RESUMEN
Human orthotopic liver transplantation was first attempted in 1963. Living related liver transplantation has been introduced by Raia in 1988. In children, biliary atresia is the leading indication of living related liver transplantation. We performed 2 cases living related liver transplantation on May, 1996. The donors were 32 and 30 year old father, recipients were his 3 year old son and 4 year old daughter. The causes of liver failure were drug induced fulminant hepatitis and recurrent cholangitis due to biliary atresia. The first case was incompatible of ABO blood typing, donor AB(Rh+) and recipient B(Rh+). The ABO incompatible donor was performed preoperatively plasmapheresis. After left lateral segmentectomy of donor and total hepatectomy of recipient, donor liver was orthotopically transplanted. The average operation time of donor and recipient were 8 hours and 12.5 hours. The amount of transfusion in donor and recipient were average 2 pints and 2.5 pints. The perioperative immunosuppression was maintained with prednisone, azathioprine and cyclosporin, but 1st case was changed from cyclosporin to OKT3 on postoperative 9th day. The postoperative complications of recipient were pulmonary edema, bacterial and fungal infection. The donors were discharged on postoperative 8th and 9th day. The first case patient was discharged postoperative 42th day due to respiratory complication. The 2nd recipient was discharged postoperative 22th day. We suggested that living related liver transplantation is good modality for resolving the graft shrtage in pediatric liver transplantation.
Asunto(s)
Adulto , Niño , Preescolar , Humanos , Azatioprina , Atresia Biliar , Tipificación y Pruebas Cruzadas Sanguíneas , Colangitis , Ciclosporina , Padre , Hepatectomía , Hepatitis , Terapia de Inmunosupresión , Fallo Hepático , Trasplante de Hígado , Hígado , Mastectomía Segmentaria , Muromonab-CD3 , Núcleo Familiar , Plasmaféresis , Complicaciones Posoperatorias , Prednisona , Edema Pulmonar , Donantes de Tejidos , TrasplantesRESUMEN
Surgical treatment have been gold standard in most cases of ureteral stricture and it`s effects were not satisfactory. Recently nonoperative dilatation offer attractive alternatives to surgery in the treatment of urodynamically significant ureteral strictures. Wide spread acceptance of balloon and other catheter techniques in dilating stenotic blood vessels, biliary tree and urinary tract led us to try these modalities for the treatment of ureteral strictures. So we tried percutaneous balloon dilatation in 5 failed retrograde ureteral dilatation cases. 4 tuberculous ureteritis and 1 postureterolithotomy state. We used the balloon catheter with techniques of percutaneous transluminal manipulation for dilatation of the ureteral stricture under fluoroscopic guidance. The results of dilatation were successful in 4 cases and failed in 1 tuberculous ureteral stricture. In successfu1 4 cases, there was no evidence of symptomatic and radiologic recurrence for 7 to 29 months of follow up period. The percutaneous balloon dilatation can be useful in case of alternative to surgery and failed retrograde balloon dilatation.