Influence of Infection by Aspergillus in Arterial Complications After Liver Transplantation: Evolution and Results in 670 Transplants
Unidad de Trasplante Hepático, Hospital Universitario Puerta de Hierro Majadahonda, UAM, Madrid, Spain.Transplantation Proceedings (Impact Factor: 0.98). 04/2011; 43(3):751-2. DOI: 10.1016/j.transproceed.2011.03.005
The incidence of fungal complications is frequent among liver transplanted subjects. Between March 1986 and June 2009, we performed 670 liver transplants in 593 patients, including 61% males and an overall average age of 46. The incidence of arterial complications in our center was 5.3% (32/593 patients), including 24 (75%) thromboses, 5 (16%) pseudoaneurysms, 2 anastomotic stenoses, and 1 an iliac graft rupture owing to a mycotic aneurysm. Four patients presented arterial complications associated with Aspergillus sp. Three of them were males of mean age 50 years and 3 had an acute rejection episode. Immunosuppression was cyclosporine (CsA), steroids, and azathioprine. Four arterial complications were diagnosed: 2 thromboses and 2 pseudoaneurysm ruptures. Two patients presented biliary complications associated with the arterial complication and Aspergillus infection. Treatment was expectant in 1 patient, interventional radiology in an other, and retransplantation in the other 2. All patients infected with Aspergillus sp. diad of sepsis and multiorgan failure. Arterial complications posttransplant associated with infection by Aspergillus sp., can be an important cause of retransplantation, sepsis and death.
Full-textDOI: · Available from: Valentin Cuervas-Mons, Oct 01, 2015
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.
- International Journal of Medical Robotics and Computer Assisted Surgery 09/2007; 3(3):183-6. DOI:10.1002/rcs.151 · 1.53 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: To assess the intermediate-term result of the use of the minimally invasive technique in the treatment of choledochal cysts in children. This is a retrospective review of all cases of choledochal cyst treated in the tertiary referral centre. The surgical technique is described and all the medical records were reviewed to assess the intraoperative and postoperative complications and follow-up problems. From October 2000 to April 2008, laparoscopic excision and reconstruction were attempted in 37 patients. Laparoscopic surgery was successfully performed in 34. Conversion was required in three patients due to oozing on cyst dissection (two) and bleeding from small bowel mesentry (one) during the early part of the series. Postoperative complications were observed in 15 patients including subhepatic collection (6), bile leakage (3), minor wound infection (4) and prolonged ileus (2). At a mean follow-up of 4.2 years, four patients developed surgical complications including intrahepatic ductal strictures in a type IV cyst (one), stump pancreatitis (one), terminal ileal obstruction from internal herniation (one) and cholangitis (one). The cosmetic result was good in all patients. We conclude that laparoscopic excision and reconstruction can be safely performed in children with a choledochal cyst with satisfactory intermediate-term results.Pediatric Surgery International 05/2009; 25(4):355-60. DOI:10.1007/s00383-009-2343-9 · 1.00 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: The purpose of this study was to assess the safety and feasibility of performing robot-assisted pediatric surgery using the da Vinci Surgical System in a variety of surgical procedures. A retrospective review of 144 robot-assisted pediatric surgical procedures performed in our institution between June 2004 and December 2007 was done. The procedures included the following: 39 fundoplications; 34 cholecystectomies; 25 gastric bandings; 13 splenectomies; 4 anorectal pull-through operations for imperforate anus; 4 nephrectomies; 4 appendectomies; 4 sympathectomies; 3 choledochal cyst excisions with hepaticojejunostomies; 3 inguinal hernia repairs; two each of the following: liver cyst excision, repair of congenital diaphragmatic hernia, Heller's myotomy, and ovarian cyst excision; and one each of the following: duodeno-duodenostomy, adrenalectomy, and hysterectomy. A total of 134 procedures were successfully completed without conversion; 7 additional cases were converted to open surgery, and 3 were converted to laparoscopic surgery. There were no system failures (e.g., setup joint, arm, or camera malfunction; power error; monocular or binocular loss; metal fatigue or break of surgeon's console hand piece; software incompatibility). There was one esophageal perforation and two cases of transient dysphagia following Nissen fundoplication. The mean patient age was 8.9 years, and the mean patient weight was 57 kg. Robot-assisted surgery appears to be safe and feasible for a number of pediatric surgical procedures. Further system improvement and randomized studies are required to evaluate the benefits, if any, and the long-term outcomes of robotic surgery.World Journal of Surgery 05/2010; 34(5):975-8. DOI:10.1007/s00268-010-0431-6 · 2.64 Impact Factor