Objectives: The purpose of this study was to identify risk factors that may predict heart failure with reduced ejection fraction (HFrEF) following orthotopic liver transplantation (OLT) and associated mortality.
Background: HFrEF following OLT is a poorly understood phenomenon, reported in 3% to 7% of transplanted patients.
Methods: This is a retrospective analysis of 176 consecutive patients who underwent OLT from 2010 to 2017.
BACKGROUND Development of post-transplant diabetes mellitus after kidney transplant (PTDM) significantly increases kidney graft loss and mortality. Several risk factors for PTDM have been reported, including Hispanic ethnicity and the use of calcineurin inhibitors and corticosteroids. The incidence and impact of PTDM in the Hispanic kidney transplant population is unknown.
View Article and Find Full Text PDFHepatic epithelioid hemangioendothelioma (HEHE) is an infrequent vascular tumor of endothelial origin that primarily occurs in women in the mid-fifth decade of life without underlying chronic liver disease or cirrhosis. Liver transplant should be the first-line of therapy in patients with large or diffuse unresectable tumors even in the presence of metastatic disease due to the favorable long-term outcome. We report the case of a 48-year-old female who complained of abdominal pain and weight loss.
View Article and Find Full Text PDFThe purpose of this study is to compare the outcome of pediatric recipients of kidneys procured using a hand-assisted laparoscopic (HALDN group) to an open technique (ODN group). Twenty-eight patients ≤18 yr old (HALDN group) were compared with 17 patients (ODN group). The serum creatinine for HALDN and ODN groups at discharge were 0.
View Article and Find Full Text PDFBackground. Recipients of laparoscopically procured kidneys have been reported to have delayed graft function, a slower creatinine nadir, and potential significant complications. As the technique has evolved laparoscopic donor nephrectomy technique is becoming the gold standard for living donation.
View Article and Find Full Text PDFImmuKnow measures ATP (ng/mL) in PHA-activated CD4+ T cells from patient's whole blood. According to published reports, median ImmuKnow is 258 ng/mL in stable pediatric kidney transplant (PKT) recipients > or =12 yr, and 165 ng/mL in those <12 yr. However, data on the effect of infection or AR on ImmuKnow are scarce.
View Article and Find Full Text PDFPurpose: Previous attempts to correlate preoperative patient characteristics with operative complexity and operative time prior to laparoscopic donor nephrectomy have found few consistent relationships. The purpose of this study is to determine the effect of abdominal and perirenal fat measured with preoperative computerized tomography (CT) upon subsequent operative time and complexity during hand-assisted laparoscopic donor nephrectomy.
Materials And Methods: A retrospective chart, database, and CT angiogram review was conducted on 103 consecutive patients who underwent a hand-assisted laparoscopic donor nephrectomy.
It is unclear which induction therapy yields the best outcomes in pediatric kidney transplantation. Retrospective data of 88 children receiving a renal allograft between November 1996 and October 2003 were analyzed. Patients received ATGI (n = 12), BI (n = 29), or NAI (n = 47).
View Article and Find Full Text PDFPurpose: Rhabdomyolysis is a rare cause of acute renal failure following laparoscopic donor nephrectomy. The incidence of rhabdomyolysis is not well known and to our knowledge the amount of creatine kinase elevation resulting in renal damage is unknown. We evaluated the incidence of increased creatine kinase, risk factors for increased creatine kinase and its effect on renal function in a series of patients undergoing hand assisted laparoscopic donor nephrectomy.
View Article and Find Full Text PDFUndifferentiated embryonal sarcoma is the third most common malignant tumor of the liver in children, accounting for 13% of hepatic malignancies in this age group. It has been considered an aggressive neoplasm with very poor prognosis until the late 1980s, when long-term survivors were reported after multiagent chemotherapy followed by resection. We, herein, report two pediatric cases of undifferentiated embryonal sarcoma treated successfully with surgical resection after neoadjuvant chemotherapy based on therapy used in childhood soft tissue sarcomas and in childhood hepatic malignancies.
View Article and Find Full Text PDFBackground And Purpose: Multidetector CT angiography (MDCTA) is being used increasingly to evaluate vascular anatomy prior to donor nephrectomy. To improve the ability of MDCTA to predict donor renal anatomy, a novel protocol including four-phase imaging with three-dimensional reconstruction and maximum intensity projections (MIPs) was incorporated into the standard donor evaluation. The purpose of this study was to determine the results of this protocol.
View Article and Find Full Text PDFObjective: Nephrogenic systemic fibrosis (NSF) is a rare multisystemic fibrosing disorder that principally affects the skin but may affect other organs of patients with renal insufficiency. The purpose of our study was to identify any common risk factors and determine whether i.v.
View Article and Find Full Text PDFPurpose: Multidetector computerized tomography angiography has been used to predict renal anatomy before donor nephrectomy. Unrecognized lumbar veins represent a significant risk during laparoscopic surgery but to our knowledge no previous group has attempted to predict lumbar veins with multidetector computerized tomography angiography before laparoscopic donor nephrectomy. We evaluated the ability of multidetector computerized tomography angiography to preoperatively predict the size and location of anomalous left lumbar veins.
View Article and Find Full Text PDFBackground: The large and variable size of the renal vein has prompted most surgeons to select linear stapling devices to secure the vein during laparoscopic donor nephrectomy. Although effective, these stapling devices have a potential for misfire. Use of the nonabsorbable polymer ligating (NPL) clip during laparoscopic donor nephrectomy provides increased graft vessel length compared with the stapling device, and the NPL clip has a locking mechanism which may increase security compared with standard titanium clips.
View Article and Find Full Text PDFThe impact of hand-assisted laparoscopic donor nephrectomy on kidney allograft function, perioperative complications, and organ supply was evaluated by retrospective analysis of 41 hand-assisted laparoscopic donor nephrectomy patients and their recipients between January and October 2003. Serum creatinine at discharge, length of stay, estimated blood loss, operative time, and perioperative complications were analyzed. The mean values for laparoscopic donors and their recipients were 1.
View Article and Find Full Text PDFNephrogenic fibrosing dermopathy (NFD) is a recently described cutaneous fibrosing disorder associated with renal dysfunction. It appears similar to scleromyxedema but with some notable exceptions, including the lack of involvement of the face and absence of plasma cells on histology, systemic involvement, and paraproteinemia. Patients can present with thickened or edematous skin with indurated papules and plaques involving the extremities and the trunk.
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