT significantly improves patients' quality of life. However, the percentage of subjects receiving psychopharmacologic treatment and referred for further psychological and psychiatric support (22%) suggests the need for careful monitoring of psychosocial aspects over the long term. 相似文献16.
M. Kavousanaki Μ. Tzagournissakis I. Zaganas K.G. Stylianou A.P. Patrianakos M.K. Tsilimbaris A. Mantaka D.N. Samonakis 《Transplantation proceedings》2019,51(2):429-432
Background
Familial amyloidosis polyneuropathy (FAP) is a rare, progressive, and life-threatening disease inherited in the autosomal dominant pattern. Liver transplantation is the only proven disease-modifying treatment to date.Aim
To study the long-term outcomes of patients transplanted for FAP under a multidisciplinary team care.Methods
We included adult patients who were transplanted for FAP indication and were followed up in a relevant clinic or admitted in our department.Results
Twelve patients (6 male) with a mean age of 43 years and mean follow-up post-transplant of 100 months were included. Three patients died in this period, 1 due to a disease-related cause. All patients had peripheral neuropathy (25% severe). Eighty-three percent had autonomic nervous system dysfunction; all men, except one, erectile dysfunction; and half of the patients several genitourinary manifestations. Gastrointestinal involvement was present in 75% of the patients. The severity of several complications related to FAP was found to be associated with waiting on the transplant list for more than 12 months.Conclusions
Patients transplanted for FAP have a long survival. Prolonged stay on the transplant waiting list is associated with frequency and severity of disease complications. These patients are best managed in the context of multidisciplinary team care. 相似文献17.
Liver Transplant Recipients With End-Stage Renal Disease Largely Benefit From Kidney Transplantation
T. Yunhua Z. Qiang J. Lipeng H. Shanzhou Z. Zebin J. Fei Z. Zhiheng W. Linhe J. Weiqiang W. Dongping G. Zhiyong H. Xiaoshun 《Transplantation proceedings》2018,50(1):202-210
Background
The incidence of end-stage renal disease (ESRD) after liver transplant (LT) has increased. The actual benefit of kidney transplantation (KT) is not completely understood in LT recipients with ESRD.Methods
We analyzed Scientific Registry of Transplant Recipients data for all KT candidates with prior LT from 1998 to 2014; the benefits of KT relative to remaining on dialysis were compared by means of multivariate Cox proportional hazards regression analysis.Results
The number of these KT candidates with prior LT has tripled from 98 in 1998 to 323 in 2015; LT recipients with ESRD remaining on dialysis have a 2.5-times increase in the risk of liver graft failure and a 3.6-times increase in the risk of patient death compared with these patients receiving KT. The adjusted liver graft and patient survival rates after donors from donation after cardiac death or expanded-criteria donor kidney transplantation were significantly higher than in patients remaining on dialysis in LT recipients with ESRD.Conclusions
The number of referrals to KT with prior LT is increasing at a rapid rate. Remaining on dialysis in LT recipients with ESRD has profound increased risks of liver graft failure and patient death in comparison to receiving a KT. LT recipients with ESRD can benefit from expanded-criteria donor and donation after cardiac death kidney transplantation. 相似文献18.
G. Mattei A. Laghi S. Balduzzi M. Moscara C. Piemonte C. Reggianini M. Rigatelli S. Ferrari L. Pingani G.M. Galeazzi 《Transplantation proceedings》2017,49(9):2105-2109
Objective
The objective of this study was to identify possible biopsychosocial predictors of organizational complexity in patients referred to the consultant psychiatrist for assessment before liver transplantation.Methods
This was a case-control study. All psychiatric consultations performed before and after liver transplantation from January 1, 2008 to December 31, 2013 were included. Complexity was operationalized as “undergoing two or more psychiatric consultations”. Controls were defined as patients who were assessed only once by the consultant. Cases were represented by patients who underwent two or more consultations. Statistical analysis was performed with STATA 13.1, using logistic regressions.Results
In this study, 515 consultations were requested for 309 patients potentially eligible for liver transplantation. Controls were 209 (67.6%); cases were 100 (32.4%). Positive psychiatric history (odds ratio [OR] = 2.44; 95% confidence interval [CI], 1.43–4.16), viral or toxic (alcohol- or drug-related) liver disease (OR = 1.93; 95% CI, 1.09–3.42), use of psychotropic medications at the baseline (OR = 2.15; 95% CI, 1.14–4.07), and female gender (OR = 1.77; 95% CI, 1.01–3.11) were significantly associated with an increased probability of being cases.Conclusions
Positive psychiatric history, viral or toxic liver disease, use of psychotropic medications at the index referral, and female gender are possible biopsychosocial predictors of complexity in patients eligible for liver transplantation. 相似文献19.
G. Peluso P. Incollingo N. Carlomagno V. D&#x;Alessandro V. Tammaro M. Caggiano M.L. Sandoval Sotelo N. Rupealta M. Candida G. Mazzoni S. Campanile G. Chiacchio A. Scotti M.L. Santangelo 《Transplantation proceedings》2019,51(1):160-163
Background
Patients on peritoneal dialysis treatment represent 15% of the global dialysis population. The major complication of peritoneal dialysis is catheter and peritoneal infection. Peritoneal dialysis patients who receive kidney transplants are at increased risk of infection because of immunosuppressive therapy.Aim
The purpose of this study is to show our ideal timing to remove peritoneal catheter after kidney transplant, which gives adequate security on renal function recovery and reduction of septic risk.Method of Study
We analyzed the outcomes of 65 patients on peritoneal dialysis who underwent kidney transplant between 2000 and 2016.Results
In 61 cases there was an immediate graft functional recovery. In 4 cases there was a delayed graft function (DGF), and we performed a hemodialysis with temporary placement of a venous catheter. In all patients we removed peritoneal dialysis catheter 30 to 45 days after transplant. There has been 1 case of catheter infection, which was treated with antibiotic therapy.Discussion
Our average time to remove the peritoneal dialysis catheter was shorter than times in previous studies, between the 30th and 45th postoperative day. In the 4 cases in which there has been a DGF, we performed hemodialysis treatment to avoid, in the immediate postoperative period, direct insults to the peritoneum by local dialysis procedures.Conclusion
Our experience show that the 30th to 45th postoperative day is a good time frame, better yet a good watershed between the safe removal of peritoneal catheter when patients have a stabilized renal function and the possibility of leaving it in situ, to resume peritoneal dialysis in case of persistent DGF. 相似文献20.
F. Giovanardi F. Nudo Q. Lai M. Garofalo A. Consolo E. Choppin De Janvry G.A. Arroyo Murillo P. Ursi D. Stabile F. Melandro P.B. Berloco R. Pretagostini L. Poli 《Transplantation proceedings》2019,51(1):128-131