ABSTRACT
We experienced a living donor liver transplantation for a 26-month-old girl with complement factor H deficiency. Complement factor H is a plasma protein that regulates the activity of the complement pathway. Complement overactivity induced by complement factor H deficiency is associated with atypical hemolytic uremic syndrome. Liver transplantation can be the proper treatment for this condition. During the liver transplantation of these patients, prevention of the complement overactivation is necessary. Minimizing complement activation, through the use of modalities such as plasma exchange before the surgery and transfusion of fresh frozen plasma throughout the entire perioperative period, may be the key for successful liver transplantation in these patients.
Subject(s)
Child, Preschool , Female , Humans , Complement Activation , Complement Factor H , Complement System Proteins , Hemolytic-Uremic Syndrome , Liver Transplantation , Living Donors , Perioperative Period , Plasma , Plasma ExchangeABSTRACT
BACKGROUND: We evaluated all ambulatory surgeries conducted at our center using several factors (the utility rate and the number of ambulatory surgery, unanticipated admission and its reasons) in order to improve the performance of our facility. We hope that this data could be an indicator of ambulatory surgeries in Korea, which will help strengthen the basis for its development. METHODS: We investigated this study by utilizing the retrospective methods. Data were obtained from hospital records over a period of 5 years (January 2006 to December 2010) for patients who underwent day surgeries at our Day Surgery Center (DSC). RESULTS: The utility rate of ambulatory surgery was 20.38%, 20.91%, 17.03%, 16.73% and 17.70% from 2006 to 2010 each year. The total number of ambulatory surgeries performed in our DSC from 2006 to 2010 was 6875, 7168, 7423, 7417 and 7798 for each year. The unanticipated admission rate were 19 patients (0.57%), 30 patients (0.93%), 20 patients (0.62%), 46 patients (1.26%) and 48 patients (1.25%), respectively. The major causes of admission were due to surgeon request and wish of patients. CONCLUSIONS: In the review of our DSC, although the number of ambulatory cases have been increased from 6875 to 7798, the trend of the utility rate of ambulatory surgery is slightly downward from 20.38% to 17.70% for the recent 5 years. All of the unanticipated admission rate per year was below 1.5% and most of the reasons of the unanticipated admission after ambulatory surgery were non-medical.
Subject(s)
Humans , Ambulatory Surgical Procedures , Hospital Records , Korea , Retrospective StudiesABSTRACT
A 37-year-old male was admitted for a hemorrhoidectomy. He received uneventfully spinal anesthesia for a hemorrhoidectomy. He had no previous history of any allergic tendency. By the request of the general surgeon, a cefotetan was intravenously administered slowly to reduce the incidence of infection. A few minutes later, anaphylactic reaction developed with hypotension, tachycardia, consciousness change and urticaria. After appropriate management, he recovered without any complication.
Subject(s)
Adult , Humans , Male , Anaphylaxis , Anesthesia, Spinal , Cefotetan , Consciousness , Hemorrhoidectomy , Hypotension , Incidence , Tachycardia , UrticariaABSTRACT
A 37-year-old male was admitted for a hemorrhoidectomy. He received uneventfully spinal anesthesia for a hemorrhoidectomy. He had no previous history of any allergic tendency. By the request of the general surgeon, a cefotetan was intravenously administered slowly to reduce the incidence of infection. A few minutes later, anaphylactic reaction developed with hypotension, tachycardia, consciousness change and urticaria. After appropriate management, he recovered without any complication.