Gabriel Gondolesi

• Professor
• Medstar Georgetown Transplantation Institute

Objectives: Technical graft loss, usually thrombotic in nature, accounts for most of the pancreas grafts that are removed early after transplant. Although arterial and venous thrombosis can occur, the vein is predominantly affected, with estimated overall rate of thrombosis of 6% to 33%. In late diagnosis, the graft will need to be removed because...

Background: Chronic intestinal failure (CIF) is a heterogeneous disease that affects pediatric and adult populations worldwide and requires complex multidisciplinary management. In recent years, many advances in intravenous supplementation support, surgical techniques, pharmacological management, and intestinal transplants have been published. Base...

Resumen Introducción: La carrera de investigador en Salud del Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) es una carrera ad honorem que permite el ingreso de profesionales de la salud que, con-tinuando con su práctica asistencial, adquieran derechos y obligaciones de investigadores con carrera rentada. A la fecha se descono...

The Short Bowel Syndrome (SBS) Registry (NCT01990040) is a multinational real-world study evaluating the long-term safety of teduglutide in patients with SBS and intestinal failure (SBS-IF) in routine clinical practice. This paper describes the study methodology and baseline characteristics of adult patients who have (ever-treated) or have never (n...

Introduction: Advances in immunosuppression have extended patient and graft survival rates after solid organ transplantation; however, this is not free of side effects. Balancing safety and efficacy is of paramount importance, particularly in the pediatric setting. Current literature comparing different protocols is scarce, and decisions are mostl...

Introduction: Health Researcher career of National Scientific and Technical Research Council (CONICET) is an ad honorem career that allows entry of health professionals who, continuing with their healthcare practice, acquire rights and obligations of researchers with a paid career. To date, quantity and/or quality of the academic production of CON...

Background: Severe intestinal insufficiency is known as chronic intestinal failure (CIF). In recent decades, medical treatments and surgical procedures have been incorporated, developed and improved under the name intestinal rehabilitation. When performed by multiand interdisciplinary teams, these treatments have high success rates. Objective: The...

Metastasis is a cancer-related systemic disease and is responsible for the greatest mortality rate among cancer patients. Interestingly, the interaction between the immune system and cancer cells seems to play a key role in metastasis formation in the target organ. However, this complex network is only partially understood. We previously found that...

Intestinal transplant (ITx) rejection lacks a reliable noninvasive biomarker and rejection surveillance relies on serial endoscopies and mucosal biopsies followed by histologic assessment. Endoscopic biopsies are also essential for identifying other ITx-related complications such as infectious, allergic, and inflammatory graft enteritis as well as...

Introduction: Immunosuppression varies among centers. Few comparative studies are published defining the best evidence-based approach. Pediatric patients are ideal to explore differences being a more homogeneous population with a lower rate of comorbidities. Methods: A retrospective study of patients receiving first liver transplantation in the fou...

Objective: To describe the worldwide experience with living donation (LD) in intestinal transplantation (ITx) and compare short- and long-term outcome to a propensity-matched cohort of deceased donors. Summary background data: ITx is a rare life-saving procedure for patients with complicated intestinal failure (IF). Living donation (LD)-ITx has...

Introducción: El sangrado digestivo post operatorio intraluminal es una entidad poco frecuente y su manifestación clínica no difiere de la hemorragia digestiva baja de otra etiología. A pesar de que su presentación más habitual es la hematoquecia autolimitada en la primera deposición, en un discreto porcentaje puede requerir transfusiones, tratamie...

Introduction: Closure of the abdominal wall after intestinal (ITx), combined liver-intestine (cL-ITx), multivisceral (MVT) or liver re-transplantation (L-reTx) usually can be a major challenge because those patients usually have a history of multiple abdominal surgeries, significant scarring and loss of abdominal domain. A variety of techniques, in...

Intestinal epithelial cells play important roles in the absorption of nutrients, secretion of electrolytes and food digestion. The function of these cells is strongly influenced by purinergic signalling activated by extracellular ATP (eATP) and other nucleotides. The activity of several ecto-enzymes determines the dynamic regulation of eATP. In pat...

Background The immune system plays a pivotal role in cancer progression. Interleukin 22 binding protein (IL-22BP), a natural antagonist of the cytokine interleukin 22 (IL-22) has been shown to control the progression of colorectal cancer (CRC). However, the role of IL-22BP in the process of metastasis formation remains unknown. Methods We used two...

The global organ transplant activity remains satisfying less than 10% of the total number of patients in the waiting list. Brain dead donors and living donors have been the most common source of organs used worldwide. Nevertheless, as part of the different measures and policies implemented to increase donation, the use of donors after cardio-circul...

Intestinal epithelial cells play important roles in the absorption of nutrients, secretion of electrolytes and food digestion. The function of these cells is strongly influenced by purinergic signalling activated by extracellular ATP (eATP) and other nucleotides. The activity of several ecto-enzymes determines the dynamic regulation of eATP. In pat...

Background Hyperinsulinemic hypoglycemia is the most common cause of severe and persistent hypoglycemia in neonates and children. It is a heterogeneous condition with dysregulated insulin secretion, which persists in the presence of low blood glucose levels. Case presentation We report a case of a 15 year-old male with hyperinsulinemic hypoglycemi...

Objectives: Immunosuppressive strategies for intestinal transplant have changed over time. However, specific intestinal transplant-oriented protocols and reports on long-term maintenance regimens are scarce. Our objective was to evaluate the impact of 2 different initial immunosuppressive protocols based on thymoglobulin (group A) and basiliximab...

Pregnant patients with short bowel syndrome (SBS) and chronic intestinal failure (CIF) can successfully reach to term their pregnancies while on parenteral nutrition (PN) but with high rates of complications. The combination of rehabilitation surgery, combined with the use of novel treatment with enterohormones, especially semisynthetic glucagon-li...

Background: Transplant therapy is considered the best and often the only available treatment for thousands of patients with organ failure that results from communicable and noncommunicable diseases. The number of annual organ transplants is insufficient for the worldwide need. Methods: We elaborate the proceedings of the workshop entitled "The R...

Background: The pancreas is an uncommon site for metastases, accounting for 0.25% to 5% of pancreatic tumors, so that solitary pancreatic metastases are rare. The most frequent primary tumor capable of metastasizing in the pancreas is clear cell renal carcinoma (CCRC). Surgical resection remains the best therapeutic alternative to achieve long-term...

Introduction: Immunosuppression practice varies among centers. Very few comparative studies are published to define the best approach on an evidence-based background. Pediatric patients are ideal to explore potential differences due to their lower rate of comorbidities, being also a more homogeneous population (50% suffering from Biliary Atresia)....

Background: Short bowel syndrome (SBS) is considered a low prevalence disease. In Argentina, no registries are available on chronic intestinal failure (CIF) and SBS. This project was designed as the first national registry to report adult patients with this disease. Methods: A prospective multicenter observational registry was created including...

Purpose of review: Intestinal failure (IF) evolved from being the last recognized organ failure, to become one of the most progressive fields in terms of therapeutic alternatives and results. Short bowel syndrome (SBS) is the main cause of IF in adults and children. The use of surgery allowed patients with unfavorable anatomy type and length to be...

Background: The hemodynamic maintenance of brain-dead donors will influence the quality of the organs procured for transplantation, including the intestine. Although norepinephrine (NE) and dopamine (DA) are commonly used to sustain mean arterial pressure in humans, there are no standardized protocols for their use during maintenance of brain-dead...

Immunosuppression handling plays a key role in the early and long-term results of transplantation.The development of multiple immunosuppressive drugs led to numerous clincial trials searching to reach the ideal regimen. Due to heterogeneity of the studied patient cohorts and flaws in many ,even randomized controlled, study designs, the answer still...

Background Type III Intestinal Failure (IF) is a devastating clinical condition. characterized by the inability of the gut to absorb necessary macronutrients, and/or water and electrolytes, requiring Parenteral Nutrition (PN) as chronic therapy. Long-term PN may lead to life-threatening complications; the loss of central venous access (LCVA) is the...

Background: Despite laparoscopic liver resection has significantly evolved, most hepatectomies are performed by the conventional approach. Objective: The aim of this study is to present the initial experience and applicability of laparoscopic liver resections. Material and methods: We conducted a retrospective analysis of patients undergoing liver...

Background: Hyperinsulinemic hypoglycemia is the most common cause of severe and persistent hypoglycemia in neonates and children. It is a heterogeneous condition with dysregulated insulin secretion, which persists in the presence of low blood glucose levels. Objectives: Describe a clinical case of hyperinsulinemic hypoglycemia, secondary to nesidi...

Background Deregulation of immune response and oxidative stress contribute to nonalcoholic fatty liver disease (NAFLD) pathogenesis. Resistin is a physiological modulator of inflammation and redox homeostasis of different cell types. Increased resistin serum concentration and the direct association between resistin hepatic expression and NAFLD seve...

Objective: We aimed to assess whether native spleen preservation during visceral transplantation (VT) affects graft-versus-host-disease (GVHD) incidence. Summary background data: GVHD is one of the most severe and frequently lethal hematological complications after VT procedures. Because there is no specific treatment for GVHD, it is imperative...

Background: Intestinal failure (IF) is a life-threatening medical condition. The management of IF in low- and middle-income countries without home parenteral nutrition (HPN) remains unclear. We recently established an intestinal rehabilitation unit (IRU) and aimed to provide our experience on the current management and outcomes of IF in Iran. Met...