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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors review the computed tomographic (CT) findings following single and double lung transplantation in children to show the spectrum of complications. The most common parenchymal complications following transplantation include acute rejection; chronic rejection or bronchiolitis obliterans; bacterial, viral, and fungal infections; and lymphoproliferative disorders. In acute and chronic rejection, CT shows ground-glass attenuation and interlobar septal thickening. The same CT findings are seen in bacterial and viral infections, with occasional pulmonary abscess seen in the former. Fungal infections are characterized by cavitary lesions, air-space disease, and mediastinal adenopathy on CT scans. In lymphoproliferative disorders, CT demonstrates pulmonary nodules or soft-tissue masses. The most frequent posttransplantation airway complications include stenosis, stent migration, and dehiscence. Dehiscence, which usually results from ischemia at the anastomosis site, is evident on CT scans as a disrupted airway and extraluminal air collections. CT is particularly important in the evaluation of airway complications because the CT results can significantly affect patient management. In parenchymal disease, CT often cannot aid in establishing a specific diagnosis, but it can be used to determine a site for biopsy, document extent of disease, and follow up results of treatment.
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PMID:CT of complications in pediatric lung transplantation. 785 45

Neurologic complications remain important factors in mortality and morbidity of liver transplant patients, despite 5-yr survival rates of nearly 75% achieved with improved surgical and anesthetic techniques, better selection of recipients and donors, and immunosuppression. In order to analyze and compare the occurrence of neuropathologic complications in children with that in adults, we reviewed all complete autopsies done on liver transplant patients at the University of Pittsburgh from March 1, 1981 until December 31, 1990. A retrospective study of all neuropathologic lesions in 68 children and 132 adults indicated a higher occurrence of cerebrovascular lesions in children than in adults. Intracranial hemorrhages occurred in 27% of the children and in 20% of adults; cerebral ischemic lesions showed even a higher prevalence in children than in adults: focal infarcts occurred in 32% of children and 18% of adults, and global brain ischemia was observed in 49% of children and 20% of adults. Intracranial aspergillosis was the most common fungal infection in both children and adults (4% children, 10% adults). Systemic posttransplant lymphoproliferative disorders were more frequent in children and occurred in nine children and four adults. CNS lymphoma occurred in two children and one adult. Progressive multifocal leukoencephalopathy was seen in one adult only.
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PMID:The neuropathology of liver transplantation: comparison of main complications in children and adults. 838 Dec 31

Orthotopic liver transplantation has become the treatment of choice for patients with end-stage nonmalignant liver disease. The surgical techniques and immunosuppressive therapy for this procedure have improved considerably. Nevertheless, there are still significant complications, particularly those of vascular origin, which can lead to graft failure and require retransplantation unless prompt treatment is instituted. These complications include arterial and venous thrombosis and stenosis; arterial pseudoaneurysm; biliary leakage, stricture, and obstruction; liver ischemia, infarction, and abscess; fluid collections and hematomas; lymphoproliferative disorders; recurrent tumors; hepatitis C virus infection; and splenic infarction. Since the clinical presentation of posttransplantation complications is frequently nonspecific and varies widely, imaging studies are critical for early diagnosis. Helical computed tomography (CT) is a valuable complement to ultrasonography (US) in the postoperative period and is a safe, accurate, and noninvasive method of demonstrating hepatic vessels (hepatic artery, portal vein, hepatic veins, and inferior vena cava) and evaluating nonvascular complications (in the hepatic parenchyma and bile duct abnormalities) and extrahepatic tissues. Knowledge and early recognition of these complications is essential for graft salvage, and CT can provide valuable information, particularly for patients with indeterminate US results or in whom US examination is difficult.
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PMID:Complications of orthotopic liver transplantation: spectrum of findings with helical CT. 1155 18

Treatment of healthy donors with recombinant human granulocyte colony-stimulating factor (rhG-CSF) allows the mobilization and peripheralization into circulating blood of an adequate number of CD34+ cells that can then be collected by leukapheresis (PBSC). This procedure avoids the invasiveness of bone marrow harvest and the risks related to general anesthesia. The main adverse effects of rhG-CSF are: bone pain, 84%, headache, 54%, fatigue, 31%, and nausea, 13%, which are usually scored by the donors as moderate to severe, resolving within 2-3 days after discontinuation of the cytokine. Analgesics, mainly acetaminophen, are sufficient to control the pain. Less than 5% of the donors experience non-cardiac chest pain, a local reaction at the injection site, insomnia, dizziness or a low-grade fever. Discontinuation of the PBSC procedure because of adverse effects of rhG-CSF or leukapheresis is rarely necessary (0.5%) but this good tolerability can be hampered by the need, in 5-20% of cases, for an adequate venous access that requires insertion of a central or venous catheter. There are no absolute contraindications to the stimulation of healthy donors with rhG-CSF but the description of cases of non-traumatic splenic rupture, iritis, cardiac ischemia, and gouty arthritis suggests that further precautionary restrictions are advisable when deciding eligibility for PBSC collection. The main advantages for patients receiving an allogeneic PBSC transplant are the faster hematologic and immunologic recovery and the potential for a greater efficacy in advanced disease by lowering the transplant-related mortality. One of the major concerns regarding the use of rhG-CSF in unrelated healthy donors is the uncertainty about its possible role in triggering malignancy, in particular myelodysplastic syndrome and acute myeloid leukemia. There are no studies with an adequate sample size and follow-up that can answer this question but two recent retrospective studies reported that in the medium term rhG-CSF is not associated with an excess of lymphoproliferative disorders. Currently, caution on the long-term safety of the use of rhG-CSF in healthy donor is still warranted but the data so far accumulated on allogeneic PBSC transplants are encouraging both as far as concerns the good short-medium tolerability profile of G-CSF-stimulation of the donor and the potential major efficacy in leukemia patients.
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PMID:The use of cytokine-stimulated healthy donors in allogeneic stem cell transplantation. 1241 88

Gastrointestinal complications are frequent in renal transplant recipients and can include oral lesions, esophagitis, peptic ulcer, diarrhea, colon disorders and malignancy. Oral lesions may be caused by drugs such as cyclosporine and sirolimus, by virus or fungal infections. Leukoplakia may develop in patients with Epstein-Barr virus (EBV) infection. The commonest esophageal disorder is represented by fungal esophagitis usually caused by candida. A number of patients may suffer from nausea, vomiting and gastric discomfort. These disorders are more frequent in patients treated with mycophenolate mofetil (MMF). Peptic ulcer is more rare than in the past. Patients with a history of peptic ulcer are particularly prone to this complication. Other gastroduodenal disorders are caused by cytomegalovirus (CMV) and herpes simplex infection. Diarrhea is a frequent disorder which may be caused by pathogen microorganisms or by immunosuppressive agents. The differential diagnosis may be difficult. Colon disorders mainly consist of hemorrhage, usually sustained by CMV infection, or perforation which may be caused by diverticulitis or intestinal ischemia. Colon cancer, anal carcinoma, and EBV-associated lymphoproliferative disorders are particularly frequent in transplant recipients. A particular gastric lymphoma called mucosa-associated lymphoid tissue (MALT) lymphoma may develop in renal transplant patients. It usually responds to the eradication of Helicobacter pylori.
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PMID:Gastrointestinal complications in renal transplant recipients. 1591 Feb 87

Alemtuzumab is an anti-CD52 monoclonal antibody used for the treatment of lymphoproliferative disorders and relapsing-remitting multiple sclerosis. We report a 30-year-old woman with relapsing-remitting multiple sclerosis who developed a type 2 non-ST elevated myocardial infarction (NSTEMI) during her first alemtuzumab infusion cycle. While acute coronary syndrome has been described with alemtuzumab in the treatment of lymphoma, alemtuzumab-associated cardiac ischemia in multiple sclerosis is uncommon and can occur in patients without cardiovascular risk factors.
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PMID:Acute myocardial infarction associated with initial alemtuzumab infusion cycle in relapsing-remitting multiple sclerosis. 3125 64