Clinical transplantation
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Clinical transplantation · Sep 2012
Neutrophil gelatinase-associated lipocalin as an early biomarker of acute kidney injury in liver transplantation.
Acute kidney injury (AKI) is a common complication and a significant prognostic factor of long-term outcome in patients undergoing liver transplantation. We evaluated the utility of urine and plasma neutrophil gelatinase-associated lipocalin (NGAL) concentrations as biomarkers of AKI during and after liver transplantation. ⋯ The urinary NGAL/urine creatinine ratio may be an early biomarker of AKI in adult patients undergoing LRLT.
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Clinical transplantation · Sep 2012
Evaluation of the right ventricular ejection fraction during classic orthotopic liver transplantation without venovenous bypass.
Right ventricular (RV) function is sensitive to changes in cardiac loading conditions, and RV dysfunction may contribute to hemodynamic instability during orthotopic liver transplantation (OLT). Thus, we evaluated RV function and its role in hemodynamic instability during classic OLT without venovenous bypass (VVB). ⋯ Right ventricular function was compromised during the anhepatic and early reperfusion stages in patients undergoing classic OLT without VVB, particularly in the high MELD score patients. Close monitoring of RV function in these patients should be considered.
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Clinical transplantation · Sep 2012
Acute kidney injury following living donor liver transplantation.
Although acute kidney injury (AKI) is regarded as a frequent complication following deceased donor liver transplantation, the incidence of AKI following living donor partial liver transplantation (LDLT) has not yet been sufficiently investigated. ⋯ Recognizing the peri-operative risk and development of AKI is important, because AKI post-LDLT is associated with a poorer graft survival and a possible worse long-term prognosis.
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Clinical transplantation · Sep 2012
Respiratory viral infections during the first 28 days after transplantation in pediatric hematopoietic stem cell transplant recipients.
Respiratory viruses (RVs) are a known cause of morbidity and mortality after hematopoietic stem cell transplantation (HSCT). In this retrospective study, we focused on the first 28 d after transplantation in pediatric HSCT recipients and showed that a multiplex PCR assay significantly increased RV detection compared with a viral culture method. Among 176 pediatric HSCT recipients, 84 with respiratory symptoms within one yr after HSCT were tested by viral culture or multiplex PCR. ⋯ In the nine patients with RV infection, five different types of RV were identified, either alone or with another RV. These were corona virus (CoV), rhinovirus (RhV) and respiratory syncytial virus combined with CoV; AdV combined with RhV; and parainfluenza virus. Viral culture detected only one case of RV infection, while multiplex PCR detected eight, suggesting that screening of respiratory infections using multiplex PCR is better than the conventional culture method.