Mycophenolate mofetil monotherapy in stable liver transplant recipients with progressive renal failure

in Transplantation Proceedings (2002), 34(3), 782-783

Reversal of oxalosis cardiomyopathy after combined liver and kidney transplantation

in Transplant International (2002), 15(1), 50-52

Few data have been published on the course of oxalosis cardiomyopathy after combined liver and kidney transplantation in hyperoxaluria patients with myocardial involvement. We report the case of a primary ... [more ▼]

Few data have been published on the course of oxalosis cardiomyopathy after combined liver and kidney transplantation in hyperoxaluria patients with myocardial involvement. We report the case of a primary hyperoxaluria type I patient with renal failure who developed end-stage cardiomyopathy. Left venticulography showed severe diffuse hypokinesia and left ventricular ejection fraction was calculated at 12%. Endomyocardial biopsy demonstrated platelike calcium oxalate crystals within the myocardium and the connective tissue, and mild perivascular fibrosis. The patient was first considered for combined liver-heart-kidney transplantation, but as his cardiac function improved slightly with an intensive dialysis program, combined liver and kidney transplantation was performed. Normal cardiac function was demonstrated at 1-year follow-up, and comparative endomyocardial biopsy showed regression of the myocardial oxalate deposits. This case adds stronger clinical, hemodynamic, and histopathological evidence that severe oxalosis cardiomyopathy may be reversed after combined liver and kidney transplantation. [less ▲]

Right Hepatic Lobectomy as a Liver Graft-Saving Procedure

in Liver Transplantation (2001), 7(3), 269-73

Retransplantation is common after liver transplantation (LT). However, in the present era of organ shortages, every attempt to save the liver graft should be performed before considering retransplantation ... [more ▼]

Retransplantation is common after liver transplantation (LT). However, in the present era of organ shortages, every attempt to save the liver graft should be performed before considering retransplantation. We report our experience with right hepatic lobectomy (RHL) for liver graft salvage. In a retrospective series of 180 adult LTs, 4 patients underwent RHL (Couinaud's segments V, VI, VII, VIII) in the post-LT period. In all cases, the procedure was performed without Pringle's maneuver or mobilization of the left liver lobe to preserve its vascularization. Three liver graft recipients developed intrahepatic biliary strictures, mainly localized to the right lobe of the graft, and RHL was performed 14, 75, and 78 months after LT. These patients were alive at last follow-up without further episodes of cholangitis or retransplantation (mean follow-up, 38 months). The fourth patient developed early post-LT right liver necrosis with a functioning hepatic artery and underwent right lobectomy 48 hours after LT. He later developed cholangitis secondary to late hepatic artery thrombosis, requiring retransplantation after 18 months. We conclude that RHL can be considered a graft-saving option in selected liver transplant recipients with localized biliary strictures, with excellent patient and graft survival. [less ▲]

Stricturoplasty in Crohn disease: short and long term follow up

in Acta Gastro-Enterologica Belgica (2001, January), 64(1), 73

120 laparoscopic sigmoidectomies in diverticulitis: a 9 years experience

in Acta Gastro-Enterologica Belgica (2001, January), 64(1), 49

Ileo-caecal actinomycosis: Report of a case simulating complicated inflammatory bowel disease

in Acta Gastro-Enterologica Belgica (2001), 64(4, Oct-Dec), 318-320

Abdominal actinomycosis is a rare infectious disease caused by Actinomyces israelii, a gram-positive anaerobic saprophyte germ that is a normal inhabitant of the upper intestinal tract in humans ... [more ▼]

Abdominal actinomycosis is a rare infectious disease caused by Actinomyces israelii, a gram-positive anaerobic saprophyte germ that is a normal inhabitant of the upper intestinal tract in humans. Actinomyces israelii rarely cause abdominal infections or actinomycosis. Abdominal actinomysosis is characterised by fistulae and abscesses and may mimic cancer or inflammatory bowel disease. Abdominal actinomycosis is difficult to diagnose preoperatively, and often require surgical removal of the diseased tissue, allowing pathologists for giving the definitive diagnosis, revealed by characteristic "sulfur granules". The authors report herein the case of a 47-year-old man who presented with diarrhoea and abdominal pain. Abdominal computed tomography evoked complicated inflammatory bowel disease and surgical procedure was decided. Laparoscopic exploration did not provide further significant information, and laparotomy with diseased bowel resection was performed. Pathology demonstrated "sulfur granules" and allowed the diagnosis of abdominal actinomycosis. This case demonstrated that abdominal actinomycosis should be included in the differential diagnosis when computed tomography shows an infiltrative and inflammatory mass. [less ▲]

Organ Donors with Primary Central Nervous System Tumor

in Transplantation (2000), 70(1), 244-8251-2

Patients with primary central nervous system (CNS) tumor have been accepted for organ donation because these tumors very rarely spread outside the CNS. However several case reports of CNS tumor ... [more ▼]

Patients with primary central nervous system (CNS) tumor have been accepted for organ donation because these tumors very rarely spread outside the CNS. However several case reports of CNS tumor transferral with organ transplantation recently challenged this attitude. Some risk factors for extraneural spread of CNS tumors have been determined, but the absence of risk factors does not exclude the possibility of metastases. To our knowledge, 13 cases of CNS tumor transferral with organ transplantation (one heart, three livers, eight kidneys, one kidney/pancreas) have been reported in the literature. Even if no prospective evaluation of the CNS tumor transmission risk with transplantation has been undergone, this risk may be estimated between a little more than 0% and 3% from retrospective series. The authors consider that patients with CNS tumor should be accepted as donors as long as the risk of dying on the waiting lists is significantly higher than the tumor transferral risk. Therefore the authors would have no restriction for transplanting organs from donors with benign or low-grade CNS tumor. For high-grade tumors, the authors would consider these donors as "marginal donors," and balance the risk of tumor transmission with the medical condition of the recipient. [less ▲]

Clinical biliary complications after adult liver transplantation: a prospective study

in Acta Gastro-Enterologica Belgica (2000, March), 63(1), 56

Cancer in Transplant Recipients

in Transplantation Proceedings (2000), 32(1), 127

Liver transplantation in a Jehovah's witness

in Lancet (1999), 353