Abstract:
OBJECTIVES:To evaluate the outcome of pediatric living donor liver transplantation (LDLT) regarding portal vein (PV) reconstruction, ABO compatibility, and impact of maternal donation on graft acceptance. BACKGROUND:LDLT and ABO-mismatched transplantation constitute feasible options to alleviate organ shortage in children. Vascular complications of portal hypoplasia in biliary atresia (BA) and acute rejection (AR) are still major concerns in this field. METHODS:Data from 250 pediatric LDLT recipients, performed at Cliniques Universitaires Saint-Luc between July 1993 and June 2012, were collected retrospectively. Results were analyzed according to ABO matching and PV complications. Uni- and multivariate analyses were performed to study the impact of immunosuppression, sex matching, and maternal donation on AR rate. RESULTS:Overall, the 10-year patient survival rate was 93.2%. Neither patient or graft loss nor vascular rejection, nor hemolysis, was encountered in the ABO nonidentical patients (n = 58), provided pretransplant levels of relevant isoagglutinins were below 1/16. In BA recipients, the rate of PV complications was lower after portoplasty (4.6%) than after truncal PV anastomosis (9.8%) and to jump graft interposition (26.9%; P = 0.027). In parental donation, maternal grafts were associated with higher 1-year AR-free survival (55.2%) than paternal grafts (39.8%; P = 0.041), but only in BA patients. CONCLUSIONS:LDLT, including ABO-mismatched transplantation, constitutes a safe and efficient therapy for liver failure in children. In BA patients with PV hypoplasia, portoplasty seems to constitute the best technique for PV reconstruction. Maternal donation might be a protective factor for AR.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Gurevich M,Guy-Viterbo V,Janssen M,Stephenne X,Smets F,Sokal E,Lefebvre C,Balligand JL,Pirotte T,Veyckemans F,Clapuyt P,Menten R,Dumitriu D,Danse E,Annet L,Clety SC,Detaille T,Latinne D,Sempoux C,Laterre PF,de Magdoi
10.1097/SLA.0000000000001094subject
Has Abstractpub_date
2015-12-01 00:00:00pages
1141-9issue
6eissn
0003-4932issn
1528-1140journal_volume
262pub_type
杂志文章abstract:BACKGROUND:The optimal transfusion threshold after surgery in children is unknown. We analyzed the general surgery subgroup of the TRIPICU (Transfusion Requirements in Pediatric Intensive Care Units) study to determine the impact of a restrictive versus a liberal transfusion strategy on new or progressive multiple orga...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e3181c5dc2e
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:To determine whether ischemic preconditioning protects the human liver against a subsequent period of ischemia in patients undergoing hemihepatectomy, and to identify possible underlying protective mechanisms of ischemic preconditioning, such as inhibition of hepatocellular apoptosis. SUMMARY BACKGROUND DATA...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200008000-00001
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:To determine whether adjuvant chemotherapy (AC) after neoadjuvant chemoradiation and esophagectomy is associated with improved overall survival for patients with locally advanced esophageal cancer, and to evaluate how pathologic disease response to neoadjuvant treatment impacts this effect. BACKGROUND:Neoadj...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001954
更新日期:2017-08-01 00:00:00
abstract::Although previous studies have suggested that bacteria may contribute to pigment gallstone formation, the current experiments provide evidence that bacteria have a central role in this process. The studies included scanning electron microscopy (SEM) of gallstones, measurements of bacterial adherence to gallstones in v...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198709000-00002
更新日期:1987-09-01 00:00:00
abstract:OBJECTIVE:Prehospital intravenous (IV) fluid administration is common in trauma patients, although little evidence supports this practice. We hypothesized that trauma patients who received prehospital IV fluids have higher mortality than trauma patients who did not receive IV fluids in the prehospital setting. METHODS...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318207c24f
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:The Hepp-Couinaud technique describes side-to-side HJ to the main left hepatic duct but a side-to-side approach is not consistently used when repairing other ducts. Compared with end-to-side repairs, side-to-side anastomoses require less dissection, theoretically preserving blood supply to the bile ducts, an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31819a6b2e
更新日期:2009-03-01 00:00:00
abstract::The University of Rochester, Department of Surgery, in response to an experimental community-wide limit on hospital budgets, studied high-cost general surgical patients as a potential source of leverage for containment of hospital costs. It was found that a small number of patients impact significantly on hospital cos...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198309000-00005
更新日期:1983-09-01 00:00:00
abstract::Three patients with Menetrier's disease and protein-losing gastropathy who were studied during a 12 year period have been presented. The characteristic findings which differentiate them from patients with hypertrophic hypersecretory gastropathy, including the Zollinger-Ellison syndrome, are: 1) hypertrophy of gastric ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197505000-00036
更新日期:1975-05-01 00:00:00
abstract::Nineteen patients with primary duodenal carcinoid were analysed retrospectively, and eight of the tumors were immunocytochemically examined. One tumor contained somatostatin, two tumors gastrin, two tumors both these peptides, and one tumor contained serotonin. In two tumors no peptide or amine could be demonstrated. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198304000-00003
更新日期:1983-04-01 00:00:00
abstract::Forty-three patients (mean age 62 +/- 1 years) were treated for ventricular septal defect (VSD) secondary to myocardial infarction. Whenever possible, operation was postponed until six weeks post-onset chest pain. However, hemodynamic instability, evidenced by cardiogenic shock, refractory pulmonary edema, or a rising...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197709000-00004
更新日期:1977-09-01 00:00:00
abstract:OBJECTIVE:The aim of the randomized clinical trial was to compare the 2 years of clinical outcomes of a lightweight (Ultrapro) vs a heavyweight (Prolene) mesh for laparoscopic total extraperitoneal (TEP) inguinal hernia repair. BACKGROUND:Lightweight meshes reduce postoperative pain and stiffness in open anterior ingu...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000001579
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:To evaluate whether intraoperative subcutaneous wound irrigation with 0.04% polyhexanide can reduce surgical site infection (SSI) in elective laparotomies compared to saline. BACKGROUND:SSI is a common complication after gastrointestinal surgery. To date, there is a lack of evidence whether subcutaneous woun...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000003645
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:To investigate the use of coffee, caffeinated drinks, and caffeine tablets for pharmacological cognitive enhancement (CE) among surgeons. BACKGROUND:Surgeons have demanding workloads, and the resulting fatigue and concentration deficits can lead to medical errors. Some surgeons use substances that promote wa...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000830
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:The authors assess the long-term results of repeat hepatectomies for recurrent metastases of colorectal cancer and determine the factors that can predict survival. SUMMARY BACKGROUND DATA:Safer techniques of hepatic resection have allowed surgeons to consider repeat hepatectomy for colorectal metastases in a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199701000-00006
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the results of pancreatic resection in pancreatic endocrine neoplasias (PENs) in patients affected by multiple endocrine neoplasia type 1 (MEN1) syndrome. BACKGROUND:Since these tumors often show an indolent course, the role of diagnostic procedures and type of surgical ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000218073.77254.62
更新日期:2006-07-01 00:00:00
abstract::A major surgical procedure can impair the delayed hypersensitivity response. This impairment is associated with suppressor cell activity that can alter either afferent or efferent responses. Using the third party mixed leukocyte culture to define cell types involved, major immune impairment was seen with the combinati...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198304000-00010
更新日期:1983-04-01 00:00:00
abstract::The records of 161 adult patients who underwent a modification of the Witzel gastrostomy without gastropexy at Ellis Fischel State Cancer Hospital, Columbia, Missouri, between 1977 and 1980, are reviewed in detail and form the basis of this report. Six of these patients had gastrostomies on two different occasions. Th...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198206000-00003
更新日期:1982-06-01 00:00:00
abstract:OBJECTIVE:We report on a new side-to-side isoperistaltic strictureplasty (SSIS), the Michelassi II or end-to-side-to-side-to-end strictureplasty, performed with discontinuous bowel loops. SUMMARY BACKGROUND DATA:The SSIS Michelassi strictureplasty was described a quarter of a century ago to avoid massive bowel resecti...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003430
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:This prospective observational study was designed to assess Pediatric Quality of Life (PedsQL) after surgical treatment for congenital diaphragmatic hernia (CDH), esophageal atresia/tracheoesophageal fistula (EA/TEF), Hirschsprung disease (HD), gastroschisis (GAS), omphalocele (OMP), and necrotizing enterocol...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002918
更新日期:2018-09-01 00:00:00
abstract::Percutaneous transluminal angioplasty (PTA) was performed as an adjunct to an operation in 43 patients with peripheral arterial insufficiency. This represents 26% of patients undergoing PTA over the past 44 months. In 23 patients PTA was done in conjunction with planned vascular reconstruction. It was successful in al...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198206000-00016
更新日期:1982-06-01 00:00:00
abstract:OBJECTIVE:To determine the impact of a clinical pathway for elective infrarenal aortic reconstruction on outcome, resource utilization, and cost in a university medical center. SUMMARY BACKGROUND DATA:Clinical pathways have been reported to control costs, reduce resource utilization, and maintain or improve the qualit...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199805000-00009
更新日期:1998-05-01 00:00:00
abstract::All cases of penetrating cardiac trauma in 1985 and 1986 in Jefferson County, Alabama, where patients dying of penetrating trauma received autopsies, were retrospectively reviewed. All hospitals in the county plus the single coroner's office provided the records of the 72 patients comprising this study. Incidents occu...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198906000-00004
更新日期:1989-06-01 00:00:00
abstract:OBJECTIVE:To analyze the feasibility and safety of Natural Orifice Transluminal Endoscopic Surgery (NOTES) appendectomy, and to analyze separately the transvaginal appendectomy (TVAE) and the transgastric appendectomy (TGAE) procedures. BACKGROUND:Laparoscopic appendectomy has rare but relevant complications, namely i...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001742
更新日期:2017-03-01 00:00:00
abstract::Forty-nine patients with chronic ulcerative colitis refractory to medical therapy and four with multiple polyposis have undergone total colectomy, mucosal protectomy, and endorectal ileal pull-through with ileoanal anastomosis at the UCLA Medical Center during the past 12 years (mean age, 19.4 years). Thirty-eight pat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198402000-00003
更新日期:1984-02-01 00:00:00
abstract::The problem of lead poisoning from bullets has been investigated by surgically implanting discs of lead, each enriched in a different natural isotope, into the tissue of two mongrel dogs and monitoring by mass spectrometry the release of the lead into each animal's blood over the course of 3 years. Lead placed in the ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198611000-00014
更新日期:1986-11-01 00:00:00
abstract::During the years 1954 through 1964, 259 individuals with primary malignant melanoma had an elective node dissection. Microscopic metastases were found in 15% of these patients. The presence of only a microscopic focus of involvement gave a 10-year cure rate of 67%; metastasis larger than a microscopic focus in a singl...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197707000-00014
更新日期:1977-07-01 00:00:00
abstract:OBJECTIVE:To examine factors influencing surgical research and assess the current state of training future surgical scientists. SUMMARY BACKGROUND DATA:The number of surgeons actively engaged in research seems to be decreasing. Training future surgical scientists to increase these numbers depends on a variety of facto...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e318163d27d
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:The authors review current definition, classification, scoring, microbiology, inflammatory response, and goals of management of secondary peritonitis. SUMMARY BACKGROUND DATA:Despite improved diagnostic modalities, potent antibiotics, modern intensive care, and aggressive surgical treatment, up to one third ...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199607000-00003
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVE:To examine preoperative dietary influences on gut-associated lymphoid tissue (GALT) cell number in the context of postoperative infectious complications. BACKGROUND:There is little clinical evidence regarding whether nutritional routes affect GALT size and/or phenotype. The influence of GALT atrophy on clini...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31827a0e05
更新日期:2013-12-01 00:00:00
abstract::Thromboxane (Tx) synthase but not cyclo-oxygenase inhibitors prevent acute tubular necrosis (ATN) after renal ischemia, a phenomenon believed to be due to stimulation of the endogenous production of vasodilating prostaglandins (PG). This study directly tests that vasodilating PG protect against the consequences of ren...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198702000-00015
更新日期:1987-02-01 00:00:00