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T Wróblewski

Publications and source records attributed to T Wróblewski.

At least 19 recordsLinked to original sources
PubMed2003

Results of liver transplantation according to indications for orthotopic liver transplantation.

OBJECTIVE: This study assessed the results of liver transplantation in patients with a variety of different indications. METHODS: From 1989 to April 2003, 209 orthotopic liver transplantations (OLTx) were performed on 196 patients, including 178 cases. The diagnoses were: PBC (n = 34); PSC (n = 13); elective postinflammatory cirrhosis in the course of hepatitis C (n = 29); hepatitis B (n = 16); postalcoholic cirrhosis (n = 23), autoimmune cirrhosis (n = 11); Wilson's disease (n = 6); cirrhosis of unknown etiology (n = 10); secondary biliary cirrhosis (n = 5); Budd-Chiari syndrome (n = 6); and benign liver neoplasms (n = 7). RESULTS: The 3-year survival rate in the group of patients transplanted electively was 74.1%. In other groups it was: PBC, 91.4%; PSC, 69.2%; hepatitis C, 69.6%; hepatitis B, 55.5%; postalcoholic cirrhosis, 80%; autoimmune cirrhosis, 81.8%; Wilson's disease, 57.1%; secondary biliary cirrhosis, 40%; Budd-Chiari syndrome, 66.6%; hemochromatosis, 100%; benign neoplasms of the liver, 87.5%; and liver cysts, 100%. CONCLUSIONS: Results of liver transplantation were closely related to the urgency of the procedure. Better results were achieved in patients operated upon routinely compared with in those operated upon emergently (74.1% vs 50%). The best results of liver transplantation were achieved in patients transplanted on a routine basis with a diagnosis of PBC (91.4%), autoimmunologic cirrhosis (81.1%), postalcoholic cirrhosis (80%), or hemochoromatosis (100%). Patients with liver insufficiency due to hepatitis B and Wilson's disease have an increased risk of graft destruction, and the rate of survival in these patients is significantly lower than in other patients.

Female↗
PubMed2003

Do all well-differentiated thyroid cancers constitute a definite contraindication to obtaining organs for transplantation? A case report.

In this case a thyroid gland tumor was diagnosed with fine needle aspiration (FNA) in a 34-year-old female donor of a liver fragment for living related liver transplantation. This diagnosis disqualified her as a donor. The increased incidence of thyroid cancer in Poland presents the possibility of their occurrence in potential donors. Well-differentiated thyroid papillary carcinomas larger than 1 cm in diameter, as well as follicular and medullary carcinomas (regardless their size and or clinical staging), present absolute contraindication to donation. Papillary microcarcinoma restricted to the thyroid gland (with no metastases in local lymph nodes) because of its specific behavior and almost always benign course, requires an individualized approach. It seemed that when a recipient is in a life-threatening condition, we should consider taking organs from a donor suffering of papillary microcarcinoma restricted to the thyroid gland.

Adult↗
PubMed2003

The impact of experience of a transplantation center on the outcomes of orthotopic liver transplantation.

The so-called learning factor has been disregarded for many years in analyzing the causes of surgical complications and post-operative mortality; it is also the case for OLT. In our center until April 2003, 209 OLT were performed in 196 patients. We evaluated the impact of experience of the transplantation team on the outcomes of liver transplantation. Thirty-four patients died (mortality rate, 16%) and 1-year survival rate, 64%. Mortality rates varied during different periods of observation due to increasing experience of the transplantation team. The causes of mortality were assessed for a series of 34 patients: it was 75% at the beginning of transplantation procedures while recent deaths have not recently exceeded 10% of cases.

Gallbladder Diseases↗
PubMed2001

Immature hepatic tumor of bimodal differentiation in a young adult patient: a novel lesion expressing beta-catenin and mimicking a distinct phase of hepatogenesis.

PATIENT AND METHODS: A large right-sided liver tumor was incidentally discovered and totally resected in a 21-year-old female patient without chronic liver disease. Histopathologic examination revealed that this malignant tumor does not fit any of the known types of primary liver tumors reported thus far. RESULTS: The lesion chiefly consisted of numerous solid nests composed of immature epithelial cells disclosing a marker profile typical for hepatocytes and strongly expressing beta-catenin. These nests were tightly associated with abnormal duct-like profiles exhibiting features of bile duct cells. CONCLUSIONS: The finding of numerous neoplastic hepatobiliary units ('liverlets') suggests that this tumor may mimic a distinct developmental phase of hepatogenesis close to ductal plate formation.

Adult↗
PubMed2001

[Histopathological investigation of the transjugular intrahepatic portocaval shunt (TIPS)].

The aim of the study was to investigate the histological structure of the artificial channel connecting one of the portal vein branches with the hepatic vein, as an effect of the transjugular intrahepatic portosystemic shunt (TIPS). The livers of six patients were investigated. In 4 of them recurrent variceal bleedings were an indication for TIPS, in the remaining 2 patients--intractable ascites. In all cases portal hypertension was due to liver cirrhosis. All patients were estimated as Child-Pugh group C. The period from the stent implantation to the moment of investigation ranged from 1 to 7 months. 2 livers were removed at the time of liver transplantation, 4 were procured at the autopsy. All shunts were patent and in none of the 6 cases dislocation of the stent occurred. The wall of the intrahepatic shunts was lined by a granulation tissue (pseudointima) covered with a layer of endothelial cells. No thrombosis, mechanical damage of the stent or extensive hypertrophy of pseudointima were found.

Adult↗
PubMed2001

Carcinoma adenoides cysticum as a primary neoplasm most probably derived from biliary ducts--case report.

UNLABELLED: Adenoid cystic carcinoma is a typical tumor of large and small salivary glands and sometimes of the breast. The aim of this report is presentation of a case of primary liver cancer with adenoid cystic cancer histology in 21-year old female patient. The tumor was discovered accidentally during pregnancy. The patient did not complain of any ailments. In biochemical tests only slightly elevated bilirubin, alkaline phosphatase and GGT concentrations were observed. No focal lesions in other organs were found in imaging examinations. Huge tumor of 30-cm diameter was found during surgery, encompassing almost whole left and right lobe of the liver. The biopsy taken from the tumor revealed histological picture typical for adenoid cystic carcinoma. Additional stainings and immunohistochemical examinations pointed to biliary ducts as possible place of origin of the neoplasm. SUMMARY: Among primary liver tumours of atypical clinical course the possibility of adenoid cystic carcinoma, deriving most probably from the biliary ducts, should be considered.

Adult↗
PubMed2001

Intrahepatic portosystemic shunt in treatment of complications of portal hypertension.

BACKGROUND: The aim of the paper is to present the role of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of portal hypertension complications such as variceal bleeding and persistent ascites. MATERIAL AND METHODS: Between June 1992 and December 2000, 56 patients with portal hypertension developed in the course of hepatic cirrhosis were qualified for TIPS. The indications for TIPS included esophageal variceal bleeding, recurrent despite endoscopic treatment (N-40), active esophageal variceal hemorrhages in which traditional methods used to stop the bleeding proved ineffective (N-8) and ascites failing to respond to high doses of diuretic agents (N-8). The studied group consisted of 30 females and 26 male patients aged from 17 to 68 (mean age 52 yrs). According to Child-Pugh surgical risk classification, 26 patients belonged to group B, and 30 to group C. RESULTS: In 50 patients (83.5%) an intrahepatic shunt was formed and the stent(s) implanted. In 42 cases (75%), long-lasting patency of the shunt was obtained and esophageal variceal bleeding was stopped. Active esophageal variceal hemorrhages were stopped in all the cases. The remission of massive ascites and hepatorenal syndrome was obtained in 7 out of 8 patients. CONCLUSIONS: TIPS is a non-surgical method relieving portal hypertension in patients with variceal hemorrhages recurrent despite endoscopic treatment. Very good results were also obtained in the cases with active variceal hemorrhages. TIPS has proved to be an effective method of treatment in the patients with massive ascites and hepatorenal syndrome.

Adolescent↗
PubMed2001

Correlation between the haemodynamics of portal collateral circulation and the incidence of esophageal bleeding in patients with portal vein thrombosis--a preliminary report.

The aim of this study was to determine a correlation between the haemodynamics of portal collateral circulation (PCC) and the incidence of bleeding episodes. The prospective analysis included 17 patients with portal hypertension resulting from prehepatic block but without history of oesophageal bleeding. Every two months the changes in PCC and incidence of oesophageal bleeding were evaluated. The follow-up ranged from 3 to 12 months. The statistical correlation between the portal haemodynamic disorders and the tendency to bleed was investigated. Variceal bleeding occurred in 6 patients during the time of observation, mostly in patients with development of hepatofugal PCC. Authors suggest that the development of hepatofugal PCC is the main factor of variceal bleeding in patients with portal vein thrombosis (PVT).

Esophagus↗
PubMed2000

Liver transplantation in the experience of the centre commencing the program.

From 1989 to 1999, 43 orthotopic liver transplantations (OLT) in 40 patients (3 retransplantations) were performed in our Department. The most common indications for OLT were noninflammatory, primary cholestatic liver diseases and postinflammatory liver cirrhosis. Fourty OLT's were done for elective indications, three--on emergency basis, because of fulminant liver failure. The majority of transplantations was performed with classical technique with the excision of retrohepatic vena cava and routine use of the extracorporeal veno-venous bypass. Only in 4 patients the piggyback technique was used and performed without temporary portocaval anastomosis. All 3 patients transplanted for fulminant liver failure died in the perioperative period. Twenty four patients are still alive and well, the longest period of observation exceeding 5 years.

Humans↗
PubMed1998

[Intrahepatic portocaval shunt as a new method for treating and prevention of bleeding from esophageal varices in portal hypertension].

UNLABELLED: The aim of this study was the presentation of percutaneous transjugular intrahepatic porto-systemic shunt (TIPS) and its place among the other methods of the treatment of esophageal variceal bleedings. In the period from June 1992 to December 1997, 31 cirrhotic patients with portal hypertension and recurrent variceal bleedings were submitted for TIPS. This group consisted of 14 female and 17 male patients, their age ranging from 17 to 68 years (average 52). According to Child-Pugh classification 4 patients represented group A, 11--group B and 16--group C. Each of these patient was admitted to our Department after recurrent bleeding, resistant to typical treatment: terlipressein infusion, balloon tamponade and endoscopic sclerotherapy. In 24 patients (78%) TIPS was performed successfully. In 7 cases TIPS was performed in candidates for orthotopic liver transplantation. CONCLUSIONS: TIPS is quite new, nearly 10 years old method for portal decompression. It is an effective and less invasive method than surgical procedures in the treatment of portal hypertension, especially in Child-Pugh group B and C patients if the sclerotherapy is not effective. It protects cirrhotic patients waiting for liver transplantation against the esophageal bleedings.

Adolescent↗