Transplantation proceedings
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Extracorporeal membrane oxygenation (ECMO) can provide excellent mechanical circulatory support (MCS). Some case reports use ECMO to rescue heart transplantation (HTx) recipients with posttransplant cardiopulmonary failure. Herein reported a series of use of ECMO to rescue HTx recipients with refractory cardiopulmonary failure have during the posttransplant period. ⋯ The weaning rate was 72.5% (29/40) and survival, 52.5% (21/40). ECMO provided temporary MCS rescuing some HTx recipients with posttransplant cardiopulmonary failure. None of the patients receiving ECMO support for >4 days survived.
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Ventricular-assist devices (VADs) have benefitted patients with end-stage heart failure as a bridge to heart transplantation (HTx). Herein, we describe our experience with HTx in the presence of extracorporeal membrane oxygenation (ECMO) together with the Thoratec VAD (Thoratec Corp, Pleasanton, California). From May 1996 to June 2009, mechanical circulatory support with the Thoratec VAD was provided in 20 patients. ⋯ If prolonged support is necessary, a VAD may be required. We observed that 65% of patients who received support from an ECMO hybridized with the Thoratec VAD could wait for a suitable donor for HTx. We recommend use of ECMO for short-term support (<1 week) and the Thoratec VAD for medium- or long-term support as a bridge to HTx.
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The aim of this study was to analyze risk factors for delayed graft function (DGF) after deceased donor kidney transplantation and to compare the clinical outcomes of non-DGF versus DGF recipients. ⋯ The independent risk factors for DGF were the cause of brain death, the terminal creatinine level, and the recipient age. In deceased donor kidney transplantation, DGF may have less effect on long-term patient and graft survivals.
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Reactive oxygen species are believed to be responsible for organ injury after reperfusion. We evaluated serial changes in lipid peroxide (LPO) as an oxidative stress marker after kidney transplantation and investigated its effects on graft function. ⋯ Oxidative stress showed a significant impact on graft function in the immediate posttransplant period.
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Yttrium-90 microspheres radioembolization (Y90-RE) has been recently introduced as promising modality of treatment in patients with hepatocellular carcinoma (HCC) who are not otherwise candidates for local ablation, surgical resection, or liver transplantation (OLT). However, its use in downstaging HCC or as a bridge for OLT is still unclear. Herein, we have presented a case where Y90-RE was used to both downstage and to serve as a bridge for OLT. ⋯ The use Y90-RE in HCC may be useful for downstaging or as a bridge to liver transplantation.