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Renal failure associated with intestinal transplantation: our experience in Spain. [artículo]

Por: Calvo Pulido, Jorge [Cirugía General y del Aparato Digestivo] | Jiménez Romero, Carlos [Cirugía General y del Aparato Digestivo] | Morales Ruiz, Enrique [Nefrología] | Cambra Molero, Félix [Cirugía General y del Aparato Digestivo] | Manrique Municio, Alejandro [Cirugía General y del Aparato Digestivo] | García-Sesma Pérez-Fuentes, Álvaro [Cirugía General y del Aparato Digestivo] | Loinaz Segurola, Carmelo [Cirugía General y del Aparato Digestivo] | Abradelo de Usera, Manuel [Cirugía General y Aparato Digestivo] | Justo Alonso, Iago [Cirugía General y del Aparato Digestivo] | Caso Maestro, Óscar [Cirugía General y del Aparato Digestivo] | Alegre Torrado, Cristina [Cirugía General y Aparato Digestivo] | Moreno González, Enrique [Cirugía General y del Aparato Digestivo].
Colaborador(es): Servicio de Cirugía General y del Aparato Digestivo | Servicio de Nefrología.
Tipo de material: materialTypeLabelArtículoEditor: Transplantation proceedings, 2014Descripción: 46(6):2140-2.Recursos en línea: Solicitar documento Resumen: Background: Renal failure (RF) is a frequent complication in non-renal solid organ transplants. In the present study, we analyze our experience with intestinal transplants (ITx). Methods: Between 2004 and 2012, we performed 21 ITx in 19 adult patients. Alemtuzumab was used as an induction agent followed by tacrolimus. Renal function was assessed before ITx and during the perioperative period. Results: The main cause for transplants was non-resectable desmoids tumors (33.3%), followed by vascular thrombosis (19%) and others. Medical complications were frequent, especially infectious diseases, which were the most common (51%). Surgical complications were also frequent, but most of them (>50%) were mild but leading to a great number of re-operations and prolonged stays in hospital. Acute rejection is very frequent (66.6%) but mild in more than 70% of the cases. Finally, RF was very frequent (68.4%; 13/19 patients) and accounted for 15.6% of all medical complications. Causes were multiple. One patient is awaiting a kidney transplant, but no other patients need renal replacement therapy at the moment. Ileostomy closure was performed in 5 of 12 patients alive, showing improved renal function in 3 of them. Conclusions: RF is a problem in ITx and is always multifactorial. Increases in hospital stay, higher morbidity and is a cause for hospital readmission. Almost all patients had an impaired renal function when discharged. Immunosuppressants and ileostomy closure as soon as possible might prevent RF.
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Formato Vancouver:
Calvo Pulido J, Jiménez Romero C, Morales Ruíz E, Cambra Molero F, Manrique Municio A, García-Sesma A et al. Renal failure associated with intestinal transplantation: our experience in Spain. Transplant Proc. 2014 Jul-Aug;46(6):2140-2.

PMID: 25131125

Contiene 4 referencias

Background: Renal failure (RF) is a frequent complication in non-renal solid organ transplants. In the present study, we analyze our experience with intestinal transplants (ITx).
Methods: Between 2004 and 2012, we performed 21 ITx in 19 adult patients. Alemtuzumab was used as an induction agent followed by tacrolimus. Renal function was assessed before ITx and during the perioperative period.
Results: The main cause for transplants was non-resectable desmoids tumors (33.3%), followed by vascular thrombosis (19%) and others. Medical complications were frequent, especially infectious diseases, which were the most common (51%). Surgical complications were also frequent, but most of them (>50%) were mild but leading to a great number of re-operations and prolonged stays in hospital. Acute rejection is very frequent (66.6%) but mild in more than 70% of the cases. Finally, RF was very frequent (68.4%; 13/19 patients) and accounted for 15.6% of all medical complications. Causes were multiple. One patient is awaiting a kidney transplant, but no other patients need renal replacement therapy at the moment. Ileostomy closure was performed in 5 of 12 patients alive, showing improved renal function in 3 of them.

Conclusions: RF is a problem in ITx and is always multifactorial. Increases in hospital stay, higher morbidity and is a cause for hospital readmission. Almost all patients had an impaired renal function when discharged. Immunosuppressants and ileostomy closure as soon as possible might prevent RF.

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