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Title: Intestinal and Multivisceral Retransplantation - The Indiana University Experience
Authors: DAVID, Andre I.TREVIZOL, AlissonMANGUS, RichardTECTOR, A. JosephVIANNA, Rodrigo M.
Citation: AMERICAN JOURNAL OF TRANSPLANTATION, v.13, suppl.2, Special Issue, p.96-96, 2013
Abstract: Introduction : Despite recent advances in immunosuppression protocols, acute cellular rejection (ACR) remains the main cause of graft loss after transplantation. Intestinal/Multivisceral retransplantation (IMVRT) became possible with early diagnosis and better handle of the recipient. Aim : Study the results of Indiana University with IMVRT. Methods : We analyzed retrospectively 10 patients submitted to retransplantation. Results : Ten recipients composed the study (five women, two men and three children) with mean age of 38 years (26 to 58) for adult recipients and 10 years (7 to 12) for child recipients. The causes for first multivisceral transplants were pseudoobstruction (3), GIST, short gut syndrome (2), volvulus, multiple organ infarction, hepatitis C and extensive portal mesentery thrombosis and gastroschisis. Severe ACR occured in 9 patients (90%). The cause for retransplant was : ACR, chronic rejection, pancreatic leak and rejection after isolated intestinal transplant. The mean interval for IMVRT was 13,9 months (1 to 47) for adults and 28,9 (2,14 and 71) for pediatrics. Eight IMVRT (2 pediatrics), one modified multivisceral retransplantation and one multivisceral and kidney retransplantation were performed. Three deaths occured 4, 6 months and 9 months after retransplant. One-year patient survial rate was 71,4% for adult recipients and 66,6% for pediatric recipients. Conclusion : Survival is feasible after IMVRT compared with usual primary transplants results. New studies are necessary for better understanding of in fluencing factors for IMVRT.
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