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Biomedical subjects

V Corno

Publications and source records attributed to V Corno.

15 recordsLinked to original sources

Liberal policy of split liver for pediatric liver transplantation. A single centre experience.

We adopted a liberal policy of extensive use of split liver in a pediatric liver transplantation (LT) program. Over a 19-month period, we have performed 64 LT in 54 patients with pediatric indications. One patient received two liver grafts as a part of a liver-small bowel transplantation and was not considered. Of the 60 LT considered, performed in 53 patients, 34 were with split grafts. The 1-year actuarial survival for the patients transplanted with a split graft was 81% and 89% when only elective cases were considered. The median time on the waiting list was 22 days with no mortality. The extensive use of split liver allowed transplantation in a large number of pediatric patients, with good results without the need for living donor liver transplantation. We envisage a trend towards systematic splitting of liver grafts.

Actuarial Analysis↗

Rejection and tacrolimus conversion therapy in paediatric liver transplantation.

Rejection and efficacy of rescue therapy with tacrolimus were evaluated in 50 children who underwent primary, ABO-compatible, liver transplantation. Six patients who died within the first week and one child who underwent retransplantation from an ABO-incompatible donor were excluded from the study. No patient or graft were lost due to rejection. We observed 48 episodes of rejection in 33 patients. Fourteen patients required conversion to tacrolimus for steroid-resistant rejection with resolution of rejection. One of these children developed PTLD. Other indications for conversion were neurotoxicity and hirsutism. One patient developed blindness of unknown origin after the conversion. Other side effects of tacrolimus were minor and resolved by lowering the dose. Five patients developed rejection after conversion; all achieved resolution with either steroid therapy or increase of tacrolimus dose. In conclusion, our study confirms that tacrolimus is an effective rescue therapy for paediatric liver transplantation.

ABO Blood-Group System↗

Laparoscopic treatment of symptomatic lymphoceles after kidney transplantation.

BACKGROUND: The incidence of lymphocele after kidney transplantation ranges from 0.6% to 18%. This study examines the use of laparoscopic ultrasound for the location of lymphoceles during laparoscopic drainage. METHODS: Between July 1993 and October 1998, we performed 147 kidney transplants. A symptomatic lymphocele was observed in 19 patients (12.9%). All of these patients underwent peritoneal laparoscopic fenestration of the lymphocele. The graft, kidney hilum, ureter, iliac vessels, and lymphoceles were identified by laparoscopic ultrasound. RESULTS: All but one patient were discharged within 24 h. One recurrence (5.2%), which was successfully treated by laparoscopy, was observed at a mean follow-up of 15.5 months. We had one complication (5.2 %)-a left hydrocele that occurred 2 days after drainage of a lymphocele located in the left iliac fossa. CONCLUSIONS: Laparoscopic peritoneal drainage of posttransplant lymphoceles shares the well known advantages of laparoscopy. Furthermore, laparoscopic ultrasound is a useful tool that allows the recognition of anatomical structures and decreases the risk of iatrogenic lesions.

Adult↗

Laparoscopic vs open splenectomy in the management of hematologic diseases.

BACKGROUND: Laparoscopic splenectomy (LS) is becoming the gold standard in the treatment of several splenic diseases. Shorter postoperative stay and more rapid return to full activity are the primary advantages of LS. METHODS: Prospective data collection of 44 consecutive LS (group 1) and comparison with a historical control group of 56 consecutive open splenectomies (OS) (group 2) were performed for hematologic diseases. RESULTS: The LS patients started earlier on an oral diet (p < 0.0001) and left the hospital sooner (p < 0.0002) than OS patients. Less blood transfusion (p < 0.004) and pain medication (p < 0.0001) was required by LS patients. They also had fewer postoperative complications (p < 0.03). Compared by diagnosis, patients with laparoscopic idiopathic thrombocytopenic purpura or Hodgkin's disease started to eat earlier (p < 0.0001) and left the hospital sooner (p < 0.01). Multivariate analysis showed that time to oral diet and postoperative stay was related to operative technique and age. Morbidity and pain medications were related, respectively, to transfusion requirements and type of surgical approach. CONCLUSIONS: Used to manage hematologic diseases, LS is feasible, effective, and safe. It offers several advantages over the open approach. The type of surgical approach seems to be the crucial factor in determining the length of the postoperative course.

Adolescent↗

[Urinary calculi in an intestinal loop used for ureteral substitution. A case report].

The authors report the case of large urinary calculi formed inside the ileal conduit diversion in a patient who underwent radical surgery for an ovarian carcinoma involving the right ureter. Two ureter stents were left to ensure drainage and were endoscopically removed after six months. Renal function and ureteral canalization were normal. However, because of a knot in the proximal end of stents, a piece 5 cm-long-was left inside the diversion. After six months the patient developed recurrent renal colics: plain abdomen X-ray and urography showed a large urinary stone around the stents fragment and several smaller stones nearby. They all were removed surgically. The pathogenesis of such complications was considered: even though the slow flux of urine in the diversion, the abnormal mucus production from the ileal mucosa and the excessive and chronic bicarbonate loss played an important role in the developing of urinary calculi, the authors believe that in this case the main responsible for the stone formation was the foreign body in the urinary diversion.

Adult↗

Modified splitting technique for liver transplantation in adult-sized recipients. Technique and preliminary results.

In the common split liver technique the liver is divided between the right lobe, to be transplanted to an adult, and the left lateral segment, to be transplanted to a small child. We have developed an alternative technique by which the cadaver donor liver is divided in its two anatomo-functional halves, both apt to be transplanted to adults or children of adult size. We have so far used this technique in three multi organ donors, generating, six liver grafts that we transplanted to six recipients with median age of 36.5 years (range 10-23) and a median weight of 55 kg (range 38-79). Patient survival was 83.3% and graft survival 66.6% with a median follow up of 10 months (range 8-14). These results show that the technique is effective and that it can consistently increase the number of liver grafts that can be transplanted into adult patients, with the available cadaver donor pool.

Adolescent↗

Primary lymphoma of the liver: a case report and review of the literature.

Primary lymphoma of the liver (PLL) is a rare disease and estimation of the real number of cases may be difficult because strict diagnostic criteria for the definition of a primary lesion are quite often not followed. We report here on a case of a patient affected by PLL who underwent successful surgical resection of the lesion followed by chemotherapy and autologous bone marrow transplantation. The patient is alive and disease free 62 months after resection.

Adult↗