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Biomedical subjects

S Faenza

Publications and source records attributed to S Faenza.

51 records · Page 3Linked to original sources
PubMed1980

[Clinico-statistical analysis of the problem of the cadaver donor in renal transplantation (clinical experience from 1945 to the present time)].

The series of cadaver donors in Bologna hospitals from 1975 to today is reviewed. All possible donors were compared with those actually utilized and the reasons that led to renunciation in a large percentage of cases are analysed. The examination shows that among the factors limiting the number of donors utilized particularly important were the criteria adopted for establishment of donor suitability, family consent and the results of support therapy of the donor's vital functions.

Adolescent↗
PubMedDate not supplied

Intensive care complications in liver and multivisceral transplantation.

The complications concerning liver and intestinal transplant surgery have relevance for the field of intensive care because they share some characteristics with those following complex long-term surgery. Thus, in this article we shall try to describe complications that are specific to liver and multivisceral transplants. A review of the existing literature on this topic reveals a large number of studies dedicated to early as well as late surgical complications, and immunosuppressive treatment, while there are far fewer contributions describing complications exclusively concerning intensive care. We shall thus attempt to focus on certain aspects where, besides the literature data, we have personal experience. In particular we want to underline the implications of failure in the functional recovery of the graft; alterations in water, electrolyte, and glycemic balance; as well as neurological, respiratory, renal, nutritional, and infective complications.

Critical Care↗
PubMedDate not supplied

Right ventricular end-diastolic volume index as a predictor of preload status in patients with low right ventricular ejection fraction during orthotopic liver transplantation.

OBJECTIVE: The objective of this study was to compare the accuracy of 2 variables: pulmonary artery occlusion pressure (PAOP) and right ventricular end diastolic volume index (RVEDVI) as predictors of the hemodynamic response to fluid challenge as well as definition of the overall correlation between RVEDVI and change in PAOP, right ventricular ejection fraction (RVEF), central venous pressure (CVP), and determination of the right ventricular function during orthotopic liver transplantation. MATERIALS AND METHODS: A modified pulmonary artery catheter equipped with a fast response thermistor was used to determine RVEF, allowing calculation of RVEF end-diastolic volume index (EDVI, as the ratio of stroke index [SI] to EF). The above-mentioned hemodynamic measures were taken in 4 phases: T0, after induction of anesthesia; T1, during anhepatic phase; T2, 30' after graft reperfusion; and T3, at the end of surgery. RESULTS: The variation of the REF value was 36 +/- 4% and 39 +/- 6%. Linear regression analysis showed a significant correlation between RVEDVI (range, 133 +/- 33-145 +/- 40 mL/m(2)) and stroke volume index (SVI) in each phase (r(2) = 0.49, P < .01; r(2) = 0.57, P < .01) at T0 and T1, respectively, and at T2 and T3 (r(2) = 0.51, P < .01; r(2) = 0.44, P < .01), respectively. No significant variations in the linear regression analysis between RVEDVI, PAOP, CVP, and RVEF were observed. No relationship was found between PAOP (range, 10 +/- 2-6 +/- 2 mm Hg) and SVI. CONCLUSION: RVEDVI may be the best clinical estimate of right ventricular preload. In fact, minor changes of RVEF have been recorded, confirming that RV function was not altered during uncomplicated orthotopic liver transplantation.

Adult↗
PubMedDate not supplied

Results of intestinal and multivisceral transplantation in adult patients: Italian experience.

PURPOSE: We report our experience with intestinal and multivisceral transplantation in Italy. METHODS: We performed 23 adult isolated intestinal transplants and seven multivisceral ones, three with liver, between December 2000 and June 2005. Indications for transplantation were loss of venous access (n = 14), recurrent sepsis (n = 10), and electrolyte-fluid imbalance (n = 6), 14 of whom also presented with total parenteral nutrition (TPN)-related liver dysfunction. Immunosuppression was based on induction agents like daclizumab (followed by tacrolimus and steroids) in the first period; alemtuzumab or thymoglobulin (with tacrolimus) in a second period after 2002. RESULTS: The mean follow-up was 742 +/- 550 days. Three-year patient actuarial survival rate was 88% for intestinal transplants and 42% for multivisceral (P = .015). Three-year graft actuarial survival rate was 73% for intestinal patients and 42.8% for multivisceral (P = .1). Graft loss was mainly due to rejection (57%). Complications were mainly represented by bacterial infections (92% of patients), relaparotomies (82%), and rejections (72%). Full bowel function without any parenteral nutrition or intravenous fluid support was achieved in 60% of recipients with functioning bowel including 95% on a regular diet. One patient underwent abdominal wall transplantation as well. DISCUSSION AND CONCLUSION: Intestinal transplantation has achieved high rates of patient and graft survival with even longer follow-up. Early referral of patients, especially in cases of TPN-liver disease, is mandatory to obtain good outcomes and avoid high mortality rates on the transplant waiting list. Immunosuppressive management remains the key factor to increase the success rate.

Adult↗
PubMedDate not supplied

[Experimental isovolemic hemodilution. Study of tissue perfusion with Hb 3% in swine].

BACKGROUND: The aim of the study is to evaluate the limits of the compensatory mechanisms and the tissue damages caused by the low oxygen content during severe normovolemic hemodilution in pigs. METHODS: The experimental procedure was performed in 10 animals after general anaesthesia was induced and iso-hypervolemic hemodilution to Hct 10% was maintained for five hours without any intensive care. Hemodynamic, biochemical and ultrastructural parameters were detected before and at the end of hemodilution in addition to analysis of oxygen delivery/uptake and mitochondrial enzymes function. RESULTS: The collected data show: the initial good compensatory mechanism was subsequently exhausted; five animals demonstrated cardiac ischemia and low CO and two of them died before the end of the experiment; no hemodynamic and hemoxymetric data predicted the cardiac ischemia; the dilution caused alterations of some detected biochemical parameters such as hemocoagulation; no evidence of morphologic and ultrastructural tissue damage or interstitial edema; decreasing in mitochondrial enzymes activity significant only for NADH-related. CONCLUSIONS: In conclusion, it seems that, in pigs at least, the compensatory mechanisms can keep a sufficient tissue oxygen supply throughout the experimental time with the exception of cardiac muscle.

Animals↗