466 results match your criteria Intestinal and Multivisceral Transplantation


Abdominal wall transplantation in organ transplantation: Our experience.

Cir Esp 2019 Apr 1. Epub 2019 Apr 1.

Servicio de Cirugía General y del Aparato Digestivo, Unidad de Cirugía Hepatobiliopancreática y Trasplante de Órganos Abdominales, Hospital Universitario Doce de Octubre, Madrid, España; Instituto de Investigación (Imas12), Departamento de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España.

Abdominal wall transplantation has been consolidated as an alternative to primary abdominal wall closure in intestinal and multiple organ transplant recipients. Given that it is feasible to obtain the visceral graft and the abdominal wall graft from the same donor, abdominal wall transplantation could offer satisfactory outcomes and be easily coordinated. Non-vascularized fascia is one of the alternatives for abdominal wall closure in transplantation. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S0009739X193007
Publisher Site
http://dx.doi.org/10.1016/j.ciresp.2019.03.002DOI Listing
April 2019
4 Reads

Long-term outcomes of ultrashort bowel syndrome due to malrotation with midgut volvulus managed at an interdisciplinary pediatric intestinal rehabilitation center.

J Pediatr Surg 2019 Feb 2. Epub 2019 Feb 2.

Center for Advanced Intestinal Rehabilitation, Department of Surgery; Boston Children's Hospital and Harvard Medical School, Boston, MA, USA. Electronic address:

Purpose: The purpose of this study was to describe long-term outcomes of pediatric-onset ultrashort bowel syndrome owing to midgut volvulus managed at an interdisciplinary intestinal rehabilitation center.

Methods: Patients with a history of malrotation and pediatric-onset midgut volvulus causing extensive bowel loss (<20% residual small bowel length expected for postconception age) and treated between 2010 and 2017 were reviewed. Data are expressed as median (IQR). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jpedsurg.2019.01.025DOI Listing
February 2019
2 Reads

Current status of graft-versus-host disease after intestinal transplantation.

Curr Opin Organ Transplant 2019 Apr;24(2):199-206

Division of Pediatric Transplantation, Department of Surgery, Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, Thomas E. Starzl Transplant Institute, University of Pittsburgh School of Medicine, Pittsburgh, USA.

Purpose Of Review: Over the past decades, visceral transplantation has become the standard of care for patients with irreversible intestinal failure who suffer complications of total parenteral nutrition (TPN). Graft-versus-host disease (GVHD) after solid organ transplantation is a rare but often fatal complication with high mortality. GVHD after intestinal transplantation, given the large lymphoid content of the graft, is more frequent compared with other solid organs. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000624DOI Listing
April 2019
14 Reads

Long-term survival in visceral transplant recipients in the new era: A single-center experience.

Am J Transplant 2019 Jan 23. Epub 2019 Jan 23.

MedStar Georgetown Transplant Institute, Georgetown University Hospital, Washington, District of Columbia.

There is a paucity of data on long-term outcomes following visceral transplantation in the contemporary era. This is a single-center retrospective analysis of all visceral allograft recipients who underwent transplant between November 2003 and December 2013 with at least 3-year follow-up data. Clinical data from a prospectively maintained database were used to assess outcomes including patient and graft survival. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/ajt.15269DOI Listing
January 2019
6 Reads

Composite and Multivisceral Transplantation: Nomenclature, Surgical Techniques, Current Practice, and Long-term Outcome.

Surg Clin North Am 2019 Feb;99(1):129-151

Center for Gut Rehabilitation and Transplantation, Cleveland Clinic, 9500 Euclid Avenue, Desk A100, Cleveland, OH 44195, USA; Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Avenue, Desk A100, Cleveland, OH 44195, USA. Electronic address:

The successful development of multivisceral and composite visceral transplantation is among the milestones in the recent history of human organ transplantation. All types of gastrointestinal transplantation have evolved to be the standard of care for patients with gut failure and complex abdominal pathologic conditions. The outcome has markedly improved over the last 3 decades owing to technical innovation, novel immunosuppression, and better postoperative care. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.suc.2018.09.010DOI Listing
February 2019
7 Reads

Small Bowel Transplantation.

Surg Clin North Am 2019 Feb;99(1):103-116

Division of Abdominal Transplant Surgery, Duke University Medical Center, DUMC Box 3522, Durham, NC 27710, USA. Electronic address:

Intestinal and multivisceral transplants are complex technical procedures that present unique challenges in the field of solid organ transplantation. This review aims to highlight the indications, techniques, outcomes, and complications specific to intestinal transplantation. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S00396109183013
Publisher Site
http://dx.doi.org/10.1016/j.suc.2018.09.008DOI Listing
February 2019
15 Reads

Surgeon's perspective on short bowel syndrome: Where are we?

World J Transplant 2018 Oct;8(6):198-202

Liver and Multiorgan Transplant Unit, St. Orsola-Malpighi University Hospital, Bologna 40138, Italy.

Short bowel syndrome (SBS) is due to a massive loss of small bowel: the reduction of gut function is below the minimum necessary to maintain health (in adults) and growth (in children) so intravenous supplementation is required. Parenteral nutrition represents the milestone of treatment and surgical attempts should be limited only when the residual bowel is sufficient to increase absorption, reducing diarrhea and slowing the transit time of nutrients, water and electrolytes. The surgical techniques lengthen the bowel (tapering it) or reverse a segment of it: developed in children, nowadays are popular also among adults. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.5500/wjt.v8.i6.198DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201325PMC
October 2018
25 Reads

Donor-Specific Antibodies in Pediatric Intestinal and Multivisceral Transplantation: The Role of Liver and Human Leukocyte Antigen Mismatching.

Liver Transpl 2018 12;24(12):1726-1735

Department of Immunology, University Hospital 12 de Octubre, Madrid, Spain.

Rejection is one of the most important drawbacks for graft and patient survival in intestinal and multivisceral transplantation. However, there is no consensus on the diagnostic criteria for humoral rejection, and the literature about the role of donor-specific antibodies (DSA) on allograft outcome and the risk factors that contribute to their development is scant with contradictory results. The present study analyzes the role of DSA exclusively in a pediatric cohort of 43 transplants. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1002/lt.25323DOI Listing
December 2018
17 Reads

The Impact of an Advanced ECMO Program on Traumatically Injured Patients.

Artif Organs 2018 Nov 24;42(11):1043-1051. Epub 2018 Jul 24.

Dewitt Daughtry Family Department of Surgery, Division of Cardiothoracic Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA.

In June 2016, an advanced extracorporeal membrane oxygenation (ECMO) program consisting of a multidisciplinary team was initiated at a large level-one trauma center. The program was created to standardize management for patients with a wide variety of pathologies, including trauma. This study evaluated the impact of the advanced ECMO program on the outcomes of traumatically injured patients undergoing ECMO. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/aor.13152DOI Listing
November 2018
31 Reads

Fatal breakthrough mucormycosis in a multivisceral transplant patient receiving micafungin: Case report and literature review.

IDCases 2018 24;12:76-79. Epub 2018 Mar 24.

Clinical Microbiology & Public Health Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Introduction: Antifungal agents are routinely used in the post-transplant setting for both prophylaxis and treatment of presumed and proven fungal infections. Micafungin is an echinocandin-class antifungal with broad antifungal cover and favorable side effect profile but, notably, it has no activity against molds of the order Mucorales.

Presentation Of Case: A 47-year-old woman underwent multivisceral transplantation for intestinal failure-associated liver disease. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.idcr.2018.03.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010962PMC
March 2018
12 Reads

Fecal pancreatic elastase-1 in the evaluation of pancreatic function after pediatric intestinal transplantation.

Pediatr Transplant 2018 Jun 21:e13247. Epub 2018 Jun 21.

MedStar Georgetown Transplant Institute, MedStar Georgetown University Hospital, Washington, DC, USA.

Fat malabsorption is common after SBT. To identify whether anatomic variant transplants differ in occurrence of exocrine pancreatic insufficiency that could contribute to fat malabsorption, we measured FPE repeatedly in 54 recipients of a SBT, ages 6.2 to 320 months. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/petr.13247DOI Listing
June 2018
24 Reads

Thrombotic and hemorrhagic complications during visceral transplantation: risk factors, and association with intraoperative disseminated intravascular coagulation-like thromboelastographic qualities: a single-center retrospective study.

Transpl Int 2018 10 5;31(10):1125-1134. Epub 2018 Jun 5.

Department of Anesthesia, Jackson Memorial Hospital, University of Miami, Miami, FL, USA.

This study describes the risk of thrombotic and hemorrhagic complications, both intraoperatively, and up to 1 month following visceral transplantation. Data from 48 adult visceral transplants performed between 2010 and 2017 were retrospectively studied [32 multivisceral (MVTx); 10 isolated intestine; six modified-MVTx]. Intraoperatively, intracardiac thrombosis (ICT)/pulmonary embolism (PE) occurred in 25%, 0% and 0% of MVTx, isolated intestine and modified MVTx, respectively, and was associated with 50% (4/8) mortality. Read More

View Article

Download full-text PDF

Source
http://doi.wiley.com/10.1111/tri.13281
Publisher Site
http://dx.doi.org/10.1111/tri.13281DOI Listing
October 2018
40 Reads

Comparable outcomes in intestinal retransplantation: Single-center cohort study.

Clin Transplant 2018 Jul 12;32(7):e13290. Epub 2018 Jun 12.

Transplant Division, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.

Background: Graft loss in intestinal transplantation (ITx) is close to 25% in the first year and 50% at 5-year post-transplantation. Although technically and immunologically challenging, intestinal retransplantation is now the 4th most common indication for ITx.

Methods: The aim of this study was to review and compare the outcomes of intestinal retransplantation with primary ITx, which included isolated ITx, modified multivisceral transplantation (mMVTx), and full MVTx, between 2003 and 2014 at Indiana University. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/ctr.13290DOI Listing
July 2018
4 Reads

Intestinal transplants: review of normal imaging appearance and complications.

Br J Radiol 2018 Oct 5;91(1090):20180173. Epub 2018 Jun 5.

1 Department of Radiology, Henry Ford Hospital , Detroit, MI , USA.

Intestinal transplant (IT) is one of the least common forms of organ transplant but is increasing both in volume of cases and number of centers performing intestinal transplants, with the busiest centers in North America and Europe. IT can be performed in isolation or as part of a multivisceral transplant (MVT). Intestinal failure either in the form of short gut syndrome or functional bowel problems is the primary indication for IT. Read More

View Article

Download full-text PDF

Source
https://www.birpublications.org/doi/10.1259/bjr.20180173
Publisher Site
http://dx.doi.org/10.1259/bjr.20180173DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350467PMC
October 2018
13 Reads

Composite and Multivisceral Transplantation: Nomenclature, Surgical Techniques, Current Practice, and Long-term Outcome.

Gastroenterol Clin North Am 2018 Jun;47(2):393-415

Center for Gut Rehabilitation and Transplantation, Cleveland Clinic, 9500 Euclid Avenue, Desk A100, Cleveland, OH 44195, USA; Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Avenue, Desk A100, Cleveland, OH 44195, USA. Electronic address:

The successful development of multivisceral and composite visceral transplantation is among the milestones in the recent history of human organ transplantation. All types of gastrointestinal transplantation have evolved to be the standard of care for patients with gut failure and complex abdominal pathologic conditions. The outcome has markedly improved over the last 3 decades owing to technical innovation, novel immunosuppression, and better postoperative care. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.gtc.2018.01.013DOI Listing
June 2018
7 Reads

Total pancreaticoduodenectomy with autologous islet transplantation 14 years after liver-contained composite visceral transplantation.

Am J Transplant 2018 Aug 14;18(8):2068-2074. Epub 2018 May 14.

Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.

Chronic pancreatitis (CP) is a severely disabling disorder with potential detrimental effects on quality of life, gut function, and glucose homeostasis. Disease progression often results in irreversible morphological and functional abnormalities with development of chronic pain, mechanical obstruction, and pancreatic insufficiency. Along with comprehensive medical management, the concept of total pancreatectomy and islet autotransplantation (TP-AIT) was introduced 40 years ago for patients with intractable pain and preserved beta-cell function. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/ajt.14880DOI Listing
August 2018
3 Reads

Posttransplant complications in adult recipients of intestine grafts without bowel decontamination.

J Surg Res 2018 05 21;225:125-130. Epub 2018 Feb 21.

Department of Surgery, Transplant Division, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address:

Background: Selective digestive decontamination is commonly used to decrease lumenal bacterial flora. Preoperative bowel decontamination may be associated with a lower wound infection rate but has not been shown to decrease risk of intra-abdominal abscess or lower leak rate for enteric anastomoses. Alternatively, the decontamination disrupts the normal flora of the gastrointestinal tract and may affect normal physiology, including immunologic function. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jss.2018.01.011DOI Listing
May 2018
3 Reads

Graft versus host disease after multivisceral transplantation: A UK center experience and update on management.

Clin Transplant 2018 May 16;32(5):e13239. Epub 2018 Apr 16.

Department of Transplant Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Graft versus host disease (GVHD) following transplantation of an intestine-containing graft occurs more frequently than with other solid organ transplants and is known to have a poor outcome. The presentation differs from other solid organ transplants, as the gastrointestinal tract is not involved following intestinal transplant. Diagnosis is based on clinical symptoms arising due to native tissue damage and the detection of donor T lymphocytes in circulating blood (T-cell chimerism). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/ctr.13239DOI Listing
May 2018
14 Reads

Invited Commentary on "Imaging of Intestinal and Multivisceral Transplantation".

Radiographics 2018 Mar-Apr;38(2):432-434

2 Department of Surgery and Transplantation, University of Alberta Hospital Edmonton, Alberta, Canada.

View Article

Download full-text PDF

Source
http://pubs.rsna.org/doi/10.1148/rg.2018180002
Publisher Site
http://dx.doi.org/10.1148/rg.2018180002DOI Listing
April 2018
4 Reads

Imaging of Intestinal and Multivisceral Transplantation.

Radiographics 2018 Mar-Apr;38(2):413-432

From the Departments of Radiology (M.A.R., N.B.A., A.A.B., A.K.D.) and Surgery (R.J.C.), University of Pittsburgh Medical Center, 200 Lothrop St, Radiology Suite 200, East Wing E2051B, Pittsburgh, PA 15213; and Department of Surgery, Cleveland Clinic Foundation, Cleveland, Ohio (K.M.A., G.C.).

Intestinal transplantation has evolved from its experimental origins in the mid-20th century to its status today as an established treatment option for patients with end-stage intestinal failure who cannot be sustained with total parenteral nutrition. The most common source of intestinal failure in both adults and children is short-bowel syndrome, but a host of other disease processes can lead to this common end-point. The development of intestinal transplantation has presented multiple hurdles for the transplant community, including technical challenges, immunologic pitfalls, and infectious complications. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1148/rg.2018170086DOI Listing
August 2018
9 Reads

Myeloid-derived suppressor cells increase and inhibit donor-reactive T cell responses to graft intestinal epithelium in intestinal transplant patients.

Am J Transplant 2018 Oct 17;18(10):2544-2558. Epub 2018 Apr 17.

Transplant Center, Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.

Recent advances in immunosuppressive regimens have decreased acute cellular rejection (ACR) rates and improved intestinal and multivisceral transplant (ITx) recipient survival. We investigated the role of myeloid-derived suppressor cells (MDSCs) in ITx. We identified MDSCs as CD33 CD11b lineage(CD3/CD56/CD19) HLA-DR cells with 3 subsets, CD14 CD15 (e-MDSCs), CD14 CD15 (M-MDSCs), and CD14 CD15 (PMN-MDSCs), in peripheral blood mononuclear cells (PBMCs) and mononuclear cells in the grafted intestinal mucosa. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/ajt.14718DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127002PMC
October 2018
6 Reads

Visceral transplantation in patients with intestinal-failure associated liver disease: Evolving indications, graft selection, and outcomes.

Am J Transplant 2018 Jun 6;18(6):1312-1320. Epub 2018 Apr 6.

MedStar Georgetown University Hospital, MedStar Georgetown Transplant Institute, Washington, DC, USA.

Intestinal failure (IF)-associated liver disease (IFALD) is widely recognized as a lethal complication of long-term parenteral nutrition. The pathophysiology of IFALD is poorly understood but appears to be multifactorial and related to the inflammatory state in the patient with IF. Visceral transplant for IFALD includes variants of intestine, liver, or combined liver-intestine allografts. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/ajt.14715DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5992069PMC
June 2018
7 Reads

Complications in pediatric intestine transplantation in the absence of peri-operative donor or recipient bowel decontamination.

Pediatr Transplant 2018 05 2;22(3):e13164. Epub 2018 Mar 2.

Department of Surgery, Transplant Division, Indiana University School of Medicine, Indianapolis, IN, USA.

This study reports the clinical complication and infection rates of an active pediatric IT program that has never utilized bowel decontamination in either the donor or the recipient. All patients undergoing IT from 2003 to 2015 at a single pediatric IT center were reviewed. Post-transplant surgical, infectious, and immunosuppressive complications are reported. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/petr.13164DOI Listing
May 2018
8 Reads

Liver-inclusive intestinal transplantation results in decreased alloimmune-mediated rejection but increased infection.

Gastroenterol Rep (Oxf) 2018 Feb 28;6(1):29-37. Epub 2017 Dec 28.

Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Background And Aims: A co-transplanted liver allograft has been thought to protect other organs from rejection-mediated injury; however, detailed analyses of co-transplanted liver on intestinal allograft outcomes have not been conducted to date. The aim of the study was to compare immune-mediated injury, causes of graft failure and clinical outcomes between recipients who underwent either a liver-inclusive intestinal transplant (LITx) or liver-exclusive intestinal transplant (LETx).

Methods: Between May 2000 and May 2010, 212 adult patients undergoing LITx (=76) and LETx (=136) were included. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1093/gastro/gox043DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5806397PMC
February 2018
4 Reads

Multimodal Surgical Approach for Adult Patients With Chronic Intestinal Pseudo-Obstruction: Clinical and Psychosocial Long-term Outcomes.

Transplant Proc 2018 Jan - Feb;50(1):226-233

Department of Clinical Sciences, S. Anna-Cona University Hospital, Ferrara, Italy.

Background: Clinical and psychosocial outcomes of a multimodal surgical approach for chronic intestinal pseudo-obstruction were analyzed in 24 patients who were followed over a 2- to 12-year period in a single center after surgery or intestinal/multivisceral transplant (CTx).

Methods: The main reasons for surgery were sub-occlusion in surgery and parenteral nutrition-related irreversible complications with chronic intestinal failure in CTx.

Results: At the end of follow-up (February 2015), 45. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.transproceed.2017.11.012DOI Listing
July 2018
6 Reads

Challenges with Intestine and Multivisceral Re-Transplantation: Importance of Timing of Re-Transplantation and Optimal Immunosuppression.

Ann Transplant 2018 Feb 6;23:98-104. Epub 2018 Feb 6.

Transplant Division, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.

BACKGROUND Patients undergoing re-transplantation often receive high doses of immunosuppression, which may lead to an immunocompromised status of the recipient. This study investigates the outcomes after intestine/multivisceral re-transplantation. MATERIAL AND METHODS Clinical outcomes of 23 patients undergoing 24 re-transplantations at a single intestine transplant center were reviewed. Read More

View Article

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248276PMC
February 2018
4 Reads

Antibody-mediated rejection in pediatric small bowel transplantation: Capillaritis is a major determinant of C4d positivity in intestinal transplant biopsies.

Am J Transplant 2018 Sep 24;18(9):2250-2260. Epub 2018 Mar 24.

Pathology Department, Hôpital Necker, Assistance Publique-Hôpitaux de Paris, Paris, France.

The diagnostic criteria for antibody-mediated rejection (ABMR) after small bowel transplantation (SBT) are not clearly defined, although the presence of donor-specific antibodies (DSAs) has been reported to be deleterious for graft survival. We aimed to determine the incidence and prognostic value of DSAs and C4d in pediatric SBT and to identify the histopathologic features associated with C4d positivity. We studied all intestinal biopsies (IBx) obtained in the first year posttransplantation (N = 345) in a prospective cohort of 23 children. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/ajt.14685DOI Listing
September 2018
19 Reads

Kidney allograft survival outcomes in combined intestinal-kidney transplant: An analysis of the UNOS/OPTN database 2000-2014.

Clin Transplant 2018 Apr 16;32(4):e13213. Epub 2018 Feb 16.

Transplant Nephrology, Division of Nephrology, Indiana University, Indianapolis, IN, USA.

Background And Objectives: Intestinal transplants carry a high morbidity/mortality. Kidney allograft outcomes after combined intestinal (IT) with kidney transplant (CIKT) remain largely uninvestigated.

Materials And Methods: The UNOS STAR database was queried to identify all such combined organ transplants from 2000 to 2015. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/ctr.13213DOI Listing
April 2018
14 Reads

The use of vascular homografts in pediatric small bowel transplantation: Single-center experience over a decade.

Pediatr Transplant 2018 03 22;22(2). Epub 2018 Jan 22.

MedStar Georgetown Transplant Institute, Georgetown University Hospital, Washington, DC, USA.

Intestinal transplantation in children has evolved with more isolated small intestine transplants being performed compared to combined liver-intestine transplants. Consequently, surgical techniques have changed, frequently requiring the use of vascular homografts of small caliber to revascularize the isolated small intestine, the impact of which on outcomes is unknown. Among 106 pediatric intestine and multivisceral transplants performed at our center since 2003, 33 recipients of an isolated small intestine graft were included in this study. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/petr.13137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6445255PMC
March 2018
5 Reads

[Intestinal transplantation in Czech Republic].

Cas Lek Cesk Winter 2017;156(7):349-354

Intestinal transplantation represents a suitable treatment for patients with intestinal failure who then develop life-threatening complications of total parenteral nutrition and for some patients with complex abdominal disorders not suitable for conventional treatment.

Methods: prior to launch of the clinical program, preparation started in 2006 initially with extensive experimentation carried out on pigs. The clinical phase involved a specialized, multidisciplinary team who examined 23 patients being considered for transplantation. Read More

View Article

Download full-text PDF

Source
April 2019
37 Reads

Life of patients 10 years after a successful pediatric intestinal transplantation in Europe.

Am J Transplant 2018 Jun 25;18(6):1489-1493. Epub 2018 Jan 25.

Necker-Enfants Malades Hospital, Paris, France.

A multicenter Europe-wide single-point study in intestinal transplantation (ITx) centers was conducted to identify and describe patients surviving for more than 10 years after ITx in childhood. The health and nutritional status, care requirements and psychosocial status were recorded. Among 120 transplanted before 2005, 38 patients with a functioning graft were included. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/ajt.14654DOI Listing
June 2018
10 Reads

Multivisceral transplant is a viable treatment option for patients with non-resectable intra-abdominal fibromatosis.

Clin Transplant 2018 03 18;32(3):e13186. Epub 2018 Jan 18.

Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.

Background: Intra-abdominal fibromatosis often involves the mesentery root which is non-resectable by conventional surgery. Multivisceral transplant (MVT), as a potential cure to non-resectable fibromatosis, has rarely been reported and the prognosis is unknown.

Methods: Six patients who underwent MVT for intra-abdominal fibromatosis were reviewed. Read More

View Article

Download full-text PDF

Source
http://doi.wiley.com/10.1111/ctr.13186
Publisher Site
http://dx.doi.org/10.1111/ctr.13186DOI Listing
March 2018
14 Reads

De novo donor-specific HLA antibodies after combined intestinal and vascularized composite allotransplantation - a retrospective study.

Transpl Int 2018 04 14;31(4):398-407. Epub 2017 Dec 14.

Oxford Transplant Centre, Nuffield Department of Surgical Sciences, Oxford University Hospitals, Churchill Hospital, Oxford, UK.

Combining vascularized composite allotransplantation (VCA) with intestinal transplantation to achieve primary abdominal closure has become a feasible procedure. Besides facilitating closure, the abdominal wall can be used to monitor intestinal rejection. As the inclusion of a VCA raises the possibility of an enhanced alloimmune response, we investigated the incidence and clinical effect of de novo donor-specific HLA antibodies (dnDSA) in a cohort of patients receiving an intestinal transplant with or without a VCA. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/tri.13096DOI Listing
April 2018
10 Reads

Paneth and intestinal stem cells preserve their functional integrity during worsening of acute cellular rejection in small bowel transplantation.

Am J Transplant 2018 Apr 4;18(4):1007-1015. Epub 2017 Dec 4.

Laboratorio de Investigación Traslacional e Inmunología Asociada al Trasplante, Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina.

Graft survival after small bowel transplantation remains impaired due to acute cellular rejection (ACR), the leading cause of graft loss. Although it was shown that the number of enteroendocrine progenitor cells in intestinal crypts was reduced during mild ACR, no results of Paneth and intestinal stem cells localized at the crypt bottom have been shown so far. Therefore, we wanted to elucidate integrity and functionality of the Paneth and stem cells during different degrees of ACR, and to assess whether these cells are the primary targets of the rejection process. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/ajt.14592DOI Listing
April 2018
45 Reads

De novo hepatocellular carcinoma post-multivisceral transplantation in a child.

Pediatr Transplant 2017 11 27;21(7). Epub 2017 Jul 27.

Department of Pediatrics, Keck School of Medicine, Division of Gastroenterology, Hepatology & Nutrition, University of Southern California, Los Angeles, CA, USA.

De novo hepatocellular carcinoma (HCC) post-transplantation in patients without viral hepatitis is extremely rare, with only three reported adult cases in the English literature. Here, we present a case of de novo HCC that developed in a 7-year-old female, who at 8 months of age received a liver, small bowel, spleen, and pancreas transplantation 6.5 years ago for gastroschisis and total parenteral nutrition (TPN)-related cirrhosis. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/petr.12991DOI Listing
November 2017
33 Reads

Insights on the impact of diet-mediated microbiota alterations on immunity and diseases.

Am J Transplant 2018 Mar 23;18(3):550-555. Epub 2017 Sep 23.

Center for Inflammation, Immunity and Infection Atlanta, Institute for Biomedical Sciences, Georgia State University, Atlanta, GA, USA.

The intestinal tract is inhabited by a large and diverse community of bacteria collectively referred to as the gut microbiota. The intestinal microbiota is composed by 500-1000 distinct species, and alterations in its composition are associated with a variety of diseases including obesity, diabetes, and inflammatory bowel disease (IBD). Importantly, microbiota transplantation from diseased patients or mice (IBD, metabolic syndrome, etc. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/ajt.14477DOI Listing
March 2018
20 Reads

Hemophagocytic lymphohistiocytosis presenting in a pediatric patient with near total colonic and small bowel aganglionosis: a case report.

J Med Case Rep 2017 Aug 31;11(1):244. Epub 2017 Aug 31.

Johns Hopkins All Children's Hospital, 501 6th Ave S, St. Petersburg, FL, 33701, USA.

Background: Total colonic and small bowel aganglionosis is a rare condition typically requiring intestinal transplant for long-term survival. There have not been any previously reported cases of near total intestinal aganglionosis complicated by concerns for hemophagocytic lymphohistiocytosis and need for both multivisceral organ transplant and hematopoietic stem cell transplant.

Case Presentation: Our patient is a 35-month-old Egyptian boy who presented with bilious emesis and failure to pass meconium shortly after birth. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13256-017-1390-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577747PMC
August 2017
7 Reads

Anesthesia for Intestinal Transplantation.

Anesthesiol Clin 2017 Sep 5;35(3):509-521. Epub 2017 Jul 5.

Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine, University of California at Los Angeles, 757 Westwood Plaza, Los Angeles, CA 90095, USA.

The diagnosis of irreversible intestinal failure confers significant morbidity, mortality, and decreased quality of life. Patients with irreversible intestinal failure may be treated with intestinal transplantation. Intestinal transplantation may include intestine only, liver-intestine, or other visceral elements. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S19322275173004
Publisher Site
http://dx.doi.org/10.1016/j.anclin.2017.04.007DOI Listing
September 2017
10 Reads

A meta-analysis of clinical outcome of intestinal transplantation in patients with total intestinal aganglionosis.

Pediatr Surg Int 2017 Aug 9;33(8):837-841. Epub 2017 Jun 9.

National Children's Research Centre, Our Lady's Children's Hospital, Dublin, Ireland.

Aim Of The Study: Total intestinal aganglionosis (TIA) occurs in less than 1% of patients with Hirschsprung disease (HD), and TIA is the most severe form of HD. Survival has improved with the advent of parenteral nutrition and intestinal transplantation (ITx). The field of ITx has rapidly progressed in the last two decades and has now become an established treatment for patients with intestinal failure. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00383-017-4107-2DOI Listing
August 2017
12 Reads

Choice of Allograft in Patients Requiring Intestinal Transplantation: A Critical Review.

Can J Gastroenterol Hepatol 2017 3;2017:1069726. Epub 2017 May 3.

Intestinal Rehabilitation and Transplantation Program, Recanati/Miller Transplantation Institute, Mount Sinai Medical Center, New York, NY, USA.

Intestinal transplantation (ITx) is indicated in patients with irreversible intestinal failure (IF) and life-threatening complications related to total parenteral nutrition (TPN). ITx can be classified into three main types. Isolated intestinal transplantation (IITx), that is, transplantation of the jejunoileum, is indicated in patients with preserved liver function. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1155/2017/1069726DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434314PMC
April 2018
32 Reads

Clinical outcomes of intestinal transplant recipients colonized with multidrug-resistant organisms: a retrospective study.

Transpl Int 2017 Sep 17;30(9):924-931. Epub 2017 Jul 17.

Department of Medicine/Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL, USA.

Rates of multidrug-resistant organisms (MDRO) colonization among intestinal transplant (ITx) recipients have not been reported. Colonization rates with vancomycin-resistant Enterococcus (VRE), carbapenem-resistant Gram-negative bacteria (CR-GNB), and methicillin-resistant Staphylococcus aureus (MRSA) were obtained retrospectively in adults undergoing ITx (isolated or multivisceral) from 1/2009 to 12/2015. We assessed for VRE, CR-GNB, and MRSA bacteremia during the first year post-transplant for patients colonized with VRE, CR-GNB, and MRSA, respectively, and for those who were not colonized. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/tri.12987DOI Listing
September 2017
10 Reads

[Negative pressure system in the treatment of enterocutaneous fistulas in the pediatric population].

Cir Pediatr 2016 Oct 10;29(4):166-170. Epub 2016 Oct 10.

Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.

Aim Of The Study: The management of children with enterocutaneous fistulas (EF) along with large abdominal wall defects secondary to multiple surgical interventions can be difficult and sometimes lead to intestinal failure (IF). The aim of this study is to present the results of negative pressure systems and their properties (edema reduction angiogenesis promotion and granulation tissue formation) in children with enterocutaneous fistulas (EF) and their prognosis.

Materials And Methods: A retrospective analysis of children with refractory, high output EF treated with NPS between 2008-2014. Read More

View Article

Download full-text PDF

Source
October 2016
29 Reads

An overview of EU and USA intestinal transplant current activity.

J Visc Surg 2017 Apr 21;154(2):105-114. Epub 2017 Apr 21.

Intestinal transplantation and rehabilitation unit, Recanati/Miller transplantation institute, The Mount Sinai medical center, New York, NY, USA. Electronic address:

Aim Of The Study: To report the current activity of intestinal transplantation in Europe (EU) and Unites States of America (USA), underlining outcomes in the last 5 years and discussing possible trends.

Patients And Methods: Data review of results was performed through analysis of ITR and UNOS registries, Eurotransplant and newsletter transplant reports, congress abstracts, international published literature, personal communications and hospital web sites.

Results: The absence in Europe of a sole organization collecting donors and the presence of many low-volume centers (less than 5 cases/year) makes the difference with USA: in the last 5 years (2010-2014), 222 intestinal/multivisceral transplants have been performed in EU countries (most of them in the UK), while in USA, the number of transplants achieved 634 procedures in the same period of time. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S18787886173000
Publisher Site
http://dx.doi.org/10.1016/j.jviscsurg.2017.01.007DOI Listing
April 2017
11 Reads

Multivisceral transplantation for abdominal tumors in children: A single center experience and review of the literature.

Pediatr Transplant 2017 Aug 9;21(5). Epub 2017 Apr 9.

Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.

Standard management of intra-abdominal pediatric solid tumors requires complete resection. However, tumors with multiple organ and vascular involvement present a unique surgical challenge. We conducted a retrospective chart review of four patients, aged 2-14 years, undergoing MVT for intra-abdominal tumors with significant involvement of the visceral arteries and/or portomesenteric venous system at our institution. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/petr.12904DOI Listing
August 2017
14 Reads

Clinical presentation and outcomes of norovirus infection in intestinal allograft compared to native intestine.

Transpl Infect Dis 2017 Jun 27;19(3). Epub 2017 Apr 27.

Transplant Infectious Diseases Program, University of Nebraska Medical Center, Omaha, NE, USA.

Background: No data are available on clinical manifestations and course of norovirus gastroenteritis (NVE) in intestinal allograft (from intestinal and multivisceral transplant recipients, ITR) compared to native intestine (from other allograft recipients, nITR).

Methods: This was a retrospective study of solid organ transplant recipients with NVE at two centers from January 1, 2010 to April 1, 2014. Chi-square, t-test, linear and logistic regression analyses were done to compare NVE in ITR vs nITR patients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/tid.12692DOI Listing
June 2017
24 Reads

Techniques for abdominal wall reconstruction in intestinal transplantation.

Curr Opin Organ Transplant 2017 Apr;22(2):135-141

aUnidad de Insuficiencia, Rehabilitatición y Trasplante Intestinal, Hospital Universitario Fundación Favaloro bServicio de Cirugia General, Hospital Universitario Fundación Favaloro, MAAC, Buenos Aires, Argentina.

Purpose Of Review: One of the most important challenges in the intestinal (ITx) and multivisceral transplant (MVTx) is to achieve a successful abdominal wall closure.

Recent Findings: A tension-free primary closure should be our aim. In most of the cases, we need to perform a component separation technique, alone or combined, to the use of a synthetic mesh. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MOT.0000000000000394DOI Listing
April 2017
6 Reads

Crohn's Disease and Intestinal Transplantation.

Dig Dis 2017 1;35(1-2):127-133. Epub 2017 Feb 1.

Hepatogastroenterology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.

Background: Most patients with Crohn's disease (CD) require one or more operations during their lifetime. Repeated resections and surgical complications may result in short gut in a subset of patients, typically those with extensive small bowel disease or a penetrating CD phenotype. The effects of short bowel syndrome (SBS) can range in seriousness from mild to life-threatening advanced intestinal failure. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1159/000449093DOI Listing
February 2017
7 Reads

Current status of intestinal and multivisceral transplantation.

Gastroenterol Rep (Oxf) 2017 02 26;5(1):20-28. Epub 2017 Jan 26.

Center for Gut Rehabilitation and Transplantation, the Cleveland Clinic Foundation, Cleveland, OH, USA

Clinical-nutritional autonomy is the ultimate goal of patients with intestinal failure (IF). Traditionally, patients with IF have been relegated to lifelong parenteral nutrition (PN) once surgical and medical rehabilitation attempts at intestinal adaptation have failed. Over the past two decades, however, outcome improvements in intestinal transplantation have added another dimension to the therapeutic armamentarium in the field of gut rehabilitation. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1093/gastro/gow045DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5444259PMC
February 2017
25 Reads