Persistence of Positive RT-PCR for SARS-CoV-2 in an Early Allogenic Stem Cells Transplantation Recipient: A Case Study

The new coronavirus SARS-CoV-2 has rapidly spread over the world causing the disease by WHO called COVID-19, is the defining global health crisis of our time and the greatest threat we have faced during this century [1]. According to the World Health Organizations (WHO) data, in February 2021, almost one hundred fifteen million of the population has been infected with more than two million deaths [2]. To date, in the absence of any specific treatment, our knowledge about this disease remains very limited and is subject to rapid change. This virus represents a serious danger for patients with hematologic malignancies due to myeloablative conditioning and immunosuppressive treatments. People receiving chemotherapy with compromised immune systems and complications after stem cell transplant have an increased risk for infection [3]. COVID-19 infection may complicate clinical symptoms with higher risk of respiratory distress [4]. Actually, the experience in the management of COVID-19 infection in the stem cell transplant recipients is limited.

Thromboxane A2 Deficit Diagnosis in a Patient with Suspicion of Von Willebrand Disease

Thromboxane A2 receptor deficiency is a qualitative platelet disorder that partially impedes adequate platelet signaling and aggregation. Generally, these patients have mild hemorrhagic manifestations in basal conditions, but may show severe bleeding when faced with a hemostatic challenge. We present the case of a 30-year-old female patient that arrives at the Hematology service with an undiagnosed bleeding disorder. She presented hemorrhagic complications during an augmentation mammoplasty and during an exodontia procedure, yet, during a C-section she presented none. At the first consultation she had normal coagulation factor levels by coagulometry, and normal platelet aggregation test for ADP, ristocetin, collagen and epinephrine. A platelet aggregation test for arachidonic acid confirmed thromboxane A2 deficit disorder. Thromboxane A2 deficit disorder is a rare qualitative platelet disorder that requires an extensive knowledge of coagulation and platelet function and tests, and a high level of clinical suspicion. These tests are especially difficult to interpret during pregnancy due to normal modifications to bodily function during this process.

Mucosal Bacterial Immunotherapy in Solid Organ Recipients with Recurrent Respiratory Tract Infections: Case Report

Bacterial infections are the most frequent infectious complications among solid organ recipients. These complications are associated with a high morbidity and mortality, despite recent advances in antimicrobial prophylaxis in the transplant setting. New therapeutic modalities are warranted. We present here a retrospective study based on medical records review of 2 solid organ recipients that were treated with mucosal bacterial immunotherapy because of recurrent bacterial respiratory infections long time after transplantation. A successful decrease of the frequency of bacterial respiratory infections during a period of up to 8 years was observed in one of the patients. We suggest that clinical trials in this field are warranted.

Providing Arterial Supply to the Liver Graft with Recipient Splenic Artery in Living Donor Liver Transplantation: Case Report

Hepatic arterial reconstruction is an important step in graft implantation in liver transplant procedure. Hepatic arterial anastomosis always demands meticulous and highly skilled surgical techniques to provide adequate blood supply to the graft. Hepatic arterial intimal dissection in liver transplantation is although a rare but documented complication, with incidence of less than 5%, but having dreadful complications. To overcome this complication of Recipient hepatic artery dissection, various techniques have been described by different authors. Here, in this case report we are describing technique of utilization of transposed recipient splenic artery for graft arterial inflow where native hepatic artery was dissected up to common hepatic artery. Post-operative recovery was uneventful and on follow up, patient was absolutely fine. So, recipient splenic artery is a safe alternative option in such complex situations for providing arterial blood flow to the graft and moreover it avoids the burden of extra anastomosis which is required in conduit technique.

Urgent Endovascular Treatment of Severe Celiac Artery Stenosis during Liver Transplantation

Arterial reconstruction during orthotopic liver transplant (OLT) can often be quite challenging in cases where the recipient hepatic artery is inadequate to provide inflow to the allograft. In these situations, an aorto-hepatic interposition graft is typically performed using the donor iliac artery [1, 2]. We present a case describing the use of urgent endovascular treatment of severe celiac artery stenosis intra-operatively during liver transplantation in a patient with significant aorto-iliac atherosclerotic disease precluding the use of an interposition graft.