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  • 1
    Electronic Resource
    Electronic Resource
    Liver transplantation after “successful” Kasai portoenterostomy: evidence that liver decompensation results from fibrotic encasement of central normal liver (1993)
    Springer
    Pediatric surgery international 8 (1993), S. 303-305 
    Details
    ISSN: 1437-9813
    Keywords: Biliary atresia ; Cirrhosis ; Liver transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two anicteric children were transplanted for hepatic decompensation 5 and 7 years after an initial “successful” Kasai portoenterostomy. Examination of the hepatectomy specimens showed two distinct zones: a central zone of apparently normal parenchyma with draining ductules surrounded by a peripheral zone of fibrotic tissue with no ductules. This is in contrast with the completely fibrotic explanted livers from children who are persistently jaundiced after an unsuccessful Kasai procedure. It is possible that the peripheral fibrotic tissue might have prevented the normal growth of the draining central segment, leading to hepatic decompensation at a later age. It may also contribute to the development of the portal hypertension seen so often in these patients. The earliest evidence of impending hepatic decompensation in these two cases was a steady decline in serum albumin level.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00173350
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Diaphragmatic nerve palsy in young children following liver transplantation (1998)
    Springer
    Transplant international 11 (1998), S. 281-283 
    Details
    ISSN: 1432-2277
    Keywords: Key words Liver transplantation ; child ; diaphragmatic nerve palsy ; Diaphragma ; nerve palsy ; liver transplantation ; Nerve palsy ; diaphragma ; liver transplantation ; Child ; diaphragmatic nerve palsy ; liver transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Diaphragmatic paralysis was identified in four children after liver transplantation. All presented with persistent right upper lobe atelectasis, pleural effusion and recurrent respiratory infections and could not be weaned from mechanical ventilatory support. Fluoroscopy and real-time ultrasound confirmed paradoxical right diaphragmatic movements. Diaphragmatic plication was undertaken and enabled rapid and sustained weaning from respiratory support in all four cases. Vascular clamping of the suprahepatic vena cava seems to be the cause. Diaphragmatic plication allows optimal recruitment of the respiratory muscles with a favourable impact on lung mechanics and gas exchange.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050142
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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