Living-related liver transplantation.

We report here, the first pediatric living-related liver transplant in Saudi Arabia and the Middle East. Our patient is a 2 year old girl with a diagnosis of progressive familial intrahepatic cholestasis, causing intractable pruritus and failure to thrive requiring liver transplantation. The child was successfully transplanted using a segment of her mother's liver for living-related liver transplantation. Two years post-transplantation the patient is doing well. With the ongoing crises in cadaveric organ availability and the high prevalence of pediatric liver disease, living related liver transplantation is an ideal solution to this difficult and challenging problem.

Infected rectus sheath hematoma: An unrecognized cause of intestinal obstruction.

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Story of the first liver transplant in saudi arabia.

Chronic liver disease is common in Saudi Arabia with viral hepatitis and schistosomiasis being the common causes. I herewith describe the experience on the first liver transplantation in Saudi Arabia and the Arab World. The patient was a 23-year old Saudi male who had cirrhosis of the liver secondary to sclerosing cholangitis. He underwent orthotopic liver transplantation on July 30, 1990. The post-operative course was uneventful and immunosuppression comprised of small doses of cyclosporine, azathioprine and prednisolone. The patient continues to be well six years post-transplant and is adequately rehabilitated.

The first liver transplant in Saudi Arabia and the Arab world.

The first liver transplant in Saudi Arabia and in the Arab world was performed on the 30th of July, 1990, in the Armed Forces Hospital in Riyadh, on a 23-year-old male with end-stage liver disease due to sclerosing cholangitis. There were no major post-operative or post-transplantation complications. Now, sixteen months post-transplantation, the patient is doing well on immunosuppressive therapy with an almost normal liver function, and is already back at work and carrying out normal activities. This report shows that liver transplantation can be performed successfully in this part of the world.

Mesenteric vein thrombosis, non-invasive diagnosis and follow-up (US + MRI), and non-invasive therapy by streptokinase and anticoagulants.

We report on the case of a young lady on oral contraceptives for only 1 month who experienced severe central abdominal pain of a progressive nature. Mesenteric vein thrombosis was diagnosed by ultrasound and confirmed by magnetic resonance imaging. The patient was treated initially with streptokinase followed by heparin and warfarin with subjective improvement, and gradual disappearance of the thrombus was observed on ultrasound and magnetic resonance imaging. In this report we wish to emphasize the feasibility of the early diagnosis of mesenteric vein thrombosis by ultrasound and magnetic resonance imaging, and the effectiveness of early thrombolytic therapy without the need for surgical intervention.

Ocular side effects of systemic steroid therapy in renal transplant patients.

Sixty-one renal transplant patients were studied for ocular complications of steroid therapy. Twenty patients (32.8%) were found to have posterior subcapsular cataract. Three patients (4.9%) had ocular hypertension. There was no significant correlation between cataract formation and the total dose of steroids, number of rejection episodes, or the period of hemodialysis. HLA-A9 was present in noncataract patients to a greater extent, a statistically significant (P less than .05) finding not reported before to our knowledge.

Survival of sub-optimal cadaver renal grafts with prolonged cold ischaemic times using cyclosporin.

Between September 1983 and December 1985, 33 cadaver kidneys with prolonged ischaemic times (mean 47.3 +/- 11.0 h), and frequently in problematic conditions, were received from Europe and transplanted into adults (16 male, 12 female, mean age 34 +/- 11 years) and children (2 male, 3 female, mean age 8.8 +/- 4.0 years), using cyclosporin (CsA) and steroid immunosuppression. Six patients have died (three with functioning grafts) and 12 grafts have been lost. Eighteen grafts remain functioning, with a mean survival of 27 months. The 1 year actuarial patient and graft survivals were 82% and 69% respectively. The mean time to cessation of haemodialysis was 17 +/- 10 days, and to stable graft function was 28 +/- 11 days. At 3 months (27 patients) mean serum creatinine was 191 +/- 88 mumol/l (2.16 +/- 1.0 mg/dl), with a mean CsA dose of 6.7 +/- 2.2 mg/kg per day. There was an association between the immediate post-transplant renographic perfusion index and the serum creatinine at 3 months (r = 0.52, P less than 0.01). At no stage did the serum creatinine correlate with CsA dose or length of ischaemic time. These results demonstrate that despite suboptimal conditions, prolonged cold ischaemic times, and periods of oliguria, cadaver kidney transplants may be managed successfully with CsA and low-dose steroids.