Case Reports in Transplantation最新文献_第10页

Nontraditional Use of TEE to Evaluate Hepatic Vasculature and Guide Surgical Management in Orthotopic Liver Transplantation 非传统TEE评价肝血管和指导原位肝移植手术管理

Case Reports in Transplantation Pub Date : 2019-06-19 DOI: 10.1155/2019/5293069

Narjeet Khurmi, M. Šeman, B. Gaitan, S. Young, David M Rosenfeld, E. Giorgakis, W. Hewitt, A. Mathur

{"title":"Nontraditional Use of TEE to Evaluate Hepatic Vasculature and Guide Surgical Management in Orthotopic Liver Transplantation","authors":"Narjeet Khurmi, M. Šeman, B. Gaitan, S. Young, David M Rosenfeld, E. Giorgakis, W. Hewitt, A. Mathur","doi":"10.1155/2019/5293069","DOIUrl":"https://doi.org/10.1155/2019/5293069","url":null,"abstract":"Intraoperative Transesophageal Echocardiography (TEE) during orthotopic liver transplant (OLT) is used to gather real-time information on cardiovascular function and intravascular volume status. We report a case where nonstandard TEE views were used to inspect the hepatic vasculature after allograft implantation. A 29-year-old male with secondary biliary cirrhosis with a MELD score of 20 underwent OLT using a liver from a 21-year-old brain-dead donor. Postreperfusion TEE, using the modified hepatic vein views, confirmed the presence of an inferior vena cava (IVC) suprahepatic anastomotic stenosis and hepatic vein and IVC thrombus resulting in hepatic venous outflow obstruction, allograft congestion, and hemodynamic instability. These nonstandard TEE images established the extent of suprahepatic caval outflow obstruction, in which intraoperative ultrasound was unable to definitively demonstrate. This guided real-time surgical decision-making in the postimplantation phase of the operation—ultimately leading to hepatic vein and IVC thrombectomy and revision of suprahepatic caval anastomosis.","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80653982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Pulmonary Type B Niemann-Pick Disease Successfully Treated with Lung Transplantation 肺移植成功治疗肺B型尼曼-皮克病

Case Reports in Transplantation Pub Date : 2019-06-16 DOI: 10.1155/2019/9431751

R. O’Neill, N. Belousova, M. Malouf

{"title":"Pulmonary Type B Niemann-Pick Disease Successfully Treated with Lung Transplantation","authors":"R. O’Neill, N. Belousova, M. Malouf","doi":"10.1155/2019/9431751","DOIUrl":"https://doi.org/10.1155/2019/9431751","url":null,"abstract":"Background Niemann-Pick Disease (NPD) type B is a rare autosomal recessive disease characterised by hepatosplenomegaly and pulmonary disease, highlighted by preserved volumes and diminished diffusion capacity of the lung for carbon monoxide (DLCO) on pulmonary function tests (PFTs). There is no current accepted treatment for the disease. We present a case of a successful bilateral lung transplant in a patient with a DLCO of 14%, and significant pulmonary changes attributable to NPD type B on computed tomography (CT) chest, and both microscopic and macroscopic assessment of the lung explant. To the author's knowledge this is only the third case of lung transplantation in a patient with NPD type B and is one of two current living patients post lung transplantation for NPD type B. Case Report A 64-year-old male patient underwent bilateral lung transplantation for NPD type B. Preoperative PFTs demonstrated preserved volumes with significantly decreased DLCO, with imaging showing a diffuse reticular interstitial pattern, typical of chronic fibrotic lung disease. The patient suffered from primary graft dysfunction type 3 in the postoperative period as well as rejection managed with methylprednisolone and intravenous immunoglobulin. The patient improved steadily and was discharged 80 days post-transplantation. Conclusions This case is only the third reported case of lung transplantation in a patient with NPD type B and the second case of a patient with NPD type B currently living post-transplantation, being at postoperative day (POD) 267 at the time of manuscript drafting. It demonstrates that lung transplantation, although hazardous, is a viable strategy for treatment in patients with NPD type B who have significant pulmonary involvement.","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84230498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Mesenchymal Stem Cell Therapy Overcomes Steroid Resistance in Severe Gastrointestinal Acute Graft-Versus-Host Disease. 间充质干细胞治疗克服严重胃肠道急性移植物抗宿主病的类固醇抵抗。

Case Reports in Transplantation Pub Date : 2019-05-21 eCollection Date: 2019-01-01 DOI: 10.1155/2019/7890673

Kyoko Moritani, Reiji Miyawaki, Kiriko Tokuda, Fumihiro Ochi, Minenori Eguchi-Ishimae, Hisamichi Tauchi, Mariko Eguchi, Eiichi Ishii, Kozo Nagai

{"title":"Mesenchymal Stem Cell Therapy Overcomes Steroid Resistance in Severe Gastrointestinal Acute Graft-Versus-Host Disease.","authors":"Kyoko Moritani, Reiji Miyawaki, Kiriko Tokuda, Fumihiro Ochi, Minenori Eguchi-Ishimae, Hisamichi Tauchi, Mariko Eguchi, Eiichi Ishii, Kozo Nagai","doi":"10.1155/2019/7890673","DOIUrl":"https://doi.org/10.1155/2019/7890673","url":null,"abstract":"The authors describe the high effectiveness of human mesenchymal stem cell (hMSC) therapy to treat steroid-refractory gastrointestinal acute graft-versus-host Disease (aGVHD) in a 15-year-old boy with acute lymphoblastic leukemia (ALL). He received allogeneic hematopoietic stem cell transplantation due to high-risk hypodiploid ALL. Around the time of engraftment, he developed severe diarrhea following high-grade fever and erythema. Although methylprednisolone pulse therapy was added to tacrolimus and mycophenolate mofetil, diarrhea progressed up to 5000~6000 ml/day and brought about hypocalcemia, hypoalbuminemia, and edema. Daily fresh frozen plasma (FFP), albumin, and calcium replacements were required to maintain blood circulation. After aGVHD was confirmed by colonoscopic biopsy, MSC therapy was administered. The patient received 8 biweekly intravenous infusions of 2×106 hMSCs/kg for 4 weeks, after which additional 4 weekly infusions were performed. A few weeks after initiation, diarrhea gradually resolved, and at the eighth dose of hMSC, lab data improved without replacements. MSC therapy successfully treated steroid-refractory gastrointestinal GVHD without complications. Despite life-threatening diarrhea, the regeneration potential of children and adolescents undergoing SMC therapy successfully supports restoration of gastrointestinal damage. Even with its high treatment costs, SMC therapy should be proactively considered in cases where young patients suffer from severe gastrointestinal GVHD.","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2019 ","pages":"7890673"},"PeriodicalIF":0.0,"publicationDate":"2019-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/7890673","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37389809","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: 9

Chronically Retained Central Venous Catheter in Deceased Donor Liver Allograft. 长期留置中心静脉导管在已故同种异体供肝移植中的应用。

Case Reports in Transplantation Pub Date : 2019-04-30 eCollection Date: 2019-01-01 DOI: 10.1155/2019/4359197

Shannon Zielsdorf, Beau Kelly, Yuri Genyk, Juliet Emamaullee

引用次数: 0

An Atypical Case of Shiga Toxin Producing-Escherichia Coli Hemolytic and Uremic Syndrome (STEC-HUS) in a Lung Transplant Recipient. 肺移植受者发生志贺毒素产生-大肠杆菌溶血性尿毒症综合征(STEC-HUS)的非典型病例。

Case Reports in Transplantation Pub Date : 2019-04-11 eCollection Date: 2019-01-01 DOI: 10.1155/2019/9465040

Louis Manière, Camille Domenger, Boubou Camara, Diane Giovannini, Paolo Malvezzi, Lionel Rostaing

引用次数: 3

Accelerated Oxalosis Contributing to Delayed Graft Function after Renal Transplantation. 加速草化病导致肾移植后移植物功能延迟。

Case Reports in Transplantation Pub Date : 2019-03-25 eCollection Date: 2019-01-01 DOI: 10.1155/2019/8942062

Yvelynne P Kelly, Astrid Weins, Melissa Y Yeung

{"title":"Accelerated Oxalosis Contributing to Delayed Graft Function after Renal Transplantation.","authors":"Yvelynne P Kelly, Astrid Weins, Melissa Y Yeung","doi":"10.1155/2019/8942062","DOIUrl":"https://doi.org/10.1155/2019/8942062","url":null,"abstract":"Hyperoxaluria is an important and underrecognized cause for allograft dysfunction and loss after transplantation. It is potentially treatable if recognized in a timely fashion. Research is ongoing to expand the array of therapeutic options available to treat this. We present a case of a 59-year-old gentleman who underwent deceased donor renal transplantation that was complicated by delayed graft function necessitating continuation of renal replacement therapy. His initial biopsy showed extensive acute tubular necrosis with associated peritubular capillaritis and interstitial nephritis and oxalate crystals in several tubules. Despite receiving methylprednisolone to treat moderate acute cellular rejection, he remained dialysis dependent with minimal urine output. An interval renal allograft biopsy revealed residual acute tubular necrosis with extensive oxalate crystals now visible in many tubules. His plasma oxalate level was concurrently elevated to 19.3 μmol/L (reference range ≤ 1.9 μmol/L). He commenced calcium citrate to manage his hyperoxaluria and ultimately became dialysis independent at 3 weeks after transplantation. This case provides an important example of accelerated oxalate nephropathy as an underappreciated contributor to delayed graft function after renal transplantation. Our accompanying discussion provides an update on current therapeutic measures for managing this challenging condition.","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2019 ","pages":"8942062"},"PeriodicalIF":0.0,"publicationDate":"2019-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/8942062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37345422","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: 4

Postinfectious Acute Glomerulonephritis in Renal Transplantation: An Emergent Aetiology of Renal Allograft Loss. 肾移植感染后急性肾小球肾炎:异体肾移植损失的紧急病因学。

Case Reports in Transplantation Pub Date : 2019-03-18 eCollection Date: 2019-01-01 DOI: 10.1155/2019/7438254

Alícia Molina-Andújar, Enrique Montagud-Marrahí, David Cucchiari, Pedro Ventura-Aguiar, Erika De Sousa-Amorim, Ignacio Revuelta, Frederic Cofan, Manel Solé, Adriana García-Herrera, Fritz Diekmann, Esteban Poch, Luis F Quintana

{"title":"Postinfectious Acute Glomerulonephritis in Renal Transplantation: An Emergent Aetiology of Renal Allograft Loss.","authors":"Alícia Molina-Andújar, Enrique Montagud-Marrahí, David Cucchiari, Pedro Ventura-Aguiar, Erika De Sousa-Amorim, Ignacio Revuelta, Frederic Cofan, Manel Solé, Adriana García-Herrera, Fritz Diekmann, Esteban Poch, Luis F Quintana","doi":"10.1155/2019/7438254","DOIUrl":"https://doi.org/10.1155/2019/7438254","url":null,"abstract":"Despite the high incidence of posttransplant infections, postinfectious acute glomerulonephritis (PIAGN) in renal allograft is a rare entity, without effective treatment and a bad prognosis. We describe two cases of PIAGN: the first one was developed 2 years after kidney transplantation, secondary to Staphylococcus aureus bacteremia with presence of extracapillary proliferation in biopsy. The patient was treated with methylprednisolone and plasma exchanges without response, remaining dialysis dependent. The second case was reported 5 years after kidney transplantation, secondary to influenza A infection. Kidney biopsy showed an IgA-dominant PIAGN and methylprednisolone boluses were initiated without clinical response, suffering a progressive worsening and loss of kidney graft. Due to the aggressive clinical course of this entity, PIAGN should be considered in the differential diagnosis of acute kidney graft failure in the context of an infection. Elderly patients have a higher risk of more severe acute renal dysfunction, requiring dialysis in a great proportion of cases.","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2019 ","pages":"7438254"},"PeriodicalIF":0.0,"publicationDate":"2019-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/7438254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37177079","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: 1

Gastric Mucormycosis in a Renal Transplant Patient Treated with Isavuconazole Monotherapy. 异戊康唑单药治疗肾移植患者胃粘膜真菌病1例。

Case Reports in Transplantation Pub Date : 2019-03-17 eCollection Date: 2019-01-01 DOI: 10.1155/2019/9839780

Imran Gani, Atbin Doroodchi, Kristina Falkenstrom, Holly Berry, Won Lee, Laura Mulloy, Muhammad Saeed, Rajan Kapoor

{"title":"Gastric Mucormycosis in a Renal Transplant Patient Treated with Isavuconazole Monotherapy.","authors":"Imran Gani, Atbin Doroodchi, Kristina Falkenstrom, Holly Berry, Won Lee, Laura Mulloy, Muhammad Saeed, Rajan Kapoor","doi":"10.1155/2019/9839780","DOIUrl":"https://doi.org/10.1155/2019/9839780","url":null,"abstract":"Gastrointestinal mucormycosis is a rare infection in solid organ transplant recipients. Our patient, a 79-year-old male, presented with severe dysphagia and odynophagia about 2 weeks after receiving a renal transplant. An upper gastrointestinal (UGI) endoscopy revealed esophagitis and gastric ulceration, the cultures from which grew Rhizopus species. A usual treatment strategy should include Amphotericin B as monotherapy or in combination with Posaconazole or Isavuconazole for such infections. Our patient was treated with Isavuconazole monotherapy, in an effort to minimize renal toxicity from Amphotericin B to the new allograft. Unique to our case was a successful clinical response and resolution of UGI lesions with Isavuconazole monotherapy. Due to the vagueness of presenting symptoms, such infections can be easily missed in an immunocompromised patient which can have tragic outcomes. Prompt diagnosis and modulation of immunosuppression are essential to decrease mortality and morbidity. Isavuconazole is a novel agent and can be used as a monotherapy for such infections, especially in renal transplant recipients.","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2019 ","pages":"9839780"},"PeriodicalIF":0.0,"publicationDate":"2019-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/9839780","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37170930","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: 10

Vascular Reconstructions in Living Unrelated Kidney Transplant Using Donor Ovarian Vein and Recipient Inferior Epigastric Artery with Simultaneous Enucleation of a Complex Cyst. 利用供体卵巢静脉和受体腹壁下动脉重建无亲缘关系活体肾移植血管并同时去核复杂囊肿。

Case Reports in Transplantation Pub Date : 2019-03-13 eCollection Date: 2019-01-01 DOI: 10.1155/2019/3272080

Giuseppe Serena, Javier Gonzalez, Giselle Guerra, Mohamed Ammar Al Nuss, Maykel Valdes, Gaetano Ciancio

{"title":"Vascular Reconstructions in Living Unrelated Kidney Transplant Using Donor Ovarian Vein and Recipient Inferior Epigastric Artery with Simultaneous Enucleation of a Complex Cyst.","authors":"Giuseppe Serena, Javier Gonzalez, Giselle Guerra, Mohamed Ammar Al Nuss, Maykel Valdes, Gaetano Ciancio","doi":"10.1155/2019/3272080","DOIUrl":"https://doi.org/10.1155/2019/3272080","url":null,"abstract":"Increasing the organ donor pool and solving the recipient demands continue to be one of the challenges in transplantation. We report our experience in transplanting a living donor kidney requiring complex vascular reconstructions and an enucleation of complex cyst. A 57-year-old male patient underwent a living unrelated kidney transplant. The living donor kidney was procured through a laparoscopic hand-assisted right donor nephrectomy. After vascular stapling, the kidney had a short upper pole arterial branch, a short renal vein (3 mm), and a complex upper pole cyst. The renal vein was elongated using the donor ovarian vein and the short upper pole artery was extended using the recipient inferior epigastric artery and anastomosed to the main renal artery. The renal allograft vessels were anastomosed end-to-side to the external iliac vessels. The complex cyst was removed performing an enucleation with a rim of normal tissue and reconstruction of the calyceal system. This case represents three different surgical reconstructions in order to make the organ available for transplantation. In some circumstances, complex vascular reconstruction of living donor kidney with removal of complex cyst represents a strategy to expand the donor pool.","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2019 ","pages":"3272080"},"PeriodicalIF":0.0,"publicationDate":"2019-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/3272080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37165422","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: 1

Unusual Presentation of Hemophagocytic Lymphohistiocytosis in a Kidney Transplant Patient. 肾移植患者异常表现的噬血细胞淋巴组织细胞增多症。

Case Reports in Transplantation Pub Date : 2019-03-10 eCollection Date: 2019-01-01 DOI: 10.1155/2019/3682378

Danwen Yang, Natanong Thamcharoen, Chelsea Marcus, Andreas Varkaris, William Aird, Eliyahu V Khankin, Francesca Cardarelli

引用次数: 5