• 제목/요약/키워드: liver transplantation

검색결과 290건 처리시간 0.028초

Outcomes of endoscopic retrograde cholangiography and percutaneous transhepatic biliary drainage in liver transplant recipients with a Roux-en-Y biliary-enteric anastomosis

  • Divyanshoo Rai Kohli;Bashar A. Aqel;Nicole L. Segaran;M. Edwyn Harrison;Norio Fukami;Douglas O. Faigel;Adyr Moss;Amit Mathur;Winston Hewitt;Nitin Katariya;Rahul Pannala
    • 한국간담췌외과학회지
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    • 제27권1호
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    • pp.49-55
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    • 2023
  • Backgrounds/Aims: Data regarding outcomes of endoscopic retrograde cholangiography (ERC) in liver transplant (LT) recipients with biliary-enteric (BE) anastomosis are limited. We report outcomes of ERC and percutaneous transhepatic biliary drainage (PTBD) as first-line therapies in LT recipients with BE anastomosis. Methods: All LT recipients with Roux-BE anastomosis from 2001 to 2020 were divided into ERC and PTBD subgroups. Technical success was defined as the ability to cannulate the bile duct. Clinical success was defined as the ability to perform cholangiography and therapeutic interventions. Results: A total of 36 LT recipients (25 males, age 53.5 ± 13 years) with Roux-BE anastomosis who underwent biliary intervention were identified. The most common indications for a BE anastomosis were primary sclerosing cholangitis (n = 14) and duct size mismatch (n = 10). Among the 29 patients who initially underwent ERC, technical success and clinical success were achieved in 24 (82.8%) and 22 (75.9%) patients, respectively. The initial endoscope used for the ERC was a single balloon enteroscope in 16 patients, a double balloon enteroscope in 7 patients, a pediatric colonoscope in 5 patients, and a conventional reusable duodenoscope in 1 patient. Among the 7 patients who underwent PTBD as the initial therapy, six (85.7%) achieved technical and clinical success (p = 0.57). Conclusions: In LT patients with Roux-BE anastomosis requiring biliary intervention, ERC with a balloon-assisted enteroscope is safe with a success rate comparable to PTBD. Both ERC and PTBD can be considered as first-line therapies for LT recipients with a BE anastomosis.

Phalloides 증후군에서 혈역학적 보조를 위해 T-PLS를 사용한 1례 (A Case of Phalloides Syndrome where T-PLS(R)was used for Hemodynamic Support)

  • 김성춘;김규석;서길준
    • 대한임상독성학회지
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    • 제2권2호
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    • pp.133-136
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    • 2004
  • Phalloides syndrome has usually occurred after incidental mushroom ingestion. It is sometimes difficult to differentiate toxic mushrooms from edible ones, especially in lay person because of their morphological similarities. In Korea, Amanita virosa and Amanita subjunquillea have been reported as a cause of fulminant hepatic failure in mushroom poisoning (phalloides syndrome). We report a case of phalloides syndrome who came to death with fulminant hepatic failure even though we planned liver transplantation and used T-PLS(R) (Twin Pulse Life Support) for hemodynamic support while waiting for the donor.

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Pharmacokinetic and Pharmacodynamic Characteristics of Cyclosporin A in Rats and Rabbits

  • Lee, Yong-Bok
    • 대한약학회:학술대회논문집
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    • 대한약학회 2002년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2
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    • pp.214-217
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    • 2002
  • Cyclosporin A (CSA) is a poorly water-soluble cyclic peptide comprising 11 amino acids. It inhibits T-lymphocyte function that plays an important role in the induction of immune response. The potent immunosuppressive activity of CSA has been used for the prevention of rejection following transplantation of liver, kidney and bone marrow, etc. The use of CSA has been often limited by several disadvantages including low bioavailability, narrow therapeutic window, nephrotoxicity, hepatotoxicity and neurotoxicity. Moreover, CSA injection is limited to patients who are unable to take the oral preparations, because it has a risk of anaphylactic shock and nephrotoxicity due to Cremophor EL$\textregistered$, a solubilizing agent used in the commercial intravenous formulation. Owing to above mentioned disadvantages of commercial products, there is a great interest in the development of the alternative dosage forms. (omitted)

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Extraordinary radiation super-sensitivity accompanying with sorafenib combination therapy: what lies beneath?

  • Lee, Jayoung;Lee, Ju Hye;Yoon, Hanbin;Lee, Ho Jeong;Jeon, Hosang;Nam, Jiho
    • Radiation Oncology Journal
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    • 제35권2호
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    • pp.185-188
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    • 2017
  • Primary liver tumor, especially hepatocellular carcinoma (HCC), is a common cause of cancer death worldwide. The incidence is generally higher in Asian countries than in western countries. Carcinogenesis of HCC is often associated with hepatitis viral infections. Current standard treatment of HCC is surgical resection or transplantation in patients with early stage disease. However, the patient with advanced stage disease, surgical resection is often limited. Sorafenib or other treatment modalities are not so effective as well. We report a case of unusual radiation super-sensitivity in advanced stage HCC, and review the literature.

Simulation on the Optimized Dose of Intravenous Anti-HBV Antibody for the Liver Transplantation Recipients

  • 김다영;한승훈
    • EDISON SW 활용 경진대회 논문집
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    • 제6회(2017년)
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    • pp.715-718
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    • 2017
  • 많은 항바이러스제의 개발에도 불구하고, B형간염바이러스 감염으로 인해 간 이식을 받은 환자를 대상으로 한 재발 억제 치료 시 항 B형간염바이러스 면역글로불린(Anti-hepatitis B immunoglobulin, HBIG) 치료는 아직도 가장 중요한 약물요법으로 여겨지고 있다. 본 연구진은 간 이식 환자에서의 6개월 간의 약동학 연구를 통해, HBIG의 약동학적 파라미터와 이에 대한 영향인자를 확인하였으며, 이를 이용해 용법용량 별로 유지요법 시기에 목표 농도 도달 가능성을 예측하는 시뮬레이션 tool을 개발하였다. 그 결과 95% 환자가 목표 농도 이상의 HBIG 농도를 유지하기 위한 용량은 '목표 농도 ${\times}$ 20'에 해당하는 것을 확인하였으며, 다수의 대학병원에서 통상적인 HBIG 유지 요법의 목표 농도를 최소 300 IU/L로 하고 있음을 고려할 때, 6,000 IU의 용량을 월 1회 투여하는 것이 바람직할 것으로 판단하였다.

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용혈위기를 동반한 윌슨병에서 교환 수혈로 회복된 소아 1예 (Hemolytic Crisis Recovered by Exchange Transfusion in a Child with Fulminant Wilson's Disease)

  • 최희정;임해리;최병호
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제9권1호
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    • pp.108-113
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    • 2006
  • 윌슨병에서 용혈성 빈혈과 전격성 간부전이 동반되면 혈장교환술이나 간이식이 필수적이다. 저자들은 간염과 용혈위기가 동반된 전격성 윌슨병 환아에서 혈장교환술을 계속하였으나 호전을 보이지 않아 교환수혈을 시행한 결과 용혈위기를 극복하였다. 현재까지 약물치료와 혈장교환술에 뒤이은 간이식이 일차 치료로 되어 있지만, 전격성 간부전이 응급으로 간이식을 해야 할 만큼 심하지 않은 경우에는 혈장교환술후 교환수혈을 시도할 수 있을 것으로 생각한다.

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Inhibitory Effects of Kochujang Extracts on the Tumor Formation and Lung Metastasis in Mice

  • Park, Kun-young;Kong, Kyu-Ri;Jung, Keun-Ok;Rhee, Sook-Hee
    • Preventive Nutrition and Food Science
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    • 제6권3호
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    • pp.187-191
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    • 2001
  • Effects of kochujang (Korean red pepper soybean paste) extracts on tumor formation, natural killer (NK) cell activity in spleen and glutathione S-transferase (GST) activity in liver were investigated in the sarcoma-180 cell transplanted mice. Inhibitory effects of these samples on lung metastasis of colon 26-M3.1 cells were also evaluated in the Balb/c mice. The injection of methanol extracts from traditional kochujang I (TK I, 0-day fermented), II (TKII, 6-month fermented), commercial kochujang (CK, 1-month fermented) and red pepper powder (RPP) significantly reduced tumor formation in Balb/c mice (p<0.05), TKII decreased tumor growth by 46% compared with control, resulting in the smallest tumor weight. The transplantation of sarcoma-180 cells increased the spleen/body weight ratio of Balb/c mice, while TKI and TKll significantly decreased this index (p<0.05). The effect of TKll and CK, fermented kochujang, on the NK cell activity of splenocytes was higher than that of sarcoma-180 cells transplanted control group. TK II recovered the activity of hepatic GST that was decreased by the transplantation of sarcoma- 180 cells in to the mice. All kochujang-treated mice had significantly fewer lung metastatic colonies than control mice. TKII was the most effective in inhibiting lung metastasis of colon 26-M3.1 cells. These results indicated that optimally ripened (6-month) TK had more suppressive effects on tumor formation and lung metastasis than RPP and kochujang without fermentation and commercially prepared kochujang in mice.

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림프세포증식성 질환에서 효과를 보인 부분적 비동맥 색전술 1례 (Successful Treatment with Partial Splenic Embolization in a Case of Post-transplantations Lymphoproliferative Disease with Persistent Hypersplenism)

  • 김미진;노영일;양은석;문경래
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제7권1호
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    • pp.92-97
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    • 2004
  • 저자들은 간 이식 후 지속적 비기능 항진에 발생된 내과적 치료에 반응하지 않는 림프세포증식성질환의 6세된 남아에서 부분적 비동맥 색전술을 치료의 한 방법으로 선택하였다. 비기능항진의 억제 효과로 면역력 증강을 통해 혈액학적 호전을 유도하고자 하였으며 치료 후 PTLD의 호전을 보인 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

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Induced neural stem cells from human patient-derived fibroblasts attenuate neurodegeneration in Niemann-Pick type C mice

  • Hong, Saetbyul;Lee, Seung-Eun;Kang, Insung;Yang, Jehoon;Kim, Hunnyun;Kim, Jeyun;Kang, Kyung-Sun
    • Journal of Veterinary Science
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    • 제22권1호
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    • pp.7.1-7.13
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    • 2021
  • Background: Niemann-Pick disease type C (NPC) is caused by the mutation of NPC genes, which leads to the abnormal accumulation of unesterified cholesterol and glycolipids in lysosomes. This autosomal recessive disease is characterized by liver dysfunction, hepatosplenomegaly, and progressive neurodegeneration. Recently, the application of induced neural stem cells (iNSCs), converted from fibroblasts using specific transcription factors, to repair degenerated lesions has been considered a novel therapy. Objectives: The therapeutic effects on NPC by human iNSCs generated by our research group have not yet been studied in vivo; in this study, we investigate those effects. Methods: We used an NPC mouse model to efficiently evaluate the therapeutic effect of iNSCs, because neurodegeneration progress is rapid in NPC. In addition, application of human iNSCs from NPC patient-derived fibroblasts in an NPC model in vivo can give insight into the clinical usefulness of iNSC treatment. The iNSCs, generated from NPC patientderived fibroblasts using the SOX2 and HMGA2 reprogramming factors, were transplanted by intracerebral injection into NPC mice. Results: Transplantation of iNSCs showed positive results in survival and body weight change in vivo. Additionally, iNSC-treated mice showed improved learning and memory in behavior test results. Furthermore, through magnetic resonance imaging and histopathological assessments, we observed delayed neurodegeneration in NPC mouse brains. Conclusions: iNSCs converted from patient-derived fibroblasts can become another choice of treatment for neurodegenerative diseases such as NPC.