Modified Multivisceral Transplantation with Native Spleen Removal in Rats

Background Modified multivisceral transplantation (MMVTx) refers to the use of a graft that includes all abdominal organs except the liver. The use of this type of transplant in children and adults expanded over the last years with good results. However, long-term survival in experimental models has not been reported. Our aim is to describe in detail some technical modifications of MMVTx to obtain long-term survival. Materials and Methods Syngeneic (Lewis–Lewis) heterotopic MMVTx was performed in 16 male rats (180–250 g). All procedures were performed under isoflurane anesthesia. The graft consisted of stomach, duodenopancreatic axis, spleen, and small bowel. The vascular pedicle consisted of a conduit of aorta, including the celiac trunk and the superior mesenteric artery (SMA), and the portal vein (PV). The engraftment was performed by end-to-side anastomosis to the infra-renal cava vein and aorta. After reperfusion, the graft was accommodated in the right side of the abdomen, and a terminal ileostomy performed. The native spleen was removed. Results Donor and recipient time was 39 ± 4.4 minutes and 69 ± 7 minutes, respectively; venous and arterial anastomosis time was 14 ± 1 minutes and 12.3 ± 1 minutes, respectively. Total ischemia time was 77.2 ± 7.9 minutes. Survival was 75% (12/16), six were sacrificed after 2 hours, and six were kept alive for long-term evaluation (more than 1 week). Conclusion Long-term survival is reported after heterotopic MMVTx in rats. The heterotopic MMVTx with native spleen removal would potentially improve the existent models for transplant research. The usefulness of this model warrants further confirmation in allogeneic experiments.

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Long-term Survival with the Right Lower Lobe as the Only Lung Tissue

The Annals of Thoracic Surgery ◽

10.1016/s0003-4975(10)60364-5 ◽

1985 ◽

Vol 40 (6) ◽

pp. 623-624 ◽

Cited By ~ 4

Author(s):

Donald R. Judd ◽

Karen S. Vincent ◽

Peter W. Kinsella ◽

Morey Gardner

Keyword(s):

Lung Tissue ◽

Lower Lobe ◽

Term Survival ◽

Long Term Survival ◽

The Right

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Long-Term Survival after Adrenalectomy for Asynchronous Metastasis of Bladder Cancer to the Bilateral Adrenal Glands

Case Reports in Urology ◽

10.1155/2012/425230 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

S. Washino ◽

M. Hirai ◽

A. Matsuzaki ◽

Y. Kobayashi

Keyword(s):

Bladder Cancer ◽

Urothelial Carcinoma ◽

Adrenal Glands ◽

Adrenal Metastasis ◽

Uneventful Recovery ◽

Term Survival ◽

Long Term Survival ◽

Metastatic Urothelial Carcinoma ◽

The Right

Isolated adrenal metastasis of bladder cancer, particularly the bilateral, is quite rare. Systemic chemotherapy is the treatment of choice for metastatic urothelial carcinoma. However, despite initially promising response rates of approximately 45%–71%, most tumors eventually show progression, and the median survival time following chemotherapy regimen is approximately 14-15 months. Recently, favorable results of surgery for metastatic urothelial carcinoma have been reported. Here, we report a rare case of asynchronous metastasis of bladder cancer to the bilateral adrenal glands with long-term survival after bilateral adrenalectomy. A 69-year-old man underwent radical cystoprostatectomy and ileal conduit urinary diversion for invasive bladder cancer. Ten months later, left adrenalectomy was performed for a left adrenal tumor, revealing metastatic urothelial carcinoma. After adjuvant chemotherapy, a tumor in the right adrenal gland was detected. Right adrenalectomy was done, and the tumor was also found to be metastatic urothelial carcinoma. The patient had an uneventful recovery after starting steroid replacement therapy. Three years later, he was doing well and had no evidence of recurrence. Adrenalectomy for isolated adrenal metastasis of urothelial carcinoma may be a reasonable option, even if such metastases are bilateral.

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Long-term survival after radical surgery for renal cell carcinoma with tumour thrombus extension into the right atrium

BJU International ◽

10.1111/j.1464-410x.2012.11515.x ◽

2012 ◽

Vol 111 (3b) ◽

pp. E59-E64 ◽

Cited By ~ 17

Author(s):

Jan Dominik ◽

Petr Moravek ◽

Pavel Zacek ◽

Jan Vojacek ◽

Miroslav Brtko ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Right Atrium ◽

Renal Cell ◽

Radical Surgery ◽

Term Survival ◽

Long Term Survival ◽

Tumour Thrombus ◽

The Right

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Long Term Survival following Firearm Injury to the Head

Medicine Science and the Law ◽

10.1177/002580247901900313 ◽

1979 ◽

Vol 19 (3) ◽

pp. 205-207

Author(s):

U. K. D. A. Goonetilleke

Keyword(s):

Arterial Thrombosis ◽

Term Survival ◽

Long Term Survival ◽

Firearm Injury ◽

Frontal Lobe Damage ◽

Personality Changes ◽

Autopsy Examination ◽

The Right ◽

The Brain

A case is reported of long term survival following extensive frontal lobe damage caused by firearm injury in 1941. The deceased lived until December 1975 with only epileptic-type fits involving the right upper arm only and no recorded personality changes. Sudden death in 1975 and autopsy examination revealed that she had died of myocardial infarction caused by coronary arterial thrombosis. In the brain there was a large cylindrical defect involving both frontal lobes.

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PD57-05 SIMULTANEOUS CARDIAC AND RENAL SURGERY FOR RENAL AND RETROPERITONEAL TUMOURS INVADING THE RIGHT ATRIUM & PERI-DIAPHRAGMATIC INFERIOR VENA CAVA: ONCOLOGICAL OUTCOME & LONG-TERM SURVIVAL

The Journal of Urology ◽

10.1016/j.juro.2018.02.2649 ◽

2018 ◽

Vol 199 (4S) ◽

Author(s):

Hannah Warren ◽

Archana Fernando ◽

Conal Austin ◽

Kay Thomas ◽

Simon Chowdhury ◽

...

Keyword(s):

Inferior Vena Cava ◽

Right Atrium ◽

Inferior Vena ◽

Vena Cava ◽

Oncological Outcome ◽

Renal Surgery ◽

Term Survival ◽

Long Term Survival ◽

The Right

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Clinical and molecular aspects of a pediatric metachronous adrenocortical tumor

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302011000100010 ◽

2011 ◽

Vol 55 (1) ◽

pp. 72-77 ◽

Cited By ~ 7

Author(s):

Lorena de Oliveira Lima ◽

Antonio Marcondes Lerario ◽

Guilherme Asmar Alencar ◽

Luciana Pinto Brito ◽

Madson Queiroz Almeida ◽

...

Keyword(s):

Molecular Mechanisms ◽

P53 Mutation ◽

Adrenocortical Tumor ◽

Term Survival ◽

Long Term Survival ◽

Over Expression ◽

Molecular Aspects ◽

The Right ◽

Igf1r Expression

The occurrence of metachronous adrenocortical carcinoma has rarely been described. We report a case of a child with virilizing adrenocortical metachronous tumors that, despite several metastases, presented long-term survival (15 years). We analyzed in this tumor IGF2, IGF1R and FGFR4 gene expression, and evaluated the presence of p.R337H germline p53 mutation and somatic CTNNB1 mutation. IGF2 gene was over-expressed in both left (Weiss score 5) and right (Weiss 7) adrenocortical tumors. IGF1R expression levels were higher in the right adrenocortical tumor. FGFR4 over-expression was also detected in the right adrenocortical tumor. In addition, this patient harbors the germline p.R337H p53 mutation and loss of heterozygosity (LOH) was detected in the tumors. No somatic CTNNB1 mutations were found in both tumors. In conclusion, we demonstrated in this unusual case the over-expression of growth signaling pathways, which are molecular mechanisms previously related to adrenocortical tumorigenesis. Furthermore, the absence of somatic CTNNB1 mutations, which is a molecular marker of poor prognosis in adults, might be related to the long-term survival of this patient.

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Truncus Arteriosus with Anomalous Origin and Intramural Course of the Right Coronary Arterie: A Surgical Challenge

Cardiology and Angiology An International Journal ◽

10.9734/ca/2020/v9i130123 ◽

2020 ◽

pp. 1-4

Author(s):

Marcel Vollroth ◽

Michael Weidenbach ◽

Ingo Dähnert ◽

Martin Kostelka ◽

Robert Wagner

Keyword(s):

Truncus Arteriosus ◽

Anomalous Origin ◽

Surgical Reconstruction ◽

High Mountain ◽

Term Survival ◽

Long Term Survival ◽

Congenital Cardiac Malformation ◽

Short And Long Term ◽

The Right

The truncus arteriosus communis is a very complex congenital cardiac malformation occurring in less than 1% of all congenital heart disease patients. Early repair remains one of the most challenging procedures in congenital cardiac surgery. Due to improvement in surgical reconstruction strategies over the past years, there is an acceptable short and long-term survival for those patients. However, each new case represents a “high mountain to climb” in ambition to achieve physiological repair with acceptable hemodynamic and a good long-term survival. We therefore present a very special case with anomalous origin and intramural course of the right coronary artery.

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Left anterior descending artery revascularization with the right internal thoracic artery T-graft: the ‘reverse composite’ configuration

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivz193 ◽

2019 ◽

Vol 29 (6) ◽

pp. 830-835

Author(s):

Yael Ag-Rejuan ◽

Dmitry Pevni ◽

Nachum Nesher ◽

Amir Kramer ◽

Yosef Paz ◽

...

Keyword(s):

Internal Thoracic Artery ◽

Myocardial Revascularization ◽

Circumflex Artery ◽

Term Survival ◽

Long Term Survival ◽

Left Circumflex Artery ◽

Left Anterior Descending Artery ◽

Composite Grafts ◽

The Right

Abstract OBJECTIVES The use of bilateral internal thoracic artery graft for myocardial revascularization has improved the long-term survival and decreased the rate of repeat interventions in patients. A key technical factor for complete arterial revascularization is sufficient length of the internal thoracic artery (ITA) graft. The purpose of this study was to compare early and long-term outcomes of ‘standard composite’ grafting and ‘reverse composite’ grafting. In the former, the left ITA (LITA) is connected to the left anterior descending artery, and the right ITA is connected end-to-side to the LITA for revascularization of the left circumflex artery. In ‘reverse composite’ grafting, the LITA is connected to the left circumflex artery, and the right ITA is connected end-to-side to the LITA, for revascularization of the left anterior descending artery. METHODS We compared the outcomes of 1365 patients who underwent coronary artery bypass grafting in Tel-Aviv Sourasky Medical Centre, using bilateral ITA as standard composite versus ‘reverse composite’ grafts, between January 1996 and December 2011. A propensity score matching analysis compared 132 pairs of patients who underwent bilateral ITA by the 2 modes. RESULTS Twelve hundred and thirty patients underwent standard ‘composite’ grafts and 135 underwent ‘reverse composite’ grafts. Early mortality and early adverse effects did not differ significantly between the groups. After matching, the difference in late mortality between the groups was not statistically significant. CONCLUSIONS This study suggests that revascularization of the left anterior descending with the right ITA, arising from an in situ LITA, is safe and provides early outcomes and long-term survival that are not significantly different from those of the standard composite grafting technique. However, there was evidence of better survival in the standard composite group.

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