Dual Transplant of Marginal Kidneys

Swiss Surgery ◽  
2003 ◽  
Vol 9 (5) ◽  
pp. 213-215
Author(s):  
Matter ◽  
Venetz ◽  
Aubert ◽  
Gachet ◽  
Burnier ◽  
...  
Keyword(s):  
Case Report ◽  
Acute Rejection ◽  
Glomerular Filtration ◽  
Graft Survival ◽  
Long Term Results ◽  
Recent Analysis ◽  
Donor Kidney ◽  
Transplant Outcomes

Introduction: Double transplantation is one possible answer to the shortage of donor organs. While each donor kidney would be unsuitable when considered as a single allograft, use of both kidneys should provide sufficient nephron mass for effective glomerular filtration. Case report: This is the first Swiss report of a dual adult transplant of marginal kidneys in a 46-year-old man, who was transplanted for the fourth time. Follow-up at 6 months is excellent without acute rejection. Conclusion: Recent analysis of dual marginal versus single ideal transplant outcomes, found a comparable 1-yr graft survival in both of the procedures. Long term results are still lacking and guidelines to decide between single, double or no transplantation are emerging.

Successful Hepatoatrial Anastomosis During a Consecutive Liver Retransplant in the Same Patient Shows Good Long-Term Results: Case Report and 2-Year Follow-Up

2019 ◽  
Vol 17 (2) ◽  
pp. 269-273 ◽  
Author(s):  
Konrad Kobryń ◽  
◽  
Paweł Nyckowski ◽  
Piotr Milkiewicz ◽  
Grzegorz Niewiński ◽  
...  
Keyword(s):  
Case Report ◽  
Long Term Results

scholarly journals Long-Term Results of a Randomized Study Comparing Three Immunosuppressive Schedules with Cyclosporine in Cadaveric Kidney Transplantation

2001 ◽  
Vol 12 (10) ◽  
pp. 2163-2169 ◽  
Author(s):  
GIUSEPPE MONTAGNINO ◽  
ANTONIO TARANTINO ◽  
GIUSEPPE P. SEGOLONI ◽  
VINCENZO CAMBI ◽  
GAETANO RIZZO ◽  
...  
Keyword(s):  
Triple Therapy ◽  
Graft Survival ◽  
Controlled Trial ◽  
Randomized Study ◽  
Dual Therapy ◽  
The Other ◽  
Long Term Results ◽  
Cadaveric Kidney

Abstract. In this randomized controlled trial started in October 1990, 354 cadaveric kidney transplant recipients were assigned to receive either cyclosporine (CsA) monotherapy (115 patients), CsA + steroids (117 patients), or CsA + steroids + azathioprine (122 patients). The median follow-up was 85.1 mo. Thirty-one deaths occurred (infection, 12; cardiovascular disease, 11; neoplasia, 4; and others, 4), and 65 grafts were lost, mostly due to acute (15) or chronic rejection (50). The cumulative graft half-life was 18.1 yr. According to the “intention-to-treat,” the 9-yr actuarial patient and graft survival were 94.0% and 73.3%, respectively, in monotherapy, 87.3% and 65.9% in dual therapy, and 87% and 72.2% in triple therapy (P= 0.647). At the last follow-up, the percentage of patients who remained with the original treatment was 51.2% in monotherapy, 81.7% in dual therapy, and 63.3% in triple therapy. At the seventh year, the mean creatinine clearances were 54.9 ± 17.6 ml/min in monotherapy, 57.9 ± 23.4 in dual therapy, and 60.6 ± 20.7 in triple therapy (P= 0.375). Cataracts (P= 0.000), osteoporosis (P= 0.000), and cardiovascular complications (P= 0.000) were more frequent in dual or triple therapy than in monotherapy. Actuarial graft survival at 9 yr in patients on monotherapy who had to have steroids added was similar to that of the other two groups (62.2%versus69.3%,P= 0.134). In conclusion, actuarial patient and graft survivals did not differ among the three schemes. The long-term renal function and survival were not affected in the patients on monotherapy who needed the addition of steroids. Monotherapy was associated with a lower incidence of extrarenal complications than the other two regimens.

scholarly journals Long-Term Stability of Root Coverage of Restored Roots: A 18-Year Follow-up Case Report

2020 ◽  
Author(s):  
Khalid S Al-Hamdan
Keyword(s):  
Case Report ◽  
Connective Tissue ◽  
Gingival Recession ◽  
Long Term Results ◽  
Restorative Material ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Root Surfaces

Tooth sensitivity is a major concern following gingival recession. Stable long-term results are necessary for the management of this condition. Here, we present a case report with the aim of validating the utilisation of a connective tissue graft to replace a restorative material over the root surface for a long term. A 36-year-old female patient presented with the chief complaint of sensitivity in her lower right (#43) and left (#33) canines, which were previously restored with a composite restoration. The recession type defect was Miller’s Class II. The old restoration was removed and replaced with a connective tissue graft, accompanied by a double-papilla flap. The case was followed-up for 18 years, and the results were stable during the follow-up period, with a highly satisfied patient. Based on these results, it can be reported that a connective tissue graft has highly predictable results and can be used for previously restored root surfaces. In addition, the connective tissue graft provides more stable results than does the use of a restorative material over root surfaces.

scholarly journals Immediate Implants Loading by 4 Units Temporary Restoration: A Case Report

2019 ◽  
Vol 4 (8) ◽  
Keyword(s):  
Case Report ◽  
Soft Tissues ◽  
Long Term Results ◽  
Immediate Loading ◽  
Implant Placement ◽  
Immediate Implants ◽  
Immediate Implant ◽  
Dental Professionals

Immediate implant placement is the placement of dental implant in the extraction socket immediately after extraction with no healing of bone or soft tissues. The timing of implant placement has increased the debate, while patients have become persistent in their desire to be treated in an efficient and expedient manner. When seeking a solution, they wish for safe and effective treatment that can be performed in the shortest possible time and with as little pain and discomfort as possible. Dental professionals with their expertise are addressing patients request as much as possible. Immediate implant placement and loading are valuable techniques for the clinician to call upon, but their skill and experience, as well as case selection, are all crucial elements to ensure successful long-term results [1]. The placement of implants immediately in fresh sockets with immediate loading is a well known treatment modality, but the practitioner has to follow a very strict protocol. This case report describes the detailed procedures of immediate implant placement with immediate loading for 2 – implants supporting 4 – units’ provisional restorations with 5 years follow-up

scholarly journals Long-Term Results of TPMT Activity Monitoring in Azathioprine-Treated Renal Allograft Recipients

2001 ◽  
Vol 12 (1) ◽  
pp. 170-176
Author(s):  
ERIC THERVET ◽  
DANY ANGLICHEAU ◽  
NATHALIE TOLEDANO ◽  
ANNE-MARIE HOULLIER ◽  
LAURE-HÉLÈNE NOEL ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Graft Survival ◽  
Renal Allograft ◽  
Long Term Results ◽  
Tpmt Activity ◽  
Acute Rejection Episode ◽  
Blood Levels ◽  
Graft Outcome ◽  
Activity Induction

Abstract. Thiopurine methyltransferase (TPMT) is implicated in the metabolism of azathioprine. The consequences of differential TPMT activity induction by azathioprine on the long-term results after renal transplantation were investigated. The erythrocyte TPMT activity in 82 patients on days 0, 7, and 30 was prospectively evaluated. Because various patterns of TPMT activity variation were noted, the population was subsequently divided between inductors (n = 47) and noninductors (n = 35). Data regarding patient and graft survival and acute rejection episodes were collected. Renal allograft assessment was performed at 3 mo and 2 yr to evaluate the renal function and the histologic lesions on routine biopsies. Data regarding azathioprine-related toxicity also were collected. In a subgroup of patients (n = 19), azathioprine blood levels were determined at day 7 and day 30. The graft survival censoring death was statistically improved in TPMT inductor patients when compared with non-TPMT inductors (P < 0.05). Among TPMT inductors, an acute rejection episode was observed in 34% of the patients versus 69% among non-TPMT inductors (P = 0.002). At 3 mo, serum creatinine was significantly lower among TPMT inductors when compared with non-TPMT inductors (123.1 ± 7.6 and 161.4 ± 13.9 μmol/L, respectively; P = 0.01). On routine allograft biopsies at 2 yr (n = 61), grade 2 or 3 chronic lesions were present in 19% versus 25%, respectively (P = NS). At days 7 and 30, the azathioprine blood levels were higher among patients who experienced acute rejection (P < 0.02). TPMT activity induction was observed in 57% of renal transplant recipients who received azathioprine. This induction was associated with better graft outcome. The appropriate conversion from azathioprine, which is a pro-drug, into 6-mercaptopurine could explain both better graft outcome and TPMT induction. Assessing the ability of azathioprine metabolism at an individualized level before transplantation may allow a more accurate choice among the different immunosuppressive treatments.

Surgical reconstruction for unilateral iliac artery lesions in patients younger than 50 years

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 474-481 ◽  
Author(s):  
Radak ◽  
Babic ◽  
Ilijevski ◽  
Jocic ◽  
Aleksic ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Limb Salvage ◽  
Iliac Artery ◽  
Graft Patency ◽  
Long Term Results ◽  
Surgical Reconstruction ◽  
Safe Procedure ◽  
Term Survival

Background: To evaluate safety, short and long-term graft patency, clinical success rates, and factors associated with patency, limb salvage and mortality after surgical reconstruction in patients younger than 50 years of age who had undergone unilateral iliac artery bypass surgery. Patients and methods: From January 2000 to January 2010, 65 consecutive reconstructive vascular operations were performed in 22 women and 43 men of age < 50 years with unilateral iliac atherosclerotic lesions and claudication or chronic limb ischemia. All patients were followed at 1, 3, 6, and 12 months after surgery and every 6 months thereafter. Results: There was in-hospital vascular graft thrombosis in four (6.1 %) patients. No in-hospital deaths occurred. Median follow-up was 49.6 ± 33 months. Primary patency rates at 1-, 3-, 5-, and 10-year were 92.2 %, 85.6 %, 73.6 %, and 56.5 %, respectively. Seven patients passed away during follow-up of which four patients due to coronary artery disease, two patients due to cerebrovascular disease and one patient due to malignancy. Limb salvage rate after 1-, 3-, 5-, and 10-year follow-up was 100 %, 100 %, 96.3 %, and 91.2 %, respectively. Cox regression analysis including age, sex, risk factors for vascular disease, indication for treatment, preoperative ABI, lesion length, graft diameter and type of pre-procedural lesion (stenosis/occlusion), showed that only age (beta - 0.281, expected beta 0.755, p = 0.007) and presence of diabetes mellitus during index surgery (beta - 1.292, expected beta 0.275, p = 0.026) were found to be significant predictors of diminishing graft patency during the follow-up. Presence of diabetes mellitus during index surgery (beta - 1.246, expected beta 0.291, p = 0.034) was the only variable predicting mortality. Conclusions: Surgical treatment for unilateral iliac lesions in patients with premature atherosclerosis is a safe procedure with a low operative risk and acceptable long-term results. Diabetes mellitus and age at index surgery are predictive for low graft patency. Presence of diabetes is associated with decreased long-term survival.

Short- and Long-Term Results of Total vs Subtotal Thyroid- ectomies in the Surgical Treatment of Graves' Disease

Swiss Surgery ◽  
2001 ◽  
Vol 7 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Robert ◽  
Mariéthoz ◽  
Pache ◽  
Bertin ◽  
Caulfield ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Long Term Results ◽  
Graves Disease ◽  
Laryngeal Nerve Palsy ◽  
Short And Long Term

Objective: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. Methods: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue - mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. Results: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT - with follow-ups averaging two years (0.5-8) - are receiving thyroxin substitution. Conclusions: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare.

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