Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation
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Exp Clin Transplant · Feb 2015
Review Case ReportsLiver transplant for neuroendocrine tumor metastatic to the liver: literature review and report of extirpation at 16-year recurrence.
New information has demonstrated that there are few long-term disease-free survivors after a liver transplant for neuroendocrine tumors. All studies have limited follow-up to 10 years after a transplant. We present the case of a recurrent metastatic carcinoid in a patient 16 years after an orthotopic liver transplant. ⋯ Newer studies have examined molecular features such as expression of E-cadherin and Ki-67 as positive predictors of long-term survival. However, no study has determined the full natural history of these tumors and for how long these patients should be followed. This anecdotal report highlights that late recurrence can occur.
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Exp Clin Transplant · Feb 2015
Comparative StudyPrognostic evaluation of patients undergoing living-donor liver transplant by APACHE II and MELD scores.
We hypothesized that the combination of APACHE II and Model for End-Stage Liver Disease systems would work satisfactorily in patients admitted to intensive care unit after living-donor liver transplant. ⋯ The modified APACHE II model provides an accurate prognosis of patients receiving a living-donor liver transplant. The combined application of Model for End-Stage Liver Disease score and APACHE II score can improve the predictive accuracy.
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Exp Clin Transplant · Dec 2014
Clinical algorithm to guide the need for endoscopic retrograde cholangiopancreatography to evaluate early postliver transplant cholestasis.
Severe cholestasis after liver transplant is common. In this study, our aim was to develop an algorithm to guide biliary intervention in these patients. ⋯ A hepatobiliary scan with a combination peak serum aspartate transaminase and peak serum total bilirubin levels offer a valuable tool to identify patients with hepatocellular dysfunction and can avoid endoscopic retrograde cholangiogram in the immediate posttransplant period.
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Exp Clin Transplant · Dec 2014
Case ReportsMyasthenic crisis after a renal transplant successfully treated with intravenous immunoglobulin.
Myasthenia gravis is an autoimmune disease characterized by muscle weakness. Myasthenic crisis is a life-threatening complication of myasthenia gravis precipitated by several factors. ⋯ During the early posttransplant period, she recovered with immediate graft function, and her graft functioning did not deteriorate during the myasthenic crisis. We suggest that physicians be aware of worsening of myasthenia gravis when patients with myasthenia gravis undergo a kidney transplant.
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Exp Clin Transplant · Oct 2014
Using low graft/recipient's body weight ratio graft with portal flow modulation an effective way to prevent small-for-size syndrome in living-donor liver transplant: a retrospective analysis.
Small-sized grafts are associated with high rates of graft failure and small-for-size syndrome. Portal flow is a causative factor for small-for-size syndrome. We sought to evaluate early graft dysfunction in smaller-sized grafts and the study factors responsible for it. ⋯ Lower graft/recipient's body weight ratio graft with portal flow modulation in case of high portal flow is an effective way to increase donor pool and donor safety with low risk of small-for-size syndrome. Portal flow is mainly responsible for small-for-size syndrome or early graft dysfunction.