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1.
Transplant Proc ; 45(10): 3650-2, 2013.
Article in English | MEDLINE | ID: mdl-24314985

ABSTRACT

Rejection is the most usual cause of primary dysfunction of hepatic allograft transplants. Acute rejection (AR) often occurs in the early post-transplantation weeks, with an incidence of 12%-19%. Chronic rejection (CR) is less usual (2.5%-17%) and irreversible. Our aim was to determine the incidence of AR and CR in patients who underwent transplantaton due to alcoholism-induced cirrhosis and the survival of these groups. We undertook a retrospective study of the 93 patients who received a liver transplant due to hepatic cirrhosis between 2005 and 2012. AR occurred in 23.7% of cases, and CR in 11.8%. The median time from implantation to the appearance of AR was 34.5 days, and for CR it was 334 days. The survival of the patients with AR and CR showed no significant differences as compared with the control group (P = .77). From our clinical appraisal, symptoms of previous AR may lead to CR, although the relationship was not significant.


Subject(s)
Graft Rejection/epidemiology , Liver Cirrhosis, Alcoholic/surgery , Liver Transplantation/adverse effects , Acute Disease , Biopsy , Chronic Disease , Female , Graft Rejection/diagnosis , Graft Rejection/mortality , Graft Survival , Humans , Incidence , Kaplan-Meier Estimate , Liver Cirrhosis, Alcoholic/diagnosis , Liver Cirrhosis, Alcoholic/mortality , Liver Transplantation/mortality , Male , Middle Aged , Predictive Value of Tests , Retrospective Studies , Risk Factors , Spain/epidemiology , Time Factors , Treatment Outcome
2.
Transplant Proc ; 45(10): 3670-1, 2013.
Article in English | MEDLINE | ID: mdl-24314992

ABSTRACT

We report our experience with a 61-year-old patient with alcoholic and hepatitis C cirrhosis who underwent liver transplantation. On the 3rd postoperative day he presented a mediastinitis secondary to esophageal perforation produced by a Linton tube. An esophagectomy with jejunostomy was performed. Tacrolimus granules for oral suspension (Modigraf) were administered through the jejunostomy. This case report highlights the use of Modigraf and the absence of secondary effects. We observed biochemical parameters during the jejunostomy period. We discuss the administration strategy applied and whether tacrolimus granules for oral suspension by jejunostomy affect the bioavailability and its side effects.


Subject(s)
Esophageal Perforation/surgery , Immunosuppressive Agents/administration & dosage , Jejunostomy , Liver Transplantation/adverse effects , Tacrolimus/administration & dosage , Administration, Oral , Biological Availability , Carcinoma, Hepatocellular/etiology , Carcinoma, Hepatocellular/surgery , Carcinoma, Hepatocellular/virology , Chemistry, Pharmaceutical , Esophageal Perforation/diagnosis , Esophageal Perforation/etiology , Esophagectomy , Hepatitis C/complications , Hepatitis C/diagnosis , Humans , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/pharmacokinetics , Liver Cirrhosis/diagnosis , Liver Cirrhosis/surgery , Liver Cirrhosis/virology , Liver Cirrhosis, Alcoholic/complications , Liver Cirrhosis, Alcoholic/diagnosis , Liver Cirrhosis, Alcoholic/surgery , Liver Neoplasms/etiology , Liver Neoplasms/surgery , Liver Neoplasms/virology , Male , Mediastinitis/diagnosis , Mediastinitis/etiology , Mediastinitis/surgery , Middle Aged , Tacrolimus/adverse effects , Tacrolimus/pharmacokinetics , Tomography, X-Ray Computed , Treatment Outcome
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