RESUMO
BACKGROUND: The development of intestinal transplant (Tx) programs introduces thymoglobulin donor treatment as well as an almost complete warm dissection of the abdominal organs to allocate them to different recipients. Our aim is to assess the reproducibility and feasibility of the surgical technique of multi-organ procurement with the use of thymoglobulin donor pre-treatment and report the short- and long-term outcomes of every graft harvested as part of multi-organ procurement (MTOp), including the intestine. METHODS: Data were collected of all organs harvested from MTOp, including the intestines allocated to our center from March 2006 to July 2011. Data from 92 recipients and 116 organs procured from 29 MTOp were analyzed. Twelve hearts, 2 lungs, and 1 cardio-pulmonary block were transplanted; primary graft dysfunction developed in 4 of the 12 hearts and in the cardio-pulmonary block. RESULTS: The survival rate was 75% and 100% for hearts and lungs, respectively. Nineteen livers, 9 kidney-pancreas, 19 kidneys, and 29 intestines were transplanted. Delayed graft function (DGF) of the pancreas developed in 3 of 9 kidney-pancreas, and the other 3 exhibited DGF of the kidney; 4 of 19 Tx kidneys had DGF. The survival was 84%, 78%, 95%, and 65.5% for livers, kidney-pancreas, kidneys, and intestines, respectively. CONCLUSIONS: Organs procured during MTOp including the intestine can be safely used, increasing organ availability and transplant applicability without compromising allocation, quality, and long-term results of the non-intestinal-procured organs.
Assuntos
Transplante de Órgãos , Coleta de Tecidos e Órgãos/métodos , Obtenção de Tecidos e Órgãos , Adolescente , Adulto , Soro Antilinfocitário , Criança , Pré-Escolar , Estudos de Viabilidade , Feminino , Sobrevivência de Enxerto , Humanos , Lactente , Intestinos/transplante , Masculino , Reprodutibilidade dos Testes , Estudos Retrospectivos , Taxa de Sobrevida , Coleta de Tecidos e Órgãos/efeitos adversos , Coleta de Tecidos e Órgãos/mortalidade , Resultado do Tratamento , Adulto JovemRESUMO
Infection is a frequent complication in patients following liver transplantation, and mycotic etiology is the third most common cause. Thrombosis of the hepatic artery is a high-risk condition for the graft and is generally secondary to noninfectious diseases. We present a 2-year-old child who developed hepatic artery obstruction due to Mucor sp. The child did not respond to medical treatment. We conclude that a high index of suspicion and rapid diagnosis are required so that aggressive and early treatment can be initiated. To our knowledge this is the first case published with this particular association.
