535 results match your criteria Intestinal and Multivisceral Transplantation


Optimal Treatment for Patients With Cavernous Transformation of the Portal Vein.

Front Med (Lausanne) 2022 24;9:853138. Epub 2022 Mar 24.

Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China.

Cavernous transformation of the portal vein (CTPV) is a sequela of extrahepatic and/or intrahepatic portal vein obstruction caused by a combination of local and risk factors. It was ever taken as a relatively rare disease due to its scant literature, which was mainly based on clinical series and case reports. CTPV often manifests as gastroesophageal variceal bleeding, splenomegaly, and portal biliopathy after the long-term insidious presentation. Read More

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First multivisceral transplantation in Mitchell-Riley/Martinez-Frias syndrome.

Pediatr Transplant 2022 Mar 20:e14270. Epub 2022 Mar 20.

Department of Pediatric Surgery, La Paz University Hospital, Madrid, Spain.

Background: MRS/MFS is a rare multisystem disorder with a poor prognosis. The high mortality rate of this syndrome is related to the severity of the associated gastrointestinal, pancreatic, and hepatobiliary conditions, as most of them are not amenable to conventional medical and surgical treatments.

Methods: We report the case of a Romani girl with all the key clinical features of MRS/MFS, and a review of cases reported in the literature. Read More

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Techniques for Closing the Abdominal Wall in Intestinal and Multivisceral Transplantation: A Systematic Review.

Ann Transplant 2022 Mar 1;27:e934595. Epub 2022 Mar 1.

Department of Gastroenterology, Clinics Hospital of the University of São Paulo, São Paulo, SP, Brazil.

Short bowel syndrome is the most common etiology of intestinal failure, resulting from either resections of different intestinal segments or a congenital condition. Due to the absence or considerable reduction of intestinal loops in the abdominal cavity, patients with short bowel syndrome present with atrophy and muscle retraction of the abdominal wall, which leads to loss of abdominal domain and elasticity. This complication is an aggravating factor of intestinal transplantation since it can prevent the primary closure of the abdominal wall. Read More

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Long-term outcomes of intestinal transplantation from donors aged under 1 year.

Pediatr Transplant 2022 06 23;26(4):e14257. Epub 2022 Feb 23.

Division of Pediatric Transplantation, Department of Surgery, Hillman Center for Pediatric Transplantation, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA.

Background: The aim of the study was to analyze the long-term outcomes of transplants utilizing ITx donors <1 year and to compare these results with older donors.

Methods: Between January 2007 and December 2019, the primary ITx donors in the Children's Hospital of Pittsburgh of UPMC were retrospectively reviewed. Short- and long-term outcomes of recipients receiving a deceased donor organ from donors <1 year were compared with those found in all other recipients. Read More

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Sarcopenia prevalence in pediatric intestinal transplant recipients: Implications on post-transplant outcomes.

Pediatr Transplant 2022 06 21;26(4):e14256. Epub 2022 Feb 21.

Division of Pediatric Gastroenterology, Hepatology, and Nutrition, UPMC Children's Hospital Pittsburgh, Pittsburgh, Pennsylvania, USA.

Background: Sarcopenia has been associated with poor surgical outcomes but has not been studied in pediatric intestinal transplantation. We aimed to determine sarcopenia prevalence in intestinal transplant recipients and the association of sarcopenia with outcomes.

Methods: We performed a cross-sectional retrospective chart review of intestinal transplant recipients from 2000-present. Read More

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Combined liver-intestinal and multivisceral transplantation for neuroendocrine tumors extending beyond the liver: A systematic literature review.

Transplant Rev (Orlando) 2022 01 21;36(1):100678. Epub 2022 Jan 21.

Leuven Intestinal Failure and Transplantation (LIFT) center, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium; Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Chronic Diseases and Metabolism (CHROMETA), Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium. Electronic address:

Background: Neuroendocrine tumors (NET) have an increasing incidence and are characterized by an invasive and metastatic presentation, rendering a curative resection not always feasible. For some patients the only life-saving option would be a multivisceral transplantation (MvTx). This systematic review aims to summarize the reported experience on combined liver-intestinal and MvTx for NET according PRISMA-guidelines. Read More

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January 2022

Abdominal Wall Vascularized Composite Allotransplantation: A Scoping Review.

J Reconstr Microsurg 2021 Dec 14. Epub 2021 Dec 14.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York.

Background:  Abdominal wall vascularized composite allotransplantation (AW-VCA) is a novel reconstructive technique used for large abdominal wall defects in combination with intestinal transplantation (ITx) or multivisceral abdominal transplantation (MVTx). Since the introduction of this procedure, several studies have been published reporting their experience. This study aims to present a scoping review looking at all available evidence-based medicine information to understand the most current surgical techniques and clinical outcomes. Read More

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December 2021

New technique for abdominal wall procurement. Initial experience.

Clin Transplant 2022 02 29;36(2):e14535. Epub 2021 Nov 29.

Unit of HPB Surgery and Abdominal Organ Transplantation, "Doce de Octubre" University Hospital, Instituto de Investigación (imas12), Department of Surgery, Faculty of Medicine, Complutense University, Madrid, Spain.

Difficulty in obtaining adequate abdominal wall closure due to loss of the abdominal domain is a frequent complication of multivisceral, isolated intestinal transplantation and in some cases of liver transplantation. Various methods for primary closure have been proposed, including the use of synthetic and biological meshes, as well as full-thickness abdominal wall and non-vascularized rectus fascia grafts. We describe a novel technique for abdominal wall procurement in which the graft is perfused synchronously with the abdominal organs and can be transplanted as a full-thickness wall or as a non-vascularized rectus fascia graft. Read More

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February 2022

Preservation of native sigmoid colon for secondary continent cystostomy after multivisceral transplantation for chronic intestinal pseudo-obstruction.

Pediatr Transplant 2022 Mar 8;26(2):e14180. Epub 2021 Nov 8.

Service de chirurgie pédiatrique viscérale, hôpital Necker - Enfants malades, Paris, France.

Chronic intestinal pseudo-obstruction (CIPO) is characterized by severe digestive +/- urinary dysmotility. If the conservative management fails, multivisceral transplantation (MVT) may be needed. However, urinary dysmotility remains after MVT and requires to continue urinary catheterizations and/or drainage. Read More

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Blockade or deficiency of PD-L1 expression in intestinal allograft accelerates graft tissue injury in mice.

Am J Transplant 2022 03 3;22(3):955-965. Epub 2021 Nov 3.

Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA.

The importance of PD-1/PD-L1 interaction to alloimmune response is unknown in intestinal transplantation. We tested whether PD-L1 regulates allograft tissue injury in murine intestinal transplantation. PD-L1 expression was observed on the endothelium and immune cells in the intestinal allograft. Read More

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Pediatric Home Parenteral Nutrition in France: A six years national survey.

Clin Nutr 2021 10 14;40(10):5278-5287. Epub 2021 Aug 14.

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Necker-Enfants Malades University of Paris-UFR Paris Descartes, Certified Center for Home Parenteral Nutrition, Reference Center for Rare Digestive Diseases in Children, Paris, France. Electronic address:

Background And Aims: Home Parenteral Nutrition (HPN) is the cornerstone management for children suffering from chronic intestinal failure (CIF). In France, HPN is organized from a network of 7 certified centers located in University Hospitals spread across the national territory. This study aims to review the data involving children on HPN over a 6-years period in France to outline the global and continuous improvement in care. Read More

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October 2021

Pediatric living donor intestine transplant following an atypical complication of COVID-19: A unique case report from India.

Am J Transplant 2021 12 9;21(12):4079-4083. Epub 2021 Sep 9.

Department of Organ Transplantation, Jupiter Hospital, Pune, Maharashtra, India.

Coronavirus disease-19 (COVID-19) infection causing severe gastrointestinal complications is rare. A 9-year-old child after recovering from mild COVID-19 infection developed small bowel gangrene due to superior mesenteric artery thrombosis. He required resection of entire necrotic small bowel along with caecum causing ultra-short bowel syndrome. Read More

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December 2021

Intestinal Autotransplantation and In-Situ Resection of Recurrent Pancreatic Head Intraductal Tubulopapillary Neoplasm with Portal Cavernoma: A Case Report.

Transplant Proc 2021 Oct 14;53(8):2598-2601. Epub 2021 Jul 14.

Department of Anesthesia, University of Miami/Jackson Memorial Hospital, Miami, Florida.

Background: Intraductal tubulopapillary neoplasm (ITPN) is a new entity of a rare premalignant pancreatic neoplasia, and a radical curative resection is indicated. As with other tumors of the root of the mesentery, the proximity of the lesion to large splanchnic vessels, abdominal aorta, and inferior vena cava poses major risks of a massive hemorrhage and visceral ischemia using conventional surgical techniques. At times, these lesions are amenable for resection using novel techniques developed from organ transplantation. Read More

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October 2021

[Chronic intestinal failure].

Chirurg 2022 Feb 15;93(2):205-214. Epub 2021 Jul 15.

Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland.

The term intestinal failure (IF) is understood as the transient or irreversible loss of the resorptive capacity of the bowels. This includes a multitude of diseases, some of which have anatomical causes and others functional causes. The functional capacity (absorption and motility) of the remaining digestive tract and the bacterial overgrowth and false colonization of the small bowel are of prognostic importance. Read More

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February 2022

Multidrug-resistant organisms: A significant cause of severe sepsis in pediatric intestinal and multi-visceral transplantation.

Am J Transplant 2022 01 28;22(1):122-129. Epub 2021 Jul 28.

Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Severe sepsis in immunocompromised children is associated with increased mortality. This paper describes the epidemiology landscape, clinical acuity, and outcomes for severe sepsis in pediatric intestinal (ITx) and multi-visceral (MVTx) transplant recipients requiring admission to the pediatric intensive care unit (PICU). Severe sepsis episodes were retrospectively reviewed in 51 ITx and MVTx patients receiving organs between 2009 and 2015. Read More

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January 2022

Allotransplantation of donor rectus fascia for abdominal wall closure in transplant patients: A systematic review.

Transplant Rev (Orlando) 2021 12 4;35(4):100634. Epub 2021 Jun 4.

Department of Abdominal Surgery, University Hospitals Leuven, Belgium.

Background: Abdominal wall closure after intestinal, multivisceral or liver transplantation can be a major challenge. Different surgical techniques have been described to close complex abdominal wall defects, but results remain variable. Two promising transplant techniques have been developed using either non-vascularized or vascularized donor rectus fascia. Read More

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December 2021

Bloodstream infections among intestinal and multivisceral transplant recipients.

Transpl Infect Dis 2021 Aug 8;23(4):e13668. Epub 2021 Jul 8.

Division of Infectious Diseases and Travel Medicine, Department of Medicine, Georgetown University Medical Center, Washington, DC, USA.

Objective: To examine the etiologies, risk factors, and microbiology of bloodstream infections (BSIs) among intestinal and multivisceral transplant recipients in the 2-year post-operative period.

Methods: A retrospective medical record review of adult intestinal or multivisceral transplant recipients between 2003 and 2015. Descriptive statistics were used to describe cohort data. Read More

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Anti-plasma cell treatment in refractory autoimmune hemolytic anemia in a child with multivisceral transplant.

Pediatr Transplant 2021 Nov 6;25(7):e14045. Epub 2021 Jun 6.

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

Background: Warm-antibody AIHA is known to complicate solid organ (SOT) and HSCT, the disease maybe refractory to standard therapy. Immunosuppressive therapies as well as IVIG, and rituximab have been the main stay of treatment. Over the past decade, B-lymphocyte targeted, anti-CD-20 antibody has been recognized in the treatment of autoimmune diseases and utilized in AIHA. Read More

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November 2021

Efficacy and safety of mammalian target of rapamycin inhibitors following intestinal and multivisceral transplantation.

Clin Transplant 2021 07 22;35(7):e14324. Epub 2021 Jun 22.

Henry Ford Hospital, Detroit, MI, USA.

This is a descriptive study reviewing the outcomes of mammalian target of rapamycin inhibitors (mTORs) in intestinal (IT) and multivisceral transplantation (MVT). This study included 22 patients, 20 adults, and two children, and an overall mean age of 46 years old at the time of transplantation. Twelve patients (54. Read More

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Multivisceral Transplantation for Diffuse Portomesenteric Thrombosis: Lessons Learned for Surgical Optimization.

Front Surg 2021 19;8:645302. Epub 2021 Feb 19.

Department of Microbiology, Immunology and Transplantation, Katholieke Universiteit Leuven, Leuven, Belgium.

Multivisceral transplantation entails the en-bloc transplantation of stomach, duodenum, pancreas, liver and bowel following resection of the native organs. Diffuse portomesenteric thrombosis, defined as the complete occlusion of the portal system, can lead to life-threatening gastrointestinal bleeding, malnutrition and can be associated with liver and intestinal failure. Multivisceral transplantation is the only procedure that offers a definitive solution by completely replacing the portal system. Read More

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February 2021

Intestinal transplantation.

Curr Opin Organ Transplant 2021 04;26(2):229-233

Departmetn of Surgery, Liver and Gastrointestinal Transplantation, Miami Transplant Institute, University of Miami/Jackson Memorial Hospital, Miami, Florida, USA.

Purpose Of Review: Intestinal transplantation has evolved to be a viable treatment option for patients with intestinal failure. This review shows the most current tendencies and practices of intestinal transplant centers and an overall comparison to intestinal rehabilitation.

Recent Findings: This review outlines that timing for referral and advances in preoperative and postoperative care of intestinal and multivisceral transplant candidates are crucial to achieve results comparable to intestinal rehabilitation. Read More

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Decline in renal function following intestinal transplant: is the die cast at 3 months?

Clin Transplant 2021 05 24;35(5):e14249. Epub 2021 Feb 24.

Department of Surgery, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.

Introduction: This study reports the incidence of chronic kidney disease (CKD) after intestinal transplant (IT) at a single, adult center in the United Kingdom.

Methods: A retrospective review of IT was undertaken. Methods of renal function assessment pre-transplant were compared. Read More

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Using Radiographic Domain for Evaluating Indications in Abdominal Wall Transplantation.

Ann Plast Surg 2021 09;87(3):348-354

From the Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery.

Background: There is currently no description of abdominal domain changes in small bowel transplantation population or consensus of criteria regarding which patients are at high risk for immediate postoperative abdominal wall complications or would benefit from abdominal wall vascularized composite allotransplantation.

Methods: A retrospective chart review was performed on 14 adult patients receiving intestinal or multivisceral transplantation. Preoperative and postoperative computed tomography scans were reviewed, and multiple variables were collected regarding abdominal domain and volume and analyzed comparing postoperative changes and abdominal wall complications. Read More

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September 2021

Re-evaluating Blood Markers as Predictors of Outcome in Multivisceral and Intestinal Transplantation.

Transplant Proc 2021 Mar 6;53(2):696-704. Epub 2021 Feb 6.

Department of Pediatrics, Division of Pediatric Infectious Disease and Immunology, University of Miami, Miami, Florida.

Background: Multivisceral transplant (MVTx) and isolated intestinal transplant (ITx) are complex surgical procedures. The subsequent proinflammatory state in the immediate postoperative period makes interpretation of blood markers difficult.

Method: We aimed to establish the course of various blood markers after MVTx/ITx, and to evaluate their use as diagnostic markers of complications. Read More

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Intestinal transplantation: an overview of the recent experimental studies.

Authors:
Mihai Oltean

Curr Opin Organ Transplant 2021 04;26(2):240-244

The Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden and Institute of Clinical Sciences, Department of Surgery, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.

Purpose Of Review: Experimental intestinal transplantation (ITx ) has generated invaluable knowledge that has ultimately benefited the clinical activity. Herein, we appraise the recent publications pertaining to experimental ITx and highlight the main current research topics.

Recent Findings: During the recent years, ischemia-reperfusion injury (IRI) and Graft-versus-host disease (GVHD) have gradually replaced acute rejection as the main research topic. Read More

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Fatal Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis with virus-infected T cells after pediatric multivisceral transplantation: A proof-of-concept case report.

Pediatr Transplant 2021 May 28;25(3):e13961. Epub 2020 Dec 28.

Department of Advanced Medicine for Viral Infections, National Center for Child Health and Development (NCCHD), Tokyo, Japan.

Background: EBV-associated HLH driven by EBV-infected CD8 T cells is a rare complication after pediatric solid organ transplantation. The etiology and disease spectrum of post-transplant EBV-HLH are poorly understood, and making a precise diagnosis and providing optimal treatment remain a challenge.

Methods/case Description/results: We report a 2-year-old multivisceral transplant recipient who developed fever and cytopenia with a persistent high EBV-load state. Read More

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Luminal polyethylene glycol solution delays the onset of preservation injury in the human intestine.

Am J Transplant 2021 06 18;21(6):2220-2230. Epub 2021 Jan 18.

The Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden.

The organ damage incurred during the cold storage (CS) of intestinal grafts has short and long-term consequences. Animal studies suggest that additional luminal preservation (LP) with polyethylene glycol (PEG) may alleviate this damage. This study aims to validate these findings using human intestines. Read More

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