Annals of Transplantation最新文献_第9页

A Systematic Review of the Literature on Chronic Kidney Disease Following Liver Transplantation 肝移植后慢性肾病的文献系统综述

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2022-04-13 DOI: 10.12659/AOT.935170

H. Miyata, Y. Morita, Anil . Kumar

{"title":"A Systematic Review of the Literature on Chronic Kidney Disease Following Liver Transplantation","authors":"H. Miyata, Y. Morita, Anil . Kumar","doi":"10.12659/AOT.935170","DOIUrl":"https://doi.org/10.12659/AOT.935170","url":null,"abstract":"Chronic kidney disease (CKD) is a serious comorbidity affecting liver transplant recipients (LTRs). Calcineurin inhibitor dosing minimization protocols and everolimus use purportedly increased from 2010, potentially impacting CKD development. This systematic literature review was designed to identify CKD incidence in adult LTRs, focusing on studies published from 2010 onwards. PubMed, Embase, and the Cochrane Database of Systematic Reviews were searched for papers reporting renal function (glomerular filtration rate [GFR]; estimated GFR [eGFR] or Chronic Kidney Disease Epidemiology Collaboration) for adult LTRs ≥6 months after transplantation. Primary outcome: renal function ≥6 months after transplantation, with CKD stage. Bias was assessed using the Cochrane Collaboration bias tool and by reviewing disclosures/industry funding. Of 3960 records identified, 14 publications were included. In at least 1 study arm, mean GFR/eGFR remained stable/improved temporally in 4 and decreased in 8 publications. Where GFR/eGFR decreased, mean eGFR was 71.4–119.6 mL/min/1.73 m2 (CKD stage 2-stage 1) across studies at baseline, and was 77.2 and 79.1 mL/min/1.73 m2 (stage 2) at 12 months. The proportion of patients with CKD increased between baseline and follow-up; 23.2–36.8% of patients had CKD stage 3a or higher at 12 months (2 studies). Rates ranged from 85.7–100% (6 months) for patient survival, 81.0% (12 months) to 100.0% (17 months) for graft survival, and 0–40% (12 months) for acute rejection. Most studies carried risk of bias. Evidence of temporal renal function decline highlights the need for continuous renal monitoring of LTRs, particularly regarding potential CKD development/progression.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e935170-1 - e935170-30"},"PeriodicalIF":1.1,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47768241","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: 2

Long-Term Effectiveness, Safety, and Patient-Reported Outcomes of Self-Administered Subcutaneous Hepatitis B Immunoglobulin in Liver Post-Transplant Hepatitis B Prophylaxis: A Prospective Non-Interventional Study 自体皮下注射乙型肝炎免疫球蛋白预防肝移植后乙型肝炎的长期有效性、安全性和患者报告的结果：一项前瞻性非干预性研究

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2022-04-11 DOI: 10.12659/AOT.936162

B. Roche, A. Bauhofer, M. Bravo, G. Pageaux, F. Zoulim, A. Otero, M. Prieto, C. Baliellas, D. Samuel

{"title":"Long-Term Effectiveness, Safety, and Patient-Reported Outcomes of Self-Administered Subcutaneous Hepatitis B Immunoglobulin in Liver Post-Transplant Hepatitis B Prophylaxis: A Prospective Non-Interventional Study","authors":"B. Roche, A. Bauhofer, M. Bravo, G. Pageaux, F. Zoulim, A. Otero, M. Prieto, C. Baliellas, D. Samuel","doi":"10.12659/AOT.936162","DOIUrl":"https://doi.org/10.12659/AOT.936162","url":null,"abstract":"Background Self-administered subcutaneous hepatitis B immunoglobulin (s.c. HBIg) in combination with nucleos(t)ide analogs (NUCs) has proved to be effective and safe in preventing hepatitis B virus (HBV) reinfection after liver transplantation. Material/Methods This non-interventional, prospective, single-arm, multicenter, international study collected data on long-term effectiveness, safety, patient satisfaction (Treatment Satisfaction Questionnaire for Medication, TSQM-11), and quality of life (EQ-5D questionnaire) in routine practice over a 2-year treatment period. Data analysis was based on 195 adults (82.1% male) transplanted for HBV-related liver diseases and treated with s.c. HBIg with/without NUC(s). Results HBV recurrence (seropositivity of HBV surface antigen and/or HBV DNA) was observed in 7/195 (3.6%) patients (annual rate: 2.01%). Hepatocellular carcinoma (HCC) recurred in 4/83 (4.8%) patients transplanted for HBV-HCC (annual rate: 2.88%). Twenty-nine adverse drug reactions occurred in 16/195 (8.2%) patients. Convenience and overall satisfaction scores of the TSQM-11 were significantly (P<0.05) improved under treatment at the 3-month, 2-year, and last follow-up visits. Quality of life remained constant over the entire observation period (EQ-5D index [P≥0.075]). S.c. HBIg was mainly self-administered (6458/9021 administrations, 71.6%) at home (8514/9021 administrations, 94.4%). Conclusions The results indicate long-term effectiveness and safety of s.c. HBIg in combination with NUC therapy in preventing post-transplant HBV reinfection under real-life conditions. The convenience of the therapy contributed to the high overall treatment satisfaction and acceptance by the patients.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e936162-1 - e936162-12"},"PeriodicalIF":1.1,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43064690","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: 1

Outcomes of Split Liver Transplantation vs Living Donor Liver Transplantation in Pediatric Patients: A 5-Year Follow-Up Study in Korea 分割肝移植与活体肝移植在儿科患者中的疗效：韩国的5年随访研究

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2022-04-07 DOI: 10.12659/AOT.935682

K. Yoon, Sanghee Song, Sanghoon Lee, O. Kim, S. Hong, N. Yi, J. M. Kim, Kwang-Wonng Lee, M. Kim, Y. Choi, K. Suh, S. Lee

{"title":"Outcomes of Split Liver Transplantation vs Living Donor Liver Transplantation in Pediatric Patients: A 5-Year Follow-Up Study in Korea","authors":"K. Yoon, Sanghee Song, Sanghoon Lee, O. Kim, S. Hong, N. Yi, J. M. Kim, Kwang-Wonng Lee, M. Kim, Y. Choi, K. Suh, S. Lee","doi":"10.12659/AOT.935682","DOIUrl":"https://doi.org/10.12659/AOT.935682","url":null,"abstract":"Background The number of pediatric patients awaiting liver transplantation has decreased. Due to its increased use in Korea, split liver transplantation (SLT) may be a substitute for living donor liver transplantation (LDLT); however, the outcomes of pediatric SLT and LDLT in Korea remain unreported. Material/Methods We reviewed data of Korean patients aged <18 years who received SLT from 2005 to 2014, based on the Korea national database and compared to recipients who underwent LDLTs at Seoul National University Hospital during the same period. Results A total of 63 and 56 patients were included in SLT and LDLT, respectively. The most common indication for LT was biliary atresia (60.3% in SLT vs 67.9% in LDLT). The Pediatric End-Stage Liver Disease score did not differ between the groups (P>0.05). The 1-, 3-, and 5-year overall survival rates were 92.1%, 90.2%, and 86.6% in the SLT and 96.4%, 94.6%, and 94.6% in the LDLT groups, respectively (P=0.21); the corresponding graft survival rates were 88.9%, 87.1%, and 83.6% in the SLT and 92.9%, 91.0%, and 91.0% in the LDLT groups, respectively (P=0.31). Fulminant hepatic failure was a risk factor for graft failure [OR, 8.77 (1.08–70.92); P=0.042], but not overall survival [OR, 11.78 (0.56–247.29); P=0.11]. Conclusions The graft and overall survival rates of SLT and LDLT were not different in pediatric patients in Korea, and fulminant hepatic failure was the only risk factor affecting graft survival outcomes.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e935682-1 - e935682-10"},"PeriodicalIF":1.1,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48379213","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: 3

Postoperative Health Status and Quality of Life After Pure Laparoscopic Donor Hepatectomy for Living Donor Liver Transplantation 活体肝移植纯腹腔镜供肝切除术后健康状况与生活质量

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2022-03-07 DOI: 10.12659/AOT.935611

C. Cho, G. Choi, J. M. Kim, J. Rhu, C. Kwon, J. Joh

{"title":"Postoperative Health Status and Quality of Life After Pure Laparoscopic Donor Hepatectomy for Living Donor Liver Transplantation","authors":"C. Cho, G. Choi, J. M. Kim, J. Rhu, C. Kwon, J. Joh","doi":"10.12659/AOT.935611","DOIUrl":"https://doi.org/10.12659/AOT.935611","url":null,"abstract":"Background Laparoscopic donor hepatectomy (LDH) for living donor liver transplantation has been performed in several specialized institutes. Surgical outcomes of LDH have shown comparable results to open donor hepatectomy (ODH), but the quality of life (QOL) after LDH is not known. This prospective questionnaire-based study was performed to assess health status and QOL of live liver donors before and after donor hepatectomy (DH). Material/Methods From May 2017 to February 2020, questionnaire items such as the Enhanced Recovery after Surgery mobility scale (EMS), Body Image Questionnaire, and EQ-5D-3L were examined up to 1 year after DH to respectively evaluate postoperative recovery, body image satisfaction, and health status. Results During the study period, 45 laparoscopic DH (LDH) donors and 2 open DH (ODH) donors were finally fully evaluated. The LDH group had a significantly higher mean EMS than ODH on postoperative day (POD) 5, and 7 (P=0.011, and P=0.004, respectively). Body image scores of the LDH group were significantly higher than that of the ODH group at 1 month after DH (17.8 vs 15.0, P=0.017). There were 45 LDH donors who recovered to preoperative values at 6 months and 1 month after DH, with no statistically significant difference in EQ-5D-3L index value and visual analogue scale (P=0.059 and P=0.217, respectively). Conclusions Within 1 month after DH, LDH donors showed faster mobility recovery and body image satisfaction to the level of preoperative status than ODH. LDH donors recovered to preoperative health status within 6 months, in accordance with previous studies of ODH donors.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e935611-1 - e935611-9"},"PeriodicalIF":1.1,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46434679","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

Do Muslims Living in Poland Approve of Organ Transplantation? 生活在波兰的穆斯林赞成器官移植吗?

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2022-03-04 DOI: 10.12659/AOT.934494

G. Kobus, H. Bachórzewska-Gajewska, J. Małyszko

{"title":"Do Muslims Living in Poland Approve of Organ Transplantation?","authors":"G. Kobus, H. Bachórzewska-Gajewska, J. Małyszko","doi":"10.12659/AOT.934494","DOIUrl":"https://doi.org/10.12659/AOT.934494","url":null,"abstract":"Background Although the International Society for Islamic Legal Studies and the Islamic Organization for Medical Sciences have officially approved of transplantations, Muslims’ opinions on this issue are not uniform. The aim of this study was to assess the general knowledge, attitudes, and opinions concerning organ transplantation among Muslim Tatars living in North-East Poland. Material/Methods The study included 78 Muslim Tatars and was carried out at the Center of Muslim Culture using the diagnostic poll method. Results Transplantation from living donors was accepted by 96.1% of respondents, and from dead donors by 88.8% of respondents. Consent to the removal of organs after the death of a close relative was approved of by 57.7%, and 1/5 of respondents objected to it. Removal of their organs after death was approved of by 70.5% of respondents, more often by persons with higher education and vocational education than among those with only elementary education. Only 2.2% of respondents had reported their objection to the Central Objection Register. Almost 40% of men and women informed their family members about their willingness to be an organ donor. Most (71.8%) respondents had a positive attitude to transplantation, 25.6% had a negative attitude, and 2.6% were neutral. Approximately 72% of respondents believed that the final decision concerning the removal of organs from dead donors should be made by the family, and according to 8.9%, it should be prescribed by the law. Conclusions Muslim Tatars living in Poland mostly accept the removal of organs both from live donors and from dead bodies. Gender and education level had a considerable impact on the decision concerning organ donation.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e934494-1 - e934494-7"},"PeriodicalIF":1.1,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43600820","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

Pancreas Allograft Thrombosis as a Post-COVID-19 Complication in a Diabetic Patient After Pancreas Transplantation 糖尿病患者胰腺移植后COVID-19后并发症的胰腺移植物血栓形成

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2022-03-01 DOI: 10.12659/AOT.935863

K. Kędzierska-Kapuza, Grzegorz Witkowski, K. Baumgart-Gryn, M. Durlik

引用次数: 1

Techniques for Closing the Abdominal Wall in Intestinal and Multivisceral Transplantation: A Systematic Review. 小肠和多脏器移植中关闭腹壁的技术:系统综述

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2022-03-01 DOI: 10.12659/AOT.934595

Allana C Fortunato, Rafael S Pinheiro, Cal S Matsumoto, Rubens M Arantes, Vinicius Rocha-Santos, Lucas S Nacif, Daniel R Waisberg, Liliana Ducatti, Rodrigo B Martino, Luiz Carneiro-D'Albuquerque, Wellington Andraus

{"title":"Techniques for Closing the Abdominal Wall in Intestinal and Multivisceral Transplantation: A Systematic Review.","authors":"Allana C Fortunato, Rafael S Pinheiro, Cal S Matsumoto, Rubens M Arantes, Vinicius Rocha-Santos, Lucas S Nacif, Daniel R Waisberg, Liliana Ducatti, Rodrigo B Martino, Luiz Carneiro-D'Albuquerque, Wellington Andraus","doi":"10.12659/AOT.934595","DOIUrl":"10.12659/AOT.934595","url":null,"abstract":"<p><p>Short bowel syndrome is the most common etiology of intestinal failure, resulting from either resections of different intestinal segments or a congenital condition. Due to the absence or considerable reduction of intestinal loops in the abdominal cavity, patients with short bowel syndrome present with atrophy and muscle retraction of the abdominal wall, which leads to loss of abdominal domain and elasticity. This complication is an aggravating factor of intestinal transplantation since it can prevent the primary closure of the abdominal wall. A vast array of surgical techniques to overcome the challenges of the complexity of the abdominal wall have been described in the literature. The aim of our study was to review the modalities of abdominal wall closure in intestinal/multivisceral transplantation. Our study consisted of a systematic review following the methodological instructions described in the PRISMA guidelines. Duplicate studies and studies that did not meet the criteria for the systematic review were excluded, especially those without relevance and an explicit relationship with the investigated theme. After this step, 63 articles were included in our study. The results obtained with these techniques have been encouraging, but a high incidence of wound complications in some reports has raised concerns. There is no consensus among transplantation centers regarding which technique would be ideal and with higher success rates and lower rates of complications.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e934595"},"PeriodicalIF":1.1,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8897964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48091649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation 他汀类药物对活体供肝移植后肝癌复发的影响

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2022-02-23 DOI: 10.12659/AOT.935604

Okjoo Lee, J. Rhu, G. Choi, J. M. Kim, Kyung-Won Kim, J. Joh

{"title":"Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation","authors":"Okjoo Lee, J. Rhu, G. Choi, J. M. Kim, Kyung-Won Kim, J. Joh","doi":"10.12659/AOT.935604","DOIUrl":"https://doi.org/10.12659/AOT.935604","url":null,"abstract":"Background Liver transplantation (LT) has been validated widely all over the world as the curative treatment for hepatocellular carcinoma (HCC). Statins have been reported to prevent the progression of HCC. There are many factors that affect recurrence of HCC, but the precise role of statins is unknown. Therefore, we examined whether statin therapy is associated with decreased HCC recurrence in patients who underwent living-donor LT (LDLT) for HCC. Material/Methods We retrospectively analyzed 844 HCC patients who underwent primary adult-to-adult LDLT in our center between January 2007 and December 2016. Statin therapy was defined as administration of statins for more than 30 cumulative defined daily doses (cDDDs) after LT. We compared HCC recurrence and patient survival between non-statin (n=334) and statin (n=52) groups. Results The recurrence rate was higher in the non-statin group; however, time-dependent multivariate analysis with Kaplan-Meier curves showed that statin users did not significantly benefit in terms of HCC recurrence-related survival or overall survival. Further, risk factor analysis of HCC recurrence and patient survival confirmed multiple regional treatments (≥3 times), high alpha fetoprotein level (≥100 ng/mL), large tumor size (≥3 cm), and microvascular invasion as risk factors for HCC recurrence, but statin treatment was not associated with a significantly lower recurrence rate of HCC or reduced mortality after adjusting for other risk factors. Conclusions Statin use might be associated with prevention of HCC progression, but no significant decrease in HCC recurrence rates in LDLT patients was recorded in this study.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e935604-1 - e935604-9"},"PeriodicalIF":1.1,"publicationDate":"2022-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41784727","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: 2

Bioinformatics Identification of Candidate Biomarkers in Endomyocardial Biopsy and Peripheral Blood for Cardiac Allograft Rejection 异体心脏移植排斥反应的候选生物标志物的生物信息学鉴定

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2022-02-21 DOI: 10.12659/AOT.935488

K. Luo, Lin Li, Mingyao Meng, Yan Chen, Zongliu Hou

{"title":"Bioinformatics Identification of Candidate Biomarkers in Endomyocardial Biopsy and Peripheral Blood for Cardiac Allograft Rejection","authors":"K. Luo, Lin Li, Mingyao Meng, Yan Chen, Zongliu Hou","doi":"10.12659/AOT.935488","DOIUrl":"https://doi.org/10.12659/AOT.935488","url":null,"abstract":"Background Cardiac allograft rejection is still a crucial barrier to achieving satisfactory outcomes after surgery. In this study, we propose to find candidate biomarkers from endomyocardial biopsy (EMB) and peripheral blood (PB) samples for efficient diagnosis and treatment of cardiac allograft rejection. Material/Methods Microarray datasets were obtained from the Gene Expression Omnibus (GEO). Differentially expressed genes (DEGs) of cardiac allograft rejection patients and control subjects from EMB and PB samples were screened using the online tool GEO2R. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of all samples’ DEGs were performed with the DAVID online tool. Protein–protein interaction (PPI) networks were constructed and visualized using Cytoscape and the top 10 hub genes were selected. Finally, the most highly enriched GO and KEGG pathways of the top 10 hub genes were determined. Results A total of 57 502 genes from EMB samples and 131 624 genes from PB samples were identified. Gene characteristics and enrichment analysis indicated that both EMB and PB samples contained DEGs involved in antigen presentation, immune cells activation, inflammatory process, and cellular injuries. In EMB samples, there were some DEGs related to heart tissue injury and cardiac malfunction. Moreover, DEGs that regulates hypoxia-induced factors and erythrocyte function in response of ischemia and hypoxia stress were present in PB samples but were absent in EMB samples. Conclusions The screened differentially expressed genes (DEGs) from EMB and PB samples of patients with cardiac graft rejection are potential candidate biomarkers of diagnosis and treatment.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e935488-1 - e935488-10"},"PeriodicalIF":1.1,"publicationDate":"2022-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46238532","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

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Uremia, and Insulin-Dependent Diabetes 肝、胰、十二指肠和肾联合移植治疗乙型肝炎肝硬化、尿毒症和胰岛素依赖型糖尿病

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2022-02-15 DOI: 10.12659/AOT.935860

Xitao Hong, Zhitao Chen, Yiwen Guo, Yu-xing Dong, Xiaoshun He, Maogen Chen, W. Ju

{"title":"Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Uremia, and Insulin-Dependent Diabetes","authors":"Xitao Hong, Zhitao Chen, Yiwen Guo, Yu-xing Dong, Xiaoshun He, Maogen Chen, W. Ju","doi":"10.12659/AOT.935860","DOIUrl":"https://doi.org/10.12659/AOT.935860","url":null,"abstract":"Background Abdominal organ cluster transplantation for the treatment of upper abdominal end-stage diseases is a serious conundrum for surgeons. Case Report We performed clinical assessment of quadruple organ transplantation (liver, pancreas, duodenum, and kidney) for a patient with end-stage liver disease, post-chronic hepatitis B cirrhosis, uremia, and insulin-dependent diabetes mellitus, and explored the optimal surgical procedure. Simultaneous classic orthotopic liver, pancreas-duodenum, and heterotopic renal transplantation was performed on a 46-year-old man. The process was an improvement of surgery implemented with a single vascular anastomosis (Y graft of the superior mesenteric artery and the celiac artery open together in the common iliac artery). The pancreatic secretions and bile were drained through a modified uncut jejunal loop anastomosis, and the donor’s kidneys were placed in the right iliac fossa. The patient was prescribed basiliximab, glucocorticoid, tacrolimus, and mycophenolate mofetil for immunosuppression. The hepatic function recovered satisfactorily on postoperative day (POD) 3, and pancreatic function recovered satisfactorily in postoperative month (POM) 1. Hydronephrosis occurred in the transplanted kidney, with elevated creatinine on POD 15. Consequently, renal pelvic puncture and drainage were performed. His creatinine dropped to a normal level on POD 42. No allograft rejections or other complications, like pancreatic leakage, thrombosis, or localized infections, occurred. The patient had normal liver, renal, and pancreas functions with insulin-independent after POD 365. Conclusions Simultaneous classic orthotopic liver, pancreas-duodenum, and heterotopic renal transplantation is a promising therapeutic option for patients with insulin-dependent diabetes combined with end-stage hepatic and renal disease, and our center’s experience can provide a reference for clinical multiorgan transplantation.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e935860-1 - e935860-9"},"PeriodicalIF":1.1,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49350903","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: 2