Hepatic allograft rescue following arterial thrombosis. Role of urgent revascularization.

Abstract:

:Hepatic artery thrombosis is a continuing source of morbidity and mortality following orthotopic liver transplantation. The cornerstone of therapy has been urgent retransplantation that is limited by organ availability. For this reason we developed a policy of urgent revascularization for allograft rescue. Hepatic artery thrombosis developed following 15 transplants of which 11 underwent urgent rearterialization. The diagnosis was made a mean of 4.8 days (range 1-10) following transplantation. Duplex ultrasonography was diagnostic in all patients and confirmed by angiography in 4 (36%). Three patients with hepatic artery thrombosis were identified following screening ultrasonography and were clinically unsuspected. Upon reexploration, a specific technical reason for hepatic artery was found in 4 patients (36%). Twelve arterial revascularization procedures were performed in 11 patients including: thrombectomy alone (n = 4); revision of anastomosis with thrombectomy (n = 5); and thrombectomy with placement of vascular conduit (n = 3). Following revascularization, 8 patients maintained hepatic artery patency. Three patients eventually required retransplantation secondary to biliary sepsis. Biliary tract complications developed in 6 patients, at a mean of 23 days following revascularization and included: breakdown of the biliary anastomosis (n = 4); stricture (n = 1); and sludge formation (n = 1). The overall graft and patient survival are 74% and 82% respectively, with a mean follow-up of 6.8 months. Hepatic allograft rescue with the use of urgent revascularization following hepatic artery thrombosis appears to be an effective means of either avoiding retransplantation or providing a bridge until a suitable donor becomes available.

journal_name

Transplantation

journal_title

Transplantation

authors

Langnas AN,Marujo W,Stratta RJ,Wood RP,Li SJ,Shaw BW

doi

10.1097/00007890-199101000-00013

subject

Has Abstract

pub_date

1991-01-01 00:00:00

pages

86-90

issue

1

eissn

0041-1337

issn

1534-6080

journal_volume

51

pub_type

杂志文章
  • Improving the prediction of donor kidney quality: deceased donor score and resistive indices.

    abstract:BACKGROUND:The deceased donor score (DDS), expanded criteria donor (ECD) definition, and resistive index (RI) were developed for pretransplant evaluation of donors. DDS and ECD are determined by a calculation of risk from donor variables, while RI is determined from flow characteristics of kidneys during machine preser...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000173798.04043.af

    authors: Nyberg SL,Baskin-Bey ES,Kremers W,Prieto M,Henry ML,Stegall MD

    更新日期:2005-10-15 00:00:00

  • Toxicity of rapamycin--a comparative and combination study with cyclosporine at immunotherapeutic dosage in the rat.

    abstract::Sprague-Dawley rats were treated for 14 days with rapamycin (RAP; 1.5 mg/kg/day i.p.), cyclosporine (15 mg/kg/day by gavage), both drugs in combination, or appropriate drug vehicles. Hematological parameters and biochemical indices of renal and hepatic function were determined throughout the experimental period, at th...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199108000-00004

    authors: Whiting PH,Woo J,Adam BJ,Hasan NU,Davidson RJ,Thomson AW

    更新日期:1991-08-01 00:00:00

  • T cells are necessary and critical for xenograft rejection in new concordant cardiac xenotransplant model.

    abstract:BACKGROUND:A new vascularized concordant xenotransplant model using the Chinese hamster as donor and mouse as recipient species is reported. This model takes advantage of the wealth of informative immune reagents and knockout and transgenic backgrounds available for the mouse. METHODS:Heterotopic auxillary cardiac tra...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199906150-00016

    authors: Obatake M,Kushida M,Kimmel S,Clarke ID,Kim PC

    更新日期:1999-06-15 00:00:00

  • A prospective randomized trial of tacrolimus and prednisone versus tacrolimus, prednisone, and mycophenolate mofetil in primary adult liver transplant recipients: an interim report.

    abstract:BACKGROUND:Tacrolimus (Tac) and mycophenolate mofetil (MMF) are newly approved immunosuppressive agents. However, the safety and efficacy of the combination of MMF and Tac in primary liver transplantation has not been determined. METHODS:An Institutional Review Board-approved, open-label prospective randomized protoco...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00007890-199811270-00024

    authors: Jain AB,Hamad I,Rakela J,Dodson F,Kramer D,Demetris J,McMichael J,Starzl TE,Fung JJ

    更新日期:1998-11-27 00:00:00

  • HLA matching and the United Network for Organ Sharing Allocation System: impact of HLA matching on African-American recipients of cadaveric kidney transplants.

    abstract:BACKGROUND:A recent proposal supports the elimination of allocation points for human leukocyte antigen (HLA) mismatches (MM) in cadaveric kidney transplantation. The intent is to increase access for some racial groups that might be disadvantaged by the representation of race-specific HLA in a largely white donor pool. ...

    journal_title:Transplantation

    pub_type: 评论,杂志文章

    doi:10.1097/00007890-200212150-00024

    authors: Rebellato LM,Arnold AN,Bozik KM,Haisch CE

    更新日期:2002-12-15 00:00:00

  • Predominant role of the Fab fragment in delaying hyperacute rejection in guinea pig-to-rat xenotransplantation.

    abstract:BACKGROUND:Human intravenous immunoglobulin G delayed xenogeneic hyperacute rejection (HAR) in the guinea pig-to-rat combination. We investigated the respective roles of the Fc and Fab fragments of the IgG molecule in this inhibitory effect. METHODS:By using a guinea pig-to-rat heart transplantation model, the efficie...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199808150-00018

    authors: Urbani L,Fabre M,Cardoso J,Lambin P,Devillier P,Soubrane O,Houssin D,Gautreau C

    更新日期:1998-08-15 00:00:00

  • Activation of the purine salvage pathway in mononuclear cells of cardiac recipients treated with mycophenolate mofetil.

    abstract:BACKGROUND:The objective of this study was to investigate purine nucleotide metabolism in peripheral blood mononuclear cells (PBMC) of cardiac transplant recipients switched from azathioprine to mycophenolate mofetil (MMF). METHODS:Concentrations of guanosine 5'triphosphate (GTP) and adenosine 5'triphosphate (ATP), th...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1097/01.tp.0000225759.54343.23

    authors: Devyatko E,Zuckermann A,Bohdjalian A,Roedler S,Dunkler D,Grimm M,Weigel G

    更新日期:2006-07-15 00:00:00

  • Multivariate analysis of donor risk factors for graft survival in kidney transplantation.

    abstract:BACKGROUND:The results of the transplantation of marginal donor kidneys remain controversial. This study aimed to investigate the impact of donor risk factors as predictors of kidney-graft outcome. METHODS:Allograft failure risk factors were studied in 7,209 cadaveric kidney-transplant recipients reporting to the Etab...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.TP.0000044171.97375.61

    authors: Pessione F,Cohen S,Durand D,Hourmant M,Kessler M,Legendre C,Mourad G,Noël C,Peraldi MN,Pouteil-Noble C,Tuppin P,Hiesse C

    更新日期:2003-02-15 00:00:00

  • Plant alkaloid tetrandrine and its analog block CD28-costimulated activities of human peripheral blood T cells: potential immunosuppressants in transplantation immunology.

    abstract:BACKGROUND:T lymphocyte activation mediated by CD28 costimulation plays a critical role in graft rejection. Plant alkaloid tetrandrine, purified from a Chinese antirheumatic herb, is a potent immunosuppressant. Here, we examined its effects on several CD28-costimulated T-cell activities. In addition, such effects were ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199911150-00027

    authors: Lai JH,Ho LJ,Kwan CY,Chang DM,Lee TC

    更新日期:1999-11-15 00:00:00

  • Polymorphisms of multidrug resistance gene (MDR1) and cyclosporine absorption in de novo renal transplant patients.

    abstract:BACKGROUND:Several single nucleotide polymorphisms (SNPs) in the multidrug resistance (MDR1) gene may play a role in the interindividual variation of cyclosporine A (CsA) absorption in renal transplant patients. METHODS:An analysis of CsA absorption measured by the dose- and weight-adjusted 4 hr area under the time-co...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000264197.88129.2e

    authors: Foote CJ,Greer W,Kiberd B,Fraser A,Lawen J,Nashan B,Belitsky P

    更新日期:2007-05-27 00:00:00

  • Sirolimus (rapamycin)-based therapy in human renal transplantation: similar efficacy and different toxicity compared with cyclosporine. Sirolimus European Renal Transplant Study Group.

    abstract:BACKGROUND:Sirolimus (rapamycin) is a potent immunosuppressant with a mechanism of action different from cyclosporine (CsA) or tacrolimus. METHODS:In 11 European centers, first cadaveric renal allograft recipients were randomized to CsA (n=42) or sirolimus (n=41). Dosing of these agents was concentration-controlled an...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00007890-199904150-00017

    authors: Groth CG,Bäckman L,Morales JM,Calne R,Kreis H,Lang P,Touraine JL,Claesson K,Campistol JM,Durand D,Wramner L,Brattström C,Charpentier B

    更新日期:1999-04-15 00:00:00

  • The role of bile salt toxicity in the pathogenesis of bile duct injury after non-heart-beating porcine liver transplantation.

    abstract:BACKGROUND:Intrahepatic bile duct strictures are a serious complication after non-heart-beating (NHB) liver transplantation. Bile salt toxicity has been identified as an important factor in the pathogenesis of bile duct injury and cholangiopathies. The role of bile salt toxicity in the development of biliary strictures...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e318170f5f7

    authors: Yska MJ,Buis CI,Monbaliu D,Schuurs TA,Gouw AS,Kahmann ON,Visser DS,Pirenne J,Porte RJ

    更新日期:2008-06-15 00:00:00

  • Langerhans cell homeostasis and turnover after nonmyeloablative and myeloablative allogeneic hematopoietic cell transplantation.

    abstract:BACKGROUND:Langerhans cells (LCs) are self-renewing epidermal myeloid cells that can migrate and mature into dendritic cells. Recipient LCs that survive cytotoxic therapy given in preparation for allogeneic hematopoietic cell transplantation may prime donor T cells to mediate cutaneous graft-versus-host disease (GVHD)....

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1097/TP.0000000000000097

    authors: Mielcarek M,Kirkorian AY,Hackman RC,Price J,Storer BE,Wood BL,Leboeuf M,Bogunovic M,Storb R,Inamoto Y,Flowers ME,Martin PJ,Collin M,Merad M

    更新日期:2014-09-15 00:00:00

  • Enhanced T cell cytokine gene expression in mouse airway obliterative bronchiolitis.

    abstract:BACKGROUND:Obliterative bronchiolitis (OB), chronic allograft rejection of the lung, is a major cause of morbidity and mortality after lung transplantation. Previous studies using the heterotopic mouse trachea model of chronic airway rejection have shown a T cell infiltrate composed of CD4+ and CD8+ T cells. The goal o...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200002150-00016

    authors: Neuringer IP,Walsh SP,Mannon RB,Gabriel S,Aris RM

    更新日期:2000-02-15 00:00:00

  • Effect of transplantation site and alpha L3T4 treatment on survival of rat, hamster, and rabbit islet xenografts in mice.

    abstract::Rat, hamster, and rabbit islets were transplanted into diabetic C57BL/B6 mice. The effect on islet xenograft survival of low-temperature culture of the donor islets, alpha L3T4 treatment of the recipients for seven days, and transplantation of the grafts either in the renal capsule or in the liver via the portal vein ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198905000-00002

    authors: Lacy PE,Ricordi C,Finke EH

    更新日期:1989-05-01 00:00:00

  • Long-term improvement in renal function after cyclosporine reduction in renal transplant recipients with histologically proven chronic cyclosporine nephropathy.

    abstract:BACKGROUND:Chronic cyclosporine (CsA) nephropathy, which has been unequivocally documented in recipients of heart, heart-lung, liver, or bone marrow transplants, as well as in nontransplant situations, usually results in a progressive deterioration of renal function. In this study, we assessed the potential reversibili...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199803150-00010

    authors: Mourad G,Vela C,Ribstein J,Mimran A

    更新日期:1998-03-15 00:00:00

  • Cell and extracellular matrix rejection in arterial concordant and discordant xenografts in the rat.

    abstract::Vascularized xenografts are rejected acutely and hyperacutely in concordant or discordant combinations, respectively. We investigated the impact of the donor-recipient combination on the rejection of arterial xenografts, analyzing the cellular and extracellular matricial compartments. Aortic xenografts were performed ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199609270-00017

    authors: Allaire E,Mandet C,Bruneval P,Bensenane S,Becquemin JP,Michel JB

    更新日期:1996-09-27 00:00:00

  • Community-acquired respiratory viral infections in lung transplant recipients: a single season cohort study.

    abstract:BACKGROUND:The impact of community-acquired respiratory virus (CARV) infections on bronchiolitis obliterans syndrome (BOS) and outcome after lung transplantation (LTx) and diagnostic techniques were prospectively evaluated. METHODS:A single-center prospective cohort study was performed in LTx-outpatients between Octob...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181a4857d

    authors: Gottlieb J,Schulz TF,Welte T,Fuehner T,Dierich M,Simon AR,Engelmann I

    更新日期:2009-05-27 00:00:00

  • Evidence that addition of azathioprine improves renal function in cyclosporine-treated patients with allograft dysfunction.

    abstract::Several approaches have been attempted to manage renal allograft dysfunction in cyclosporine-prednisone (CsA-Pred)-treated patients. Conversion to conventional therapy and perioperative triple drug have been associated with high rates of acute rejection episodes, infections, or neoplasms. We report our experience in d...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1097/00007890-199108000-00017

    authors: Pascual J,Marcén R,Orofino L,Quereda C,Mampaso F,Liaño F,Ortuño J

    更新日期:1991-08-01 00:00:00

  • Islet filtration: a simple and rapid new purification procedure that avoids ficoll and improves islet mass and function.

    abstract::Islet isolation is a time-consuming process. Islet yields vary, and previous in vitro studies suggest that Ficoll may be an islet toxin. Here, we describe an alternative, Ficoll-free method to purify murine islets by filtration through a cell strainer. Collagenase digestion of pancreata was carried out using standard ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200209270-00023

    authors: Salvalaggio PR,Deng S,Ariyan CE,Millet I,Zawalich WS,Basadonna GP,Rothstein DM

    更新日期:2002-09-27 00:00:00

  • Costimulation blockade: current perspectives and implications for therapy.

    abstract::T cells must be activated before they can elicit damage to allografts, through interaction of their T cell receptor (TCR) with peptide-MHC complex and through accessory molecules. Signaling through accessory molecules or costimulatory molecules is a critical way for the immune system to fine tune T cell activation. An...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/TP.0b013e31826d4672

    authors: Kinnear G,Jones ND,Wood KJ

    更新日期:2013-02-27 00:00:00

  • The presence of HLA-directed antibodies after heart transplantation is associated with poor allograft outcome.

    abstract:BACKGROUND:The clinical significance of HLA-directed antibodies newly detected after transplantation (HT) is controversial. METHODS:Seventy-one HT recipients consented to enroll. Mean follow-up time was 28 months (range 6-48). Panel reactive antibody (PRA) analysis was performed on posttransplant sera (2 weeks, 1, 2, ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000180564.14050.49

    authors: Tambur AR,Pamboukian SV,Costanzo MR,Herrera ND,Dunlap S,Montpetit M,Heroux A

    更新日期:2005-10-27 00:00:00

  • Humoral Reactivity of Renal Transplant-Waitlisted Patients to Cells From GGTA1/CMAH/B4GalNT2, and SLA Class I Knockout Pigs.

    abstract:BACKGROUND:Antipig antibodies are a barrier to clinical xenotransplantation. We evaluated antibody binding of waitlisted renal transplant patients to 3 glycan knockout (KO) pig cells and class I swine leukocyte antigens (SLA). METHODS:Peripheral blood mononuclear cells from SLA identical wild type (WT), α1, 3-galactos...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000001646

    authors: Martens GR,Reyes LM,Li P,Butler JR,Ladowski JM,Estrada JL,Sidner RA,Eckhoff DE,Tector M,Tector AJ

    更新日期:2017-04-01 00:00:00

  • Combined lung and liver transplantation: the United States experience.

    abstract:BACKGROUND:Combined transplantation of the lungs and liver is indicated for patients who would not be expected to survive transplantation of either organ alone. No single center has accumulated a significant experience, and as a result the expectations for this operation in the current era are unknown. METHODS:Patient...

    journal_title:Transplantation

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/01.tp.0000165717.23652.09

    authors: Barshes NR,DiBardino DJ,McKenzie ED,Lee TC,Stayer SA,Mallory GB,Karpen SJ,Quiros-Tejeira RE,Carter BA,Fraser CD Jr,Goss JA

    更新日期:2005-11-15 00:00:00

  • Effects of a short course of leflunomide on T-independent B-lymphocyte xenoreactivity and on susceptibility of xenografts to acute or chronic rejection.

    abstract:BACKGROUND:Leflunomide is a novel immunosuppressive agent with promising activity for xenotransplantation. It is not clear yet which mechanisms of action of leflunomide are responsible for that. METHODS:In a hamster-to-C57BL/6 nude mouse heart transplantation model, a 2-week course of leflunomide was used after transp...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000147464.63188.4b

    authors: Yan Y,Verbeken E,Yu L,Rutgeerts O,Goebels J,Segers C,Lin Y,Waer M

    更新日期:2005-01-27 00:00:00

  • No improvement of pancreas transplant endocrine function by exogenous insulin infusion (islet rest) in the postoperative period.

    abstract::The concept of islet exhaustion maintains that exposure of pancreatic islets to hyperglycemia and other stresses leads to islet dysfunction and irreparable damage. The process of pancreatic transplantation places many stresses on islets (e.g., counter-regulatory hormones, steroids, cyclosporine toxicity). As practiced...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198907000-00006

    authors: Dafoe DC,Campbell DA Jr,Rosenberg L,Merion RM,Ucros I,Vinik AI,Klandorf H,Turcotte JG

    更新日期:1989-07-01 00:00:00

  • Comparison between duodenal button and duodenal segment in pancreas transplantation.

    abstract::Two technical modifications have been suggested for whole-pancreas transplantation with bladder drainage. The duodenal button technique (DB [Madison]) and the duodenal segment technique (DS [Iowa]) are the most commonly performed procedures (1,2). From December 1985 until May 1988 we performed 32 combined pancreas-kid...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198901000-00026

    authors: D'Alessandro AM,Sollinger HW,Stratta RJ,Kalayoglu M,Pirsch JD,Belzer FO

    更新日期:1989-01-01 00:00:00

  • Advanced donor-origin melanoma in a renal transplant recipient: immunotherapy, cure, and retransplantation.

    abstract:BACKGROUND:A kidney transplant recipient inadvertently contracted donor-origin melanoma, which was found to be very advanced at presentation. Withdrawal of immunosuppression failed to induce rejection, and interferon-alpha was required. When florid allograft rejection was in progress, the allograft was removed, before ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199809150-00020

    authors: Suranyi MG,Hogan PG,Falk MC,Axelsen RA,Rigby R,Hawley C,Petrie J

    更新日期:1998-09-15 00:00:00

  • Cytomegalovirus serostatus pairing and deceased donor kidney transplant outcomes in adult recipients with antiviral prophylaxis.

    abstract:BACKGROUND:The objectives of this study are to investigate the impact of cytomegalovirus (CMV) donor (D)/recipient (R) serostatus on kidney transplant outcomes in recipients who received CMV prophylaxis and to investigate the association of individual antiviral agents (acyclovir, ganciclovir, and valganciclovir) with o...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181f7c053

    authors: Kuo HT,Ye X,Sampaio MS,Reddy P,Bunnapradist S

    更新日期:2010-11-27 00:00:00

  • Racial Differences in Survival of Incident Home Hemodialysis and Kidney Transplant Patients.

    abstract:BACKGROUND:Previous studies have indicated that patients on maintenance hemodialysis have worse survival compared with kidney transplant (KTx) recipients. However, none of these studies have compared mortality of the US patients using alternative dialysis modalities such as home hemodialysis (HHD) with KTx recipients. ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000001005

    authors: Molnar MZ,Ravel V,Streja E,Kovesdy CP,Mehrotra R,Kalantar-Zadeh K

    更新日期:2016-10-01 00:00:00