scholarly journals Intracardiac Thrombosis during Adult Liver Transplantation

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Marina Moguilevitch ◽  
Carlene Broderick
Keyword(s):  
Liver Transplantation ◽  
Case Reports ◽  
Correct Diagnosis ◽  
Treatment Modalities ◽  
Adult Liver ◽  
Hemodynamic Compromise ◽  
Lethal Complications ◽  
Retrospective Nature ◽  
Very High ◽  
Intracardiac Thrombosis

Intracardiac thrombosis (ICT) and pulmonary embolism (PE) during adult liver transplantation are rare but potentially lethal complications. They are often overlooked because of significant diagnostic challenges. The combination of hemodynamic compromise and transesophageal echocardiography (TEE) findings allows for correct diagnosis. A large variety of putative risk factors for ICT and PE have been suggested, but these events are considered to be multifactorial. There are different proposed treatment modalities for these devastating complications. Unfortunately, in spite of growing knowledge in this area, intraoperative and postoperative mortalities remain very high. The retrospective nature of the study of these events makes the case reports extremely valuable.

How we treat sickle hepatopathy and liver transplantation in adults

Blood ◽  
2014 ◽  
Vol 123 (15) ◽  
pp. 2302-2307 ◽  
Author(s):  
Kate Gardner ◽  
Abid Suddle ◽  
Pauline Kane ◽  
John O’Grady ◽  
Nigel Heaton ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Sickle Cell ◽  
Liver Dysfunction ◽  
Therapeutic Option ◽  
Organ Damage ◽  
Treatment Modalities ◽  
Cell Disease ◽  
Limited Evidence ◽  
Acute Form ◽  
Future Work

Abstract Sickle cell disease (SCD) has evolved into a debilitating disorder with emerging end-organ damage. One of the organs affected is the liver, causing “sickle hepatopathy,” an umbrella term for a variety of acute and chronic pathologies. Prevalence of liver dysfunction in SCD is unknown, with estimates of 10%. Dominant etiologies include gallstones, hepatic sequestration, viral hepatitis, and sickle cell intrahepatic cholestasis (SCIC). In addition, causes of liver disease outside SCD must be identified and managed. SCIC is an uncommon, severe subtype, with outcome of its acute form having vastly improved with exchange blood transfusion (EBT). In its chronic form, there is limited evidence for EBT programs as a therapeutic option. Liver transplantation may have a role in a subset of patients with minimal SCD-related other organ damage. In the transplantation setting, EBT is important to maintain a low hemoglobin S fraction peri- and posttransplantation. Liver dysfunction in SCD is likely to escalate as life span increases and patients incur incremental transfusional iron overload. Future work must concentrate on not only investigating the underlying pathogenesis, but also identifying in whom and when to intervene with the 2 treatment modalities available: EBT and liver transplantation.

PRELIMINARY EXPERIENCE WITH ALEMTUZUMAB (CAMPATH-1H) AND LOW-DOSE TACROLIMUS IMMUNOSUPPRESSION IN ADULT LIVER TRANSPLANTATION

2004 ◽  
Vol 77 (8) ◽  
pp. 1209-1214 ◽  
Author(s):  
Andreas G. Tzakis ◽  
Panagiotis Tryphonopoulos ◽  
Tomoaki Kato ◽  
Seigo Nishida ◽  
David M. Levi ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Low Dose ◽  
Adult Liver

Immune Cell Functional Assay in Monitoring of Adult Liver Transplantation Recipients With Infection

2010 ◽  
Vol 89 (5) ◽  
pp. 620-626 ◽  
Author(s):  
Feng Xue ◽  
Jianjun Zhang ◽  
Longzhi Han ◽  
Qigen Li ◽  
Ning Xu ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Immune Cell ◽  
Functional Assay ◽  
Adult Liver

Augmentation Patch V-venoplasty to Correct Atretic Changes of the Portal Vein During Adult Liver Transplantation

2021 ◽  
Author(s):  
Pietro Addeo ◽  
Olivier Julliard ◽  
Caroline Schaaf ◽  
Chloe Paul ◽  
François Faitot ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Portal Vein ◽  
Adult Liver

In Support of Initial Parenteral Medical Management of Intrathecal Baclofen Withdrawal in Spasticity Patients

2021 ◽  
pp. 875512252110392
Author(s):  
Brian L. LaRowe ◽  
Vicki M. Nussbaum
Keyword(s):  
Case Reports ◽  
Treatment Plan ◽  
Correct Diagnosis ◽  
Treatment Protocol ◽  
Patient Characteristics ◽  
Clinical Problem ◽  
Clinical Situation ◽  
Intrathecal Baclofen ◽  
Wide Range ◽  
Baclofen Withdrawal

Background: Spasticity may present as a wide range of symptoms and conditions. With this protean presentation, a consensus regarding the best course of treatment does not exist. Those patients most severely affected may receive significant benefit from intrathecal baclofen delivery. However, this therapy may itself lead to patient injury in the event of withdrawal. Objective: Withdrawal from intrathecal baclofen may devolve rapidly into a situation in which the patient may incur significant morbidity and even death. A focused, prompt treatment plan would afford the patient the best possible outcome. Methods: The medical literature was reviewed for reports of plans of treatment of baclofen withdrawal and the results obtained. The nature of this problem does not lend itself to a typical study design, depending on case reports and basic pharmacological science application. The paucity of such reports severely limits categorical comparison of patient characteristics and clinical circumstances. Clinical situations, patient characteristics, and therapies were considered and compared. Outcomes of the varied treatments were evaluated for efficacy. Results: Inaccurate diagnoses, delayed correct diagnoses, and the absence of a consistent, treatment plan contributed to widely disparate outcomes. Prompt, correct diagnosis and intensive care unit–based continuous benzodiazepine infusion with titration led to a controlled clinical situation and maximized patient outcomes. Conclusions: Patients going through withdrawal from intrathecal baclofen achieved best outcomes when treated with a continuous infusion and titration of an intravenous benzodiazepine. A well-defined treatment protocol employing this management, reporting serial outcomes, would enable further refinement of the treatment of this clinical problem.

Tacrolimus and Single Intraoperative High-dose of Anti-T-lymphocyte Globulins Versus Tacrolimus Monotherapy in Adult Liver Transplantation

2018 ◽  
Vol 268 (5) ◽  
pp. 776-783 ◽  
Author(s):  
Samuele Iesari ◽  
Kevin Ackenine ◽  
Maxime Foguenne ◽  
Chantal De Reyck ◽  
Mina Komuta ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
T Lymphocyte ◽  
High Dose ◽  
Adult Liver

scholarly journals Systemic Capillary Leak Syndrome (Clarkson Syndrome) in Cancer Patients: A Systematic Review

2018 ◽  
Vol 7 (11) ◽  
pp. 418 ◽  
Author(s):  
Jae Shin ◽  
Keum Lee ◽  
I. Lee ◽  
Ji Oh ◽  
Dong Kim ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Case Reports ◽  
Laboratory Data ◽  
Capillary Leak Syndrome ◽  
Treatment Modalities ◽  
Capillary Leak ◽  
Contributing Factors ◽  
Systemic Capillary Leak Syndrome ◽  
Increased Risk ◽  
Anti Cancer

Systemic capillary leak syndrome (SCLS) is a rare disease characterized by shock caused by capillary hyperpermeability. The disease can occur in cancer patients and effective therapeutic strategies have not been established yet. The aim of the study was to analyze the clinical and laboratory data, treatment modalities, and mortality rate of patients and to identify contributing factors leading to mortality of SCLS in cancer. We searched MEDLINE (inception to July 2018) and of 4612 articles, we identified 62 case reports on SCLS associated with cancer or cancer-related drugs in a total of 53 articles. SCLS was associated with cancer itself in 43.6%, with anti-cancer agents in 51.6% and bone marrow transplantation (BMT) in 4.8%. Among anti-cancer agents, granulocyte-colony stimulating factor (G-CSF) was the most frequently associated drug (14.6%), followed by interleukin (IL)-2 (11.4%). The most common associated malignancies were hematologic (61.3%) with non-Hodgkin lymphoma (22.7%) and multiple myeloma (12.9%) being the leading causes. Common symptoms and signs included dyspnea (27.4%), edema (67.7%), hypotension (32.2%), pleural effusion (29.0%), ascites (22.7%), oliguria (22.7%), and weight gain (21.0%). Patients with SCLS were treated with steroids (59.7%), volume replacement (33.8%), diuretics (24.2%), inotropes (9.6%), methylxanthines (12.8%), β2 agonists (4.8%), while intravenous immunoglobulins (IVIG) were administered in 2 patients (3.2%) only. Among sixteen deaths during follow-up, four were directly attributed to SCLS. Hematologic malignancies were associated with an increased risk for mortality (hazard ratio (HR) 8.820, 95% confidence interval (CI) 1.126–69.063, p = 0.038). Taken together, SCLS can be one important adverse event in cancer patients and careful monitoring of fluid volume is required in the management of SCLS.

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