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Biomedical subjects

D Castaing

Publications and source records attributed to D Castaing.

At least 91 records · Page 5Linked to original sources
PubMed1992

Effect of storage temperature on early graft function following liver transplantation.

The effect of storage temperature on early graft function following liver transplantation was investigated by analyzing the results following transplantation during three periods in which different techniques for graft storage were used. The techniques involved ice-packing (period 1), storage in a standard operating room refrigerator without ice-packing (period 2) and storage in an accurately controlled refrigerator without ice-packing (period 3). In period 2 there was a significantly higher incidence of histological lesions, primary non-function and retransplantation compared to periods 1 and 3. It was concluded that this was due to inaccurate control of the standard refrigerator in period 2, thus allowing the temperature of the graft to increase, while in periods 1 and 3 the graft temperature was kept close to 4 degrees C by ice-packing and accurate refrigerator control, respectively. These results demonstrate that accurate control of storage temperature is important in terms of subsequent graft function. This may become more important as storage times are progressively increased with the use of UW solution.

Cold Temperature↗
PubMed1992

[Portal hypertension: a rare cause of hematuria].

A patient with undiagnosed cirrhosis presented with massive haematuria 16 years after augmentation colonoplasty. Portal hypertension (PHT) was responsible for a portocaval collateral circulation with vesical varices detected by low pressure endoscopy performed between episodes of haematuria. A very similar case was published in 1991. Surgical haemostatis with partial or total resection of the colonoplasty was only temporarily effective in our patient, who subsequently underwent liver transplantation due to repeated episodes of hepatic encephalopathy. No recurrence of haematuria was observed six years after the diversion. This rare cause of haematuria must be considered in view of the widespread use of intestinal conduits in urology: a dozen cases have been reported after transileal cutaneous ureterostomy, occurring an average of 3 years after the operation. Direct treatment of the varices, either by surgical devascularisation or resection or be endoscopic laser sclerosis or coagulation, is only temporarily effective. Treatment of the PHT appears to be the most effective measure in the long term: beta-blockers administered in the absence of episodes of haematuria or portal by-pass surgery in the case of failure.

Hematuria↗
PubMed1992

The Paul Brousse liver transplant series 1989 to 1992: new trends in the last four years.

In the last four years, 551 liver transplantations have been performed at the Paul Brousse center, for a total of 840 liver transplantations performed from 1984 to 1992. Several changes have been observed in the field of liver transplantation in the past years. The field of immunosuppression was marked mainly by the advent of FK506 as a preventive treatment of rejection and as a treatment of cortico-resistant rejection. Results are still under analysis. From the surgical viewpoint, the main modification was the advent of UW solution, which extends cold ischemic time. However, our policy was to maintain the cold ischemic time at less than 12 hours. Primary indications for liver transplantations have changed with an increase in the rate of patients transplanted for cirrhosis related to hepatitis virus infection: from 24% in the period 1984-1988 to 42% in the period 1989-1992. The difference was due mainly to HCV-related cirrhosis, which increased from 8% to 20%. Alcoholic cirrhosis was a rare indication in the period 1989-1992 (3.4%); however, it was an increasing indication in the last 2 years. In order to improve the long-term results, major attention was given to the recurrence of initial liver disease. In patients transplanted for HBsAg-positive liver disease, long-term passive anti-HBs immunoprophylaxis was administered, which reduced the rate of HBV recurrence in patients without HBV replication before transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

Academic Medical Centers↗
PubMed1992

Liver transplantation by "face-à-face" venacavaplasty.

A modification of the technique of liver transplantation by the face-à-face venacavaplasty is described and the use in four patients reported. This technique enables livers with a small vena cava to be inserted in an anatomic fashion and should help increase the use of such grafts where disparity between vessel size exists.

Adult↗
PubMed1991

Adenomyomatosis of the gallbladder. A premalignant lesion?

Gallbladder cancer is the most common malignant tumor of the biliary tract, but its early diagnosis is uncommon. The use of ultrasonography has increased the detection of benign gallbladder tumors, and the premalignant potential of gallbladder adenomas is now undisputed. Adenomyomatosis of the gallbladder has recently been suggested to have malignant potential, and we report a case of adenocarcinoma of the gallbladder occurring in localized adenomyomatosis that was successfully treated by radical curative surgery. The more rigorous use of ultrasonography and a more aggressive approach to "benign" polypoid lesions of the gallbladder may represent the best way of achieving early diagnosis and cure in gallbladder cancer.

Adenocarcinoma↗
PubMed1990

[Contribution of peroperative ultrasonography in the surgery of liver tumors].

Intraoperative echography helps both in the detection of the tumor and in the assessment of the vascular and biliary anatomy. The experience reported here was gained with 114 carcinomas in cirrhotic livers, 46 carcinomas in normal livers, 330 cases of metastases to the liver and 55 benign tumors. Ultrasound has modified the surgical prediction in 10 to 30% of all cases, according to the group.

Carcinoma, Hepatocellular↗
PubMed1989

[Evaluation of the spread of cancer of the exocrine pancreas and biliary tract].

The assessment of pancreatic and biliary tract carcinoma extension obviously depends on the possibilities of treatment. Resection being the only treatment of these malignancies, the assessment must be conducted in such a way as to search for its contra-indications, and it will deal successively with the patient's operability, the distal extension of the tumour (thoracic CT scan, Abdominal CT scan, ultrasonography of the liver and abdomen) and its local and regional extension (ultrasonography of the liver and pancreas, transparietal transhepatic cholangiography, angiography). If these examinations show no formal contra-indication to surgery, then exploratory laparotomy will be performed to determine whether the operation is technically feasible and whether it should consist of resection or palliative bypass.

Biliary Tract Neoplasms↗
PubMed1989

[Optimization of multiple abdominal organ procurement].

Multiple abdominal organ procurement should enable the kidneys, the liver and the whole pancreas to be removed. Simultaneous removal of the liver and pancreas depends on arterial variations. In subjects with one single hepatic artery simultaneous removal of the liver and the whole pancreas is always possible. In subjects with right hepatic artery, the whole pancreas can only be removed if the right hepatic artery and the median hepatic artery can be left to the liver transplanter and if the coeliac trunk, the common hepatic artery, the gastroduodenal artery and the splenic artery can be preserved to feed the pancreas.

Hepatic Artery↗
PubMed1989

Emergency orthotopic liver transplantation in two patients using one donor liver.

Because of its anatomy, the liver can be divided into two hemilivers suitable for use as two grafts for liver transplantation. The line of division is the main scissure, giving the right hemiliver (segments 5-8) and the left hemiliver (segments 2-4). Segment 1 (caudate lobe) has to be resected. The vessels are divided between the two grafts: the vena cava remains on the right; on the left, the left hepatic vein is sutured into the vena cava of the recipient, which is retained intact. The left graft retains only the left branch of the portal vein, the bile duct and the hepatic artery. The right graft retains the portal trunk, the common bile duct and the right branch of the hepatic artery. This procedure was used for emergency grafting of two patients with fulminant hepatitis when only one donor was available. Both recipients recovered from coma and regained normal liver function. However, both died from causes not specifically related to the operative technique, one from multiple organ failure on the 20th day and the other from diffuse cytomegalovirus infection on the 45th day.

Adult↗
PubMed1989

Hepatocellular carcinoma with normal adjacent liver. Hepatitis B virus DNA status.

We investigated hepatitis B virus (HBV) DNA status in the liver of 22 patients with hepatocellular carcinoma (HCC) developed on a non-cirrhotic, histologically normal liver tissue. HBV serological markers were present in 2 of the 22 subjects. HBV DNA sequences were identified in the liver of only 5 of the 22 patients with HCC. Evidence for clonal expansion of HBV-infected cells was found for one HBsAg-positive subject. This study indicates a much lower rate of HBV DNA positivity in the group of HCC developed on histologically normal livers as compared to that observed in HCC with liver cirrhosis.

Adolescent↗