High-output cardiac failure secondary to a brachiocephalic arteriovenous hemodialysis fistula: two cases.

The use of native arteriovenous fistulas for hemodialysis access is important to the success of this form of treatment for patients with end-stage renal disease. Native fistulas have been shown to provide improved longevity and to have lower complication rates when compared to prosthetic graft fistulas. High-output cardiac failure related to hemodialysis fistulas is an uncommon complication of their usage.

Gastric bypass in morbidly obese kidney transplant recipients.

Severe post-transplant obesity has previously been shown to have a negative impact on graft survival following kidney transplantation. It also contributes to late patient mortality and is associated with hypertension, diabetes and hyperlipidemia. We undertook Roux-en-Y gastric bypass (GBP) in three morbidly obese (200-260% ideal body weight) (IBW) patients 6-8 yr following kidney transplantation.

A percutaneous technique for venovenous bypass in orthotopic cadaver liver transplantation and comparison with the open technique.

Venovenous bypass minimizes the hemodynamic alterations during the anhepatic phase of liver transplantation. A new technique for the percutaneous placement of the bypass cannulae is described and compared to the cut-down ("open") technique. The records of 81 patients who underwent 94 liver transplants between August 1991 and April 1994 were reviewed for indications for transplant, United Network for Organ Sharing status, mean age, body surface area, bypass technique and time, flow rates, cardiac output, mean arterial pressure and central venous pressure during bypass, the development of deep venous thrombophlebitis, and lymphoceles.

Small intestinal microcirculatory effects of octreotide.

Somatostatin and its analogue, octreotide acetate, are thought to decrease mesenteric blood flow; however, it is unknown whether the decrease occurs at the central, regional, or microvascular level. We hypothesized that the circulatory effects of octreotide are regulated at the microvascular level. Changes in superior mesentery artery (SMA) flow in response to octreotide were measured with a perivascular ultrasonic flow probe.

Locally invasive aspergillosis of the bowel.

Locally invasive aspergillosis of the bowel and peritoneal cavity is a rare complication of immunosuppression, broad-spectrum antibiotic therapy, and corticosteroid administration. We present the case of a 9-year-old boy with acute lymphocytic leukemia who presented with a small bowel obstruction. Surgical treatment of the aspergillosis required multiple aggressive resections of all involved bowel segments.