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  • Torres, Alvaro, et al. (författare)
  • Contrast-enhanced ultrasound for identifying circulatory complications after liver transplants in children
  • 2019
  • Ingår i: Pediatric Transplantation. - Stockholm : Karolinska Institutet, Dept of Clinical Science, Intervention and Technology. - 1397-3142 .- 1399-3046.
  • Tidskriftsartikel (refereegranskat)abstract
    • Our main goal with this study was to share our off-label experience with CEUS for identifying circulatory complications after liver transplantation in children. A total of 74 CEUS examinations performed on 34 pediatric patients who underwent a liver transplant were retrospectively included. About 53% of the examinations were performed on children 2 years old or younger. About 82% of the examinations were performed within 30 days from the transplant. About 62% of patients were transplanted due to a cholestatic disease, 11% due to a metabolic disease, 8% were re-transplanted due to graft failure, and 19% was due to other conditions. BA was the most common reason for transplantation and represented 38% of patients. About 38% of the transplantations were performed with whole grafts from DD, 40% with split liver grafts, and 22% with left lateral segments from LD. For diagnosing arterial circulatory complications, the PPV was 80%. For diagnosing portal vein circulatory complications, the PPV was 66.7%. NPV was 100%. In 28% of the examinations, the examiner could not visualize the normal arterial blood flow without CEUS. CEUS is a non-invasive and safe imaging technique that seems valuable in these patients and further efforts are needed to license its use in the post-transplant setting.
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  • Arvidson, Johan, et al. (författare)
  • Toxic epidermal necrolysis and hemolytic uremic syndrome after allogeneic stem-cell transplantation
  • 2007
  • Ingår i: Pediatric Transplantation. - : Wiley. - 1397-3142 .- 1399-3046. ; 11:6, s. 689-693
  • Tidskriftsartikel (refereegranskat)abstract
    • TEN and HUS are challenging complications with excessive mortality after HSCT. We report the development of these two conditions in combination in a nine-yr-old boy after HSCT from an unrelated donor. TEN with skin detachment of more than 90% of body surface area developed after initial treatment for GvHD. Within a few days of admission to the burns unit, the patient developed severe hemolysis, hypertension, thrombocytopenia, and acute renal failure consistent with HUS, apparently caused by CSA. The management included intensive care in a burns unit, accelerated drug removal using plasmapheresis, and a dedicated multi-disciplinary team approach to balance immunosuppression and infections management in a situation with extensive skin detachment. The patient survived and recovered renal function but requires continued treatment for severe GvHD. Suspecting and identifying causative drugs together with meticulous supportive care in the burns unit is essential in the management of these patients and long-term survival is possible.
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  • Benden, C, et al. (författare)
  • Pediatric transplantation: ten years on
  • 2009
  • Ingår i: Pediatric transplantation. - : Wiley. - 1399-3046 .- 1397-3142. ; 13:3, s. 272-277
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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  • Resultat 1-10 av 103

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