Perioperative risk factors associated with delayed graft function following deceased donor kidney transplantation: A retrospective, single center study.

Background: There is an abundant need to increase the availability of deceased donor kidney transplantation (DDKT) to address the high incidence of kidney failure. Challenges exist in the utilization of higher risk donor organs into what appears to be increasingly complex recipients; thus the identification of modifiable risk factors associated with poor outcomes is paramount.

Aim: To identify risk factors associated with delayed graft function (DGF).

Role of innate and acquired immune mechanisms in clinical intestinal transplant rejection.

Background: Long-term outcomes of intestinal transplantation are limited by infection and rejection. To understand the underlying immune mechanisms, graft infiltrating and peripheral blood cells were analyzed using multiple ex vivo assays in intestinal transplantation recipients.

Methods: Infiltrating cells from rejected (graft enterectomy for rejection) and accepted or quiescent (stoma closure in stable transplant recipients) grafts were isolated and phenotypically characterized as to subsets and Toll-like receptor expressions as well as functionally tested for antimicrobial and antidonor immune responses.

Liver retransplantation of more than two grafts for recurrent failure.

Background: Transplantation of more than two livers for recurring graft failure has not been specifically addressed in the literature.

Methods: A retrospective analysis was conducted from a total of 2527 overall liver transplants at our institution. Main indications for multiple retransplant included primary nonfunction, chronic rejection, hepatic artery thrombosis, and recurrent disease.

Heterotopic uterus transplantation in a swine model.

Background: The aim of our study was to examine the feasibility of allogeneic uterine transplantation in a large animal model.

Methods: We performed heterotopic uterine transplants in genetically defined mini-pigs. Immunosuppression was tacrolimus administered intravenously for the first 12 days posttransplantation followed by oral cyclosporine maintenance immunosuppression.

Infrahepatic vena cavocavostomy, a modification of the piggyback technique for liver transplantation.

We describe our experience with a modification of the piggyback (PB) technique for orthotopic liver transplantation in which the donor infrahepatic vena cava is used as the venous outflow tract. From May 1997 to January 2006, a total of 109 cases using this technique were performed in 101 patients. Collected data included recipient demographics and diagnosis, warm ischemia time, use of venovenous bypass or temporary portacaval shunt and complications related to the venous outflow and graft, and patient survival.

Gastroduodenal artery as the inflow tract to repair the right hepatic artery in a combined vasculobiliary injury after laparoscopic cholecystectomy.

The frequency and significance of right hepatic artery injury associated with bile duct injury after laparoscopic cholecystectomy is unknown. Many reports suggest that a concomitant arterial injury worsens the outcome and prognosis of the bile duct injury even after an initially successful biliary repair. The optimal management of this complicated injury is controversial.

Testing of a new prototype surgical stapler that automates the rollover sleeve technique for venous anastomoses.

The creation of successful vascular anastomoses is of primary importance in many surgical fields. Numerous attempts to automate this process have been made. These techniques have slowly gained acceptance, but their use is still limited.

Intestinal and multivisceral transplantation in children.

Objective: To describe a single-center experience of pediatric intestinal transplantation (Itx) and to provide an overview of the children who underwent this procedure along with their outcomes.

Summary Background Data: Pediatric Itx presents multiple challenges because of the very young ages at which patients require transplantation and their higher susceptibility to infectious complications.

Methods: We have performed 141 Itx in 123 children with a median age of 1.

100 multivisceral transplants at a single center.

Objective: The objective of this study was to summarize the evolution of multivisceral transplantation over a decade of experience and evaluate its current status.

Summary Background Data: Multivisceral transplantation can be valuable for the treatment of patients with massive abdominal catastrophes. Its major limitations have been technical and rejection of the intestinal graft.

Gastroduodenal artery steal syndrome during liver transplantation: intraoperative diagnosis with Doppler ultrasound and management.

Arterial steal syndrome (ASS) after liver transplantation has been reported. ASS causes arterial hypo-perfusion of the graft liver and devastating consequences. However, the diagnosis tends to be delayed.