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1.
Curr Opin Organ Transplant ; 28(4): 316-325, 2023 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-37418582

RESUMEN

PURPOSE OF REVIEW: Intestinal and multivisceral transplantation (ITx, MVTx) is the cornerstone in treatment of irreversible intestinal failure (IF) and complications related to parenteral nutrition. This review aims to highlight the unique aspects of the subject in pediatrics. RECENT FINDINGS: Etiology of intestinal failure (IF) in children shares some similarity with adults but several unique considerations when being evaluated for transplantation will be discussed. Owing to significant advancement in IF management and home parenteral nutrition (PN), indication criteria for pediatric transplantation continues to be updated. Outcomes have continued to improve with current long-term patient and graft survival in multicenter registry reports reported at 66.1% and 48.8% at 5 years, respectively. Pediatric specific surgical challenges such abdominal closure, post transplantation outcomes, and quality of life are discussed in this review. SUMMARY: ITx and MVTx remain lifesaving treatment for many children with IF. However long-term graft function is still a major challenge.


Asunto(s)
Enfermedades Intestinales , Insuficiencia Intestinal , Nutrición Parenteral en el Domicilio , Adulto , Niño , Humanos , Calidad de Vida , Intestinos/trasplante , Supervivencia de Injerto , Enfermedades Intestinales/cirugía , Enfermedades Intestinales/complicaciones , Estudios Multicéntricos como Asunto
3.
Hum Immunol ; 85(3): 110800, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38599892

RESUMEN

Intestinal allografts are the most immunologically complex and carry the highest risk of rejection among solid organ transplantation, necessitating complex immunosuppressive management. We evaluated the latest information regarding induction immunosuppression, with an emphasis on established, novel, and emergent therapies. We also reviewed classic and novel induction immunosuppression strategies for highly sensitized recipients. Comparable progress has been made in intestinal transplantation clinical outcomes since the implementation of induction strategies. This review shows a clear diversity of induction protocols can be observed across different centers. The field of intestinal transplantation is still in its early stages, which is further complicated by the limited number of institutions capable of intestinal transplantation and their geographical variation, which further hinders the development of adequately powered studies in comparison to other organs. As the implementation of institution-specific induction protocols becomes more refined and results are disseminated, future research efforts should be directed towards the development of efficacious induction strategies.


Asunto(s)
Rechazo de Injerto , Terapia de Inmunosupresión , Inmunosupresores , Intestinos , Trasplante de Órganos , Humanos , Intestinos/trasplante , Intestinos/inmunología , Rechazo de Injerto/inmunología , Rechazo de Injerto/prevención & control , Inmunosupresores/uso terapéutico , Terapia de Inmunosupresión/métodos , Trasplante de Órganos/métodos
4.
J Hand Microsurg ; 14(4): 271-275, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36398153

RESUMEN

Flap failure, partial or complete, can have great negative impact on the patient and the reconstructive outcome. The effect of thermal regulation on flap survival is well recognized. This article focuses on the importance of external warming devices as a standard on postoperative flap care to avoid any temperature-related vascular compromise. PubMed, Medline, and EMBASE search had been performed. More than 60 papers have been reviewed. Out of them, that 29 references have been included in this review. The authors emphasize on the importance of strict postoperative flap temperature control with active warming devices as a standard of practice to minimize any related microcirculatory changes.

5.
J Hand Microsurg ; 13(2): 114-118, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33867771

RESUMEN

Metacarpal joint hyperextension is common cause of postoperative dissatisfaction after trapeziectomy in the management of basal thumb osteoarthritis. The senior author uses this technique to address this biomechanical problem at the time of trapeziectomy.

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