ABSTRACT
University of Wisconsin (UW) solution has been known as the standard solution for liver graft preservation. Alternative preservation solutions have been used in liver transplantation, such as histidine-tryptophan-ketoglutarate (HTK) and Celsior solution. Institut Georges Lopez-1 (IGL-1) is a new preservation solution with lower potassium and lower viscosity than UW solution that has recently been used in liver transplant. Data from 178 patients who received transplants from August 2008 to June 2013 at Hospital Santa Isabel, Blumenau, Brazil, were analyzed. All patients received grafts from brain death donors. In November 2011 we started to use IGL-1 as an alternate preservation solution. Therefore, 53 patients using IGL-1 preserved grafts were compared to 125 using HTK solution. The donor age in the HTK group ranged from 11-77 years, with a mean of 43.4 ± 4.8. In the IGL-1 group donor age ranged from 9-62 years, with a mean of 35.8 ± 4.5. Cold ischemia time in the HTK group ranged from 85-1145 minutes, mean 443.5 ± 183.5 minutes. In the IGL-1 group, cold ischemia time ranged from 85-670 minutes, mean 329.3 ± 134.8 minutes. The overall operative mortality rate was 14% (25 patients); in the HTK group, 14.4% (18 patients); and in the IGL-1 group, 13.4% (7 patients). One graft in the HTK group presented with primary non-function (PNF), 0.7%; there were none in the IGL-1 group. In our study, IGL-1 has been shown to be safe to use as a preservation solution for liver transplantation. Early post-transplant graft function was comparable to that observed with HTK solution, although a tendency for lower alanine aminotransferase levels was noticed. IGL-1 has been shown to be safe, cost efficient, and an effective preservation solution.
Subject(s)
End Stage Liver Disease/surgery , Liver Transplantation , Organ Preservation Solutions , Organ Preservation/methods , Adolescent , Adult , Aged , Child , End Stage Liver Disease/mortality , Female , Glucose , Humans , Liver Transplantation/mortality , Male , Mannitol , Middle Aged , Potassium Chloride , Procaine , Retrospective Studies , Treatment Outcome , Young AdultABSTRACT
La seudoobstrucción aguda del colon es un síndrome pobremente comprendido, caracterizado por signos, síntomas y hallazgos radiológicos de obstrucción de colon sin evidencia de obstrucción mecánica. Se reporta el caso de gestante de 37 años que presentó distensión abdominal progresiva y dolor abdominal luego de parto eutócico. La radiografía simple de abdomen demostró dilatación marcada del colon. Se realizó un enema hidroopaco con el que se descartó la obstrucción mecánica. La exploración quirúrgica confirmó dilatación del colon sigmoides con perforación. Se realizó resección parcial del colon (AU)
Acute colonic pseudo-obstruction is a poorly understood syndrome, characterized by the signs, symptoms and radiological pattern of large bowel obstruction without evidence of mechanical obstruction. We report the case of a 37-year-old pregnant woman who developed progressive abdominal distention and abdominal pain after a eutocic delivery. Plain abdominal X-ray showed a markedly dilated large bowel. Mechanical colonic obstruction was excluded with hypaque enema. Surgical exploration confirmed dilatation of the sigmoid colon with perforation. Partial colon resection was performed (AU)
Subject(s)
Humans , Female , Adult , Colonic Pseudo-Obstruction , Delivery, Obstetric/adverse effects , Colectomy , Risk Factors , Postpartum PeriodABSTRACT
Se describe un caso de síndrome «en espejo» de una paciente de 16 años con embarazo de 22 semanas, quien consultó por presentar dolor abdominal de fuerte intensidad. La ecografía fetal demostró la presencia de un feto único en presentación cefálica, gran cantidad de líquido en la cavidad abdominal y torácica fetal, edema placentario, polihidramnios y tumoración quística en la región sacra. Se obtiene un recién nacido con edema subcutáneo generalizado, con escasa cantidad de líquido pleural y pericárdico y tumoración compatible con teratoma sacrococcígeo fetal (AU)
A case of mirror syndrome is described in a 16-year-old patient with a 22-week pregnancy who presented with severe abdominal pain. Fetal ultrasonography showed the presence of a single cephalic fetus, a large amount of fluid in the fetal abdominal and thoracic cavities, placental edema, polyhydramnios and a cystic tumor in the sacral region. The newborn showed subcutaneous edema with scarce pleural and pericardial fluid and a tumor compatible with fetal sacrococcygeal teratoma (AU)
