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Human parvovirus B19-associated early postoperative acquired pure red cell aplasia in simultaneous pancreas-kidney transplantation:A case report

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World Journal of Clinical Cases 2021年第8期9卷 1968-1975页

作者： Hui Wang Ying-Xin Fu Wen-Li Song Zhen Wang Gang Feng Jie Zhao Ye-Qi Nian Yu Cao department of kidney and pancreas transplant Tianjin First Central HospitalSchool of MedicineNankai UniversityTianjin 300192China

BACKGROUND Acquired pure red cell aplasia(aPRCA)related to human parvovirus B19(HPV B19)is rarely reported in simultaneous pancreas-kidney transplantation(SPKT)recipients;there has yet to be a case report of early postoperative *** this current study,we report the case of a Chinese patient who experienced the disease in the early postoperative *** SUMMARY A 63-year-old man,with type 2 diabetes and end-stage renal disease,received a brain dead donor-derived *** treatment consisted of tacrolimus,prednisone,enteric-coated mycophenolate sodium(EC-MPS),and thymoglobulin combined with methylprednisolone as *** hemoglobin(Hb)level declined due to melena at postoperative day(POD)3,erythropoietinresistant anemia persisted,and reticulocytopenia was diagnosed at POD *** bone marrow aspirate showed decreased erythropoiesis and the presence of giant pronormoblasts at POD *** next-generation sequencing(mNGS)of a blood sample identified HPV B19 infection at POD ***-MPS was withdrawn;three cycles of intravenous immunoglobulin(IVIG)infusion therapy were administered;and tacrolimus was switched to *** HPV B19-associated aPRCA resolved completely and did not relapse within the 1-year follow-up *** diminution in mNGS reads was correlated with Hb and reticulocyte count *** HPV B19-associated aPRCA can occur at an early period after *** effective therapy regimen includes IVIG infusion and adjustment of the immunosuppressive ***,mNGS can be used for the diagnosis and to reflect disease progression.

关键词： Anemia Human parvovirus B19 Intravenous immunoglobulin Metagenomic Next-generation sequencing pancreas transplantation Case report

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Does ischemia-free machine perfusion lead to early allograft dysfunction (EAD) free liver transplantation?

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 678-680页

作者： Hani M.Wadei Kristopher P.Croome Division of kidney and pancreas transplant Department of TransplantMayo ClinicJacksonvilleFLUSA Division of transplant Surgery Department of TransplantMayo ClinicJacksonvilleFLUSA

Normothermic machine perfusion(NMP)is an innovative technique used in solid organ transplantation that involves perfusing the organ with specialized solution or leukocyte depleted red blood cells at near-normal body temperature aiming at mimicking physiological conditions,and providing optimal conditions for organ preservation which leads to reduced risk of ischemia reperfusion injury(IRI)when compared to the standard static cold storage(SCS)(1).One of the key advantages of NMP is its ability to assess the quality of the organ in real-time and assessment of the organ performance prior to *** continuously monitoring parameters such as blood flow,oxygen consumption,and lactate production,clinicians can evaluate the viability of the organ and make more informed decisions about its suitability for *** real-time assessment can help reduce the risk of transplanting organs that may not function optimally or have a higher likelihood of complications ***,NMP may expand the pool of donor organs by allowing for the use of organs that may have been deemed marginal or unsuitable for transplantation using traditional methods(1,2).

关键词： Early allograft dysfunction(EAD) normothermic machine perfusion(NMP) liver transplant outcomes

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Suture ligation for submucosal hemostasis during hand-sewn sideto-side duodeno-ileostomy in simultaneous pancreas and kidney transplantation

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World Journal of Gastrointestinal Surgery 2021年第9期13卷 988-999页

作者： Hui Wang Ying-Xin Fu Wen-Li Song Chun-Bai Mo Gang Feng Jie Zhao Guang-Hui Pei Xiao-Feng Shi Zhen Wang Yu Cao Ye-Qi Nian Zhong-Yang Shen department of kidney and pancreas transplant Tianjin First Central HospitalSchool of MedicineNankai UniversityTianjin 300192China

BACKGROUND Enteric anastomotic(EA)bleeding is a potentially life-threatening surgical complication associated with enteric anastomosis during simultaneous pancreas and kidney transplantation(SPKT).AIM To investigate whether suture ligation(SL)for submucosal hemostasis during hand-sewn enteric anastomosis could decrease the morbidity of early EA bleeding in *** We compared the outcomes of 134 patients classified into SL(n=44)and no SL(NSL)groups(n=90).This study adheres to the declarations of Istanbul and Helsinki and all donors were neither paid nor *** During the first postoperative week,the EA bleeding rate in the SL group was lower than that in the NSL group(2.27%vs 15.56%;P=0.021);no relationship was found between EA bleeding and donor age,mean pancreatic cold ischemia time,platelet count,prothrombin time international normalized rate,activated partial thromboplastin time,and thrombin *** leakage was observed in one case in the SL group at postoperative day(POD)14 and in one case at POD 16 in the NSL group(P=0.754).No significant difference was found between the two groups in the patient survival,pancreas graft survival,or kidney graft *** SL for submucosal hemostasis during hand-sewn enteric anastomosis in SPKT can decrease the morbidity of early EA bleeding without increasing the anastomotic leakage rate.

关键词： Anastomosis Gastrointestinal bleeding Hemostasis Ligation pancreas transplantation

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kidney re-transplantation after living donor graft nephrectomy due to de novo chromophobe renal cell carcinoma:A case report

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World Journal of Clinical Cases 2021年第17期9卷 4365-4372页

作者： Hui Wang Wen-Li Song Wen-Juan Cai Gang Feng Ying-Xin Fu department of kidney and pancreas transplant Tianjin First Central HospitalSchool of MedicineNankai UniversityTianjin 300192China department of Pathology Tianjin First Central HospitalSchool of MedicineNankai UniversityTianjin 300192China

BACKGROUND There are few reported cases of allograft nephrectomy due to malignancy followed by successful renal re-transplantation two years *** this paper,we report a patient who underwent kidney re-transplantation after living donor graft nephrectomy due to de novo chromophobe renal cell carcinoma(ChRCC)involving the allograft *** SUMMARY A 34-year-old man underwent living kidney transplantation at the age of 22 years for end-stage renal *** immunosuppression consisted of tacrolimus,mycophenolate mofetil(MMF),and *** years posttransplantation,at another hospital,ultrasonography revealed a small mass involving the upper pole of the *** patient declined further examination and treatment at this *** years and three months post-transplantation,the patient experienced decreasing appetite,weight loss,gross hematuria,fatigue,and *** tests showed anemia(hemoglobin level was 53 g/L).Contrast-enhanced computed tomography revealed a large heterogeneous cysticsolid mass involving the upper pole of the renal *** nephrectomy was performed and immunosuppressants were *** and immunohistochemical features of the tumor were consistent with *** year after allograft nephrectomy,low doses of tacrolimus and MMF were administered for preventing *** years after allograft nephrectomy,the patient underwent kidney *** function remained stable with no ChRCC recurrence in more than 2-years of *** De novo ChRCC in kidney graft generally has a good prognosis after graft nephrectomy and withdrawal of *** re-transplantation could be a viable treatment.A 2-year malignancy-free period may be sufficient time before re-transplantation.

关键词： Chromophobe Renal cell carcinoma kidney Nephrectomy transplantation Case report

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Pelvic lipomatosis and renal transplantation:A case report

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World Journal of Clinical Cases 2020年第16期8卷 3548-3552页

作者： Jie Zhao Ying-Xin Fu Gang Feng Chun-Bai Mo department of kidney transplant Tianjin First Central HospitalTianjin 300192China

BACKGROUND Pelvic lipomatosis is a rare disease of unknown etiology,characterized by the overgrowth of pelvic adipose tissue that causes compression of the urinary tract including the bladder and ureters,rectum and blood *** patient may progressively develop obstructive uropathy which could subsequently lead to renal *** present,there are no reports of renal transplantation due to uremia caused by pelvic *** ideal management of patients with pelvic lipomatosis after renal transplantation is not yet well-established due to the lack of literature and follow-up *** SUMMARY We report a 37-year-old male patient with pelvic lipomatosis who received a successful living donor renal transplantation on July 22,*** operation was complicated as the iliac vessels and bladder were wrapped entirely in excessive abnormal *** external iliac artery and vein were located using ultrasonographic *** adipose tissue around the right bladder was removed as far as possible,and the graft ureter was reimplanted into the bladder,using the Lich-Gregoir *** 22 mo after transplantation,graft percutaneous nephrostomy was performed under ultrasonographic guidance for urinary diversion due to hydronephrosis of the graft ***-up at four years showed that the renal allograft function was *** When patients with pelvic lipomatosis develop renal failure,renal transplantation could be a feasible treatment strategy.

关键词： Pelvic lipomatosis kidney transplantation Uremia Hydronephrosis Bladder Urinary obstruction Case report

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Liver transplantation for hepatocellular carcinoma:an update

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Hepatobiliary & Pancreatic Diseases International 2011年第3期10卷 234-242页

作者： Ali Zarrinpar Fady Kaldas Ronald W Busuttil Dumont-UCLA transplant Center Division of Liver and Pancreas Transplantation Department of Surgery David Geffen School of Medicine at UCLA

BACKGROUND: Hepatocellular carcinoma (HCC) is a heterogeneous malignancy with multiple etiologies, high incidence, and high mortality. The standard surgical management for patients with HCC consists of locoregional ablation, surgical resection, or liver transplantation, depending on the background state of the liver. Eighty percent of patients initially presenting with HCC are unresectable, either due to the extent of tumor or the level of underlying hepatic dysfunction. While in patients with no evidence of cirrhosis and good hepatic function resection has been the surgical treatment of choice, it is contraindicated in patients with moderate to severe cirrhosis. Liver transplantation is the optimal surgical treatment. DATA SOURCES: PubMed search of recent articles (from January 2000 to March 2011) was performed looking for relevant articles about hepatocellular carcinoma and its treatment. Additional articles were identified by evaluating references from selected articles. RESULTS: Here we review criteria for transplantation, the types, indications, and role of locoregional therapy in treating the cancer and in downstaging for possible later transplantation. We also summarize the contribution of immunosuppression and adjuvant chemotherapy in the management and prevention of HCC recurrence. Finally we discuss recent advances in imaging, tumor biology, and genomics as we delineate the remaining challenges for the diagnosis and treatment of this disease. CONCLUSIONS: Much can be improved in the diagnosis and treatment of HCC. A great challenge will be to improve patient selection to criteria based on tumor biology. Another will be to incorporate systemic agents post-operatively in patients at high risk for recurrence, paying close attention to efficacy and safety. The future direction of the effort in treating HCC will be to stimulate prospective trials, develop molecular imaging of lymphovascular invasion, to improve recipient selection, and to investigate biomarkers

关键词： liver transplantation hepatocellular carcinoma liver neoplasm downstaging immunosuppression locoregional therapy

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Current insights on haemorrhagic complications in percutaneous nephrolithotomy

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Asian Journal of Urology 2022年第1期9卷 81-93页

作者： Sujeet Poudyal department of Urology and kidney transplant Surgery Tribhuvan University Teaching HospitalKathmanduNepal

Objective:Percutaneous nephrolithotomy(PCNL)is the standard procedure for the management of large and complex renal *** loss during PCNL may occur during puncture,tract dilatation,and stone ***,despite recent advances in PCNL,haemorrhagic complication still *** study aims to enlighten on various aspects of haemorrhagic complication in PCNL,mainly focusing on risk factors and management of this dreadful ***:Literature search for the study was carried out using advanced search engines like PubMed,Cochrane,and Google Scholar,combining keyword“percutaneous lithotomy”with other keywords like“bleeding”,“haemorrhage”,“complications”,“stone scoring systems”,“mini-PCNL ***”,“dilatation techniques”,“supine ***”,“USG-guided”,“endoscopic combined intra-renal surgery”,“papillary ***-papillary puncture”,“bilateral”,and“angioembolization”.The articles published between January 1995 and September 2020 were included for the ***:A total of 3670 articles published from January 1995 to September 2020 were screened for the *** not consistent,multiple studies have described various preoperative and intraoperative risk factors related to significant bleeding in *** of these risk factors help urologists to anticipate and promptly manage haemorrhagic complications associated with the procedure.A conservative approach suffices to control bleeding in most cases;nevertheless,bleeding can be life-threatening and few still need surgical intervention in the form of angiographic embolisation or open surgical ***:As hemorrhagic complication in PCNL is associated with considerable morbidity and mortality,prudent intraoperative decision and postoperative care are necessary for its timely prevention,detection,and management.

关键词： Percutaneous nephrolithotomy Bleeding Embolisation Renal stone Puncture

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A"reappearance"of gallbladder in a liver transplant recipient

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Hepatobiliary Surgery and Nutrition 2018年第5期7卷 412-413页

作者： Al Warith Al Hashmi Fabrizio Panaro Francis Navarro department of General and Liver/pancreas transplant Surgery University of Montpellier-College of MedicineHopital Saint EloiMontpellierFrance

In liver transplantation graft cholecystectomy is performed *** leaks have an incidence of 2–25%following liver *** bile leaks are diagnosed within 30 days and rarely after 3 *** this article,we describe a case of bi... 详细信息

关键词： gallbladder routine liver

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Comparative study of living donor kidney transplants:Right vs left

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World Journal of transplantation 2025年第1期15卷 115-123页

作者： Taqi Khan Nadeem Ahmad Qaisar Iqbal Muneeb Hassan Lajward Asnath Naveed Khan Sajid Shakeel kidney transplant Unit Rehman Medical InstitutePeshawar 25100Khyber PakhtunkhwaPakistan department of Surgery Princess Noura Binti AbdulRehman UniversityRiyadh 84428Saudi Arabia

BACKGROUND transplant teams often hesitate to use the right kidney(RK)in living donor(LD)transplants due to the complexities of anastomosing the short,thin-walled right renal veins,which can potentially lead to graft loss or graft ***,circumstances may arise where selecting the RK over the left kidney(LK)is ***,it is crucial to thoroughly examine the implications of such a choice on the overall transplant *** To compare transplant outcomes between recipients of RK and LK while examining the factors that influence these *** We retrospectively analyzed data from adult patients who received LD kidney transplants involving meticulous patient selection and surgical techniques at our center from January 2020 to December *** included all kidney donors who were over 18,fit to donate,and had undergone diethylenetriamine pentaacetic acid split function and/or computed tomography based *** variables examined comprised donor and recipient demographics,and outcome measures included technical graft loss(TGL),delayed or slow graft function(SGF),and post-transplant serum creatinine(SC)*** used a logistic regression model to assess the likelihood of adverse outcomes considering the donor kidney *** Of the 250 transplants performed during the period,56(22%)were *** recipient demographics and transplant factors were comparable for the right and LKs,except that the donor warm and cold ischemia time were shorter for *** and SGF each occurred in 2%(n=1)of RKs and 0.5%(n=1)of LKs,the difference being *** complications,however,were not related to the venous *** RK(2%)developed delayed graft function after 48 hours,which was attributable to postoperative hypoxia rather than the surgical *** post-transplant SC trend and mean SC at the last follow-up were similar across both kidney *** The donor kidney side has little impact on post-transplant

关键词： Living donor Right kidney Right renal vein Venous anastomosis Technical graft loss Early graft function

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Surgical complications after pancreatic transplantation:A computed tomography imaging pictorial review

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World Journal of Gastroenterology 2023年第46期29卷 6049-6059页

作者： Carlo D'Alessandro Matteo Todisco Caterina Di Bella Filippo Crimì Lucrezia Furian Emilio Quaia Federica Vernuccio department of Radiology University of PadovaPadova 35128Italy department of Radiology 2 University Hospital of PadovaPadova 35128Italy department of Surgical Kidney and Pancreas Transplantation UnitPadova 35128Italy kidney and pancreas transplantation Unit University of PaduaPadova 35128Italy department of Biomedicine Neuroscience and Advanced Diagnostics(BiND)University of PalermoPalermo 90127Italy department of Radiology University Hospital of PadovaPadova 35128Italy

Pancreatic transplantation is considered by the American Diabetes Association and the European Association for the Study of Diabetes an acceptable surgical procedure in patients with type 1 diabetes also undergoing kidney transplantation in pre-final or end-stage renal disease if no contraindications are *** transplantation,however,is a complex surgical procedure and may lead to a range of postoperative complications that can significantly impact graft function and patient *** computed tomography(CT)is often adopted to evaluate perfusion of the transplanted pancreas,identify complications and as a guide for interventional radiology *** assessment after pancreatic transplantation should start with the evaluation of the arterial Y-graft,the venous anastomosis and the *** regard to complications,CT allows for the identification of vascular complications,such as thrombosis or stenosis of blood vessels supplying the graft,the detection of pancreatic fluid collections,including pseudocysts,abscesses,or leaks,the assessment of bowel complications(anastomotic leaks,ileus or obstruction),and the identification of *** aim of this pictorial review is to illustrate CT findings of surgical-related complications after pancreatic *** knowledge of surgical techniques is of key importance to understand postoperative anatomic changes and imaging ***,we first provide a short summary of the main techniques of pancreatic ***,we provide a practical imaging approach to pancreatic transplantation and its complications providing tips and tricks for the prompt imaging diagnosis on CT.

关键词： Diabetes mellitus Type 1 pancreas transplantation Complications Computed tomography Diagnostic imaging

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