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Liver transplantation for patients with intrahepatic cholangiocarcinoma

Hepatobiliary & Pancreatic Diseases International 2022年第6期21卷 590-593页

作者： Adarsh Vijay hoonbae jeon Division of Hepato-Pancreato-Biliary&Abdominal Transplant Surgery Tulane Abdominal Transplant InstituteTulane University School of MedicineNew OrleansLA 70112-2632USA

Cholangiocarcinoma(CCA)constitutes a group of heterogeneous malignant tumors emerging in the biliary tree[1].Based on their anatomical distribution,CCA is classified into perihilar cholangio-carcinoma(pCCA),distal cholangiocarcinoma(dCCA)and intrahep-atic cholangiocarcinoma(iCCA)and they account for 60%-70%,20%-30%and 5%-10%of CCA,*** past decade has seen a 2-fold increase in annual percentage change in incidence of iCCA in USA when compared to the prior three decades[2].

关键词： carcinoma patients Liver

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Acute Appendicitis Confined to an Incisional Hernia Following Renal Transplantation

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Open Journal of Organ Transplant Surgery 2013年第3期3卷 50-52页

作者： Shanel Bhagwandin Raquel Garcia-Roca hoonbae jeon Department of Transplant Surgery University of Illinois Chicago USA

We present a case of a 57 years old moderately obese woman with a known 12 cmincisional hernia, who subsequently developed an incarcerated acute appendicitis. The patient underwent an uneventful orthotopic liver and renal transplant five years prior, and was compliant with ongoing immunosuppression without rejection. She presented with 8 hours of acute onset right lower quadrant pain, associated with anorexia, documented fevers, and nausea. Noncontrast CT demonstrated a blind-ending tubular structure with an enhancing and thickened wall within a hernia defect of the right lower quadrant. The patient underwent emergent laparotomy and a non-perforated appendix was completely excised at its base. Discussion: There have been documented reports of an acute appendicitis associated with inguinal hernias, given the eponym Amyand’s hernia. Appendicitis may present within hernias, and there should be a low threshold for radiologic assessment of its components when there is clinical doubt about the symptoms associated with the hernia. Our recommendation prompts early use of non-contrast CT scan in transplant patients with known hernias on examination and abdominal tenderness over the renal allograft considering the high risk of perforation of acute appendicitis and strangulation.

关键词： Acute Appendicitis Renal Transplantation Renal Allograft Incisional Hernia Amyand’s Hernia Hernial Appendicitis

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Successful living donor intestinal transplantation in crossmatch positive recipients: Initial experience

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World Journal of Gastrointestinal Surgery 2016年第1期8卷 101-105页

作者： Raquel Garcia-Roca Ivo G Tzvetanov hoonbae jeon Elisabeth Hetterman Jose Oberholzer Enrico Benedetti Division of Transplantation Department of Surgery University of Illinois at Chicago Hospital and Heals Sciences Systems Department of Pharmacy practice (MC886) College of Pharmacy University of Illinois at Chicago Hospital and Heals Sciences Systems

Sensitized patients tend to have longer waiting times on the deceased donor list and are at increased risk of graft loss from acute or chronic rejection compared to non-sensitized candidates. Desensitization protocols are utilized to decrease the levels of alloantibodies and to convert an initial positive cross-match to prospective donors into a negative crossmatch. These procedures are mostly available in the setting of living donation. Due to the elective nature of the procedure, desensitization protocols can be extended until the desire result is obtained prior to transplantation. We present two cases of successful desensitization protocol applied to living donor intestinal transplant candidates that converted to negative cross-match to their donors. We present two cases of intestinal transplant candidates with a potential living donor to whom they are sensitized. Both cases underwent successful transplantation after desensitization protocol. No evidence of humoral rejection has occurred in either recipient. Living donor intestinal transplantation in sensitized recipients against the prospective donors provides the ability to implement a desensitization protocol to convert to negative crossmatch.

关键词： Living donor Positive crossmatch Intestinal transplant Desensitization protocol Donor specificantibody Plasmapheresis

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