Case Reports in Transplantation最新文献

{"title":"Techniques for Management of Portal Vein Thrombosis during Liver Transplantation.","authors":"Navdeep Singh, Kenneth Washburn, Sylvester Black, Austin Schenk","doi":"10.1155/2020/8875196","DOIUrl":"https://doi.org/10.1155/2020/8875196","url":null,"abstract":"Portal vein thrombosis (PVT) poses a unique challenge in liver transplant. The management of PVT differs according to the extent of thrombosis. Anastomosis of a donor portal vein to a varix is a viable option when an adequate size varix is identified on preoperative imaging or intraoperatively. Here, we describe our experience in two liver transplant cases with cavernous transformation of the portal vein where the donor portal vein was anastomosed to a varix using a donor iliac vein interposition graft.","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2020 ","pages":"8875196"},"PeriodicalIF":0.0,"publicationDate":"2020-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8875196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38460689","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}

{"title":"Temporal Change in Blood Group after Bone Marrow Transplant: A Case of Successful ABO-Incompatible Deceased Donor Transplant.","authors":"Susanna Lam,&nbsp;Sebastian Hultin,&nbsp;John Preston,&nbsp;Scott Campbell","doi":"10.1155/2020/7461052","DOIUrl":"https://doi.org/10.1155/2020/7461052","url":null,"abstract":"<p><p>ABO-incompatible kidney transplantation has been successfully utilised in a deceased donor and living donor kidney transplantation to improve organ utilisation and decrease waiting times. We describe a case of a successful, unanticipated ABO-incompatible donation after cardiac death (DCD) kidney transplant in a patient who had a previous ABOi haematopoietic stem cell transplant (HSCT) and had reverted to his original blood group B, after matching as a blood group A recipient with a blood group A donor. The recipient was unsensitized with a cPRA which was 0% and no donor-specific antibodies and zero HLA mismatch. An urgent anti-A titre was 1 : 2. Given the low antibody titres, we proceeded to transplantation. The patient developed delayed graft function and required dialysis on postoperative day 1 and day 2. The creatinine fell spontaneously on day 5, with progressively increased urine output and stable graft function on discharge at day 6. Anti-A titres were 1 : 1 on serial postoperative measurements. There were no rejection episodes, and the patient has a functioning graft at 16 months posttransplant. We describe a rare case in which the blood group can change after stem cell transplant and should be checked. We also demonstrate that a DCD ABOi transplant in the context of low anti-A titres for a patient with previous ABOi stem cell transplant can be performed successfully with standard immunosuppression.</p>","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2020 ","pages":"7461052"},"PeriodicalIF":0.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/7461052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38247843","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}

{"title":"Posttransplant Intrarenal Lymphangiectasia.","authors":"Ali Kord,&nbsp;Enrico Benedetti,&nbsp;James T Bui","doi":"10.1155/2020/8824833","DOIUrl":"https://doi.org/10.1155/2020/8824833","url":null,"abstract":"<p><p>Renal lymphangiectasia is an extremely rare benign condition in the setting of transplanted kidneys. We describe a 50-year-old female with a past medical history of lupus nephritis and renal transplants who presented with right lower quadrant pain and was found to have intrarenal lymphangiectasia on imaging and laboratory tests. The patient was treated with percutaneous drainage initially and then wide peritoneal fenestration and omentoplasty. An extremely rare adult case with intrarenal lymphangiectasia thirteen months after kidney transplant was described in this study. Imaging, particularly computed tomography (CT) and magnetic resonance imaging (MRI), plays a key role in the diagnosis of renal lymphangiectasia.</p>","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2020 ","pages":"8824833"},"PeriodicalIF":0.0,"publicationDate":"2020-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8824833","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38247844","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}

{"title":"Effectiveness of Factor XIII Infusion in Treatment of Refractory Ureteral Leakage after Kidney Transplantation.","authors":"Ryoichi Maenosono,&nbsp;Tomohisa Matsunaga,&nbsp;Hajime Hirano,&nbsp;Hayahito Nomi,&nbsp;Shunri Taniguchi,&nbsp;Yuya Fujiwara,&nbsp;Koichiro Minami,&nbsp;Hirofumi Uehara,&nbsp;Teruo Inamoto,&nbsp;Haruhito Azuma","doi":"10.1155/2020/1780760","DOIUrl":"https://doi.org/10.1155/2020/1780760","url":null,"abstract":"<p><p>Despite the evolution of transplantation techniques, urological complications are common and result in loss of graft. We report the case of a 57-year-old man who developed continuous urine leakage despite pyeloureteral neoanastomosis and stenting after kidney transplantation from his dizygotic twin. Suspecting ureteral leakage, we performed pyeloureteral neoanastomosis using his native right ureter and a ureteral stent 5 days after the kidney transplant. However, urine leakage continued for several days. Because the plasma factor XIII level decreased to 48%, we administered factor XIII products (Fibrogammin P; CSL Behring, King of Prussia, PA) after the surgery. Although its utility and safety in patients with renal failure and/or transplantation are unclear, urine leakage stopped after the infusion of fibrogammin without any side effects. This is the first case report of the use of factor XIII for refractory urine leakage after kidney transplantation. Although further studies are needed, administration of factor XIII products could be one option for refractory urine leakage after transplantation.</p>","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2020 ","pages":"1780760"},"PeriodicalIF":0.0,"publicationDate":"2020-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1780760","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38203899","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}

{"title":"Pneumatosis Intestinalis in Adult Bilateral Lung Transplant Patients: A Single Institution Experience and Literature Review.","authors":"Eric Christiansen,&nbsp;Nisha Singh,&nbsp;Amy Trahan,&nbsp;Sofya Tokman,&nbsp;David Row,&nbsp;Olga Kalinkin","doi":"10.1155/2020/5023948","DOIUrl":"https://doi.org/10.1155/2020/5023948","url":null,"abstract":"<p><p>Pneumatosis intestinalis (PI) is a radiologic finding which is characterized by the accumulation of gas within the bowel wall. This radiologic finding is traditionally thought of in the sense of intestinal ischemia. An uncommon cause of this finding is post organ transplantation. We did an institutional and literature review of this finding to demonstrate its distinct imaging features and benign nature. It was observed to occur in approximately 5.2% of patients post lung transplant (23/442). On imaging, it displays an expansile/bubbly appearance of gas within the bowel wall that is distinct from the traditional findings seen in intestinal ischemia. Clinical review showed that posttransplant patients with PI can be successfully managed conservatively with early enteral nutrition, oxygen, antibiotics, and limited follow-up imaging. With the increasing use of organ transplantation, PI is being diagnosed with increased frequency. It is important to let clinicians know of this entity and its potential outcomes.</p>","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2020 ","pages":"5023948"},"PeriodicalIF":0.0,"publicationDate":"2020-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5023948","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38238737","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}

{"title":"Kidney Transplantation for Erdheim-Chester Disease.","authors":"Jongwon Yoo,&nbsp;Cynthia Gunsteen,&nbsp;Sima Patel,&nbsp;Ted Clevy-Schneller,&nbsp;Sucha Nand,&nbsp;Divya Jain,&nbsp;Raquel Garcia-Roca,&nbsp;Amishi Desai,&nbsp;Sanjeev Akkina","doi":"10.1155/2020/3954165","DOIUrl":"https://doi.org/10.1155/2020/3954165","url":null,"abstract":"<p><p>Erdheim-Chester disease is a rare inflammatory disease that infiltrates skeletal and extra-skeletal tissue. Chronic kidney disease (CKD) in Erdheim-Chester disease is usually attributed to retroperitoneal lesions that lead to urologic obstruction and hydronephrosis. In this report, we describe a patient diagnosed with Erdheim-Chester disease who eventually developed end-stage kidney disease (ESKD). After complete remission of Erdheim-Chester disease by vemurafenib therapy and 2 years of hemodialysis, the patient underwent a deceased donor kidney transplantation with basiliximab induction and tacrolimus/mycophenolic acid maintenance. After conversion of mycophenolic acid to azathioprine due to cost, acute cellular rejection had occurred, and he was treated with steroid therapy. The patient remained in complete remission from Erdheim-Chester disease and dialysis-free 16 months after transplant. Kidney transplantation is another treatment option for those patients with Erdheim-Chester disease who suffer from renal failure in the setting of complete remission.</p>","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2020 ","pages":"3954165"},"PeriodicalIF":0.0,"publicationDate":"2020-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/3954165","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38238736","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}

{"title":"Repair with Gonadal Vein Patch in the Unexpected Left Renal Vein Injury During Donor Nephrectomy","authors":"M. F. Yuzbasioglu, A. Isler, S. Topuz, Alper Boz, O. Peker, N. Özer","doi":"10.31487/j.tcr.2020.01.06","DOIUrl":"https://doi.org/10.31487/j.tcr.2020.01.06","url":null,"abstract":"Objective: The objective of this presentation is to share our experiences with an unusual repair of a defective\u0000graft renal vein using an own gonadal vein, which occurred iatrogenically during a laparoscopic donor\u0000nephrectomy.\u0000Case Report: A 35-year-old man with situs inversus totalis was referred to our clinic for a living-related\u0000renal transplant with a diagnosis of end-stage renal disease. The donor was 66-year-old mother of the patient.\u0000Laparoscopic left donor nephrectomy was planned for his mother . At the end of laparascopic disection renal\u0000vein tear occurred during the renal extraction. Without any intervention renal extraction was performed to\u0000maintain the patency of renal allograft and to stabilize the donor. Partial hemorrhage from renal vein was\u0000brought under control. Donor nephrectomy was completed with a defective remaining segment of renal\u0000vein. We decided to repair with gonadal vein patch ın the unexpected renal vein injury. Patch from tearing\u0000part of renal vein with short gonadal vein repairment was performed. After repairment of graft renal vein,\u0000anastomosis to external iliac vein was performed. The trans-plant procedure was completed successfully.\u0000The kidney functioned immediately. Doppler ultrasound revealed that perfusion of the kidney was normal.\u0000The postoperative creatinine levels of recipient were in the normal ranges. Daily urine output was normal.\u0000Conclusion: Repairment of a defective graft renal vein by using own gonadal vein seems to be a simple,\u0000safe, and reliable method. This technique provides an alternative approach for the reconstruction of vessels\u0000in living-donor kidney transplants.","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78218637","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}

{"title":"Kidney Transplant and Ileal Conduit Diversion on the Same Surgical Procedure: Clinical Case and Review of the Literature","authors":"P. D. López, J. E. R. García, J. Vives, C. Castañé, S. Chiva, A. G. Cortés, J. F., Ancizu Marckert, G. Bernardos, M. T. Roca, G. A. Boville, F. Chillón, F., Villacampa Aubá, D. R. Costa, F. Alonso, B. M. López, J. I. P. Piédrola","doi":"10.31487/j.tcr.2020.02.02","DOIUrl":"https://doi.org/10.31487/j.tcr.2020.02.02","url":null,"abstract":"Introduction: There are multiple causes of end-stage renal disease (ESRD). One of the most uncommon\u0000cause is the obstruction of the lower urinary tract due to the development of new endourological procedures\u0000and the improvement in clean intermittent catheterization. However, urodynamic problems that require\u0000solutions to bladder problems continue to appear that will directly affect the function of the kidney graft.\u0000Objective: Clearly state the possibility of performing a bladder conduit technique at the same time as a\u0000kidney transplant as an option for patients who undergo kidney transplantation with incompetent bladders.\u0000A clinical case is described as an example.\u0000Material and Methods: The clinical case of a patient with left cutaneous ureterostomy due to neurogenic\u0000bladder who is a candidate for renal transplant is presented. An ileal conduit type urinary diversion is\u0000performed in the same surgical act as the renal transplant. The existing literature is analyzed in relation to\u0000the different types of urinary diversion and how they affect renal function.\u0000Clinical Case and Results: Here we present a 50-year-old male with hypotonic bladder since 19th years old\u0000secondary to sacral lipectomy. He developed a progressive deterioration of renal function until he started\u0000hemodialysis program in 2018. Ileal conduit and renal transplant are performed through right pararectal\u0000incision, reimplantation of the ureter in the antimesenteric side of the intestinal loop. No increase of\u0000complications was observed in the post-transplant. The patient was discharged the 7th day after surgery.\u0000Serum creatinine at 6 months after renal transplantation 1.2mg/dl.\u0000Conclusion: Ileal conduit is a valid resource in patients with neurogenic bladders or with emptying\u0000problems whose solution puts at risk the functionality of the graft. Similar recovery is observed in time\u0000compared to a kidney transplant without ileal shunt. Post-transplant graft function was good without an\u0000increase in complications.","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74469016","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}

{"title":"Cryptococcal Pneumonia in a Pediatric Patient with Renal Transplantation","authors":"B. Ekici, C. Kabasakal, Cemaliye Başaran, I. Bulut, S. Taner","doi":"10.31487/j.tcr.2020.01.08","DOIUrl":"https://doi.org/10.31487/j.tcr.2020.01.08","url":null,"abstract":"Cryptococcosis is a significant opportunistic infection in solid organ transplant recipients. Patients may have\u0000asymptomatic colonization or symptoms of isolated pulmonary disease and severe pneumonia. The disease\u0000is diagnosed by culture, direct microscopy or detection of cryptococcal antigen in the body fluid or tissues.\u0000We herein present a C. neoformans pneumonia in a renal transplant patient. An 18-year-old male, renal\u0000transplanted from his mother, admitted to hospital due to increase in creatinine. On physical examination,\u0000there was no finding other than hypertension and operation scar. Urea and creatinine were increased. Renal\u0000doppler USG revealed increased renal parenchymal echogenicity. Immunosuppressive drug levels were in\u0000normal range. Renal biopsy was consistent with acute cellular rejection and treatment was started. Fever\u0000appeared on the following week. Immunosuppressants doses were reduced; antibiotics started empirically.\u0000HRCT revealed multiple nodules, lymphadenopathies and pleural effusion. C. neoformans was detected in\u0000blood culture. Detailed history revealed the patient was pigeon feeder. Amphotericin B and fluconazole was\u0000started. On follow up BPAP was needed owing respiratory distress. Blood culture became negative on the\u000013th day of treatment. The treatment of the patient was completed in six weeks and followed by prophylaxis.\u0000The patient is now being followed up at baseline creatinine 1.73 mg / dl in the 1st year after discharge. We\u0000would like to remind that opportunistic fungal infections may also be the cause of fever in solid organ\u0000transplant patients. It should be noted these infections may result with high mortality without early diagnosis\u0000and appropriate treatment.","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84173723","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}

{"title":"Proton Pump Inhibitor-Induced Galactorrhea in a Kidney Transplant Recipient: A Friend or Foe?","authors":"Marios Prikis,&nbsp;Julie MacDougall,&nbsp;Nina Narasimhadevara","doi":"10.1155/2020/8108730","DOIUrl":"https://doi.org/10.1155/2020/8108730","url":null,"abstract":"<p><p>Over the last decades, proton pump inhibitors (PPIs) have been widely used as the mainstay for treatment and prevention of gastrointestinal side effects, gastroesophageal reflux, and peptic ulcer disease. However, their safety profile has come into question recently after reports relating them to several side effects as well as kidney disease. Omeprazole, one of the mainly used PPIs, is almost entirely metabolized by the liver but the resulting metabolites are renally excreted. These metabolites may inhibit cytochrome P450 2C19 (CYP2C19) and cytochrome P450 3A4 (CYP3A4) reversibly, but as recent evidence suggests, they may also be involved in causing kidney disease. In the setting of renal dysfunction, these metabolites will not be excreted from the body and will accumulate further causing kidney damage and inhibiting CYP enzymes to a greater extent. Abnormally high serum prolactin levels leading to galactorrhea may be the result of such an accumulation. To our knowledge, there have been only three previously reported cases of PPI-induced galactorrhea in the literature but none in a kidney transplant recipient. In patients with established kidney disease and reduced glomerular filtration rate like kidney transplant recipients, the use of PPIs should be thoroughly assessed. Reduced clearance of their metabolites may lead to progression of the kidney disease and lead to more unwanted side effects. We present a case of a female kidney transplant recipient with worsening allograft function who presented with sudden galactorrhea and hyperprolactinemia while on a high-dose omeprazole for gastroesophageal reflux disease.</p>","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2020 ","pages":"8108730"},"PeriodicalIF":0.0,"publicationDate":"2020-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8108730","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38073537","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}