Transplantation proceedings
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Observational Study
Ultrasonographic optic nerve sheath diameter is correlated with arterial carbon dioxide concentration during reperfusion in liver transplant recipients.
Cerebral blood flow and intracranial pressure (ICP) has been known to be increased after graft reperfusion during liver transplantation, which was correlated with arterial carbon dioxide concentration (PaCO2). Ultrasonographic measurement of optic nerve sheath diameter (ONSD) is a simple and noninvasive method for evaluating ICP. We investigated the correlation between ONSD and the PaCO2 during reperfusion in liver transplant recipients. ⋯ ONSD was increased just after reperfusion, which demonstrated good correlation with PaCO2 during reperfusion in liver transplant recipients. This finding suggests that the carbon dioxide can play a key role in increasing ONSD during hepatic graft reperfusion.
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Accepted treatment for severe pulmonary arterial hypertension (PAH) includes intravenous epoprostenol and lung transplantation (LT). Inhaled iloprost plus oral sildenafil (Ilo-Sil) is an alternative strategy that may also delay the need for LT. ⋯ These results suggest that therapy with Ilo-Sil represents an acceptable alternative in patients with severe and unstable PAH.
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Hepatic ischemia/reperfusion (HI/R) injury is a common pathologic process caused by many clinical settings, such as liver resection, liver transplantation, hypovolemic shock, and trauma. The use of ambroxol, which acts as a mucolytic agent, provides antioxidant and anti-inflammatory effects. ⋯ These results indicated that ambroxol attenuated rat HI/R through upregulation of intracellular antioxidant and anti-apoptotic signaling pathways.
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To analyze the mechanism of acid-base disorders in liver transplant recipients and to examine the relationship between these disorders and the fluids administered during surgery. ⋯ Hyperchloremia is the primary contributor to metabolic acidosis in liver transplant recipients. Possibly the use of chloride-rich solutions increases the incidence of this disorder.
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Talc lung granulomatosis results from the intravenous use of medication intended for oral use. Talc (magnesium silicate) acts as filler in some oral medications; when injected intravenously, it deposits in the lungs leading to airflow obstruction and impaired gas exchange. ⋯ After a careful selection process, 19 patients with talc lung granulomatosis have received lung allografts in our program. Long-term survival for these patients is excellent and our results suggest the previous use of intravenous drugs should not necessarily preclude lung transplantation.