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  • Liver transplantation, glioblastoma  (1)
  • Liver transplantation, selective bowel decontamination  (1)
  • 1
    ISSN: 1432-2277
    Keywords: Glioblastoma, liver transplantation ; Liver transplantation, glioblastoma ; Malignancy, donor related, liver transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The transmission of donor-related malignancies by organ transplantation is a rather rare event. There has only been one report on the development of a brain tumor metastasis in liver transplantation. From September 1988 to January 1993, 342 donor hepatectomies with subsequent transplantation were performed at our center. The main donor diagnoses included subarachnoidal bleeding (n=128; 37.4%), isolated head injury (n=114; 33.3%), multiple injuries (n=55; 16.1%), primary cerebral neoplasia (n=13; 3.8%), and other (n=32; 9.4%). Primary cerebral neoplasia included glioblastoma (n=4), meningioma (n=3), astrocytoma (n=2), angioma (n=2), neurocytoma (n=1), and ependymoma (n=1). In the group of donors suffering from primary cerebral neoplasia, procured organs other than the liver included kidneys (n=20), combined kidneys and pancreata (n=1), pancreata (n=2) hearts (n=8), combined hearts and lungs (n=1), and single lungs (n=1). Follow-up of the respective graft recipients ranged from 28 to 68 months (median 43 months). Recurrent malignancy was observed once, in a liver graft recipient. The donor, a 48-year-old female, had undergone surgical resection of an intracerebral multiform glioblastoma and died 4 months later of a relapse in the brain stem. The 28-year-old female recipient had undergone transplantation for an autoimmune-hepatitic cirrhosis. Four months later, histopathological examination of an intraperitoneal and intrahepatic mass revealed a poorly differentiated, small-cell pleomorphic cancer, identified as a glioma metastasis by S100-and glial fibrillary acidic protein immunohistochemical staining. The patient died 6 months post-transplantation. On autopsy, no further neoplastic lesions were detected. Our review adds a second reported case of a liver graft-transmitted brain tumor to the literature and the fourth donor-related malignancy after hepatic transplantation in general.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2277
    Keywords: Selective bowel decontamination, liver transplantation ; Liver transplantation, selective bowel decontamination ; Infections, liver transplantation, serective bowel decontamination
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Bacterial and fungal infections are a major cause of morbidity and mortality after orthotopic liver transplantation. In the immunocompromised host, infections are thought to arise from the gut, which is almost always colonized with potential pathogens. Using oral selective bowel decontamination (SBD), potential pathogens can be eradicated from the gut and infections prevented. In this catamnestic study we have reviewed gastrointestinal colonization, bacterial and fungal infections, and bacterial resistance to standard antibiotics in our first 206 liver transplant patients while under SBD. With few exceptions, gram-negatives were eradicated from the gastrointestinal tract and secondary colonization was inhibited. In spite of unsatisfactory elimination of Candida, probably because nystatin doses were too low, Candida infections were rare (n=4) and none was fatal. One and two-year survival rates were 93% and 92%, respectively. The bacterial and fungal infection rate was 27.8% with an infection-related mortality of 1.95%. Infections with aerobic grampositive bacteria prevailed and only 11 gram-negative and 11 fungal infections occurred; among the latter, Aspergillus and Mucor were the most serious and responsible for three of the six deaths in this series. With regard to the development of resistance, we found an increasing number of enterococci and coagulase-negative staphylococci resistant to ciprofloxacin and imipenem, respectively, but unlikely as a consequence of SBD.
    Type of Medium: Electronic Resource
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