scholarly journals PTH-125 Survival Following Intestinal And Multivisceral Transplantation At Addenbrooke’s Hospital, Cambridge, Uk

Gut ◽  
2014 ◽  
Vol 63 (Suppl 1) ◽  
pp. A266.1-A266
Author(s):  
C Rutter ◽  
L Sharkey ◽  
A Butler ◽  
N Russell ◽  
C Pither ◽  
...  
Keyword(s):  
Multivisceral Transplantation

scholarly journals Familial Adenomatous Polyposis and Desmoid Tumor Treated with Multivisceral Transplantation and Kidney Autotransplantation: Case Report and Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Libor Janousek ◽  
Robert Novotny ◽  
Michal Kudla ◽  
Martin Oliverius ◽  
Petr Wohl ◽  
...  
Keyword(s):  
Ex Vivo ◽  
Deceased Donor ◽  
Multiple Organ ◽  
Nephron Sparing Surgery ◽  
Tumour Resection ◽  
Adenomatous Polyposis ◽  
Multivisceral Transplantation ◽  
Nephron Sparing ◽  
One Year ◽  
Kidney Autotransplantation

Introduction. Desmoid tumours (DT) are commonly associated with Gardener’s syndrome. Their surgical resection may be complicated by their close proximity to major vessels, multiple organ involvement, and frequent local recurrence. Multivisceral transplantation (MVTx) is an alternative treatment for patients with intestinal and liver failure. In patients with DT closely associated with renal structures but without end-stage kidney disease, concomitant excision of the patient’s own kidney, ex vivo tumour resection with nephron-sparing surgery, or autotransplantation has been proposed. Case Presentation. A 36-year-old Caucasian female weighing 60 kg with Gardener’s syndrome with a history of abdominal surgery was presented to our department with progressive abdominal distention associated with paroxysmal pain. With the use of CT, the patient was diagnosed with a mass arising from the mesenterial region. The patient had normal kidney function and nonalcoholic steatohepatitis. The patient was indicated for MVTx. Management and Outcome. After 16 months on the waiting list, the patient received a multivisceral graft from a deceased donor. Following the restoration of graft vascular flow, the patient’s right kidney was removed and the DT dissected ex vivo before autotransplantation into the right pelvic fossa. The patient received immunosuppressive, antithrombotic, and antibiotic treatment. There was no acute rejection, though the patient experienced pulmonary infection, dysphagia, and oesophageal reflux with fungal infection. The patient had required temporary dialysis for acute renal failure for 75 days. One year after the surgery, nausea and violent vomiting caused delayed gastric emptying caused by spastic pylorus. Clinical improvement was achieved using gastric peroral endoscopic myotomy (G-POEM). Conclusion. MVTx with kidney autotransplantation is a feasible treatment option in patients with familiar adenomatous polyposis complicated by an abdominal DT. Precise tumour dissection with nephron-sparing surgery was carried ex vivo. G-POEM was used to relieve MVTx-related gastroparesis. The patient had no disease reoccurrence after one-year follow-up.

Extending the Indications of Intestinal Transplantation - modified multivisceral transplantation for end-stage pseudomyxoma peritoneii

2017 ◽  
Vol 101 ◽  
pp. S89 ◽  
Author(s):  
Srikanth Reddy ◽  
Tom Cecil ◽  
Phil Allan ◽  
Vrakas Georgios ◽  
Ali Smith ◽  
...  
Keyword(s):  
Intestinal Transplantation ◽  
Multivisceral Transplantation ◽  
End Stage

PWE-237 Prevalence of low bone mineral density in patients undergoing intestinal or multivisceral transplantation at addenbrooke’s hospital, cambridge

Gut ◽  
2015 ◽  
Vol 64 (Suppl 1) ◽  
pp. A316.1-A316
Author(s):  
T Ambrose ◽  
LM Sharkey ◽  
J Louis-Auguste ◽  
CS Rutter ◽  
J Green ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Mineral Density ◽  
Low Bone Mineral Density ◽  
Multivisceral Transplantation

Multivisceral Transplantation for Diffuse Portomesenteric Thrombosis

2015 ◽  
Vol 261 (2) ◽  
pp. e48 ◽  
Author(s):  
Chetana Lim ◽  
Prashant Bhangui ◽  
Chady Salloum ◽  
Daniel Azoulay
Keyword(s):  
Multivisceral Transplantation

OC-033 Outcomes following small intestinal and multivisceral transplantation at addenbrooke’s hospital, cambridge

Gut ◽  
2015 ◽  
Vol 64 (Suppl 1) ◽  
pp. A17-A17
Author(s):  
CS Rutter ◽  
LM Sharkey ◽  
E Allen ◽  
T Ambrose ◽  
S Duncan ◽  
...  
Keyword(s):  
Multivisceral Transplantation ◽  
Small Intestinal

scholarly journals Early hemodynamics and metabolic changes after total abdominal evisceration for experimental multivisceral transplantation

2009 ◽  
Vol 24 (2) ◽  
pp. 156-161 ◽  
Author(s):  
Ruy J. Cruz Junior ◽  
Alejandra G. Garrido ◽  
Maurício Rocha e Silva
Keyword(s):  
Vena Cava ◽  
En Bloc Resection ◽  
Experimental Models ◽  
Metabolic Changes ◽  
Therapeutic Modality ◽  
En Bloc ◽  
Systemic Hemodynamic ◽  
Circulating Blood Volume ◽  
Multivisceral Transplantation ◽  
The Impact

PURPOSE: Multivisceral transplantation (MVTx) has been accepted as standard therapeutic modality for patients with short-bowel syndrome associated with irreversible liver failure. Even nowadays, experimental models of MVTx grounds high incidence of intraoperative or early recipient mortality. Despite the known deleterious effects of hepatosplanchnic exenteration the impact of this procedure on systemic hemodynamics and metabolism remains to be determined. METHODS: Nine dogs (20.1±0.5 kg) were subjected to an en bloc resection of all abdominal organs including, stomach, duodenum, pancreas, liver, spleen, small bowel, and colon. A woven double velour vascular graft was interposed between the suprahepatic and infrahepatic vena cava. Systemic hemodynamic were evaluated through a Swan-Ganz catheter, ultrasonic flowprobes, and arterial lines. Systemic O2-derived variables, glucose, and lactate metabolism were analyzed throughout the experiment. RESULTS: Complete abdominal exenteration was associated with significant reduction in cardiac output, and mean arterial pressure (57% and 14%, respectively). Two hours after reperfusion a significant reduction in arterial pH and glucose were also observed. Oxygen consumption remained unaltered during the first two hours of the experiment, with a significant increase of lactate levels (1.4±0.3 vs. 7.6±0.4, p<0.05). Three animals died before the 3 hours of reperfusion were completed. Total abdominal exenteration for MVTx in dogs is associated with early major hemodynamics, and metabolic changes. CONCLUSION: The deleterious hemodynamic alterations observed are probably related with the association of severe acidosis, hyperlactemia, hypoglycemia, and reduction of total circulating blood volume. Close hemodynamic and metabolic monitoring should be provided during experimental MVTx in order to promote an increase in successful rates of this complex and challenging procedure.

scholarly journals Neoadjuvant peptide receptor radionuclide therapy and modified multivisceral transplantation for an advanced small intestinal neuroendocrine neoplasm: an updated case report

2017 ◽  
Vol 2 (4) ◽  
pp. 247-253
Author(s):  
Ashley K. Clift ◽  
Henk Giele ◽  
Srikanth Reddy ◽  
Rubens Macedo ◽  
Adil Al-Nahhas ◽  
...  
Keyword(s):  
Radionuclide Therapy ◽  
Surgical Techniques ◽  
Peptide Receptor Radionuclide Therapy ◽  
Neuroendocrine Neoplasm ◽  
Peptide Receptor ◽  
Multivisceral Transplantation ◽  
First Case ◽  
Mesenteric Root ◽  
Number Of Patients ◽  
Small Intestinal

AbstractSmall intestinal neuroendocrine neoplasms (SI-NEN) frequently metastasise to regional lymph nodes, and surgery is the mainstay of therapy for such patients. However, despite the possible use of advanced surgical techniques, the resection of both primary and locoregional diseases is not always attainable. Intestinal and multivisceral transplantation has been performed in a small number of patients with conventionally nonresectable, slow-growing tumours threatening the mesenteric root but has remained controversial. The use of donor skin in “sentinel flaps” in transplantation theoretically offers advantages in tailoring immunosuppression and monitoring for rejection. We represent (with extended follow-up) the first case of a patient with inoperable extensive mesenteric metastases from SI-NEN, who underwent neoadjuvant peptide receptor radionuclide therapy before a modified multivisceral transplant with a concomitant vascularised sentinel forearm flap. At 48 months after transplantation, our patient remained at full physical activity with no evidence of disease recurrence on either tumour biochemistry or radiological imaging.

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