Notes

Perigastric Hyaline-Vascular Alternative Castleman's Disease.
9% vs 79.3%, P = .001 and 10-year 73.6% vs 63.5%, P = .004). Suboptimal kidneys showed a 1.6-fold higher adjusted hazard ratio (aHR) of all-cause graft loss (95% confidence interval [CI] 1.1-2.5, P = .025) and had the same impact as older donor age (≥ 54 years old, aHR 1.6, 95% CI 1.1-2.4, P = .008). Conclusions The impact of suboptimal kidney should be factored into the donor selection process.Background In living donor liver transplantation (LDLT), a graft-to-recipient weight ratio (GRWR) of under 0.8 is recognized as the critical graft size. Our aim was to compare the survival rates of recipients with small-for-size grafts (SFSG GRWR 17 mm Hg) to interrupt the splenic bloodstream. We divided all LDLT cases retrospectively into 3 groups an SFSG group (n = 22), NSG group (n = 154), and LFSG group (n = 12). We investigated the survival rates in these groups. Furthermore, we divided the SFSG group into 2 subgroups an SFSG with splenectomy (SFSG+S) group (n = 7) and an SFSG without splenectomy group. We investigated the occurrence rates of lethal complications such as portal vein thrombosis, hepatic artery thrombosis, and hepatic vein thrombosis. Results The 5-year survival rate in the SFSG group was significantly lower (52.8%) than in the other groups (NSG 84.5%; LFSG 83.3%), but that of the SFSG+S group was similar (80.0%) to that of other groups. There was no difference in the occurrence of postoperative complications such as portal vein thrombosis, hepatic artery thrombosis, or hepatic vein thrombosis between the SFSG+S group and other groups. Conclusions Graft survival of LDLT using SFSG+S was as good as that of normal-sized grafts. Reducing portal vein pressure was important for SFSG.Background The development of consistent animal experimental models is important for continued research on specific biological and immunologic aspects of vascularized composite allografts. It is also important for the translation of immune regulation and tolerance induction strategies and treatment ideas from bench to bedside. The purpose of our study is to provide an outline of the use of animal models in simulated facial transplant surgery and to investigate the feasibility of animal model use. Methods The animals underwent hemifacial flap transplant surgery. The flaps were placed on the external carotid artery and external jugular vein of the donor animal. Twenty-one procedures were performed in 4 different animals (6 rats, 5 rabbits, 6 dogs, 4 pigs). Two experienced plastic surgeons and 5 students performed allotransplant. Results All 4 models were suitable for facial allotransplant with different anatomic characteristics. Average feasibility scores were 4.8 for pigs, 3.6 for rabbits, 3.2 for dogs, and 3.4 for rats. Evaluations concluded that pigs were the most practical and realistic models for facial allotransplant training. Other models achieved validation thresholds. Conclusions This study is the first comparative validation assessment of animal models used in facial allotransplant. It supports the use of pig models for surgical skills training. Pigs were the preferred simulation models, while rats, rabbits, and dogs were considered inferior models for transplant simulation.Background The introduction of rituximab has contributed to successful living donor kidney transplantations in ABO-incompatible recipients and has replaced splenectomy for desensitization. However, several reports still suggest that postoperative splenectomy may be effective in preventing graft failure in patients with acute antibody-mediated kidney transplant rejection (AAMR) in kidney transplantation. Therefore, we aim to assess if preoperative splenectomy also could be an alternative practical choice to avoid AAMR in high-risk rejection cases such as flow cytometry crossmatch (FCXM)-positive cases. Material and method We carried out 4 living donor kidney transplantations in FCXM-positive cases 3 underwent pretransplant splenectomy, and 1 did not. Results All 3 cases in whom pretransplant splenectomy was performed were discharged without rejection. On the contrary, in the case where pretransplant splenectomy was not performed, there was graft rejection and additional desensitization therapies were needed. Conclusion While larger clinical studies with longer observation periods are needed, our report suggested that pretransplant splenectomy may lead to successful short-term kidney transplantation outcomes in FCXM-positive cases.Objective The aim of this study was to assess gastrointestinal (GI) monitoring in the group of patients who underwent orthotopic liver transplantation (OLTx) because of primary sclerosing cholangitis (PSC) concomitant with inflammatory bowel disease (IBD). DEG-77 Methods Analysis was performed of data collected from medical histories and telephone calls in 33 patients who underwent OLTx in the Department of General and Transplantation Surgery of the Medical University of Warsaw from 2001 through 2017 because of PSC concomitant with IBD. Results Only 52% of patients claimed they stayed under constant supervision of a GI clinic. The remaining 48% patients were exclusively under transplantation clinic supervision, which controlled graft function. Of 27 patients, 18 (67%) underwent regular colonoscopy examination. According to the American Society of Gastrointestinal Endoscopy and other international organizations' guidelines, patients with PSC and IBD should have yearly screening colonoscopy. Only 9 patients met these guidelines. The median of intervals between colonoscopies among the other 9 patients was 2 years. Among the remaining 9 patients who did not have regular colonoscopy, the gap between endoscopic examinations reached 10-14 years. Fifteen patients (55%) had at least 1 polyp resected during the colonoscopy examination. Conclusions Fewer than half of patients follow the medical recommendations concerning their health condition and screening. The main reason for not performing regular colonoscopies was remission and/or lack of symptoms of IBD. According to the previously mentioned guidelines, the absence of symptoms of IBD does not exempt patients from annual colonoscopy. Some of the negligence was a result of lack of adequate access to gastroenterology specialists.
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