Thrombolytics for late superior caval vein thrombus in a patient with tricuspid atresia and single-lung Glenn anastomosis.

Background: Those with cyanotic heart disease have an elevated bleeding risk but also are hypercoaguable. Treating haemodynamically significant thrombi in this unique cohort poses a monumental challenge. Case A 29-year-old women with tricuspid atresia and left pulmonary artery atresia presented with superior caval vein syndrome.

Liver transplantation and cirrhotomimetic hepatocellular carcinoma: classification and outcomes.

Liver transplantation has become the standard-of-care treatment for hepatocellular carcinoma (HCC) that falls within certain size and numerical criteria for patients with cirrhosis. Cirrhotomimetic (CMM) HCC is an uncommon growth pattern that infiltrates cirrhotic parenchyma, can become extensive in size, and can evade detection via radiological studies. Liver transplant outcomes for this type of HCC are not well reported but generally are considered to be poor.

Clinical outcomes among renal transplant recipients with pre-transplant weakly reactive donor-specific antibodies.

Background: Alloantibody can lead to antibody-mediated rejection and graft loss in renal transplantation, necessitating an assessment of cross-match compatibility. Within the past decade, more specific solid phase assays of alloantibody have been widely adopted, allowing virtual cross-matching based on unacceptable antigens, the threshold of which is determined by individual centers.

Methods: We examined the clinical outcomes of 482 patients transplanted 2007-2009 in a single center, focusing on 30 patients with weakly reactive donor-specific antibody (DSA) determined prospectively prior to renal transplant.

Transjugular intrahepatic portosystemic shunts in liver transplant recipients.

The insertion of a transjugular intrahepatic portosystemic shunt (TIPS) is a minimally invasive procedure used to relieve the signs and symptoms of portal hypertension in patients with liver disease. The most common indications for placement are refractory ascites and variceal hemorrhage. In properly selected candidates, TIPS placement can serve as a bridge to liver transplantation.

Immune dysfunction and infections in patients with cirrhosis.

Patients with cirrhosis are immunocompromised and susceptible to infections. Although detection and treatment of spontaneous bacterial peritonitis (SBP) have improved, overall survival rates have not increased greatly in recent decades-infection still increases mortality 4-fold among patients with cirrhosis. Hospitalized patients with cirrhosis have the highest risk of developing infections, especially patients with gastrointestinal (GI) hemorrhage.