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PubMed2006

[Evaluation of an articulated spacer for two-stage reimplantation for infected total knee arthroplasty: 28 cases].

PURPOSE OF THE STUDY: Two-stage reimplantation remains the most popular solution for infected total knee arthroplasty. We have used articulated spacers since their introduction in 2000. We evaluated tolerance, joint motion under general anesthesia before reimplantation and also the infectious and functional long-term outcome. MATERIAL AND METHODS: Between June 2000 and April 2003, we implanted an articulated spacer in 28 patients who required revision of their total knee arthroplasty. Postoperatively, contact weight bearing was allowed with unlimited knee motion depending on pain control. Mean time between implant removal and reimplantation was eight weeks (range 6-16 weeks). RESULTS: There was one dislocation due to excessive play between the two components. Passive joint motion before reimplantation was 53 degrees (range 5-80 degrees ). At last follow-up, 24 patients were free of overt infection and all antibiotic regimens had been discontinued for at least 20 months (20-48 months). Two patients required a second two stage revision. One had an arthrodesis and in one only suppressive antibiotic therapy was possible. DISCUSSION: Spacer removal appears easy at reimplantation. Good knee flexion (greater than 40 degrees in ten patients and greater than 60 degrees in eight) facilitated exposure, avoiding the need for tilting of the tibial tuberosity in seven patients. Functional and infectious outcomes were similar to those reported in the literature. CONCLUSION: The spacer appears to improve patient comfort between the two operations. It also facilitates the reimplantation procedure because of the easier exposure and greater knee flexion compared with a mono-bloc spacer or an external fixator. There must however be enough bone stock to hold the articulated spacer in place.

Arthroplasty, Replacement, Knee↗
PubMed2003

Ureteral reimplantation before bladder neck plasty in the reconstruction of bladder exstrophy: indications and outcomes.

OBJECTIVES: After initial closure, all exstrophy patients have vesicoureteral reflux. This reflux is usually managed with antimicrobial prophylaxis, surveillance, and ureteral reimplantation concurrent with bladder neck plasty. Patients with recurrent urinary tract infections or worsening hydronephrosis may require earlier correction of reflux. This subset of patients was reviewed to determine the ability to correct reflux adequately, the difficulty with subsequent bladder neck plasty, and the long-term continence results. METHODS: We reviewed an exstrophy database of more than 700 patients and identified 19 who underwent ureteral reimplantation independent of bladder neck plasty. All had undergone bladder closure in infancy. Eleven had since undergone modified Young-Dees-Leadbetter bladder neck plasty. Five patients were awaiting bladder neck reconstruction, 2 girls were continent without bladder neck plasty, and one had undergone augmentation. RESULTS: Indications for early ureteral reimplant were recurrent febrile infections despite adequate prophylaxis (n = 15) or worsening hydronephrosis on follow-up (n = 4). In the 11 patients who had undergone subsequent bladder neck repair, prior reimplantation did not increase the operative difficulty or complications. The continence results among these 11 were comparable with those in patients without prior reimplantation. In 1 patient, reflux recurred and was corrected at the time of bladder neck plasty. None had further urinary tract infections, and hydronephrosis improved in three and stabilized in one. CONCLUSIONS: In patients who present with recurrent infections or worsening hydronephrosis after initial exstrophy closure, early reimplantation can be undertaken. If performed with later bladder neck plasty in mind, the surgical treatment of incontinence is not compromised and recurrent infections and upper tract changes will be abated.

Abdominal Wall↗
PubMed2000

Variations in the presenting and treatment features in reimplanted permanent incisors in children and their effect on the prevalence of root resorption.

OBJECTIVE: To examine variations in the presentation and treatment of reimplanted incisors in children and to determine the effect of these on the prevalence of external root resorption. SETTING: Departments of Paediatric Dentistry, Belfast and Newcastle upon Tyne. DESIGN: Recording of the timing of the injury and the storage mediums (including air) and of reimplantation, the stage of root development, the degree of contamination and the time of commencement of root treatment. Cases were reviewed clinically and radiographically at intervals of 3 months. Root resorption was classified as present or absent. Logistic regression and cross-tabulations were produced with the presence of resorption set as the outcome. RESULTS: 128 reimplanted permanent incisor teeth, their median dry time prior to reimplantation being 15 minutes (range 4-52 mins), the median time in a liquid medium being 45 minutes (range 0-650 mins), with a median splinting time of 15 days (range 4-52 days) and a median pulp extirpation time of 15 days (range 0-612 days). There was a lower prevalence of resorption when the period of dryness was less than or equal to 5 minutes (p = 0.025). The prevalence of resorption in teeth with no visible contamination was 57.1%, for those with contamination which were washed clean it was 75%, in those rubbed clean it was 87.5%, and it was 100% for those reimplanted with visible contamination still present (p = 0.014). The corrected odds ratio for contamination was 2.99 and for an extension of 10 minutes of dryness it was 1.29. CONCLUSION: The degree of contamination and the period of dryness were the major risk factors for resorption in this study of reimplanted teeth in children.

Adolescent↗
PubMed2004

[Cochlear reimplantation - experiences and results].

BACKGROUND: There have been remarkable developments in Cochlear Implants in the past years. Technical improvements lead to more reliable and durable devices. In cases of traumatic and atraumatic device failure a reimplantation of the Cochlear Implant is necessary. METHODS: In a retrospective study we examined 15 patients with 17 Cochlear reimplantation procedures after a traumatic or atraumatic device failure between 1996 and 2002. The reasons leading to the revision, the intraoperative findings, the perioperative complications and the postoperative audiological results as well as the personal evaluation of the revision procedure were analyzed. RESULTS: In our study there were 11 children and 4 adults. In 10 cases a traumatic and in 7 cases an atraumatic device failure lead to the reimplantation. In 13 of the 15 patients the revision surgery took place within 1 month after the date of device failure. The electrode array could be reinserted safely without any perioperative complications. The postoperative results showed a continuous development of speech perception in all patients. The personal evaluation of the reimplantation procedure was positive in all cases. CONCLUSIONS: Cochlear reimplantation in cases of traumatic or atraumatic device failure is a safe procedure without any serious perioperative complications. The timely reimplantation leads to a continuous development of speech perception.

Age Factors↗
PubMed2005

Endoscopic cross-trigonal ureteral reimplantation under carbon dioxide bladder insufflation: a novel technique.

PURPOSE: To report on a novel technique of endoscopic intravesical ureteral mobilization and cross-trigonal ureteral reimplantation under carbon dioxide insufflation of the bladder (pneumovesicum) for correcting primary vesicoureteral reflux (VUR) in infants and children. PATIENTS AND METHODS: Ten boys and six girls with dilating primary VUR (7 bilateral; 23 refluxing ureters) associated with recurrent urinary-tract infections and multiple pyelonephritic renal scars underwent endoscopic Cohen's cross-trigonal ureteral reimplantation with CO(2) pneumovesicum. Their ages ranged from 10 months to 13 years (mean 4.1 years). The endoscopic procedure was preceded by distention of the bladder with saline and insertion of a 5-mm Step port over the bladder dome under cystoscopic guidance. The bladder was then drained and insufflated with CO(2) to 10 to 12 mm Hg pressure with a suction catheter inserted per urethra to occlude the internal urethral meatus. A 5-mm 30 degrees endoscope was used to provide intravesical vision. Two more 3- to 5-mm working ports were inserted on the lateral bladder wall on either side. Endoscopic intravesical mobilization of the ureter, dissection of a submucosal tunnel, and a Cohen's type of crosstrigonal ureteral reimplantation using interrupted 5-0 monofilament sutures was then performed under videoscopic guidance. Bladder drainage by a urethral catheter was maintained for 24 hours postoperatively. RESULTS: Endoscopic cross-trigonal ureteral reimplantation under CO(2) pneumovesicum was successfully performed in all except one patient, who had displacement of a port into the extravesical space after completion of the ureteral reimplantation necessitating a small vesicotomy for closure of the mucosal defect. The mean operating time was 136 minutes (range 80-230 minutes), being 112 minutes for unilateral cases and 178 minutes for bilateral cases. Two boys developed mild suprapubic and scrotal emphysema postoperatively that subsided spontaneously. All other patients recovered uneventfully and remained well. Follow-up cystograms showed complete resolution of VUR in all except one unit that had persistent grade I reflux, thus giving a success rate of 96%. CONCLUSIONS: This early experience illustrates that endoscopic intravesical ureteral mobilization and crosstrigonal ureteral reimplantation can be performed safely and effectively with routine laparoscopic surgical techniques and instruments under CO(2) insufflation of the bladder, achieving a high success rate in reflux resolution that is equivalent to that obtained with the open technique but with minimal invasiveness and much faster recovery. The longer-term outcome and potential physiological effects of CO(2) pneumovesicum on the bladder and upper-tract function will need to be evaluated further.

Adolescent↗
PubMed2005

Simplified technique for laparoscopic extravesical ureteral reimplantation in the porcine model.

BACKGROUND AND PURPOSE: Laparoscopic intravesical and standard Lich-Gregoir repair have been reported but are technically challenging. Herein, we present our experience with a simplified laparoscopic reimplantation of the ureter to correct vesicoureteral reflux (VUR). MATERIALS AND METHODS: Bilateral VUR was created cystoscopically in six minipigs, as confirmed by a static cystogram 6 weeks later. The laparoscopic extravesical correction of VUR was performed utilizing a full-thickness cystotomy. The ureter was transposed inside the bladder, and a full-thickness bladder closure was performed. No attempt was made to cover the ureter with urothelium. No stents or catheters were utilized postoperatively. Three months after reimplantation, the animals were evaluated with serology, a static cystogram, an intravenous urogram (IVU), and gross pathologic and histopathologic examination. RESULTS: The postoperative cystograms confirmed no reflux in all the reimplanted ureters and residual grade 1 to 3 reflux in the non-reimplanted ureters. All pigs voided normally and were completely continent. Cystoscopic evaluation revealed complete epithelialization over the reimplanted ureter. One surgical complication occurred: the ureter was incorporated into the bladder closure and became obstructed. The IVU in all other pigs demonstrated patent ureters with prompt function. CONCLUSIONS: Laparoscopic reimplantation of the ureter utilizing this modified Lich-Gregoir approach corrected reflux in all animals. The full-thickness bladder incision and intravesical transposition of the ureter greatly simplifies the laparoscopic procedure. This laboratory experience encourages further clinical evaluation in the pediatric population with VUR.

Animals↗
PubMed2004

Techniques for uretero-intestinal reimplantation.

PURPOSE OF REVIEW: Uretero-intestinal reimplantation is a crucial component of urinary diversion. Several techniques for refluxing and nonrefluxing uretero-intestinal reimplantation have been established and modified to minimize anastomotic complications and preserve renal function. We review current experience with uretero-intestinal reimplantation in different types of urinary diversion. RECENT FINDINGS: The basic principles of uretero-intestinal reimplantation are still controversially discussed. Several studies have focused on complications of urinary reflux from direct end-to-side or end-to-end anastomosis, such as pyelonephritis and calculus formation. Strictures at the anastomotic site of nonrefluxing tunneled ureteral reimplantation resulting in hydronephrosis and renal deterioration have led some to question the need for an antirefluxive anastomosis, at least in "low pressure urinary diversion". Alternative surgical procedures aim to avoid reflux and minimize the risk for anastomotic strictures by direct ureteral reimplantation into an intact isoperistaltic afferent ileal segment or the prevalvular ileum, with the ileocaecal valve functioning as an antireflux mechanism. SUMMARY: A "gold standard" for uretero-intestinal anastomosis in urinary diversion does not yet exist. Further prospective randomized studies are required to identify the best anastomotic techniques for different types of urinary diversion.

Humans↗
PubMed2003

Use of erythropoietin in two-stage reimplantation total hip arthroplasty.

This study was done to quantify the effect of epoetin alfa on the transfusion requirements of patients having two-stage reimplantation for infected total hip arthroplasties. This prospective study included 30 consecutive patients treated with a two-stage reimplantation procedure during a 2-year period at one institution. Each patient received a standard dose of epoetin alpha (40,000 units) subcutaneous in the interval between resection and reimplantation. Transfusions were administered only when warranted by clinical symptoms and were not governed by predetermined hemoglobin levels. When compared with a control group of similar patients, the hemoglobin levels before reimplantation were significantly higher (14.0 g/dL versus 11.8 g/dL) and the median allogeneic blood requirements were significantly lower (0 units/patient [range, 0-6] versus 4.3 units per patient [range, 0-9]). Epoetin alfa used in the interval between the resection and reimplantation stage significantly increased the hemoglobin levels and decreased the rate of transfusion for patients having two-stage reimplantation total hip arthroplasty.

Aged↗
PubMed2005

Use of enamel matrix protein derivative before dental reimplantation: a histometric analysis.

The use of enamel matrix protein in the treatment of periodontal defects has shown a favorable action on the proliferation of periodontal ligament cells, as well as on collagen formation and mineralization. The goal was to evaluate, histologically and histometrically, periodontal tissue regeneration after dental reimplantation using enamel matrix protein derivative (Emdogain, Biora AB, Malmö, Sweden). Male rats (Albinus, Wistar), weighing between 180 and 200 g, were divided in 3 groups. Animals in group I (control) had the upper right incisors extracted, the root canal was sealed with calcium hydroxide, and teeth were reimplanted in their alveoli. Group II underwent the same procedure, but the remaining periodontal ligament was removed from the root surfaces by root planing before reimplantation. In group III,following removal of the periodontal ligament, Emdogain was applied to the root surfaces. Animals were sacrificed 7, 20, and 60 days after reimplantation, and the alveoli were fixed, processed, and stained with hematoxylin and eosin. Formation of periodontal ligament, resorption areas, and ankylosis were analyzed. The results showed that group I (control) was better than groups II and III, with statistically significant differences on days 7 and 20 after reimplantation for formation of periodontal ligament. It may be concluded that with the methodology used, Emdogain was unable to stimulate tissue repair in reimplanted teeth.

Alveolar Process↗
PubMed2004

Results of tapered ureteral reimplantation for primary megaureter: extravesical versus intravesical approach.

PURPOSE: Extravesical ureteroneocystostomy is an accepted technique for the surgical treatment of vesicoureteral reflux. However, many surgeons continue to use an intravesical technique when extensive ureteral tailoring is required in the case of primary megaureter. We present our experience and outcomes with these techniques. MATERIALS AND METHODS: A retrospective cohort study was performed of all patients who underwent tapered ureteral reimplantation between 1990 and 2002. Patient demographics, surgical technique and outcomes were recorded. Patients with ureteral dilatation secondary to bladder or urethral pathology were excluded from study. A successful postoperative outcome was defined as improved hydronephrosis and no vesicoureteral reflux. RESULTS: A total of 53 patients with 65 megaureters were identified. Mean patient age at surgery was 4.9 years and mean followup was 3.8 years. Primary obstructive megaureter was present in 31 renal units, while refluxing megaureter was present in 34. An excisional tapering technique was performed in all cases. An extravesical reimplantation was performed in 29 renal units and an intravesical reimplantation in 36. The success rate was 86% for intravesical and 76% for extravesical reimplantation. The success rate was 90% for obstructive megaureters and 74% for refluxing megaureters. Success rate for patients with voiding dysfunction was 93% with an intravesical approach but only 50% with an extravesical approach. CONCLUSIONS: Extensive ureteral tailoring with an extravesical ureteral reimplantation may be performed safely and effectively for primary obstructive megaureter. Patients with voiding dysfunction or preoperative vesicoureteral reflux may benefit from an intravesical ureteral reimplantation.

Adolescent↗
PubMed1973

Retention of the original topographic polarity by the 180 degrees rotated tectal reimplant in young adult goldfish.

1. The pattern of visual projection from the retina on to the optic tectum was studied with neurophysiological mapping methods following reimplantation of the optic tectum in young adult goldfish.2. When a rectangular piece of the tectum was dissected out and then reimplanted to the same tectum in situ, the restored visual projection showed a normal retinotopic order over the area of the tectal reimplant.3. If the tectal tissue was reimplanted after rotation by 180 degrees , the visual projection from that part of the retina which innervated the 180 degrees rotated tectal reimplant was found to be organized in a completely reverse retinotopic order within the reimplanted area in contrast to the normal projection from the other part of the retina on to the intact surrounding area of the same optic tectum.4. The results indicate that a piece of reimplanted tectal tissue retains its original topographic polarity regardless of whether the tectal tissue was rotated or not.5. The retention of original topographic polarity by a small fraction of the tectal tissue suggests that the optic tectum is not a passive receiver of incoming optic fibres but an active accommodator which selects appropriate optic fibres to make proper synaptic connexions in a consistent topographic order.

Animals↗
PubMed1989

Removal and reimplantation of the parietal cortex of mice during the first nine days of life: consequences for the barrelfield.

Vibrissal follicles on one side of the mouse whiskerpad are topologically connected to barrels in the contralateral somatosensory cortex. Barre's develop from postnatal day 3 to 6. Recently, I have observed that the barrelfields still develop in pieces of parietal cortex that were removed and reimplanted, in the same place and with the original orientation, on the day of birth, or on postnatal days 1 or 3. Now, two questions were asked: (i) Can the barrelfield form and/or remain in place after interrupting thalamocortical connections at different ages (from birth to postnatal day 9)? (ii) How does the cortex behave, in terms of cellular layers, after the interruption of thalamocortical connections? To answer these questions the parietal cortex was removed and reimplanted in the same place with the original orientation, in 79 mice from a C3H strain. Fifty-one mice survived and were processed for histology. Their brains were cut coronally to facilitate the identification of the limits of the reimplanted cortex and of its cellular layering. In 29 cases the reimplanted cortex could be identified, and in 17 cases barrel-like structures had developed. The "barrelfields" were obtained from coronal sections of each piece of reimplanted cortex, by means of a computer program which permitted reconstructing these pieces of cortex and rotating them in space. In this way, barrel-like structures and "barrelfields" could be visualized as if obtained from sections made tangential to the parietal cortex. "Barrelfields" were found in pieces of cortex reimplanted at different ages up to postnatal day 9. Cortical layers appeared to be more close to normal in cases operated after postnatal day 5.

Aging↗
PubMed1999

Staphylococcus aureus prosthetic joint infection treated with prosthesis removal and delayed reimplantation arthroplasty.

OBJECTIVE: To estimate in patients with Staphylococcus aureus prosthetic joint infection after total hip arthroplasty (THA) or total knee arthroplasty (TKA) the microorganism-specific cumulative probability of treatment failure after prosthesis removal and delayed reimplantation arthroplasty. PATIENTS AND METHODS: All patients with S aureus THA or TKA infection, according to a strict case definition, who were treated with prosthesis removal and delayed reimplantation arthroplasty at Mayo Clinic Rochester between 1980 and 1991 were identified. The study group comprised patients who were free of infection at the time of reimplantation arthroplasty. This cohort was followed up until treatment failure, infection with another organism, prosthesis removal, death, or loss to follow-up occurred. The Kaplan-Meier survival method was used to estimate the cumulative probability of treatment failure. RESULTS: Among 120 S aureus prosthetic joint infections treated with prosthesis removal during the study period, 38 episodes (22 THA, 16 TKA) in 36 patients met the study inclusion criteria. After a median of 7.4 years (range, 0.9 year-16.4 years) of follow-up, treatment failure occurred in 1 (2.6%) of 38 episodes 1.4 years after reimplantation arthroplasty. The 5-year cumulative probability of treatment failure was 2.8% (95% confidence interval, 0%-8.2%). CONCLUSIONS: These data suggest that prosthesis removal and delayed reimplantation arthroplasty is an effective treatment to limit the recurrence of S aureus prosthetic joint infection, provided there is no evidence of infection at the time of reimplantation arthroplasty.

Adult↗
PubMed1998

[Ureteral reimplantation on psoas bladder: long-term results].

OBJECTIVE: To evaluate indications and long-term results of ureteral reimplantation with psoas hitch bladder. MATERIALS AND METHODS: Between January 1985 and December 1997, we performed psoas-hitch ureteral reimplantation in 18 patients (13 females and 5 males). Mean age was 48 years old. All ureteral injuries involved a pelvic portion of the ureter. The indication was: ureteral injury during gynecological procedures in 5 cases, stricture following open uretero-lithotomy in 3 cases, avulsion of the ureter during ureteroscopy in 1 case, stricture following prior ureteral reimplantation in 3 cases, prostate cancer involving the distal ureter in 1 case, megaureter in 1 case, radiation therapy in 1 case, pelvic and ureteral endometriosis in 3 cases. Treatment consisted to adequate mobilization of the bladder, fixation of the posterolateral corner of the bladder to psoas and ureteral reimplantation with anti-reflux system. In all cases, psoas-hitch ureteral reimplantation has been performed because of an inability to perform end-to-end uretero-ureterostomy or direct uretero-neocystostomy. RESULTS: No complications were observed. At follow-up of 7 months to 12 years (mean 5.7 years) we noticed 13 success (72.4%), 4 improvements (22.2%) and one patient (5.4%) was lost at follow-up. No nephrectomy was done. CONCLUSION: Psoas-hitch bladder ureteral reimplantation is simple, effective and a first-line procedure for the replacement of the long defects of the lower ureter.

Adult↗
PubMed1989

[Unilateral primary vesico-ureteral reflux: uni- or bilateral reimplantation?].

The need of bilateral reimplantation in unilateral reflux is still stressed by some authors. The following represents the rationale for this surgical management. 1. correction of unilateral reflux may increase bladder pressure and in this way induce a contralateral reflux; 2. the operation on one side may lead to changes in the muscles and cause reflux on the opposite one; 3. reflux, though unilateral, is the result of a malformation involving the whole trigone. Nevertheless, the authors regard as unjustified the reimplantation of a normal ureterovesical junction being in-acceptable the risk, even if low, of operative failure on a ureter without reflux. Literature data show an incidence of contralateral reflux after unilateral reimplantation of 11-32%. Such incidence, however, tends to decrease (1.9-20%) one year after the operation due to the spontaneous resolution of reflux in most of the cases. The grade of reflux was low (I-II grade) in the majority of cases. The authors report on 38 cases of unilateral primitive vesico-ureteral reflux who underwent unilateral ureteral reimplantation between 1981 and 1982. Minimum follow-up was 2 years. After surgery, contralateral reflux occurred in 4 cases (10.5%) but it spontaneously subsided within 3 years in all of them. Contralateral reflux was asymptomatic in 3 cases and in no cases caused renal scars. The authors conclude that unilateral ureteral reimplantation is the procedure of choice in children with unilateral reflux. Bilateral reimplantation, however, will be performed in patients with bilateral reflux who showed disappearance of reflux on one side before the operation.

Adolescent↗
PubMedDate not supplied

[Case of reimplanted tooth with long-lasting clinical effect].

The author describes a case of reimplantation of 44 of a 35-year-old woman, 19 years ago. Later, 10 years after the reimplantation apical osteotomy, according to indications, was performed to the same tooth. The X-ray, performed in 1985, shows that resorptive processes around the tooth and root has not advances as yet. It started after the root treatment on the adjecent 46 in 1985. The author thinks that the mass failure of teeth reimplantation (short-term therapeutic effect of 5-6 years and not with all reimplantations) reduces the interest of the researchers in it without any grounds. The case described shows that, very likely, under certain conditions and certain operation technique, unconsciously blended in the case described, very good therapeutic effect could be relied on via the reimplantation. It is presumed that the initiation of resorption has been provoked by the devitalization of an adjacent tooth, possibly due to disturbed trophicity in the region around it. It has been concluded that a great many problems, still unknown, of teeth reimplantation wait their proper solution.

Adult↗
PubMedDate not supplied

The function of surfactant is impaired during the reimplantation response in rat lung transplants.

In this study we investigated the surfactant function in rat lung transplants at the peak of the reimplantation response in experimental groups with increasing warm ischemic times of the lung transplant. The left and right lungs in five groups of rats were assessed 24 hours after left lung transplantation: rats receiving transplants with lung graft ischemic times of 60 (n = 4), 90 (n = 5), and 120 (n = 5) minutes, donor rats with 120 minutes lung ischemia (n = 5) and normal (nonoperated) rats (n = 6). The reimplantation response was assessed by the ventilation score on chest roentgenograms, measurement of the static lung compliance, and the (serum) protein concentration in the bronchoalveolar lavage fluid. Surfactant in the bronchoalveolar lavage fluid was assessed by measuring the amount and the composition of surfactant phospholipids and the in vitro surfactant function in a pulsating bubble surfactometer. We found that longer ischemic times caused a more severe reimplantation response in the left lung grafts. Although the ventilation scores were equally low in the 60-, 90-, and 120-minute ischemia groups, the lung compliances decreased and the (serum) protein concentrations increased stepwise in correlation with longer ischemic times. The amount of surfactant phospholipids during the reimplantation response was not changed, but the percentage phosphatidyl choline decreased progressively in parallel with the severity of the reimplantation response. Finally, the in vitro function of surfactant from the lung transplants decreased in parallel with the prolongation of the ischemic time, whereas the function of surfactant from donor lungs with 120 minutes of ischemia and from native right lungs was not changed. We conclude that the surfactant function is impaired during the reimplantation response as a result of a high concentration of inhibiting serum proteins and a low percentage of phosphatidyl choline.

Animals↗
PubMed1994

Splenic reimplantation does not affect outcome in chronic canine model.

The effects of septic insult were compared in a canine model of splenic reimplantation. Sequential changes in hematologic, hepatic, and immunologic function were monitored biweekly in 18 dogs during 10 months after splenectomy, splenectomy with reimplantation, or sham operation. There was no significant difference in these measures between the two groups. At the end of the 10-month period, spleen scans with technetium (99Tc) labeled, heat-damaged RBCs were obtained on the reimplanted dogs. 99Tc scanning revealed no active splenic implants at 10 months. All dogs were then infected with intravenous Type III pneumococcus for 9 consecutive days. There were no measurable hematologic, hepatic, or immunologic differences between groups before or after the septic insult. These animals were then sacrificed for histologic analysis of the splenic reimplants. Reimplant histology showed active germinal centers, but the surrounding pulp was fibrotic and lymphocyte-depleted. Splenic reimplantation in this canine model yields no apparent benefit.

Analysis of Variance↗