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  • 1
    Electronic Resource
    Electronic Resource
    Plasma levels of piperacillin and vancomycin used as prophylaxis in liver transplant patients (1993)
    Springer
    European journal of clinical pharmacology 45 (1993), S. 529-534 
    Details
    ISSN: 1432-1041
    Keywords: Piperacillin ; Vancomycin ; liver transplantation ; antibioprophylaxis ; pharmacokinetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The pharmacokinetics of piperacillin and vancomycin used intravenously as antibioprophylaxis were measured in the plasma and bile during orthotopic liver transplantation. Piperacillin (4 g and then 2 g every 4 h) and vancomycin (1 g and then 0.5 g every 6 h) were infused in 10 patients. During vascular clamping without venovenous bypass, clearance of both antibiotics decreased in relation to renal insufficiency. During the surgical procedure, volume of distribution of both drugs increased because of fluid redistribution. The peaks of piperacillin after first, second and third administrations were respectively 314, 265 and 210 mg·l−1, while trough levels were 46.5, 55.2 and 54.5 mg·l−1. The peaks of vancomycin were 54.4, 49.6 and 40.9 mg·l−1, while first and second trough levels were 9.5 and 12 mg·l−1. These plasma concentrations were quite similar to levels reported in healthy subjects despite large blood loss and fluid replacement. However, piperacillin trough concentrations (〈64 mg/l) were too low in relation to its concentration-dependent antibacterial activity and vancomycin peak concentrations (≥40 mg/l) were slightly too high in relation to its toxicity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00315309
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  • 2
    Electronic Resource
    Electronic Resource
    Heterozygous protein C deficiency and dysfibrinogenemia acquired by liver transplantation (1995)
    Springer
    Transplant international 8 (1995), S. 307-311 
    Details
    ISSN: 1432-2277
    Keywords: Protein C deficiency ; liver transplantation ; Liver transplantation ; protein C deficiency ; Liver transplantation ; dysfibrinogenemia ; Dysfibrino-genemia ; liver transplatation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Orthotopic liver transplantation is now a successful treatment for end-stage liver diseases. Since most components of the coagulation system are synthesized by liver parenchymal cells, there is always a risk of genetic defects of hemostasis being transmitting by liver transplantation. Some coagulation factor defects, such as protein C deficiency, do not induce abnormalities in routine coagulation tests and, thus, go undetected before organ procurement. We report the first case, to our knowledge, of the transmission of heterozygous protein C deficiency, an autosomal recessive genetic defect, associated with dysfibrinogenemia, an autosomal dominant trait, by liver transplantation. Both the recipient and the donor presented with severe thrombotic complications. This case shows that potentially morbid genetic defects can be transmitted by organ transplantation, and it emphasizes the difficulty associated with organ procurement criteria, particularly for liver transplantation, in which routine blood tests appear insufficient for determining whether or not organs can or should be procured from a given donor.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00346885
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Pontine myelinolysis following liver transplantation: a report of two cases (1993)
    Springer
    Transplant international 6 (1993), S. 26-28 
    Details
    ISSN: 1432-2277
    Keywords: Myelinolysis ; liver transplantation — Pontine myelinolysis ; liver transplantation — Liver transplantation ; pontine myelinolysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two cases of central pontine myelinolysis (CPM) following orthotopic liver transplantation (OLT) are reported. Several months after the onset of this neurological syndrome, the two patients are still alive but with severe neurological sequelae. Some patients undergoing emergency OLT present a high risk of CPM because of pre-existing malnutrition, encephalopathy, and hepatic insufficiency. All of these are associated with an inevitable abrupt rise in sodium serum concentration due to intraoperative compensation of blood losses with high-sodium content blood products. Whenever the renal capacity to excrete sodium is impaired by the surgical procedure, continuous intraoperative venouvenous hemofiltration is recommended.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00336635
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    Paper (German National Licenses)
    Fulltext
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