Transplantation Reports最新文献

{"title":"Denosumab treatment for osteopenia or osteoporosis in heart transplant recipients: Effects and safety","authors":"Juan C. Uzquiano ,&nbsp;Ana Alonso Méndez ,&nbsp;Álvaro Juano Bielsa ,&nbsp;María Dolores García-Cosío Carmena ,&nbsp;Juan F. Delgado Jiménez ,&nbsp;Paz Sanz-Ayán","doi":"10.1016/j.tpr.2022.100103","DOIUrl":"10.1016/j.tpr.2022.100103","url":null,"abstract":"<div><h3>Background</h3><p>Osteoporosis is a prevalent complication in heart transplant population. Denosumab is a monoclonal antibody that inhibits bone resorption approved for the treatment of corticosteroid-induced osteoporosis and potentially useful in heart transplant recipients.</p></div><div><h3>Objective</h3><p>To describe the metabolic and densitometric effects of denosumab in these patients, as well as the adverse effects observed.</p></div><div><h3>Methods</h3><p>We performed a study of 9 transplant patients between 2014 and 2019 who were treated with denosumab for osteopenia or osteoporosis. All patients received postoperative calcium and vitamin D supplements. We measured the changes in densitometric and metabolic variables and compared them by Student's t-test.</p></div><div><h3>Results</h3><p>After therapy, bone mineral density (BMD) and Tscore at lumbar spine improved a mean of 0.0458 and 0.5000, respectively (<em>p</em> &lt; 0.05). The mean increase of BMD was 6.09% at lumbar spine and 7.84% at femoral neck. There was a case of abrupt decrease of BMD at total hip. A decrease in magnesium levels was observed after a dose of denosumab (<em>p</em> &lt; 0.05), which included 1 case of hypomagnesemia. There were 2 cases of hypophosphatemia, and none of hypocalcaemia. 77.78% of the patients had infections, one of them serious.</p></div><div><h3>Conclusion</h3><p>Denosumab was shown to improve BMD at lumbar spine and could be a valid alternative for the treatment of osteoporosis in heart transplant patients. The risk of hypocalcaemia could be minimized with calcium adjustment prior to starting treatment. More studies are needed to assess its effects and the risk of infections.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"7 3","pages":"Article 100103"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959622000117/pdfft?md5=62939aa6073f2b5ab3793b69df990b7b&pid=1-s2.0-S2451959622000117-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43856947","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":"Cardiopulmonary death donation","authors":"Hassan Argani","doi":"10.1016/j.tpr.2022.100104","DOIUrl":"10.1016/j.tpr.2022.100104","url":null,"abstract":"","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"7 3","pages":"Article 100104"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959622000129/pdfft?md5=eaa45dd395116b9943f5d80f832ea8e9&pid=1-s2.0-S2451959622000129-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46939349","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":"Pancreas transplantation from donors after cardiac death – The US experience","authors":"Angelika C. Gruessner,&nbsp;Subodh J. Saggi,&nbsp;Rainer W.G. Gruessner","doi":"10.1016/j.tpr.2022.100099","DOIUrl":"10.1016/j.tpr.2022.100099","url":null,"abstract":"<div><h3>Introduction</h3><p>Since the beginning of pancreas transplantation, the rate of donation after cardiac (or circulatory) death (DCD) accounts for only 3% of all transplants in the US. This is the result of perceived higher complication rates and overall worse outcome with DCD donors. Such misconceptions and an increased demand for deceased donor (DD) organs warrant a systematic review of the use of DCD compared with donation after brain death (DBD) pancreata to objectively assess DCD outcome after pancreas transplantation in the US.</p></div><div><h3>Methods</h3><p>All 22,160 DD pancreas transplants performed in diabetic patients between 1/1/2001 and 12/31/2020 were included in this analysis. To assess changes in outcomes, patient and graft survival was computed using the Kaplan-Meier method in 5-year intervals. Comprehensive univariate and multivariable comparisons of posttransplant complications and patient and pancreas and kidney graft survival between DCD and DBD pancreas transplants were performed to assess the donor impact.</p></div><div><h3>Results</h3><p><u>In the US</u> over the past 20 years most DCD donors were used for simultaneous pancreas and kidney (SPK) transplants and less often for solitary pancreas transplants. DCD transplants never accounted for more than 4% per year of all pancreas transplants. A comparison of the pancreas donor risk index (pDRI) between DCD and DBD pancreata showed that the only distinguishing factor was DCD donation. SPK patient, pancreas, and kidney graft survival for DCD donors did not change significantly over time. One- and 3 -year DCD patient survival reached 96% and 93%, pancreas graft survival 90% and 84%, and kidney graft survival 96% and 91%, respectively. For the last decade, no differences in patient and graft survival between DCD and DBD donors were detected (<em>P</em> &gt; 0.67). The relative risk for the use of a DCD donor was not increased (<em>P</em> &gt; 0.6). Influential risk factors were older donor and recipient age as well as longer preservation times. Larger transplant center accepted DCD donors more frequently and showed better outcome. While the rate of early pancreas complications was the same for DCD vs. DBD transplants, delayed kidney graft function was significantly higher in DCD kidneys secondary to more long-distance shipping across the country. The multivariable analysis showed a 4-times higher rate in delayed graft function. Longer cold preservation time and older donor age further increased the risk of graft failure. The use of machine perfusion of the kidney graft reduced the relative risk of delayed graft function by 50%.</p></div><div><h3>Summary</h3><p>The use of DCD donor organs in pancreas transplantation is not associated with higher failure or complication rates in the US. A pancreas offer from a DCD donor should not be the sole reason to decline the organ for transplantation. Careful selection of specific donor and recipient factors, as well as advanced pr","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"7 2","pages":"Article 100099"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959622000087/pdfft?md5=f94611bb9a3a6d6d06e04ed30055914f&pid=1-s2.0-S2451959622000087-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48798861","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":"L-arginine prevents ischemic injury in explanted rat intestinal regions in an ex vivo perfusion model","authors":"Michele Finotti ,&nbsp;Maria Barahona ,&nbsp;Renee M. Maina ,&nbsp;Taras Lysyy ,&nbsp;Raghav Agarwal ,&nbsp;Phillip Schmitt ,&nbsp;Giorgio Caturegli ,&nbsp;Chiara Di Renzo ,&nbsp;Alessandro Anselmo ,&nbsp;David Mulligan ,&nbsp;John P. Geibel ,&nbsp;Francesco D'Amico","doi":"10.1016/j.tpr.2022.100096","DOIUrl":"10.1016/j.tpr.2022.100096","url":null,"abstract":"<div><h3>Background</h3><p>The small intestine is one of the most sensitive organs to ischemia. L-arginine has been shown to reduce damage from ischemia and reperfusion injury. We hypothesize that explanted intestinal segments from rats will demonstrate reduced susceptibility to ischemic injury when perfused with l-arginine.</p></div><div><h3>Methods</h3><p>45 small intestinal segments were harvested from male Sprague-Dawley rats and connected to an ex vivo intestinal perfusion device. Ischemic damage was induced by perfusing the extraluminal side with Ringer-HEPES buffer saturated with 100% N2. All segments were then perfused intraluminally with and without l-arginine. We conducted a set of experiments with intraluminal perfusion with both l-arginine and N-nitroarginine methyl ester (L-NAME), an inhibitor of the nitric oxide – arginine pathway. Control segments were perfused extraluminally under non-ischemic conditions and intraluminally with and without l-arginine. The intraluminal perfusate contained FITC-inulin, and the fluorescence signal of FITC-inulin was measured to calculate average fluid secretion, which directly corresponds to the extent of ischemic injury.</p></div><div><h3>Results</h3><p>Intestinal segments perfused with l-arginine had significantly decreased secretion over time in comparison to intestinal segments perfused without l-arginine (p&lt;0.0001). Perfusion with L-NAME abrogated the protective effect of l-arginine.</p></div><div><h3>Conclusion</h3><p>Intraluminal perfusion with l-arginine reduced ischemic damage to harvested intestine.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"7 2","pages":"Article 100096"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959622000051/pdfft?md5=825054dc528742035dccee8f8bb93798&pid=1-s2.0-S2451959622000051-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45570827","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":"Brain death hormone therapy and Graft survival: A systematic review of the literature","authors":"Marzieh Latifi Dr. ,&nbsp;Farzaneh Bagherpour ,&nbsp;Habib Rahban Dr. ,&nbsp;Elahe Pourhossein ,&nbsp;Sanaz Dehghani Dr.","doi":"10.1016/j.tpr.2022.100098","DOIUrl":"https://doi.org/10.1016/j.tpr.2022.100098","url":null,"abstract":"<div><h3>Introduction</h3><p>During brain death, several events occur, including hormonal. metabolic and systemic changes. This systematic review aims to find the role of hormone therapy in cadaver donors and its impact on graft function and/or survival following solid organ transplantation.</p></div><div><h3>Method and materials</h3><p>Randomized clinical trials were reviewed to investigate the effects of hormone therapy on graft survival amongst brain death cases. studies from Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were identified and reviewed for this current work. Two reviewers independently rated the quality of the study. As a result, 18 studies met inclusion criteria and were included in this study.</p></div><div><h3>Results</h3><p>Over 2235 titles were retrieved from various search sources and 16 full papers were identified for possible inclusion. Trial sample sizes varied widely from 25 to 12,333 patients. Multiple therapy schemes were developed and applied for brain death donors. The first scheme simply involved applying Triiodothyronine, Dopamine, Immunosuppressive, Vasopressin and Desmopressin separately. The second scheme consisted of applying double hormone therapy using Methylprednisolone and Vasopressin simultaneously. Finally, triple hormone therapy was applied which included Methylprednisolone, Triiodothyronine and Arginine vasopressin.</p></div><div><h3>Conclusions</h3><p>Results from this systematic study indicated no significant effects on overall organ survival in recipients who received brain death hormone therapy. Thus, the potential effects of hormone therapy in brain death scenarios are still unknown and need further investigation.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"7 2","pages":"Article 100098"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959622000075/pdfft?md5=942c8b41b306d96e2e6f6b5677e9df57&pid=1-s2.0-S2451959622000075-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136515495","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":"Hemostasis caused by stent-graft insertion followed by graft removal for pancreas graft bleeding due to chronic rejection: A case report","authors":"Kohei Miura ,&nbsp;Takashi Kobayashi ,&nbsp;Hirosuke Ishikawa ,&nbsp;Seiji Saito ,&nbsp;Yasuo Obata ,&nbsp;Yohei Miura ,&nbsp;Koji Toge ,&nbsp;Yuki Hirose ,&nbsp;Taku Ohashi ,&nbsp;Kazuyasu Takizawa ,&nbsp;Jun Sakata ,&nbsp;Masayuki Tasaki ,&nbsp;Kazuhide Saito ,&nbsp;Yoshihiko Tomita ,&nbsp;Toshifumi Wakai","doi":"10.1016/j.tpr.2022.100095","DOIUrl":"10.1016/j.tpr.2022.100095","url":null,"abstract":"<div><h3>Introduction</h3><p>Lethal symptoms due to graft rejection warrant rapid removal of the transplanted graft to save the patient's life. We report a case of massive pancreas graft bleeding due to chronic rejection that necessitated graft removal after hemostasis by stent graft insertion.</p></div><div><h3>Case presentation</h3><p>A 39-year-old woman underwent simultaneous pancreas-kidney transplantation for type I diabetes and chronic renal failure nine years ago. She suffered irreversible kidney damage from severe chronic rejection due to drug non-compliance. She was admitted to the emergency department for abdominal pain and bloody stools. She presented with signs of shock based on her vitals due to massive bleeding in the stool a day after hospitalization and required systemic management in the intensive care unit (ICU). Enhanced computed tomography (CT) scan revealed active bleeding from the duodenal portion of the pancreas graft. Hemostasis was achieved by inserting a stent graft into the right external iliac artery. The respiratory and circulatory status of the patient improved after the intervention, and she was transported to our hospital day after treatment. The graft was removed along with the part of the anastomosed intestine, which was reconstructed with a functional end-to-end anastomosis.</p></div><div><h3>Conclusion</h3><p>We encountered a patient with hemorrhagic shock due to bleeding from a rejected pancreas graft. The patient was successfully treated and saved using stent-graft hemostasis followed by graft removal. Clinicians and surgeons should be mindful of chronic rejection, which could lead to life-threatening hemodynamic complications.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"7 2","pages":"Article 100095"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S245195962200004X/pdfft?md5=b13da16583ad2ee7dea06d7e29834b5a&pid=1-s2.0-S245195962200004X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55218361","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":"Extended Literature Review of the role of erythropoietin stimulating agents (ESA) use in the management of post renal transplant anaemia","authors":"Iman Alshamsi","doi":"10.1016/j.tpr.2022.100097","DOIUrl":"10.1016/j.tpr.2022.100097","url":null,"abstract":"<div><h3>Background</h3><p>: Anemia is known to impact quality of life and survival in both renal and non-renal patients. End stage kidney disease (ESKD) patient's survival substantially improves post transplantation. Observational studies have reported better patients and graft outcomes in non anemic renal transplant recipients. Anemia of chronic kidney disease (CKD) is frequently linked to erythropoietin deficiency. Patients with post-transplant anemia (PTA) represent a distinct subset of CKD population. The benefit of using erythropoietin stimulating agents (ESA) in PTA is not clearly defined.</p></div><div><h3>Aim</h3><p>: The aim of this extended literature review is to define the role of ESA use in improving hemoglobin (Hb) level and graft survival in patients with PTA.</p></div><div><h3>Methods</h3><p>: An extended literature review was done to identify randomized controlled trials (RCTs) with patients with PTA as the study population, the use of erythropoietin stimulating agents as the intervention, and the renal function and Hb level as the outcomes. The aim of this literature review is to delineate the role of using ESA in PTA. Medline, Google scholar, Scopus, and CINHAL data bases were searched and papers meeting the pre-set inclusion criteria were identified.</p></div><div><h3>Results</h3><p>: A total of 163 papers were identified. After screening the results, four papers met the inclusion criteria and were included for review. 2/4 papers recruited patients with early PTA, while 2/4 papers recruited patients with late PTA. The early PTA papers were not consistent in reporting the effect of ESA in improving renal outcomes. Both studies showed that using ESA had no additional benefit in anemia treatment. 2/4 studies looked at late PTA. The study designs were similar and the follow up period was 2-3 years. Both studies showed a better graft survival in the higher Hb group.</p></div><div><h3>Conclusion</h3><p>: In the case of early PTA, the benefit of using ESA is not clear. The two RCTs studying the effect of ESA in patients with late PTA showed that targeting higher Hb levels was associated with better graft function. The optimal Hb target and the utility of intravenous iron need further clarifications.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"7 2","pages":"Article 100097"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959622000063/pdfft?md5=7a437426d3dfbe5bb03cc1e2a6d0aa84&pid=1-s2.0-S2451959622000063-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42346935","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":"Cellular immunity in BK polyomavirus associated nephropathy following adult kidney transplantation","authors":"Laila Schneidewind ,&nbsp;Uwe Grunwald ,&nbsp;Desiree L. Dräger ,&nbsp;Thomas Neumann ,&nbsp;Jennifer Kranz ,&nbsp;Oliver W. Hakenberg","doi":"10.1016/j.tpr.2022.100093","DOIUrl":"https://doi.org/10.1016/j.tpr.2022.100093","url":null,"abstract":"<div><h3>Background</h3><p>BK polyomavirus (BKPyV) is the most important polyomavirus affecting renal transplant recipients. BKPyV associated nephropathy (BKVAN) is seen in about 5% of renal transplant patients and can lead to graft loss in up to 50% of cases. Monitoring of specific immunity combined with viral load could be used to individually assess the risk of viral reactivation. However, cellular immunity and targeting the immune system have also the potential to be used in therapy development. Consequently, we performed a rapid review about cellular immune responses to summarize the evidence for planning new research on treatment. Additionally, we present an immunologically interesting case of BKVAN.</p></div><div><h3>Methods</h3><p>We performed a rapid review with a search in MEDLINE from 1971 to 2021. Additionally, we present an immunological interesting case of BKVAN.</p></div><div><h3>Results</h3><p>The literature search for original studies yielded 92 results. Finally, nine studies were considered, two of them were experimental studies, three retrospective case series and four prospective clinical trials. On the whole, there is evidence that virus-specific T cells could be used for monitoring of BKVAN, but also for therapy.</p></div><div><h3>Conclusions</h3><p>Cellular immune response to BKVAN is complex, but further prospective clinical studies, especially in virus-specific T cells are necessary.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"7 1","pages":"Article 100093"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959622000026/pdfft?md5=dd0a4c668f399d13414f14f6b28e2aff&pid=1-s2.0-S2451959622000026-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136833973","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":"Subclinical non-HLA AMR detection and monitoring with surveillance dd-cfDNA in a kidney transplant recipient","authors":"Erik L. Lum ,&nbsp;Sabrina Lee ,&nbsp;Jonathan Zuckerman ,&nbsp;Suphamai Bunnapradist","doi":"10.1016/j.tpr.2022.100092","DOIUrl":"https://doi.org/10.1016/j.tpr.2022.100092","url":null,"abstract":"<div><p>Elevations in dd-cfDNA at the time of kidney allograft dysfunction are associated with an increased risk of rejection. The utility of such measurements in a stable allograft is unknown. Herein we present a case utilizing routine surveillance dd-cfDNA to detect subclinical active BANFF rejection with persistent elevations and biopsy evidence of ongoing injury despite treatments. Due to treatment failure she developed chronic allograft nephropathy within six months of transplantation. Surveillance and post treatment monitoring of dd-cfDNA may be useful early detection and monitoring of rejection in kidney transplant recipients and as a marker in future studies.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"7 1","pages":"Article 100092"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959622000014/pdfft?md5=1127432b2f9dfc84560d097790aabfaf&pid=1-s2.0-S2451959622000014-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136833969","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":"Re-appropriation of a right anterior thoracotomy approach to portal-systemic bypass for liver transplantation in a patient with complete superior vena cava occlusion","authors":"Justin A. Steggerda ,&nbsp;Andre Y. Son ,&nbsp;Marcos E. Pozo ,&nbsp;Amit Pawale ,&nbsp;Aaron S. Reynolds ,&nbsp;Kush Desai ,&nbsp;Daniel Galvez-Lima ,&nbsp;Josh Herborn ,&nbsp;Andre DeWolf ,&nbsp;Daniela Ladner ,&nbsp;Juan Carlos Caicedo ,&nbsp;Nitin Katariya ,&nbsp;Daniel Borja-Cacho","doi":"10.1016/j.tpr.2021.100086","DOIUrl":"10.1016/j.tpr.2021.100086","url":null,"abstract":"<div><p>The utilization of venovenous bypass in liver transplantation (LT) has become less frequent and more center dependent over time. Unfortunately, this has left many transplant surgeons, particularly younger trainees, unfamiliar with the techniques and indications for its utilization. We present a case of LT in a patient with complete superior vena cava (SVC) occlusion prohibiting direct vascular access. A multi-disciplinary approach involving interventional radiology, anesthesiology, cardiac surgery, and transplant surgery, was used to diagnose, evaluate, and develop an operative plan for successful LT. In doing so, a novel approach to portosystemic bypass was utilized involving a right mini-thoracotomy with direct cannulation of the right atrium to gain central venous access and optimize venous return during LT. As a center that does not routinely use venovenous bypass, this multidisciplinary approach was crucial identifying the need for a rarely used technique for vascular access and performance of a successful LT.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"6 4","pages":"Article 100086"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959621000147/pdfft?md5=e1146daad7e21051d270399a56159240&pid=1-s2.0-S2451959621000147-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41791653","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}