Transplantation proceedings最新文献_第10页

Central Nervous System Post-Transplant Lymphoproliferative Disorder After Kidney Transplantation in an Epstein–Barr Virus–Seronegative Recipient Despite Serial EBV-DNA Monitoring: A Case Report 尽管有一系列EBV-DNA监测，Epstein-Barr病毒血清阴性受体肾移植后中枢神经系统移植后淋巴增生性疾病：一例报告。

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2026-06-01 Epub Date: 2026-05-17 DOI: 10.1016/j.transproceed.2026.05.001

Takuya Shimogawa , Shigeyoshi Yamanaga , Kazuki Munemura , Mariko Toyoda , Chiaki Kawabata , Yoei Miyabe , Yasuhiro Yamamoto , Yu Watanabe , Akito Inadome , Yuji Hidaka , Hiroshi Yokomizo

{"title":"Central Nervous System Post-Transplant Lymphoproliferative Disorder After Kidney Transplantation in an Epstein–Barr Virus–Seronegative Recipient Despite Serial EBV-DNA Monitoring: A Case Report","authors":"Takuya Shimogawa , Shigeyoshi Yamanaga , Kazuki Munemura , Mariko Toyoda , Chiaki Kawabata , Yoei Miyabe , Yasuhiro Yamamoto , Yu Watanabe , Akito Inadome , Yuji Hidaka , Hiroshi Yokomizo","doi":"10.1016/j.transproceed.2026.05.001","DOIUrl":"10.1016/j.transproceed.2026.05.001","url":null,"abstract":"<div><h3>Background</h3><div>Post-transplant lymphoproliferative disorder (PTLD) is a serious complication of organ transplantation that is strongly associated with Epstein–Barr virus (EBV) infection. Serial monitoring of peripheral blood EBV -DNA is widely used for early detection of PTLD; however, its sensitivity is limited, particularly in cases involving the primary central nervous system.</div></div><div><h3>Case presentation</h3><div>A 23-year-old female patient underwent living-donor kidney transplantation from her mother and was classified as having standard immunological risk. The EBV serostatus was donor-positive/recipient-negative, and serial peripheral blood EBV-DNA monitoring was performed after transplantation. Despite the EBV-DNA levels remaining below 4 log<sub>10</sub> IU/mL, the patient developed progressive neurological symptoms. Subsequent neuroimaging and histopathological evaluations led to the diagnosis of central nervous system PTLD (CNS-PTLD). Treatment consisted of immunosuppression reduction, localized radiotherapy, and systemic rituximab-based chemotherapy and resulted in complete metabolic remission.</div></div><div><h3>Conclusion</h3><div>Although EBV-DNA levels over 5 log<sub>10</sub> IU/mL indicate an urgent concern for PTLD, this case highlights that CNS-PTLD can develop in high-risk transplant recipients even in the absence of significant EBV-DNAemia. Careful clinical assessment and prompt diagnostic evaluation of neurological symptoms are crucial for early diagnosis and appropriate management, particularly in donor-positive/recipient-negative kidney transplant recipients.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 5","pages":"Pages 890-895"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fulminant Acanthamoeba Encephalitis Diagnosed By Cell-Free DNA in a Renal Transplant Patient: A Case Report 肾移植患者无细胞DNA诊断暴发性棘阿米巴脑炎一例报告。

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2026-06-01 Epub Date: 2026-05-22 DOI: 10.1016/j.transproceed.2026.05.005

Scott M. Wilson , Armghan A. Munir , Marie Le , Enver Akalin , Roger A. Fecher , Judah Burns , Victoria Muggia , Luz E. Liriano-Ward

{"title":"Fulminant Acanthamoeba Encephalitis Diagnosed By Cell-Free DNA in a Renal Transplant Patient: A Case Report","authors":"Scott M. Wilson , Armghan A. Munir , Marie Le , Enver Akalin , Roger A. Fecher , Judah Burns , Victoria Muggia , Luz E. Liriano-Ward","doi":"10.1016/j.transproceed.2026.05.005","DOIUrl":"10.1016/j.transproceed.2026.05.005","url":null,"abstract":"<div><div>Granulomatous amoebic encephalitis (GAE) caused by <em>Acanthamoeba</em> spp. is a rare, nearly universally fatal central nervous system infection that predominantly affects immunocompromised individuals, including solid organ transplant (SOT) recipients. Early diagnosis is essential but often delayed due to nonspecific symptoms and the limited sensitivity of conventional diagnostic tests. We describe the case of a 58-year-old man who presented with fever and diarrhea one month after a simultaneous pancreas-kidney transplant. Despite broad-spectrum antimicrobial therapy, he developed status epilepticus and rapid neurologic deterioration. Extensive infectious workup, including cerebrospinal fluid studies, was non-diagnostic, and neuroimaging revealed multifocal infarcts and cerebral edema. Plasma microbial cell-free DNA sequencing identified <em>Acanthamoeba</em> spp., leading to a presumptive diagnosis of GAE that was later confirmed postmortem. This case represents the first reported use of plasma-based next-generation sequencing to diagnose <em>Acanthamoeba</em> GAE and highlights the clinical utility of noninvasive molecular diagnostics in immunocompromised hosts with unexplained encephalopathy. Earlier recognition of rare pathogens using these tools may facilitate more timely interventions and improve outcomes in transplant recipients with rapidly progressive neurologic syndromes.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 5","pages":"Pages 899-902"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early Detection of a Testicular Mixed Germ Cell Tumor by Alpha-Fetoprotein Surveillance After Pediatric Liver Transplantation: Case Report and Literature Review 小儿肝移植后甲胎蛋白监测早期发现睾丸混合生殖细胞瘤：病例报告及文献复习。

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2026-06-01 Epub Date: 2026-04-15 DOI: 10.1016/j.transproceed.2026.03.010

Takahiko Omameuda , Taiichi Wakiya , Yasunaru Sakuma , Yasuharu Onishi , Yukihiro Sanada , Noriki Okada , Yuta Hirata , Toshio Horiuchi , Kiichiro Takadera , Ryosuke Akimoto , Naoki Saegusa , Hironori Yamaguchi

{"title":"Early Detection of a Testicular Mixed Germ Cell Tumor by Alpha-Fetoprotein Surveillance After Pediatric Liver Transplantation: Case Report and Literature Review","authors":"Takahiko Omameuda , Taiichi Wakiya , Yasunaru Sakuma , Yasuharu Onishi , Yukihiro Sanada , Noriki Okada , Yuta Hirata , Toshio Horiuchi , Kiichiro Takadera , Ryosuke Akimoto , Naoki Saegusa , Hironori Yamaguchi","doi":"10.1016/j.transproceed.2026.03.010","DOIUrl":"10.1016/j.transproceed.2026.03.010","url":null,"abstract":"<div><div>Liver transplant (LT) recipients, particularly pediatric survivors, face an elevated lifetime risk of de novo malignancies due to prolonged immunosuppressive therapy. Alpha-fetoprotein (AFP) is widely used as a biomarker for hepatocellular carcinoma (HCC) in post-LT surveillance, but elevations may also reflect extrahepatic tumors. Here, we report a rare case of a testicular tumor incidentally detected through AFP monitoring in a pediatric LT survivor. A 20-year-old male with situs inversus totalis underwent living donor LT for biliary atresia at 1 year of age. Nineteen years post-transplant, AFP was elevated to 493 ng/mL during routine surveillance, raising suspicion for de novo HCC. Imaging studies revealed no liver lesions, but physical examination identified testicular swelling. Scrotal ultrasonography demonstrated a heterogeneous mass, and orchiectomy confirmed a mixed germ cell tumor composed of seminoma, yolk sac tumor, and embryonal carcinoma. AFP normalized postoperatively, and the patient is being carefully monitored during postoperative surveillance. This case highlights both the benefits and limitations of AFP-driven surveillance: while it facilitated early detection of a curable extrahepatic tumor, reliance on AFP alone may miss AFP-negative testicular cancers. Comprehensive surveillance strategies incorporating tumor markers, structured physical examinations, and patient education are warranted, with future emphasis on standardized guidelines for pediatric LT survivors.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 5","pages":"Pages 910-915"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Case Report: Retransplantation for Adult-Onset Bilirubin Encephalopathy After Auxiliary Partial Liver Transplant for Crigler-Najjar Syndrome Type 1 in Childhood 病例报告：儿童期Crigler-Najjar综合征1型患者辅助部分肝移植后胆红素脑病再移植。

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2026-06-01 Epub Date: 2026-05-20 DOI: 10.1016/j.transproceed.2026.04.021

Norihiro Goshima , Yasuhiro Fujimoto , Ryota Hyodo , Yuki Masano , Yasuhiro Ogura

{"title":"Case Report: Retransplantation for Adult-Onset Bilirubin Encephalopathy After Auxiliary Partial Liver Transplant for Crigler-Najjar Syndrome Type 1 in Childhood","authors":"Norihiro Goshima , Yasuhiro Fujimoto , Ryota Hyodo , Yuki Masano , Yasuhiro Ogura","doi":"10.1016/j.transproceed.2026.04.021","DOIUrl":"10.1016/j.transproceed.2026.04.021","url":null,"abstract":"<div><div>Crigler-Najjar syndrome (CNS) type 1 is a genetic disorder that leads to severe unconjugated hyperbilirubinemia. Auxiliary partial orthotopic liver transplantation (APOLT) is preferred for metabolic liver diseases as a portion of the native liver is retained. Reported here are details of a 32-year-old male who developed bilirubin encephalopathy due to graft failure 27 years after APOLT performed at 5-year-old for CNS type 1. Initially, the bilirubin level was low, which then gradually increased to 7.3 mg/dL at age 12. At the age of 31, the bilirubin level began to rise rapidly and we submitted a request for deceased donor liver transplantation (DDLT) to the Committee for the Evaluation of Indications for DDLT in Japan. However, that was deemed as not indicated, because unconjugated bilirubin-dominant hyperbilirubinemia alone is generally not considered to cause encephalopathy in adults. Despite the high bilirubin level, the patient remained neurologically asymptomatic until occurrence of acute decompensation. At 32 years old, he was admitted on an emergency basis to our hospital with severe hyperbilirubinemia and neurological symptoms. After managing his general condition with intensive care, DDLT was finally performed, resulting in a drastic resolution of various symptoms. The findings in this case show that bilirubin-induced neurotoxicity in adults may be reversible and indicate that the current liver transplantation criteria used in Japan, which limit eligibility for CNS to pediatric patients, may have contributed to delayed transplantation. Re-evaluation of the transplant eligibility criteria is necessary to allow for a more inclusive approach that encompasses adult patients.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 5","pages":"Pages 928-933"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Breakthrough CMV Infection Due to de Novo Letermovir Resistance in a Kidney Transplant Recipient: A Case Report 肾移植受者由利特莫韦耐药性引起的突破性巨细胞病毒感染：1例报告。

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2026-06-01 Epub Date: 2026-05-22 DOI: 10.1016/j.transproceed.2026.04.019

Muzammeel Hada , Abd Assalam Qannus , Fariba Donovan

引用次数: 0

Simultaneous Pancreas and Kidney Transplantation in a Patient With Congenital Hemophilia A: A rare Case Report and Management Insights 先天性血友病a患者同时胰肾移植一例：罕见病例报告及治疗见解。

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2026-06-01 Epub Date: 2026-05-18 DOI: 10.1016/j.transproceed.2026.04.024

Takahiro Shimaoka , Kazuki Sasaki , Hirofumi Akita , Yosuke Mukai , Shinichiro Hasegawa , Daisaku Yamada , Yoshito Tomimaru , Takehiro Noda , Hidenori Takahashi , Shogo Kobayashi , Hirokazu Kashiwagi , Hiroaki Yonishi , Kazuyuki Miyashita , Kazuaki Yamanaka , Shigeaki Nakazawa , Yoichi Kakuta , Norio Nonomura , Yuichiro Doki , Hidetoshi Eguchi

{"title":"Simultaneous Pancreas and Kidney Transplantation in a Patient With Congenital Hemophilia A: A rare Case Report and Management Insights","authors":"Takahiro Shimaoka , Kazuki Sasaki , Hirofumi Akita , Yosuke Mukai , Shinichiro Hasegawa , Daisaku Yamada , Yoshito Tomimaru , Takehiro Noda , Hidenori Takahashi , Shogo Kobayashi , Hirokazu Kashiwagi , Hiroaki Yonishi , Kazuyuki Miyashita , Kazuaki Yamanaka , Shigeaki Nakazawa , Yoichi Kakuta , Norio Nonomura , Yuichiro Doki , Hidetoshi Eguchi","doi":"10.1016/j.transproceed.2026.04.024","DOIUrl":"10.1016/j.transproceed.2026.04.024","url":null,"abstract":"<div><h3>Background</h3><div>Simultaneous pancreas-kidney transplantation (SPK) is a definitive treatment for end-stage kidney disease (ESKD) and type 1 diabetes mellitus. However, even with careful perioperative control of hemostasis, SPK carries a high risk of postoperative bleeding, which is exacerbated in patients with hemophilia A. Here, we report the first known successful SPK in a patient with congenital hemophilia A.</div></div><div><h3>Case report</h3><div>A 52-year-old man was diagnosed with hemophilia A at 2 years of age. He developed type 1 diabetes mellitus at 25 years of age, which progressed to ESKD at 43 years of age. A comprehensive preoperative FVIII replacement protocol was applied during the perioperative period, using continuous infusion with bolus supplementation to maintain target VIII activity levels (100% intraoperatively, 80% during the first postoperative week, and ≥30% thereafter).</div></div><div><h3>Conclusion</h3><div>This case demonstrates that SPK transplantation can be safely performed in patients with congenital hemophilia A, by implementing appropriate FVIII replacement strategies and close multidisciplinary collaboration.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 5","pages":"Pages 845-848"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fibromuscular Dysplasia in a Deceased Donor Renal Allograft: Staged Hybrid Endovascular Management and Review of the Literature 已故供体肾移植的纤维肌肉发育不良：分阶段混合血管内治疗和文献回顾。

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2026-06-01 Epub Date: 2026-05-18 DOI: 10.1016/j.transproceed.2026.05.003

Aasim Khan , Shirley Cai , Vikram Puttaswamy , Yvonne Shen , Linda Thebridge , Charles Fisher , Animesh Singla

{"title":"Fibromuscular Dysplasia in a Deceased Donor Renal Allograft: Staged Hybrid Endovascular Management and Review of the Literature","authors":"Aasim Khan , Shirley Cai , Vikram Puttaswamy , Yvonne Shen , Linda Thebridge , Charles Fisher , Animesh Singla","doi":"10.1016/j.transproceed.2026.05.003","DOIUrl":"10.1016/j.transproceed.2026.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Fibromuscular dysplasia (FMD) in deceased donor renal allografts is rarely reported in the transplant literature, and there is currently no consensus regarding graft utilization when identified prior to retrieval or optimal operative management following implantation.</div></div><div><h3>Methods</h3><div>We report a case of deceased donor renal transplantation in which a focal mid–renal artery FMD lesion causing significant stenosis was identified intraoperatively using routine duplex ultrasonography, despite a normal macroscopic appearance of the renal artery on the back table. As the donor had demonstrated normal renal function, a decision was made not to intervene on the lesion at the time of implantation.</div></div><div><h3>Results</h3><div>Post-operatively, the renal allograft produced urine; however, serum creatinine failed to improve. On post-operative day 3, percutaneous balloon angioplasty of the transplant renal artery stenosis was performed successfully. Renal function normalized promptly following the intervention and remained stable at 12 months of follow-up.</div></div><div><h3>Conclusions</h3><div>This case highlights several important considerations. A deceased donor kidney with normal donor renal function may still fail to provide adequate recipient function due to previously unsuspected FMD, potentially accounting for unexplained early graft dysfunction in some cases. Routine intraoperative duplex ultrasonography facilitated early detection of the lesion, allowing timely elective intervention. Endovascular repair represents an effective and safe management strategy for FMD in renal allografts when performed in appropriately experienced centers.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 5","pages":"Pages 871-876"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Weight of Balance: Anesthetic Management in Liver Transplantation for Critically Ill Patients. A Case Report 平衡的重量：危重病人肝移植的麻醉管理。一个病例报告。

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2026-06-01 Epub Date: 2026-04-20 DOI: 10.1016/j.transproceed.2026.04.005

Priscilla Polanco Fernández , Daniela Yailén González Rodríguez , Laura Isabel Ruiz Torres , José Carlos Vera Gómez , Axel Sánchez Cedillo , Omar Vásquez Gómez , Ángel Augusto Pérez Calatayud , César Enrique Vásquez Corró , Carla Escorza Molina

{"title":"The Weight of Balance: Anesthetic Management in Liver Transplantation for Critically Ill Patients. A Case Report","authors":"Priscilla Polanco Fernández , Daniela Yailén González Rodríguez , Laura Isabel Ruiz Torres , José Carlos Vera Gómez , Axel Sánchez Cedillo , Omar Vásquez Gómez , Ángel Augusto Pérez Calatayud , César Enrique Vásquez Corró , Carla Escorza Molina","doi":"10.1016/j.transproceed.2026.04.005","DOIUrl":"10.1016/j.transproceed.2026.04.005","url":null,"abstract":"<div><h3>Background</h3><div>Liver transplantation in critically ill patients with multiple organ dysfunction poses a unique anesthetic challenge due to profound coagulopathy, hemodynamic instability, and metabolic derangements.</div></div><div><h3>Case Presentation</h3><div>We describe a 50-year-old male with alcoholic cirrhosis (MELD-Na 27) who underwent 2 consecutive liver transplants within 72 hours. The initial surgery involved aspiration of 15 L of purulent ascites and 8000 mL of blood loss. Advanced hemodynamic monitoring, balanced fluid therapy with albumin, vasopressor support (norepinephrine and vasopressin), goal-directed coagulation management (ROTEM), and strict metabolic control were implemented. Post-reperfusion hypotension and bradycardia were managed with adrenaline and atropine. Twelve hours later, he was reoperated for hemoperitoneum and subsequently underwent urgent retransplantation for hepatic artery thrombosis. Hemodynamic stability was achieved during the second procedure. Despite successful graft perfusion, the patient developed pneumonia and renal failure requiring replacement therapy, leading to a fatal outcome.</div></div><div><h3>Conclusion</h3><div>Physiology-guided anesthesia can sustain intraoperative stability in extreme scenarios, but outcome depends on preoperative physiological reserve and timing of intervention.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 5","pages":"Pages 907-909"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Longmire Type I in a Transplant Liver Graft: A Salvage Solution for Complex Hepaticojejunostomy Stricture Longmire I型肝移植：复杂肝空肠吻合术狭窄的修复方案。

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2026-06-01 Epub Date: 2026-05-18 DOI: 10.1016/j.transproceed.2026.02.028

Evangelia Florou , Yoh Zen , Nabil Kibriya , Michael Heneghan , Parthi Srinivasan , Andreas Prachalias

{"title":"Longmire Type I in a Transplant Liver Graft: A Salvage Solution for Complex Hepaticojejunostomy Stricture","authors":"Evangelia Florou , Yoh Zen , Nabil Kibriya , Michael Heneghan , Parthi Srinivasan , Andreas Prachalias","doi":"10.1016/j.transproceed.2026.02.028","DOIUrl":"10.1016/j.transproceed.2026.02.028","url":null,"abstract":"<div><h3>Background</h3><div>Liver transplantation using a left lateral segment (LLS) graft is a lifesaving procedure for pediatric recipients. While long-term graft function may remain well preserved, biliary complications can arise over time, threatening both graft viability and patient well-being. In some cases, endoscopic or radiological interventions may be infeasible or fail to provide durable relief. We present a case of a biliary anastomotic stricture following pediatric LLS transplantation, successfully managed using a rarely performed but technically valuable surgical approach, that of intrahepatic hepaticojejunostomy known as Longmire type I procedure.</div></div><div><h3>Case Report</h3><div>A 21-year-old female, who underwent LLS liver transplantation at 8 months of age for acute liver failure, presented with recurrent episodes of cholangitis. She had previously undergone complex biliary revision with 2 separate hepaticojejunostomies, but subsequently developed a stricture mainly involving the segment II bilio-enteric anastomosis. Radiological intervention failed to traverse the stricture. A segmental intrahepatic cholangio-jejunostomy, commonly referred to as the Longmire type I procedure, was performed successfully, relieving the obstruction and preserving graft function.</div></div><div><h3>Conclusion</h3><div>Biliary complications remain the Achilles’ heel of long-term liver transplant outcomes. While endoscopic and radiological interventions are typically first-line, surgical revision of hepaticojejunostomy is sometimes required. However, re-operative biliary surgery carries significant risks, especially in the context of previous revisions. Intrahepatic cholangio-jejunostomy offers a viable alternative in selected patients, as demonstrated in this case, which is the first of its kind reported in the literature following pediatric living donor liver transplantation.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 5","pages":"Pages 919-924"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to the Editor regarding “Anti-inflammatory Effects and Pharmacokinetics of Bupivacaine in Transversus Abdominis Plane Block for Living Liver Donors: A Prospective Randomized Clinical Trial” by Yalina et al 关于Yalina等人的“布比卡因在活体肝供者经腹平面阻滞中的抗炎作用和药代动力学：一项前瞻性随机临床试验”的致编辑信

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2026-06-01 Epub Date: 2026-06-04 DOI: 10.1016/j.transproceed.2026.04.017

Juan Fernando Cortés Pomar

引用次数: 0