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The Genotype Frequency of CYP2C19 Enzyme after Liver Transplantation. 肝移植后CYP2C19酶基因型频率的变化。
IF 0.7 Q4 TRANSPLANTATION Pub Date : 2019-01-01 Epub Date: 2019-05-01
P Badiee, Z Hashemizadeh, S A Malek-Hosseini, B Geramizadeh

Background: Liver transplant recipients are treated with various drugs, the metabolism of which is dependent on the cytochrome P450 polymorphic genotype.

Objective: To identify the polymorphic variety of CYP2C19 genotype in liver allograft before and after transplantation.

Methods: The study was conducted on 88 liver recipients. The CYP2C19 genotypes in donors and recipients were the same in 32 and different in 56 recipients. Extracted genomic DNA from the leukocytes and liver graft tissues were analyzed by TaqMan SNP genotyping assay. The distributions of homozygote, heterozygote, poor and ultra-rapid metabolizers' genotypes were investigated in both groups.

Results: The distributions of CYP2C19 genotypes before transplantation in the blood and liver graft were within the normal range. After transplantation, in patients with different CYP2C19 genotype in donors and recipients, the genotypes of homozygote and ultra-rapid metabolizers were significantly decreased (p=0.024); the heterozygotes and poor metabolizer genotypes were significantly increased (p=0.017).

Conclusion: The variety in CYP2C19 genotyping must be considered in patients with different genotypes in donor and recipients to predict the dosage regimens, optimize the treatment and decrease toxicity.

背景:肝移植受者接受多种药物治疗,这些药物的代谢依赖于细胞色素P450多态性基因型。目的:探讨同种异体肝移植前后CYP2C19基因型的多态性变化。方法:对88例肝脏受者进行研究。供体和受体CYP2C19基因型32例相同,56例不同。采用TaqMan SNP基因分型法对白细胞和肝移植组织提取的基因组DNA进行分析。研究了两组小鼠纯合子、杂合子、代谢不良者和超快速代谢者基因型的分布。结果:移植前血液和肝脏中CYP2C19基因型分布均在正常范围内。移植后,供体和受体CYP2C19基因型不同的患者,纯合子基因型和超快速代谢物基因型均显著降低(p=0.024);杂合子和低代谢基因型显著增加(p=0.017)。结论:在不同基因型的供受体患者中,CYP2C19基因分型的变化是预测给药方案、优化治疗方案、降低毒性的重要依据。
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引用次数: 0
Idarucizumab in High-risk Thoracic Surgery. Idarucizumab在高危胸外科手术中的应用
IF 0.7 Q4 TRANSPLANTATION Pub Date : 2018-01-01 Epub Date: 2018-05-01
R López-Vilella, J Sanz-Sánchez, I Sánchez-Lázaro, E Marques-Sule, J Rueda-Soriano, L Almenar-Bonet

Direct oral anticoagulants have suggested a favorable profile compared with vitamin K antagonists. However, the lack of treatment to reverse the effect of direct oral anticoagulants has limited its use in some patients who require rapid reversal of anticoagulation, as those included in the transplant waiting list. Idarucizumab is a recently approved drug to reverse the anticoagulant effect of dabigatran. However, the clinical experience when using this drug is scarce. Herein, we present a clinical case on anticoagulation reversal with idarucizumab to perform heart and lung transplantation in a patient with Eisenmenger syndrome.

与维生素K拮抗剂相比,直接口服抗凝剂的效果更好。然而,缺乏逆转直接口服抗凝剂效果的治疗方法,限制了它在一些需要快速逆转抗凝治疗的患者中的应用,如那些在移植等待名单中的患者。Idarucizumab是最近批准的一种逆转达比加群抗凝作用的药物。然而,临床使用该药的经验很少。在这里,我们提出了一个临床病例抗凝逆转用依达鲁珠单抗进行心肺移植患者艾森曼格综合征。
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引用次数: 0
Interaction between Herpes Virus Infections and IL10 and Risk of Bone Marrow Suppression. 疱疹病毒感染与IL10的相互作用及骨髓抑制的风险。
IF 0.7 Q4 TRANSPLANTATION Pub Date : 2018-01-01 Epub Date: 2018-08-01
R Yaghobi, F Alizadeh, A Khodavandi

Background: Syndrome of transient bone marrow suppression may result from various extra-hematological diseases, such as immunological deregulations, and viral infectious diseases secondarily affecting the function of hematopoietic stem cells.

Objective: To evaluate the pathogenic role of herpes viruses and their contraction with IL10 cytokine gene polymorphism, which can impair hematopoiesis in patients with transient bone marrow suppression.

Methods: In a cross-sectional study 30 patients who admitted to Namazi Hospital, affiliated to Shiraz University of Medical Sciences, with transient bone marrow suppression were recruited. Diagnosis of the transient bone marrow suppression was made by expert hematologists. A control group consisting of 100 healthy unrelated individuals was also included. One EDTA-treated blood sample was collected from each studied patients and plasma was isolated. The molecular prevalence of cytomegalovirus and HHV8 evaluated was evaluated using real-time and nested PCR protocols, respectively. The SNPs of the IL10 (rs 1800896-1082G/A) cytokine gene was evaluated by PCR-RFLP method.

Results: Cytomegalovirus and HHV8 infections were found in 2 and 3 of studied patients with transient bone marrow suppression. Significant higher frequency of IL10 G allele and GG genotype were found in HHV8-infected patients comparing to uninfected ones. Higher frequencies of A allele and AG and AA genotypes of IL10 were found in cytomegalovirus-uninfected patients comparing to infected ones, respectively. The significant higher frequencies of IL10 AA and AG genotypes were found in controls compared to bone marrow suppressed patients.

Conclusion: IL10 genetic polymorphism might have determinative role in resistance to the cytomegalovirus, especially HHV8 infections, in patients with bone marrow suppression. Focus in new interaction between HHV8 infection and IL10 genetics in bone marrow suppressed patients should be completed by the analysis of the anti-herpes virus immunity in future studies.

背景:短暂性骨髓抑制综合征可能是由各种血液外疾病引起的,如免疫调节失调和继发性影响造血干细胞功能的病毒性传染病。目的:用IL10细胞因子基因多态性评价疱疹病毒的致病作用及其对短暂性骨髓抑制患者造血功能的影响。方法:在一项横断面研究中,招募了30名入住设拉子医科大学附属Namazi医院的短暂性骨髓抑制患者。血液科专家诊断为短暂性骨髓抑制。由100名健康的无关个体组成的对照组也包括在内。从每个研究患者中采集一份EDTA处理的血样,并分离血浆。分别使用实时和嵌套PCR方案评估巨细胞病毒和HHV8的分子流行率。采用PCR-RFLP方法对IL10(rs1800896-1082G/A)细胞因子基因的SNPs进行检测。结果:在短暂骨髓抑制的研究患者中,2例和3例发现巨细胞病毒和HHV8感染。与未感染者相比,HHV8感染者的IL10 G等位基因和GG基因型频率明显更高。与感染者相比,未感染巨细胞病毒的患者中IL10的A等位基因和AG和AA基因型的频率分别较高。与骨髓抑制的患者相比,在对照组中发现IL10 AA和AG基因型的频率显著更高。结论:IL10基因多态性可能在骨髓抑制患者对巨细胞病毒特别是HHV8感染的抵抗中起决定性作用。在未来的研究中,应通过对抗疱疹病毒免疫的分析来完成对骨髓抑制患者中HHV8感染和IL10基因之间新的相互作用的关注。
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引用次数: 0
Massive Subcutaneous Emphysema, Pneumoperitoneum, Pneumoretroperitoneum, and Pneumoscrotum following Endoscopic Retrograde Cholangiopancreatography in a Living Liver Donor. 活体肝供者经内窥镜逆行胰胆管造影后发现大量皮下肺气肿、气腹、腹膜后气肿及阴囊。
IF 0.7 Q4 TRANSPLANTATION Pub Date : 2018-01-01 Epub Date: 2018-08-01
S Akbulut, B Isik, Y Karipkiz, S Yilmaz

Despite having many advantages, living donor liver transplantation has not been adopted by western countries due to risk of nearly life-threatening complications after living donor hepatectomy (LDH). Herein, we aimed at presenting the management of a 19-year-old patient who suffered life-threatening complications after right lobe LDH. A multiple detector computed tomography (MDCT) revealed a bilioma at the cut surface of the remnant liver, for which a transhepatic drainage catheter was placed. Endoscopic retrograde cholangiopancreatography (ERCP) performed to decompress biliary tract, but the biliary tract could not be cannulized due to post-precut bleeding. On the next day, extensive crepitation was detected and MDCT showed subcutaneous emphysema, pneumoperitoneum, pneumoretroperitoneum, and pneumoscrotum (ERCP-related duodenal perforation?). However, the patient showed significant deterioration of physical examination findings, fever, and infectious parameters, and therefore was taken to the operating room. Kocher maneuver revealed no apparent duodenal perforation. Then, a 2-mm bile duct was found open at the caudate lobe, through which bile leaked. Then, common bile duct exploration and T-tube placement were performed, followed by suture closure of the bile orifice at the caudate lobe. Massive air previously identified completely disappeared one week after the operation.

尽管活体肝移植有许多优点,但由于活体肝切除术(LDH)后几乎危及生命的并发症的风险,活体肝移植尚未被西方国家采用。在此,我们的目的是介绍一位19岁的患者在右肺LDH后遭受危及生命的并发症的处理。多检测器计算机断层扫描(MDCT)显示在残肝切面有胆囊瘤,为此放置了经肝引流管。行内镜逆行胆管造影(ERCP)对胆道进行减压,但由于术前出血,胆道无法插管。次日,大范围咯气,MDCT示皮下肺气肿、气腹、腹膜后气肿、阴囊气肿(ercp相关十二指肠穿孔)。然而,患者的体格检查结果、发热和感染参数明显恶化,因此被送往手术室。Kocher手法未见明显十二指肠穿孔。然后,在尾状叶发现一个2mm的胆管打开,胆汁通过该胆管流出。然后探查胆总管,放置t管,缝合尾状叶胆管口。此前确认的大量空气在行动一周后完全消失。
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引用次数: 0
Fatal Case of Pulmonary Invasive Aspergillus after Heart Transplant with a Rapidly Progressive Course. 心脏移植后肺部侵袭性曲霉菌死亡病例,病程进展迅速。
IF 0.7 Q4 TRANSPLANTATION Pub Date : 2018-01-01 Epub Date: 2018-08-01
B Shakerian, N Razavi, M H Mandegar

The incidence of invasive fungal infections is lower than that of bacterial infections in heart transplant recipients. However, they are always life-threatening. Clinical manifestations may range from asymptomatic colonization to disseminated infection. This complication is responsible for significant morbidity and mortality, particularly in heart transplant recipients. Herein, we present on a cardiac transplant recipient who presented with invasive pulmonary aspergillosis quickly leading to death, in spite of early diagnosis and aggressive therapy. It just took 10 hours from the diagnosis to death. In other reports, this period was at least 12 days.

在心脏移植受者中,侵袭性真菌感染的发病率低于细菌感染。但是,真菌感染总是会危及生命。临床表现可从无症状定植到播散性感染。这种并发症会导致严重的发病率和死亡率,尤其是在心脏移植受者中。在此,我们介绍了一名心脏移植受者的病例,尽管他得到了早期诊断和积极治疗,但还是很快患上了侵袭性肺部曲霉菌病,最终导致死亡。从确诊到死亡仅用了 10 个小时。而在其他报告中,这段时间至少需要 12 天。
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引用次数: 0
Tools for the Measurement of Psychological Aspects of Organ Donation among the Families of Brain-dead People. 脑死亡患者家属器官捐献心理测量工具。
IF 0.7 Q4 TRANSPLANTATION Pub Date : 2018-01-01 Epub Date: 2018-05-01
S Ahmadian, M Khaghanizadeh, M H Zarghami, E Khaleghi, A Ebadi

Background: According to the basic ethical principle of non-maleficence, organ procurement systems need to be accountable to donor families. As organ donation can be potentially traumatic, donor families are at risk of developing psychological damage. Appropriate measurement tools are needed to diagnose such disorders and develop appropriate treatment measures.

Objective: To examine the appropriateness of measurement tools and approaches used in previous studies for assessing donor families' psychological well-being.

Methods: A structured online search was conducted in electronic databases namely ScienceDirect, PubMed, ProQuest, Scopus, Ovid, and Web of Science. The main inclusion criterion was the use of psychological assessment tools for data collection.

Results: 10 studies were included in which different tools had been used for measuring donor families' psychological well-being in the following 5 dimensions: stress, depression, grief, general health, and positive legacy of trauma. The major pitfalls of the reviewed studies were failure to specifically assess complicated grief and differentiating it from other psychological disorders, diversity of the tools used for psychological well-being assessment, and lack of clear definitions of donor families' psychological well-being and its dimensions.

Conclusion: Donor families' psychological well-being is a complex and multidimensional concept and the existing measurement tools cannot accurately assess it. Therefore, the concept needs to be clearly explored and defined. Developing a comprehensive measurement tool or a set of scales is necessary for the early diagnosis of any impairment in donor families' psychological well-being.

背景:根据非恶意的基本伦理原则,器官获取制度需要对供体家庭负责。由于器官捐赠可能带来潜在的创伤,捐赠家庭面临着心理伤害的风险。需要适当的测量工具来诊断这些疾病并制定适当的治疗措施。目的:检验以往研究中用于评估供体家庭心理健康的测量工具和方法的适宜性。方法:在ScienceDirect、PubMed、ProQuest、Scopus、Ovid、Web of Science等电子数据库中进行结构化在线检索。主要纳入标准是使用心理评估工具收集数据。结果:纳入了10项研究,其中使用了不同的工具来测量供体家庭在以下5个方面的心理健康:压力、抑郁、悲伤、一般健康和创伤的积极遗产。所审查的研究的主要缺陷是未能具体评估复杂悲伤并将其与其他心理障碍区分开来,用于心理健康评估的工具多样性,以及缺乏对捐赠者家庭心理健康及其维度的明确定义。结论:献血者家庭的心理健康是一个复杂的多维概念,现有的测量工具无法准确评估。因此,这个概念需要被清楚地探索和定义。开发一套全面的测量工具或一套量表对于早期诊断捐赠者家庭心理健康的任何损害是必要的。
{"title":"Tools for the Measurement of Psychological Aspects of Organ Donation among the Families of Brain-dead People.","authors":"S Ahmadian,&nbsp;M Khaghanizadeh,&nbsp;M H Zarghami,&nbsp;E Khaleghi,&nbsp;A Ebadi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>According to the basic ethical principle of non-maleficence, organ procurement systems need to be accountable to donor families. As organ donation can be potentially traumatic, donor families are at risk of developing psychological damage. Appropriate measurement tools are needed to diagnose such disorders and develop appropriate treatment measures.</p><p><strong>Objective: </strong>To examine the appropriateness of measurement tools and approaches used in previous studies for assessing donor families' psychological well-being.</p><p><strong>Methods: </strong>A structured online search was conducted in electronic databases namely <i>ScienceDirect, PubMed, ProQuest, Scopus, Ovid,</i> and <i>Web of Science</i>. The main inclusion criterion was the use of psychological assessment tools for data collection.</p><p><strong>Results: </strong>10 studies were included in which different tools had been used for measuring donor families' psychological well-being in the following 5 dimensions: stress, depression, grief, general health, and positive legacy of trauma. The major pitfalls of the reviewed studies were failure to specifically assess complicated grief and differentiating it from other psychological disorders, diversity of the tools used for psychological well-being assessment, and lack of clear definitions of donor families' psychological well-being and its dimensions.</p><p><strong>Conclusion: </strong>Donor families' psychological well-being is a complex and multidimensional concept and the existing measurement tools cannot accurately assess it. Therefore, the concept needs to be clearly explored and defined. Developing a comprehensive measurement tool or a set of scales is necessary for the early diagnosis of any impairment in donor families' psychological well-being.</p>","PeriodicalId":14242,"journal":{"name":"International Journal of Organ Transplantation Medicine","volume":"9 2","pages":"53-67"},"PeriodicalIF":0.7,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37023414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tacrolimus-induced Ascites after Liver Transplant. 他克莫司致肝移植术后腹水。
IF 0.7 Q4 TRANSPLANTATION Pub Date : 2018-01-01 Epub Date: 2018-05-01
M Hosseini, M Aliakbarian, K Akhavan-Rezayat, O Shadkam, S Milani

Massive post-transplantation ascites is a rare but serious condition following liver transplantation. Although, many etiologies are suggested as the cause of this complication, in some cases the definitive etiology remains unknown. Drug-induced post-transplantation ascites is one of the possible etiologies. In this study we present a case of ascites caused by tacrolimus in the post-liver transplantation period. A 49-year-old man with hepatitis B virus cirrhosis underwent liver transplantation and received tacrolimus, mycophenolate and prednisolone, as the immunosuppressive regimen. Progressive ascites developed after 10 days, in spite of a normal liver function. Various studies, including liver biopsy, were performed but we could not find any etiology for this complication. The tacrolimus was switched to rapamune. Ascites was completely disappeared and up to the last follow-up visit, the patient remained asymptomatic for more than two years. We concluded that after ruling out other etiologies, tacrolimus as a rare cause of post-transplantation ascites should be taken into account. The treatment is discontinuation of the drug.

肝移植术后大量腹水是一种罕见但严重的情况。虽然,许多病因被认为是导致这种并发症的原因,但在某些情况下,明确的病因仍然未知。药物性移植后腹水是可能的病因之一。在这项研究中,我们提出了一例他克莫司在肝移植后引起的腹水。1例49岁乙型肝炎肝硬化患者行肝移植,并接受他克莫司、麦考酚酸盐和强的松龙作为免疫抑制方案。尽管肝功能正常,但10天后出现了进行性腹水。进行了各种研究,包括肝活检,但我们无法找到任何并发症的病因。他克莫司换成了雷帕莫。腹水完全消失,直到最后一次随访,患者无症状持续两年多。我们的结论是,在排除其他病因后,他克莫司作为移植后腹水的罕见病因应予以考虑。治疗方法是停药。
{"title":"Tacrolimus-induced Ascites after Liver Transplant.","authors":"M Hosseini,&nbsp;M Aliakbarian,&nbsp;K Akhavan-Rezayat,&nbsp;O Shadkam,&nbsp;S Milani","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Massive post-transplantation ascites is a rare but serious condition following liver transplantation. Although, many etiologies are suggested as the cause of this complication, in some cases the definitive etiology remains unknown. Drug-induced post-transplantation ascites is one of the possible etiologies. In this study we present a case of ascites caused by tacrolimus in the post-liver transplantation period. A 49-year-old man with hepatitis B virus cirrhosis underwent liver transplantation and received tacrolimus, mycophenolate and prednisolone, as the immunosuppressive regimen. Progressive ascites developed after 10 days, in spite of a normal liver function. Various studies, including liver biopsy, were performed but we could not find any etiology for this complication. The tacrolimus was switched to rapamune. Ascites was completely disappeared and up to the last follow-up visit, the patient remained asymptomatic for more than two years. We concluded that after ruling out other etiologies, tacrolimus as a rare cause of post-transplantation ascites should be taken into account. The treatment is discontinuation of the drug.</p>","PeriodicalId":14242,"journal":{"name":"International Journal of Organ Transplantation Medicine","volume":"9 2","pages":"102-104"},"PeriodicalIF":0.7,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37024373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Concurrent Umbilical Hernia Repair at the Time of Liver Transplantation: A Six-Year Experience from a Single Institution. 肝移植时脐疝同步修复:来自单一机构的六年经验。
IF 0.7 Q4 TRANSPLANTATION Pub Date : 2018-01-01 Epub Date: 2018-02-01
A J Perez, I N Haskins, A S Prabhu, D M Krpata, C Tu, S Rosenblatt, K Hashimoto, T Diago, B Eghtesad, M L J Rosen

Background: Umbilical hernias are common in patients with end-stage liver disease undergoing liver transplantation. Management of those persisting at the time of liver transplantation is important to define.

Objective: To evaluate the long-term results of patients undergoing simultaneous primary umbilical hernia repair (UHR) at the time of liver transplantation at a single institution.

Methods: Retrospective chart review was performed on patients undergoing simultaneous UHR and liver transplantation from 2010 through 2016. 30-day morbidity and mortality outcomes and long-term hernia recurrence were investigated.

Results: 59 patients had primary UHR at the time of liver transplantation. All hernias were reducible with no overlying skin breakdown or leakage of ascites. 30-day morbidity and mortality included 5 (8%) superficial surgical site infections, 1 (2%) deep surgical site infection, and 7 (12%) organ space infections. Unrelated to the UHR, 10 (17%) patients had an unplanned return to the operating room, 16 (27%) were readmitted within 30 days of their index operation, and 1 (2%) patient died. With a mean follow-up of 21.8 months, 7 (18%) patients experienced an umbilical hernia recurrence.

Conclusion: Despite the high perioperative morbidity associated with the transplant procedure, concurrent primary UHR resulted in an acceptable long-term recurrence rate with minimal associated morbidity.

背景:脐疝在接受肝移植的终末期肝病患者中很常见。肝移植时对那些持续存在的患者的处理是很重要的。目的:评价在同一医院同时行原发性脐疝修复术(UHR)的患者肝移植的长期疗效。方法:对2010年至2016年同时行UHR和肝移植的患者进行回顾性分析。观察30天的发病率、死亡率、预后及长期疝复发率。结果:59例患者在肝移植时发生原发性UHR。所有疝均可复位,无复盖皮肤破裂或腹水渗漏。30天的发病率和死亡率包括5例(8%)浅表手术部位感染,1例(2%)深部手术部位感染,7例(12%)器官间隙感染。与UHR无关,10例(17%)患者意外返回手术室,16例(27%)患者在首次手术后30天内再次入院,1例(2%)患者死亡。平均随访21.8个月,7例(18%)患者出现脐疝复发。结论:尽管移植手术的围手术期发病率很高,但并发原发性UHR导致了可接受的长期复发率和最小的相关发病率。
{"title":"Concurrent Umbilical Hernia Repair at the Time of Liver Transplantation: A Six-Year Experience from a Single Institution.","authors":"A J Perez,&nbsp;I N Haskins,&nbsp;A S Prabhu,&nbsp;D M Krpata,&nbsp;C Tu,&nbsp;S Rosenblatt,&nbsp;K Hashimoto,&nbsp;T Diago,&nbsp;B Eghtesad,&nbsp;M L J Rosen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Umbilical hernias are common in patients with end-stage liver disease undergoing liver transplantation. Management of those persisting at the time of liver transplantation is important to define.</p><p><strong>Objective: </strong>To evaluate the long-term results of patients undergoing simultaneous primary umbilical hernia repair (UHR) at the time of liver transplantation at a single institution.</p><p><strong>Methods: </strong>Retrospective chart review was performed on patients undergoing simultaneous UHR and liver transplantation from 2010 through 2016. 30-day morbidity and mortality outcomes and long-term hernia recurrence were investigated.</p><p><strong>Results: </strong>59 patients had primary UHR at the time of liver transplantation. All hernias were reducible with no overlying skin breakdown or leakage of ascites. 30-day morbidity and mortality included 5 (8%) superficial surgical site infections, 1 (2%) deep surgical site infection, and 7 (12%) organ space infections. Unrelated to the UHR, 10 (17%) patients had an unplanned return to the operating room, 16 (27%) were readmitted within 30 days of their index operation, and 1 (2%) patient died. With a mean follow-up of 21.8 months, 7 (18%) patients experienced an umbilical hernia recurrence.</p><p><strong>Conclusion: </strong>Despite the high perioperative morbidity associated with the transplant procedure, concurrent primary UHR resulted in an acceptable long-term recurrence rate with minimal associated morbidity.</p>","PeriodicalId":14242,"journal":{"name":"International Journal of Organ Transplantation Medicine","volume":"9 1","pages":"20-25"},"PeriodicalIF":0.7,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35906672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Results of Kidney Transplantation from Expanded Criteria Donors: A Single-Center Experience. 扩大标准供者肾移植的结果:单中心经验。
IF 0.7 Q4 TRANSPLANTATION Pub Date : 2018-01-01 Epub Date: 2018-02-01
B Palkoci, M Vojtko, J Fialová, D Osinová, M Lajčiaková

Background: Collection of kidneys from extended criteria donors (ECD) with diagnosed brain-death forms a part of the collection program that increases the number of transplantations.

Objective: To compare the results of ECD with those of standard criteria donors (SCD).

Methods: In a retrospective analysis in a group of 156 kidney donors, we identified ECD donors. We detected the basic parameters of the donors before kidney collection, and then evaluated the function of the graft, the survival of the graft, and the survival of the patients after 1, 3, and 5 years of transplantation. The results were then compared with the function of the graft from those of SCD donors.

Results: The ECD donors were significantly (p<0.001) older than the SCD donors. They had a higher body mass index (p=0.006) and prevalence of hypertension (p<0.001) and diabetes mellitus (p=0.004) compared to SCD donors. The graft function within the first 6 months and the survival of recipients in the first year of transplantation were significantly worse in ECD than in SCD groups (p=0.01, and 0.023, respectively). No difference in the graft survival was observed between the two groups.

Conclusion: The long-term function of the graft and survival of patients and grafts in recipients of kidneys from ECD donors are comparable to SCD donors. Exploitation of the given organs for transplantation is important due to the constantly increasing demand versus limited offer of organs.

背景:从诊断为脑死亡的扩展标准供体(ECD)收集肾脏是增加移植数量的收集计划的一部分。目的:比较ECD与标准供体(SCD)的结果。方法:在一组156肾供者的回顾性分析中,我们确定了ECD供者。我们在取肾前检测供者的基本参数,然后评估移植物的功能、移植物的存活,以及移植后1年、3年和5年患者的存活。然后将结果与来自SCD供体的移植物的功能进行比较。结果:ECD供者与SCD供者肾脏移植的远期功能及患者和移植肾的存活相当。由于需求不断增加而器官供应有限,利用特定器官进行移植是很重要的。
{"title":"Results of Kidney Transplantation from Expanded Criteria Donors: A Single-Center Experience.","authors":"B Palkoci,&nbsp;M Vojtko,&nbsp;J Fialová,&nbsp;D Osinová,&nbsp;M Lajčiaková","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Collection of kidneys from extended criteria donors (ECD) with diagnosed brain-death forms a part of the collection program that increases the number of transplantations.</p><p><strong>Objective: </strong>To compare the results of ECD with those of standard criteria donors (SCD).</p><p><strong>Methods: </strong>In a retrospective analysis in a group of 156 kidney donors, we identified ECD donors. We detected the basic parameters of the donors before kidney collection, and then evaluated the function of the graft, the survival of the graft, and the survival of the patients after 1, 3, and 5 years of transplantation. The results were then compared with the function of the graft from those of SCD donors.</p><p><strong>Results: </strong>The ECD donors were significantly (p<0.001) older than the SCD donors. They had a higher body mass index (p=0.006) and prevalence of hypertension (p<0.001) and diabetes mellitus (p=0.004) compared to SCD donors. The graft function within the first 6 months and the survival of recipients in the first year of transplantation were significantly worse in ECD than in SCD groups (p=0.01, and 0.023, respectively). No difference in the graft survival was observed between the two groups.</p><p><strong>Conclusion: </strong>The long-term function of the graft and survival of patients and grafts in recipients of kidneys from ECD donors are comparable to SCD donors. Exploitation of the given organs for transplantation is important due to the constantly increasing demand versus limited offer of organs.</p>","PeriodicalId":14242,"journal":{"name":"International Journal of Organ Transplantation Medicine","volume":"9 1","pages":"1-9"},"PeriodicalIF":0.7,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35906670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
One-year Allograft and Patient Survival in Renal Transplant Recipients Receiving Antiplatelet Therapy at the Time of Transplantation. 移植时接受抗血小板治疗的肾移植受者一年同种异体移植和患者生存率。
IF 0.7 Q4 TRANSPLANTATION Pub Date : 2018-01-01 Epub Date: 2018-02-01
T Benkö, M Gottmann, S Radunz, A Bienholz, F H Saner, J W Treckmann, A Paul, D P Hoyer

Background: Antiplatelet therapy is common in patients on the waiting list for kidney transplantation.

Objective: To evaluate the incidence of post-operative bleeding in patients with antiplatelet therapy undergoing kidney transplantation and analyze the impact on the outcome.

Methods: We studied all patients with concomitant antiplatelet therapy undergoing kidney transplantation in our center from January 2007 to June 2012. Data were collected by chart review. Univariate and multivariate logistic regression and Cox proportional hazard model were used to identify risk factors for the long-term outcome.

Results: Of 744 kidney transplant recipients during the study period, 161 received oral antiplatelet therapy and were included in the study. One-third of the patients demonstrated signs of bleeding, half of which requiring surgical treatment. Coronary artery disease, deceased donor kidney transplantation, and dual antiplatelet medication were independent risk factors for post-operative bleeding. One-year allograft survival was significantly better in the non-bleeding group (91.4% vs 75.9%, p=0.023). Multivariable analysis found that post-operative bleeding, recipient age, and biopsy-proven rejection were independent risk factors for graft survival. Recipient age and biopsy-proven rejection were also identified as independent risk factors for patient survival.

Conclusion: This analysis indicated a high risk for post-operative bleeding in renal transplant patients under antiplatelet therapy. The associated negative effect on allograft survival underscored the need to reduce any risk factors for post-operative bleeding.

背景:抗血小板治疗在等待肾移植的患者中很常见。目的:评价肾移植术后接受抗血小板治疗的患者术后出血的发生率,并分析其对预后的影响。方法:对2007年1月至2012年6月在我中心接受肾移植同时抗血小板治疗的患者进行研究。通过图表回顾收集数据。采用单因素和多因素logistic回归及Cox比例风险模型确定影响长期预后的危险因素。结果:在研究期间的744例肾移植受者中,有161例接受了口服抗血小板治疗,并被纳入研究。三分之一的患者表现出出血的迹象,其中一半需要手术治疗。冠状动脉疾病、死亡供肾移植和双重抗血小板药物是术后出血的独立危险因素。非出血组一年同种异体移植存活率显著提高(91.4% vs 75.9%, p=0.023)。多变量分析发现,术后出血、受体年龄和活检证实的排斥反应是移植物存活的独立危险因素。受体年龄和活检证实的排斥反应也被确定为患者生存的独立危险因素。结论:本分析提示肾移植术后接受抗血小板治疗的患者出血风险高。对同种异体移植存活的相关负面影响强调了减少术后出血的任何危险因素的必要性。
{"title":"One-year Allograft and Patient Survival in Renal Transplant Recipients Receiving Antiplatelet Therapy at the Time of Transplantation.","authors":"T Benkö,&nbsp;M Gottmann,&nbsp;S Radunz,&nbsp;A Bienholz,&nbsp;F H Saner,&nbsp;J W Treckmann,&nbsp;A Paul,&nbsp;D P Hoyer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Antiplatelet therapy is common in patients on the waiting list for kidney transplantation.</p><p><strong>Objective: </strong>To evaluate the incidence of post-operative bleeding in patients with antiplatelet therapy undergoing kidney transplantation and analyze the impact on the outcome.</p><p><strong>Methods: </strong>We studied all patients with concomitant antiplatelet therapy undergoing kidney transplantation in our center from January 2007 to June 2012. Data were collected by chart review. Univariate and multivariate logistic regression and Cox proportional hazard model were used to identify risk factors for the long-term outcome.</p><p><strong>Results: </strong>Of 744 kidney transplant recipients during the study period, 161 received oral antiplatelet therapy and were included in the study. One-third of the patients demonstrated signs of bleeding, half of which requiring surgical treatment. Coronary artery disease, deceased donor kidney transplantation, and dual antiplatelet medication were independent risk factors for post-operative bleeding. One-year allograft survival was significantly better in the non-bleeding group (91.4% <i>vs</i> 75.9%, p=0.023). Multivariable analysis found that post-operative bleeding, recipient age, and biopsy-proven rejection were independent risk factors for graft survival. Recipient age and biopsy-proven rejection were also identified as independent risk factors for patient survival.</p><p><strong>Conclusion: </strong>This analysis indicated a high risk for post-operative bleeding in renal transplant patients under antiplatelet therapy. The associated negative effect on allograft survival underscored the need to reduce any risk factors for post-operative bleeding.</p>","PeriodicalId":14242,"journal":{"name":"International Journal of Organ Transplantation Medicine","volume":"9 1","pages":"10-19"},"PeriodicalIF":0.7,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35906671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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International Journal of Organ Transplantation Medicine
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