当前位置： SCI文献检索 > TRANSPLANTATION PROCEEDINGS期刊下所有文献 > Management of venous access problems before and after intestinal transplantation: case reports.

Management of venous access problems before and after intestinal transplantation: case reports.

Abstract：

:Patients suffering irreversible loss of intestinal function require total parenteral nutrition (TPN). During long-term TPN, catheter infections are a common problem and intestinal transplantation (ITx) is indicated when patients experience loss of venous access. We report two patients with short bowel syndrome--one before and one after ITx. The patient listed for ITx had several catheter infections with septic temperatures. Staphylococcus aureus, detected in blood cultures, was treated with vancomycin. Packing of the central venous line (CVL) with vancomycin was not successful; the CVL was changed. Search for an infectious focus identified a septic femoral head destruction that was treated by incision and implantation of a hip endoprothesis. Thereafter, the patient was free from infection. The second patient underwent ITx on January 2, 2003, and is free from TPN. ITx was complicated by temporary acute renal failure and heparin-induced thrombocytopenia (HIT) syndrome. After compensation of kidney function, the patient required additional saline solution (1 to 2 L/d) to optimize renal perfusion. A CVL was placed in the external iliac vein (EIV) due to previous loss of venous access. At 2 months after ITx, the CVL was infected and the patient was septic. MR scan revealed only one jugular vein to provide vascular access. Therefore, the CVL was changed from the right to the left EIV. Postoperatively, the patient developed thrombosis of right iliac vein and a wound infection that is probably related to the nearby graft ileostomy. At present, the patient is in good condition with a functioning graft. In conclusion, recurrent CVL infections before ITx might reflect other infectious foci that require intensive diagnostic evaluation. After ITx, CVL infection may cause venous thrombosis. Therefore, a single upper venous access should be preserved for optimal care.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Braun F,Platz KP,Faendrich F,Kremer B,Mueller AR

doi

10.1016/j.transproceed.2004.01.083

subject

Has Abstract

pub_date

2004-03-01 00:00:00

pages

392-3

issue

eissn

0041-1345

issn

1873-2623

pii

S0041134504001034

journal_volume

pub_type

杂志文章

在线工具

Management of venous access problems before and after intestinal transplantation: case reports.